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Plasma lipid profiles in adults after prenatal exposure to the Dutch famine^1,2,3

¹ From the Departments of Clinical Epidemiology and Biostatistics and Obstetrics and Gynecology, the Academic Medical Center, the University of Amsterdam, and the MRC Environmental Epidemiology Unit, the University of Southampton, United Kingdom.

Background: Small body size at birth has been reported to be associated with an atherogenic lipid profile in humans, and animal experiments have shown that undernutrition during pregnancy permanently alters cholesterol metabolism in the offspring. There is no direct evidence in humans that maternal malnutrition during pregnancy affects the lipid profiles of the offspring.

Objectives: We assessed the effects of maternal malnutrition during specific periods of gestation on plasma lipid profiles in persons aged 50 y.

Design: This was a follow-up study of men and women born at term as singletons in a university hospital in Amsterdam between 1 November 1943 and 28 February 1947 around the time of a severe famine.

Results: Persons exposed to famine in early gestation had a more atherogenic lipid profile than did those who were not exposed to famine in utero. Their LDL-HDL cholesterol ratios were significantly higher (by 13.9%; 95% CI: 2.6–26.4%). Additionally, their plasma HDL-cholesterol and apolipoprotein A concentrations tended to be lower, and their plasma total cholesterol, LDL-cholesterol, and apolipoprotein B concentrations tended to be higher, although these differences were not statistically significant. The effect of famine was independent of size at birth and adult obesity.

Conclusions: An atherogenic lipid profile might be linked to a transition from poor maternal nutrition in early gestation to adequate nutrition later on. This suggests that maternal malnutrition during early gestation may program lipid metabolism without affecting size at birth.

Key Words: Cholesterol • lipid profile • famine • undernutrition • fetal growth • fetal origins • the Netherlands

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