Fetal Exposure to Chinese Famine Increases Obesity Risk in Adulthood

Fetal exposure to famine may have long-term consequences in adulthood. The purpose of the present study was to explore the association between famine exposure in fetal life (Chinese famine in 1959-1961) and obesity risk in adulthood. A total of 8054 subjects (3422 male, 4632 female) were recruited from the cross-sectional 2010-2012 China National Nutrition and Health Survey (CNNHS). The subjects born in 1960 and 1961 were selected as the exposed group, while the subjects born in 1963 were selected as the unexposed group. Multiple linear or logistic regression was performed to examine the association between fetal exposure to famine and risk of obesity (body mass index (BMI), waist circumference (WC), obesity, central obesity) adjusting for gender, education level, economic status, physical exercise, sedentary time, smoking, drinking, the intake of livestock and poultry and the intake of cereal and beans. Compared with the unexposed group, WC increased by 0.52 cm after adjusting the covariates (p = 0.021) and females in the exposed group had a significantly higher prevalence of central obesity with an odds ratio (OR) of 1.15 (1.01,1.31) after adjusting the confounders (p = 0.030). WC increased by 0.71 cm, 1.21 cm after adjusting the covariates compared with the unexposed group among the total subjects and the female subjects in urban areas (p = 0.021, p = 0.001). The female subjects had a significantly higher prevalence of obesity and central obesity, with ORs of 1.34 (1.04,1.71) (p = 0.022), 1.28 (1.07,1.53) (p = 0.008) respectively. Our results suggest that fetal exposure to the Chinese famine increased obesity risk in adulthood, and the association was stronger in female and urban subjects.