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Obesity at the age of 50 y in men and women exposed to famine prenatally^1,2,3

¹ From the Departments of Clinical Epidemiology and Biostatistics and Obstetrics and Gynaecology, Academic Medical Centre, University of Amsterdam, and the MRC Environmental Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, United Kingdom.

Background: It was shown that men who were conceived during the Dutch famine of 1944–1945 had higher rates of obesity at age 19 y than those conceived before or after it.

Objective: Our objective was to study the effects of prenatal exposure to the Dutch famine on obesity in women and men at age 50 y.

Design: We measured the body size of 741 people born at term between November 1943 and February 1947 in Amsterdam. We compared people exposed to famine in late, mid, or early gestation (exposed participants) with those born before or conceived after the famine period (nonexposed participants).

Results: The body mass index (BMI; in kg/m²) of 50-y-old women exposed to famine in early gestation was significantly higher by 7.4% (95% CI: 0.7%, 14.5%) than that of nonexposed women. BMI did not differ significantly in women exposed in mid gestation (-2.1%; -7.0%, 3.1%) or in late gestation (-1.3%; -6.3%, 3.9%). In 50-y-old men, BMI was not significantly affected by exposure to famine during any stage of gestation: BMI differed by 0.4% (-3.5%, 4.5%) in men exposed to famine in late gestation, by -1.2% (-5.5%, 3.3%) in those exposed in mid gestation, and by 0.5% (-4.6%, 6.0%) in those exposed in early gestation compared with nonexposed men.

Conclusions: Maternal malnutrition during early gestation was associated with higher BMI and waist circumference in 50-y-old women but not in men. These findings suggest that pertubations of central endocrine regulatory systems established in early gestation may contribute to the development of abdominal obesity in later life.

Key Words: Obesity • critical period • reduced fetal growth • programming • maternal nutrition • metabolic syndrome

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