Abstract
Objective: To study the risks for hypertension, glucose intolerance and overweight forty years after fetal or childhood exposure to famine afflicting Biafra during the Nigerian civil war (1967-1970).
Design: Prospective cohort study performed in June 27 – July 31, 2009.
Setting: Enugu, Nigeria. Participants: Adults (n=1,339) born before (1965-67), during (1968-January 1970), or after (1971-73) the years of famine.
Main outcome measures: Blood pressure (BP), random plasma glucose and anthropometrics, as well as prevalence of hypertension (BP >140/90 mmHg), impaired glucose tolerance (IGT; p-glucose 7.8-11.0 mmol/l), diabetes (DM; p-glucose ≥11.1 mmol/l), or overweight (BMI >25 kg/m2).
Results: Fetal-infant exposure to famine was associated with elevated systolic (+7 mmHg; p< 0.001) and diastolic (+5 mmHg; p< 0.001) BP, increased p-glucose (+0.3 mmol/L; p < 0.04) and waist circumference (+ 3cm, p< 0.001), increased risk of systolic hypertension (adjusted OR 2.87; 95% CI 1.90-4.34), IGT (OR 1.65; 95% CI 1.02-2.69) and overweight (OR 1.41; 95% CI 1.03-1.93) as compared to people born after the famine. The effect of fetal-infant famine on BP was seen in both women and men, whereas the effect on IGT was seen in men only, and the increased risk of overweight was confined to women.
Conclusions: Fetal and infant undernutrition is associated with significantly increased risk of hypertension and impaired glucose tolerance in 40-year-old Nigerians. Prevention of undernutrition during pregnancy and in infancy should therefore be given high priority in health, education, and economic agendas.
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Hult, M., Tornhammar, P., Ueda, P. et al. 12 Hypertension, Diabetes and Overweight: Looming Legacies of the Biafran Famine. Pediatr Res 68 (Suppl 1), 8–9 (2010). https://doi.org/10.1203/00006450-201011001-00012
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DOI: https://doi.org/10.1203/00006450-201011001-00012
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