QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) All Versions of this Article: 139/8/1555    most recent jn.109.105536v1 Purchase Article View Shopping Cart Alert me when this article is cited Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Google Scholar Articles by Stein, A. D. Articles by Lumey, L. H. PubMed PubMed Citation Articles by Stein, A. D. Articles by Lumey, L. H.

---

Nutritional Epidemiology

Associations of Gestational Exposure to Famine with Energy Balance and Macronutrient Density of the Diet at Age 58 Years Differ According to the Reference Population Used^1,2

³ Rollins School of Public Health, Emory University, Atlanta, GA 30322; ⁴ Mailman School of Public Health, Columbia University, New York, NY 10032; ⁵ TNO Quality of Life, Leiden 2301 CE, The Netherlands; and ⁶ Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205

Individuals exposed to the Dutch Famine of 1944–45 during gestation have increased adiposity, which might be due to changes in energy intake, physical activity, or metabolic efficiency. We studied 357 persons born between January 1945 and March 1946 whose mothers experienced famine during or immediately preceding pregnancy, 298 persons born in the same 3 institutions during 1943 or 1947 (time controls), and 311 same-sex sibling controls. We obtained food frequency and physical activity data by questionnaire between 2003 and 2005 (mean age 58 y). We defined gestational exposure as exposure to a ration of <3762 kJ/d (<900 kcal/d) for at least 10 wk. For the whole study population, energy intake was 9225 ± 2650 kJ/d and physical activity was 7380 ± 4331 metabolic equivalents (MET)·min/wk. Compared with time controls, gestational famine exposure was associated with 113 kJ/d (95% CI, –272, 502) higher energy intake, 0.01 percentage point (95% CI, –0.88, 0.89) higher fat density, 688 MET·min/wk (95% CI, –1398, 23) lower physical activity, and 63 kJ/d (95% CI, –130, 259) higher predicted energy expenditure (pEE). Compared with sibling controls, gestational famine exposure was associated with 4 kJ/d (95% CI, –702, 711) higher energy intake, 2.01 percentage points (95% CI, 0.38, 3.63) higher fat density, 97 MET·min/wk) (95% CI, –1243, 1050) lower physical activity score, and 188 kJ/d (95% CI, –163, 539) higher pEE. Gender-specific associations (P < 0.05 for heterogeneity) emerged for protein density and pEE using time controls and for energy intake using sibling controls. Associations were weak, differed by choice of control, and may reflect sampling variability or methodological differences. Persistent small energy imbalances could explain the increased weight of famine-exposed individuals.

^* To whom correspondence should be addressed. E-mail: lumey{at}columbia.edu.

Manuscript received 5 February 2009. Initial review completed 22 March 2009. Revision accepted 1 June 2009.

Published online 23 June 2009.