Early life famine exposure and anthropometric profile in adulthood: a systematic review and Meta-analysis

Early life growth is related to pubertal growth and adult height - a QEPS-model analysis

BACKGROUND

The early life growth period, from conception to ~2 years of age, has proven crucial for later health. We hypothesized that early life growth could explain variations in pubertal growth and timing, and adult height.

METHODS

This retrospective, population-based study was conducted in Sweden. A subgroup, including individuals of all gestational ages and birth sizes (n = 4700, 50% males), from the longitudinal GrowUp1974&1990Gothenburg cohorts was used. QEPS variables were analyzed in univariate and multivariate linear regression models, separately per sex; Q-function throughout all growth periods, and specific E- and P-functions, for early life growth and pubertal growth, respectively.

RESULTS

In multivariate models, early life growth explained 37-38% of the variability in specific pubertal growth, but less so the variability in pubertal timing. Variability in adult height was explained by birth size (57-62%), early growth (66-67%), childhood growth (65-69%), and to a lesser degree by mid-parental height (35-39%). The change in height during puberty explained 8-9% of the variation in adult height.

CONCLUSION

This study indicates that early life growth is strongly associated with the variability in pubertal growth, and adult height, but not with the timing of pubertal growth.

IMPACT

Early life growth is important as it can serve as a marker for future growth, development, and health. The association between length growth during fetal life and infancy and pubertal growth and timing, and adult height, is only partly understood. Using the QEPS growth model, specific early life growth (E-function) and specific pubertal growth (P-function), including individual variations in tempo and amplitude, can be studied separately from ongoing basic growth (Q-function). This study showed that early life growth is strongly associated with and explains specific pubertal height gain and adult height but less so the timing of pubertal growth.

Early-life nutrition and adult-life outcomes

OBJECTIVES

To verify the association between early-life nutrition and chronic adult diseases.

DATA SOURCES

Medline, Embase, Cochrane Database, and Lilacs.

SUMMARY OF FINDS

The Developmental Origins of Health and Disease (DOHaD) hypothesis postulates that a mismatch between early-life circumstances and later-life situations may have an impact on chronic diseases. In this review, the authors emphasize the research supporting the impact of early nutrition on the origins of adult height, obesity and metabolic syndrome, type 2 diabetes mellitus, cardiovascular diseases, and reproductive outcomes.

CONCLUSION

Even though this is a new topic and there are still many research questions to be answered, there is strong evidence that both deficiency and excess nutrition in early life can cause epigenetic changes that have effects that last a lifetime and contribute to the development of chronic diseases. Public health efforts to protect adults from getting chronic diseases should focus on nutrition in the first 1000 days of life, from conception to the end of the second year of life.

Exposure to Chinese famine in early life and height across 2 generations: a longitudinal study based on the China Health and Nutrition Survey

BACKGROUND

Poor nutrition early in life is associated with short stature, which is associated with increased risk of cardiovascular disease and mortality in later life. Less evidence is available about the impact of early-life nutrition on height growth in the subsequent generation.

OBJECTIVES

This study investigated the associations of famine exposure in utero and early childhood with height across 2 generations.

METHODS

We used longitudinal data from the China Health and Nutrition Survey. We included 5401 participants (F1) born in 1955-1966 (calendar year around the Chinese famine in 1959-1961) and their 3930 biological offspring (F2). We classified F1 participants into subgroups by famine exposure status (unexposed/exposed) and timing (fetal-/childhood-exposed) according to their birth year and grouped F2 by their parents' exposure. Linear regression models were applied to examine the associations of famine exposure with adult height of F1 and F2. Linear mixed effect models with fractional polynomial functions were performed to estimate the difference in height between exposure groups of F2 during childhood.

RESULTS

Participants (F1) exposed to famine in utero or in childhood were shorter than those unexposed by 0.41 cm (95% CI: 0.03, 0.80) and 1.12 cm (95% CI: 0.75, 1.48), respectively. Offspring (F2) of exposed fathers were also shorter than those of unexposed parents by 1.07 cm (95% CI: 0.28, 1.86) during childhood (<18 y) and by 1.25 cm (95% CI: 0.07, 2.43) in adulthood (≥18 y), and those with exposed parents had a reduced height during childhood by 1.29 cm (95% CI: 0.68, 1.89) (all P values < 0.05). The associations were more pronounced among child offspring of highly-educated F1, particularly for paternal exposure and among female offspring (all P for interaction < 0.05).

CONCLUSIONS

The findings support the intergenerational associations of famine exposure in early life with height in Chinese populations, indicating the public health significance of improving the nutritional status of mothers and children in the long run.

Maternal nutrition during mid-pregnancy and children's body composition at 7 years of age in the SELMA study

Optimal nutrition during pregnancy is vital for both maternal and child health. Our objective was to explore if prenatal diet is associated with children's height and body fat. Nutrient intake was assessed through a FFQ from 808 pregnant women and summarised to a nutrition index, 'My Nutrition Index' (MNI). The association with children's height and body fat (bioimpedance) was assessed with linear regression models. Secondary analysis was performed with BMI, trunk fat and skinfolds. Overall, higher MNI score was associated with greater height (β = 0·47; (95 % CI 0·00, 0·94), among both sexes. Among boys, higher MNI was associated with 0·15 higher BMI z-scores, 0·12 body fat z-scores, 0·11 trunk fat z-scores, and larger triceps, and triceps + subscapular skinfolds (β = 0·05 and β = 0·06; on the log2 scale) (P-value < 0·05). Among girls, the opposite associations were found with 0·12 lower trunk fat z-scores, and smaller subscapular and suprailiac skinfolds (β = -0·07 and β = -0·10; on the log2 scale) (P-value < 0·05). For skinfold measures, this would represent a ± 1·0 millimetres difference. Unexpectedly, a prenatal diet in line with recommended nutrient intake was associated with higher measures of body fat for boys and opposite to girls at a pre-pubertal stage of development.

Long-term effects of child nutritional status on the accumulation of health human capital

Research on the impact of childhood nutrition on adult health and human capital has been extensively studied in developed countries, but research in China on this topic is limited. Nowadays, for children's nutritional status, while significant progress has been made in addressing childhood undernutrition in China, regional disparities persist, conversely, the prevalence of childhood overweight continues to rise. For adults' health human capital, the burden of chronic non-communicable diseases among Chinese residents is gradually increasing, over 50% of Chinese residents are overweight or obese, with obesity being one of the risk factors for other chronic diseases. Therefore, this study uses national representative data from 1991 to 2015 China Health and Nutrition Survey (CHNS), matched with individual information from their childhood, to examine the relationship between childhood nutrition and adult health human capital. Based on the two-way fixed effects models and logit models, the study finds that childhood nutrition status measured by height-for-age z score (HAZ) significantly and continuously has been influencing adult health human capital measured by height, BMI, self-rated health (SRH), whether have been sick in last four weeks (SH). BMI-for-age z score (BMIZ) significantly and continuously influence adult health human capital measured by BMI, blood pressure, and perceived stress (PS). Among that, this study places special emphasis on the long-lasting effects of late childhood and adolescence (ages exceeding 6) on the progressive height accumulation and sustained presence of elevated blood pressure. In conclusion, reducing childhood overweight and promoting linear growth and development throughout the whole childhood can reduce the future burden of disease on the nation.