American Journal of Epidemiology Vol. 145, No. 11: 987-994
Copyright © 1997 by The Johns Hopkins University School of Hygiene and Public Health
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No Increased Mortality in Later Life for Cohorts Bom during Famine
1Odense University Medical School Odense, Denmark
2The Danish Epidemiology Science Centre, The Steno Institute of Public Health, Department of Epidemiology and Social Medicine, Aarhus University Hospital Aarhus, Denmark
3Sanford Institute, Duke University Durham, NC
Reprint requests to Dr. Kaare Christensen, Odense University Medical School, Winslowparken 17, DK-5000 Odense C, Denmark.
Nutrition early in life may influence adult mortality. The fetal-origins hypothesis suggests that nourishment before birth and during the individual's infancy programs the development of risk factors for several important diseases of middle and old age. The present study was designed to evaluate the impact of extreme nutritional deprivation in utero and during infancy and early childhood on mortality in later life. The authors analyzed the survival of the cohorts bom in Finland during the severe 1866–1868 famine and during the 5 years immediately preceding and 5 years immediately following the famine. The study included 331, 932 individuals bom prior to the famine, 161, 744 bom during the famine, and 323, 321 bom after the famine. The authors assessed survival by cohorts from birth to age 17 years and from age 17 to 40, 60, and 80 years, as well as average length of life after age 80 years. Survival from birth to age 17 years was significantly lower in cohorts born before and during the famine than in the cohorts bom after the famine (males, 0.566 vs. 0.671, a difference of 0.105 (95% confidence interval (CI) 0.102–0.108); females, 0.593 vs. 0.692, a difference of 0.099 (95% CI 0.096–0.102)). At subsequent ages, inCIuding old age, mortality was practically identical in the famine-bom cohorts and in the five cohorts bom before and after the crisis. For both males and females, survival from 17 to 80 years and mean remaining lifetime at age 80 years were very similar across the 13 cohorts studied. These findings suggest that, although cohorts subjected to prolonged and extreme nutritional deprivation in utero and during infancy and early childhood suffer an immediate rise in mortality, after the crisis has passed, they carry no aftereffects that influence their survival in later life. Am J Epidemiol 1997; 145: 987-94.
cohort effect; fetal growth retardation; mortality; nutrition; survival rate
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