Famine exposure in the young and the risk of type 2 diabetes in adulthood

Diabetes. 2012 Sep;61(9):2255-60. doi: 10.2337/db11-1559. Epub 2012 May 29.

Abstract

The developmental origins hypothesis proposes that undernutrition during early development is associated with an increased type 2 diabetes risk in adulthood. We investigated the association between undernutrition during childhood and young adulthood and type 2 diabetes in adulthood. We studied 7,837 women from Prospect-EPIC (European Prospective Investigation Into Cancer and Nutrition) who were exposed to the 1944-1945 Dutch famine when they were between age 0 and 21 years. We used Cox proportional hazards regression models to explore the effect of famine on the risk of subsequent type 2 diabetes in adulthood. We adjusted for potential confounders, including age at famine exposure, smoking, and level of education. Self-reported famine exposure during childhood and young adulthood was associated with an increased type 2 diabetes risk in a dose-dependent manner. In those who reported moderate famine exposure, the age-adjusted type 2 diabetes hazard ratio (HR) was 1.36 (95% CI [1.09-1.70]); in those who reported severe famine exposure, the age-adjusted HR was 1.64 (1.26-2.14) relative to unexposed women. These effects did not change after adjustment for confounders. This study provides the first direct evidence, using individual famine exposure data, that a short period of moderate or severe undernutrition during postnatal development increases type 2 diabetes risk in adulthood.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Aged
  • Child
  • Child, Preschool
  • Diabetes Mellitus, Type 2
  • Female
  • Humans
  • Infant
  • Infant, Newborn
  • Malnutrition / complications*
  • Middle Aged
  • Netherlands / epidemiology
  • Prospective Studies
  • Risk
  • Starvation / complications*
  • Starvation / epidemiology
  • World War II
  • Young Adult