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23-08-2011 | Article

Undernutrition in adolescence increases CV risk in adulthood

Abstract

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MedWire News: Exposure to undernutrition during adolescence may increase cardiovascular risk in adult life, researchers suggest.

"Since the incidence of cardiovascular disease (CVD) is the number one cause of death globally, and rising in many parts of the world, further research into the impact of undernutrition during sensitive periods of growth and maturation is warranted," say Annet van Abeelen (University Medical Center Utrecht, The Netherlands) and co-authors.

The study, published in the European Heart Journal, included 7845 women who were variously affected during the Dutch Famine of 1944 to1945, when they were aged between 0 and 21 years.

During the Dutch Famine, the official daily ration for adults dropped from 1400 kcal in October 1944 to below 1000 kcal the following month. At the height of the famine, between December 1944 to April 1945, the official daily ration varied between 400 and 800 kcal.

The researchers used multivariate analysis to analyze the effect of the famine on the risk for coronary heart disease (CHD) and stroke in women aged 0-9 years (pre-adolescent childhood), 10-17 years (adolescence), and 18 years or older (young adults) at the time of the famine.

The women reported the extent of their starvation during the famine using a self-administered questionnaire at baseline. Those who reported being 'very much' exposed to both hunger and weight loss were categorized by the researchers as severely exposed, those who responded 'hardly' were categorized as being unexposed, and all other participants were categorized as moderately exposed.

Analysis that adjusted for potential confounders including age at famine exposure, smoking, and level of education as a proxy for socioeconomic status revealed that overall, higher famine exposure was associated with higher CHD risk.

Severely exposed adolescent women had a 38% increased risk for CHD risk than unexposed adolescent women. This association was only slightly attenuated after adjustment for potential confounders (hazard ratio=1.27).

Overall, women who were exposed to famine had a 21% reduced risk for stroke than those who were unexposed. Young adults in particular had a 35% reduced risk for stroke compared with unexposed women.

"Our findings support the notion that disturbed postnatal development, particularly in adolescence, can have important implications for adult heath," write the authors.

In a related commentary, Yalda Jamshidi (St George's University of London, UK) and co-authors said that further research is needed to better understand the mechanisms behind the association between undernutrition and CVD risk.

They called for public health strategies to be devised, which they said could have a "significant impact" on disease burden.

MedWire (www.medwire-news.md) is an independent clinical news service provided by Springer Healthcare Limited. © Springer Healthcare Ltd; 2011

By Piriya Mahendra