Hypertension, diabetes and overweight: looming legacies of the Biafran famine.

<h4>Background</h4>Sub-Saharan Africa is facing rapidly increasing prevalences of cardiovascular disease, obesity, diabetes and hypertension. Previous and ongoing undernutrition among pregnant women may contribute to this development as suggested by epidemiological studies from high inco...

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Autores principales:	Martin Hult, Per Tornhammar, Peter Ueda, Charles Chima, Anna-Karin Edstedt Bonamy, Benjamin Ozumba, Mikael Norman
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2010
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/601c607b70cc455b8eae85443e65a360
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spelling	oai:doaj.org-article:601c607b70cc455b8eae85443e65a3602021-11-18T07:02:59ZHypertension, diabetes and overweight: looming legacies of the Biafran famine.1932-620310.1371/journal.pone.0013582https://doaj.org/article/601c607b70cc455b8eae85443e65a3602010-10-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/21042579/pdf/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Background</h4>Sub-Saharan Africa is facing rapidly increasing prevalences of cardiovascular disease, obesity, diabetes and hypertension. Previous and ongoing undernutrition among pregnant women may contribute to this development as suggested by epidemiological studies from high income countries linking undernutrition in fetal life with increased burden of non-communicable diseases in later life. We undertook to study the risks for hypertension, glucose intolerance and overweight forty years after fetal exposure to famine afflicted Biafra during the Nigerian civil war (1967-1970).<h4>Methods and findings</h4>Cohort study performed in June 27-July 31, 2009 in Enugu, Nigeria. Adults (n = 1,339) born before (1965-67), during (1968-January 1970), or after (1971-73) the years of famine were included. Blood pressure (BP), random plasma glucose (p-glucose) and anthropometrics, as well as prevalence of hypertension (BP>140/90 mmHg), impaired glucose tolerance (IGT; p-glucose 7.8-11.0 mmol/l), diabetes (DM; p-glucose ≥11.1 mmol/l), or overweight (BMI>25 kg/m(2)) were compared between the three groups. Fetal-infant exposure to famine was associated with elevated systolic (+7 mmHg; p<0.001) and diastolic (+5 mmHg; p<0.001) BP, increased p-glucose (+0.3 mmol/L; p<0.05) and waist circumference (+3 cm, p<0.001), increased risk of systolic hypertension (adjusted OR 2.87; 95% CI 1.90-4.34), IGT (OR 1.65; 95% CI 1.02-2.69) and overweight (OR 1.41; 95% CI 1.03-1.93) as compared to people born after the famine. Limitations of this study include the lack of birth weight data and the inability to separate effects of fetal and infant famine.<h4>Conclusions</h4>Fetal and infant undernutrition is associated with significantly increased risk of hypertension and impaired glucose tolerance in 40-year-old Nigerians. Prevention of undernutrition during pregnancy and in infancy should therefore be given high priority in health, education, and economic agendas.Martin HultPer TornhammarPeter UedaCharles ChimaAnna-Karin Edstedt BonamyBenjamin OzumbaMikael NormanPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 5, Iss 10, p e13582 (2010)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Martin Hult Per Tornhammar Peter Ueda Charles Chima Anna-Karin Edstedt Bonamy Benjamin Ozumba Mikael Norman Hypertension, diabetes and overweight: looming legacies of the Biafran famine.
description	<h4>Background</h4>Sub-Saharan Africa is facing rapidly increasing prevalences of cardiovascular disease, obesity, diabetes and hypertension. Previous and ongoing undernutrition among pregnant women may contribute to this development as suggested by epidemiological studies from high income countries linking undernutrition in fetal life with increased burden of non-communicable diseases in later life. We undertook to study the risks for hypertension, glucose intolerance and overweight forty years after fetal exposure to famine afflicted Biafra during the Nigerian civil war (1967-1970).<h4>Methods and findings</h4>Cohort study performed in June 27-July 31, 2009 in Enugu, Nigeria. Adults (n = 1,339) born before (1965-67), during (1968-January 1970), or after (1971-73) the years of famine were included. Blood pressure (BP), random plasma glucose (p-glucose) and anthropometrics, as well as prevalence of hypertension (BP>140/90 mmHg), impaired glucose tolerance (IGT; p-glucose 7.8-11.0 mmol/l), diabetes (DM; p-glucose ≥11.1 mmol/l), or overweight (BMI>25 kg/m(2)) were compared between the three groups. Fetal-infant exposure to famine was associated with elevated systolic (+7 mmHg; p<0.001) and diastolic (+5 mmHg; p<0.001) BP, increased p-glucose (+0.3 mmol/L; p<0.05) and waist circumference (+3 cm, p<0.001), increased risk of systolic hypertension (adjusted OR 2.87; 95% CI 1.90-4.34), IGT (OR 1.65; 95% CI 1.02-2.69) and overweight (OR 1.41; 95% CI 1.03-1.93) as compared to people born after the famine. Limitations of this study include the lack of birth weight data and the inability to separate effects of fetal and infant famine.<h4>Conclusions</h4>Fetal and infant undernutrition is associated with significantly increased risk of hypertension and impaired glucose tolerance in 40-year-old Nigerians. Prevention of undernutrition during pregnancy and in infancy should therefore be given high priority in health, education, and economic agendas.
format	article
author	Martin Hult Per Tornhammar Peter Ueda Charles Chima Anna-Karin Edstedt Bonamy Benjamin Ozumba Mikael Norman
author_facet	Martin Hult Per Tornhammar Peter Ueda Charles Chima Anna-Karin Edstedt Bonamy Benjamin Ozumba Mikael Norman
author_sort	Martin Hult
title	Hypertension, diabetes and overweight: looming legacies of the Biafran famine.
title_short	Hypertension, diabetes and overweight: looming legacies of the Biafran famine.
title_full	Hypertension, diabetes and overweight: looming legacies of the Biafran famine.
title_fullStr	Hypertension, diabetes and overweight: looming legacies of the Biafran famine.
title_full_unstemmed	Hypertension, diabetes and overweight: looming legacies of the Biafran famine.
title_sort	hypertension, diabetes and overweight: looming legacies of the biafran famine.
publisher	Public Library of Science (PLoS)
publishDate	2010
url	https://doaj.org/article/601c607b70cc455b8eae85443e65a360
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Hypertension, diabetes and overweight: looming legacies of the Biafran famine.

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