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Pradeilles R, Irache A, Norris T, Chitekwe S, Laillou A, Baye K. Magnitude, trends and drivers of the coexistence of maternal overweight/obesity and childhood undernutrition in Ethiopia: Evidence from Demographic and Health Surveys (2005-2016). MATERNAL & CHILD NUTRITION 2024; 20 Suppl 5:e13372. [PMID: 35615766 PMCID: PMC11258774 DOI: 10.1111/mcn.13372] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Revised: 04/11/2022] [Accepted: 04/26/2022] [Indexed: 06/15/2023]
Abstract
Ethiopia faces a rising problem of overweight and obesity alongside a high prevalence of undernutrition; a double burden of malnutrition (DBM). This study aimed to quantify the magnitude and trends of household-level DBM-defined as the coexistence of maternal overweight/obesity and child undernutrition (i.e., stunting or anaemia)-in Ethiopia between 2005, 2011 and 2016 and understand the potential drivers influencing DBM and the change in DBM over time. Data come from the Ethiopian Demographic and Health Surveys. National and regional prevalence estimates of the DBM were calculated (n = 13,107). Equiplots were produced to display inequalities in the distribution of DBM. Factors associated with DBM were explored using pooled multivariable logistic regression analyses for 2005, 2011 and 2016 (n = 9358). These were also included in a logistic regression decomposition analysis to understand their contribution to the change in DBM between 2005 and 2016 (n = 5285). The prevalence of household-level DBM at the national level was low, with a modest increase from 2.4% in 2005% to 3.5% in 2016. This masks important within-country variability, with substantially higher prevalence in Addis Ababa (22.8%). Factors positively associated with DBM were maternal age (odds ratio [OR] = 1.04 [1.02, 1.06]), urban residence (OR = 3.12 [2.24, 4.36]), wealth (OR = 1.14 [1.06, 1.24]) and the number of children <5 in the household (OR = 1.30 [1.12, 1.49]). Overall, 70.5% of the increase in DBM between 2005 and 2016 was attributed to increased wealth, urban residence and region. Double-duty actions that address multiple forms of malnutrition are urgently needed in urban settings.
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Affiliation(s)
- Rebecca Pradeilles
- School of Sport, Exercise and Health Sciences (SSEHS)Loughborough UniversityLoughboroughUK
| | - Ana Irache
- Warwick Medical SchoolUniversity of WarwickCoventryUK
| | - Tom Norris
- Department of Targeted Intervention, Division of Surgery and Interventional ScienceUniversity College LondonLondonUK
| | | | | | - Kaleab Baye
- Center for Food Science and NutritionAddis Ababa UniversityAddis AbabaEthiopia
- Research Center for Inclusive Development in Africa (RIDA)Addis AbabaEthiopia
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Alves JGB, Alves LV. Early-life nutrition and adult-life outcomes. J Pediatr (Rio J) 2024; 100 Suppl 1:S4-S9. [PMID: 37813343 PMCID: PMC10960187 DOI: 10.1016/j.jped.2023.08.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Accepted: 08/25/2023] [Indexed: 10/11/2023] Open
Abstract
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.
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Affiliation(s)
| | - Lucas Victor Alves
- Department of Neuropediatrics, Instituto de Medicina Integral Prof. Fernando Figueira (IMIP), Recife, PE, Brazil
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Yao WY, Yu YF, Li L, Xu WH. Exposure to Chinese famine in early life and height across 2 generations: a longitudinal study based on the China Health and Nutrition Survey. Am J Clin Nutr 2024; 119:433-443. [PMID: 38309830 DOI: 10.1016/j.ajcnut.2023.10.021] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Revised: 09/20/2023] [Accepted: 10/18/2023] [Indexed: 02/05/2024] Open
Abstract
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.
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Affiliation(s)
- Wei-Yuan Yao
- Department of Epidemiology, Fudan University School of Public Health, Shanghai, China; Yiwu Research Institute of Fudan University, Yiwu, Zhejiang Province, China
| | - Yong-Fu Yu
- Department of Biostatistics, Fudan University School of Public Health, Shanghai, China
| | - Leah Li
- Population, Policy and Practice Research and Teaching Department, University College London Great Ormond Street Institute of Child Health, London, United Kingdom
| | - Wang-Hong Xu
- Department of Epidemiology, Fudan University School of Public Health, Shanghai, China; Yiwu Research Institute of Fudan University, Yiwu, Zhejiang Province, China.
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Li S, Nor NM, Kaliappan SR. Long-term effects of child nutritional status on the accumulation of health human capital. SSM Popul Health 2023; 24:101533. [PMID: 37916186 PMCID: PMC10616551 DOI: 10.1016/j.ssmph.2023.101533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Revised: 08/09/2023] [Accepted: 10/09/2023] [Indexed: 11/03/2023] Open
Abstract
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.
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Affiliation(s)
- Sa Li
- School of Business and Economics, Universiti Putra Malaysia, 43400, UPM, Serdang, Selangor, Malaysia
| | - Norashidah Mohamed Nor
- School of Business and Economics, Universiti Putra Malaysia, 43400, UPM, Serdang, Selangor, Malaysia
| | - Shivee Ranjanee Kaliappan
- School of Business and Economics, Universiti Putra Malaysia, 43400, UPM, Serdang, Selangor, Malaysia
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Song Q, Li N, Sun C, Li Y, King B, Lowe S, Bentley R, Su W, Wang H, Guo X, Liang Q, Liang M, Qu G, Liu H, Ding X, Sun Y. Famine exposure in adolescence is associated with a higher risk of overweight/obesity and abdominal obesity in adulthood: A meta-analysis. Nutr Res 2022; 107:128-138. [PMID: 36215886 DOI: 10.1016/j.nutres.2022.09.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Revised: 09/07/2022] [Accepted: 09/12/2022] [Indexed: 12/27/2022]
Abstract
Some studies have shown that famine exposure during adolescence can increase cardiovascular disease and diabetes susceptibility in later life. The association between famine exposure in adolescence and overweight/obesity and abdominal obesity in adulthood has been inconsistent. Based on previous studies, we hypothesized that famine exposure in adolescence increases the risk of overweight/obesity and abdominal obesity in adulthood. Eight databases, including PubMed, Embase, Cochrane Library, and Web of Science, were searched from their inception until November 2021. We initially identified 3982 records and finally included 7 articles after screening. The included articles were of moderate to high quality, containing 16 estimates of overweight/obesity and 3 estimates of abdominal obesity. Pooled odds ratios (ORs) with 95% CIs were used to estimate the association between them. The random effects model was adopted as the pooling method. There was a significant association between famine exposure in adolescence and overweight/obesity in adulthood (OR, 1.17; 95% CI, 1.02-1.33). Adolescents exposed to famine had a greater risk of abdominal obesity in adulthood than their unexposed counterparts (OR, 1.35; 95% CI, 1.03-1.76). These results were more pronounced in females than in males. In summary, our meta-analysis indicates that famine exposure during adolescence increases the risk of overweight/obesity and abdominal obesity in adulthood. This suggests that we need to pay timely attention to the nutritional status of adolescents to prevent adverse health consequences of malnutrition. More high-quality studies are needed to confirm these conclusions, given the limitations of this study.
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Affiliation(s)
- Qiuxia Song
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei 230032, Anhui, China
| | - Ning Li
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei 230032, Anhui, China
| | - Chenyu Sun
- AMITA Health Saint Joseph Hospital Chicago, Chicago, IL 60657, USA
| | - Yaru Li
- College of Osteopathic Medicine, Des Moines University, Des Moines, IA, 50312, USA; Internal Medicine, Swedish Hospital, Chicago, IL 60625, USA
| | - Bethany King
- College of Osteopathic Medicine, Des Moines University, Des Moines, IA, 50312, USA; Internal Medicine, MercyOne Des Moines Medical Center, Des Moines, Iowa 50314, USA
| | - Scott Lowe
- College of Osteopathic Medicine, Kansas City University, Kansas City, MO 64106, USA
| | - Rachel Bentley
- College of Osteopathic Medicine, Kansas City University, Kansas City, MO 64106, USA
| | - Wanying Su
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei 230032, Anhui, China
| | - Hao Wang
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei 230032, Anhui, China
| | - Xianwei Guo
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei 230032, Anhui, China
| | - Qiwei Liang
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei 230032, Anhui, China; Children's Hospital of Anhui Medical University, Hefei 238006, Anhui, China
| | - Mingming Liang
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei 230032, Anhui, China
| | - Guangbo Qu
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei 230032, Anhui, China
| | - Haixia Liu
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei 230032, Anhui, China
| | - Xiuxiu Ding
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei 230032, Anhui, China
| | - Yehuan Sun
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei 230032, Anhui, China; Chaohu Hospital, Anhui Medical University, Hefei 238006, Anhui, China.
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Impact of prenatal famine exposure on adulthood fasting blood glucose level. Sci Rep 2022; 12:6198. [PMID: 35418574 PMCID: PMC9008050 DOI: 10.1038/s41598-022-10120-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Accepted: 03/21/2022] [Indexed: 11/08/2022] Open
Abstract
In the past decade, in low-income countries, there have been a rapid rise in prevalence of diabetes among adult population. Hence, understanding the context specific drivers of this change including the impacts of childhood nutrition adversaries on adult metabolic conditions is critical undertaking. This study investigates the potential effects of prenatal famine exposure to the Ethiopian great famine (1983–1985) on adulthood blood glucose level of survivors. A total of 441 adults (222 exposed and 219 controls) were included in the study. Self-reported place of birth and, date of birth and/or age were used to identify participants. A multivariable linear regression analysis was used to analyze the impact of prenatal famine exposure on the level of fasting blood glucose. In linear regression, unadjusted model (Model 1), fasting blood glucose level was increased by 4.13 (β = 4.13; 95% CI .41, 7.42) points in prenatal famine exposed groups, compared with non-exposed. Similarly, the positive association of prenatal famine exposure and fasting blood glucose level was maintained after adjusted for sex (Model 2) (β = . 4.08 95% CI .056, 7.50). Further adjusted for age, residence, educational status, wealth index and family size (Model 3) resulted in 4.10 (β = . 4.10 95% CI .45, 7.56) points increases in fasting blood glucose level. In model 4 adjusting for dietary pattern, physical activity level and family history of diabetes, alcohol and cigarette smoking resulted in 3.90 (β = 3.90, 95% CI 039, 7.52) points increase in fasting glucose level. In the he full adjusted model (Model 5) prenatal exposure to famine was resulted in 3.78 (β = 3.78, 95% CI .22, 7.34) increases in fasting blood glucose level after adjusted for BMI and waist to height ratio. There existed a positive association of prenatal famine exposure and adulthood blood glucose levels. In this population, establishing effective overweight/obesity prevention programs to minimize the co-impact of early famine exposure on blood glucose control are important.
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Tadese K, Ernst V, Weaver AL, Thacher TD, Rajjo T, Kumar S, Kaufman T, Wi CI, Lynch BA. Association of Perinatal Factors With Severe Obesity and Dyslipidemia in Adulthood. J Prim Care Community Health 2022; 13:21501327211058982. [PMID: 35249418 PMCID: PMC8905209 DOI: 10.1177/21501327211058982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Background: Perinatal factors including gestational age, birthweight, size for gestational age, delivery route, maternal parity, maternal age, maternal education, socioeconomic status, race, and sex, are associated with the future risk of obesity and co-morbid conditions. This study evaluated the relationship of birthweight for gestational age and perinatal factors with severe obesity and dyslipidemia in adulthood. Methods: We conducted a population-based, retrospective birth cohort study of infants born to residents of Olmsted County, MN between 1976 and 1982. Outcomes were assessed after age 18 years until October 2020, including severe obesity (BMI ≥ 40 kg/m2) and dyslipidemia (total cholesterol ≥200 mg/dL, non-high density lipoprotein [non-HDL] cholesterol ≥145 mg/dL or HDL cholesterol <40 mg/dL). We obtained mother’s age, education level, and parity as well as newborn sex, race, type of delivery, single/multiple birth, gestational age, and birthweight from birth certificate data. Individual-level socioeconomic status (SES) of the household at birth was determined with the HOUSES index. Results: Of 10 938 birth cohort subjects, 7394 had clinic visits after age 18 years and were included, with 2630 having severe obesity (n = 798) or dyslipidemia (n = 2357) as adults. In multivariable models, female sex, singleton birth, less maternal education, and lower SES defined by HOUSES were independently associated with an increased risk of severe obesity in adulthood. Non-white race, singleton birth, and lower birthweight were independently associated with adult dyslipidemia. Birthweight for gestational age was not associated with severe obesity or dyslipidemia. Conclusion: Perinatal factors were associated with both severe obesity and dyslipidemia in adulthood. Lower SES at birth was predictive of severe obesity in adulthood, highlighting the opportunity to investigate modifiable perinatal social determinants to reduce the risk of severe obesity.
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Affiliation(s)
- Kristene Tadese
- Mayo Clinic Alix School of Medicine, Rochester, MN, USA
- Brian A. Lynch, Department of Pediatric and Adolescent Medicine, Mayo Clinic, 200 1st Street NW, Rochester, MN 55905-0002, USA.
| | - Vivian Ernst
- Department of Family Medicine, Mayo Clinic, Rochester, MN, USA
| | - Amy L. Weaver
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA
| | - Tom D. Thacher
- Department of Family Medicine, Mayo Clinic, Rochester, MN, USA
| | - Tamim Rajjo
- Department of Family Medicine, Mayo Clinic, Rochester, MN, USA
| | - Seema Kumar
- Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Tara Kaufman
- Department of Family Medicine, Mayo Clinic, Rochester, MN, USA
| | - Chung-Il Wi
- Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Brian A. Lynch
- Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, Minnesota, USA
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Fanzo J, Rudie C, Sigman I, Grinspoon S, Benton TG, Brown ME, Covic N, Fitch K, Golden CD, Grace D, Hivert MF, Huybers P, Jaacks LM, Masters WA, Nisbett N, Richardson RA, Singleton CR, Webb P, Willett WC. Sustainable food systems and nutrition in the 21st century: a report from the 22nd annual Harvard Nutrition Obesity Symposium. Am J Clin Nutr 2021; 115:18-33. [PMID: 34523669 PMCID: PMC8755053 DOI: 10.1093/ajcn/nqab315] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Accepted: 09/10/2021] [Indexed: 01/02/2023] Open
Abstract
Food systems are at the center of a brewing storm consisting of a rapidly changing climate, rising hunger and malnutrition, and significant social inequities. At the same time, there are vast opportunities to ensure that food systems produce healthy and safe food in equitable ways that promote environmental sustainability, especially if the world can come together at the UN Food Systems Summit in late 2021 and make strong and binding commitments toward food system transformation. The NIH-funded Nutrition Obesity Research Center at Harvard and the Harvard Medical School Division of Nutrition held their 22nd annual Harvard Nutrition Obesity Symposium entitled "Global Food Systems and Sustainable Nutrition in the 21st Century" in June 2021. This article presents a synthesis of this symposium and highlights the importance of food systems to addressing the burden of malnutrition and noncommunicable diseases, climate change, and the related economic and social inequities. Transformation of food systems is possible, and the nutrition and health communities have a significant role to play in this transformative process.
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Affiliation(s)
| | - Coral Rudie
- Division of Gastroenterology, Hepatology and Nutrition, Boston Children's Hospital, Boston, MA, USA
| | - Iman Sigman
- Metabolism Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Steven Grinspoon
- Metabolism Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Tim G Benton
- Energy, Environment and Resources Programme, Chatham House, London, United Kingdom
| | - Molly E Brown
- Department of Geographical Sciences, University of Maryland College Park, College Park, MD, USA
| | - Namukolo Covic
- International Food Policy Research Institute, Addis Ababa, Ethiopia
| | - Kathleen Fitch
- Metabolism Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Christopher D Golden
- Department of Nutrition, Harvard TH Chan School of Public Health, Boston, MA, USA
| | - Delia Grace
- Natural Resources Institute, University of Greenwich, Chatham Maritime, United Kingdom,Animal and Human Health, International Livestock Research Institute, Nairobi, Kenya
| | - Marie-France Hivert
- Department of Population Medicine, Harvard Pilgrim Health Care Institute, Harvard Medical School, Boston, MA, USA
| | - Peter Huybers
- Department of Earth and Planetary Sciences, Harvard University, Boston, MA, USA
| | - Lindsay M Jaacks
- Global Academy of Agriculture and Food Security, The University of Edinburgh, Edinburgh, United Kingdom
| | - William A Masters
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
| | - Nicholas Nisbett
- Health and Nutrition Cluster, Institute of Development Studies, Falmer, United Kingdom
| | | | - Chelsea R Singleton
- Department of Social, Behavioral, and Population Sciences, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA
| | - Patrick Webb
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
| | - Walter C Willett
- Department of Epidemiology, Harvard TH Chan School of Public Health, Boston, MA, USA
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Abate KH, Abdullahi M, Abdulhay F, Arage G, Mecha M, Yenuss M, Hassen H, Belachew T. Education can modify the long term impact of early childhood famine exposure on adulthood economic achievement: a historical cohort study among the survivors of the great Ethiopian famine 1983-85. ACTA ACUST UNITED AC 2021; 79:67. [PMID: 33947464 PMCID: PMC8097899 DOI: 10.1186/s13690-021-00564-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Accepted: 03/19/2021] [Indexed: 12/05/2022]
Abstract
Background Previous famine studies reported the inverse link between early life nutritional deprivation and adulthood optimal health outcomes. However, there remain sparse data on the impact of early life famine exposure in later life economic achievement. Hence, we set out to examine the association of early life famine exposure on economic achievement among survivors of the 1983–85 great Ethiopian famine. Method A historical cohort study design was employed among 968 adult men and women in the Raya Kobo district, Northern Ethiopia. Participants were categorized into in utero exposed, postnatal exposed and unexposed groups based on self-reported age and birthdate. Structured questionnaire was used to collect data on socio-demographic and individual assets. Principal component analysis (PCA) was used to determine wealth index as proxy for economic achievement. Multinomial logistic regression analyses were employed to examine the independent effect of early life famine exposure on the outcome. Results In unadjusted model, compared to unexposed cohorts, in utero and postnatal famine exposed cohorts were nearly twice more likely to fall in the lowest wealth category (OR: 1.93, 95% CI: 1.40, 2.64) and (OR: 2.12, 95%CI: 1.45, 3.08), respectively. However, these associations became non-significant when adjusted for biologic and demographic variables (P > 0.05). Instead, educational status appeared to have significant association with wealth; those who can’t read or write among in utero and postnatal exposed group were three times more likely to fall in low wealth index category than those who achieved secondary and above level of education (OR = 3.00 95% CI: 1.74, 5.18) and (OR = 2.92, 95% CI: 1.48, 5.76), respectively. Similarly, those with primary education among in uero and postnatal famine exposed cohorts were twice more likely to fall in the low wealth index than compared to those secondary and above level of education (OR = 2.04 95% CI: (1.18, 3.54) and (OR = 2.17 95% CI: 1.12, 4.22), respectively. Conclusion Education appears to be a significant independent factor to determine one’s economic achievement in the studied famine cohort. This may imply, the possible impact of early life famine exposure on economic achievement later in adult life could be modified through better education. Our findings justify the need of expanding education in hunger spots in general and in famine settings in particular. Supplementary Information The online version contains supplementary material available at 10.1186/s13690-021-00564-w.
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Affiliation(s)
- Kalkidan Hassen Abate
- Department of Nutrition and Dietetics, Institute of Health, Jimma University, Jimma, Ethiopia.
| | - Misra Abdullahi
- Department of Population and Family Heath, Institute of Health, Jimma University, Jimma, Ethiopia
| | - Fedlu Abdulhay
- Department of Obstetrics and Gynecology, Faculty of Medical Sciences, Jimma University, Jimma, Ethiopia
| | - Getachew Arage
- Department of Nutrition and Dietetics, College of Health Sciences, DebreTabor University, Debre Tabor, Ethiopia
| | - Mohammed Mecha
- Department of Internal Medicine, Faculty of Medical Sciences, Jimma University, Jimma, Ethiopia
| | - Mohammed Yenuss
- Department of Environmental Health Science, College of Health and Medical Sciences, Wollo University, Dessie, Ethiopia
| | - Habtamu Hassen
- Department of Nutrition and Dietetics, Institute of Health, Jimma University, Jimma, Ethiopia
| | - Tefera Belachew
- Department of Nutrition and Dietetics, Institute of Health, Jimma University, Jimma, Ethiopia
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