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Background: Few studies in humans have related maternal undernutrition to the size of the adult offspring. Objective: The objective was to assess whether reductions in food intake by pregnant women during the Dutch famine of 1944 -1945 were related to offspring length, weight, and indexes of adiposity in middle age. Design: We recruited 1) exposed persons born in western Netherlands between January 1945 and March 1946 whose mothers experienced famine during or immediately preceding pregnancy, 2) unexposed persons born in the same 3 institutions during 1943 or 1947 whose mothers did not experience famine during this pregnancy, and 3) unexposed same-sex siblings of persons in series 1 or 2. Anthropometric measurements (n ҃ 427 males and 529 females) were obtained between 2003 and 2005. We defined 4 windows of gestational exposure (by ordinal weeks 1-10, 11-20, 21-30, and 31 through delivery) on the basis of exposure to a ration of 900 kcal/d during the whole 10-wk interval. Results: Exposure to reduced rations was associated with increased weight and greater indexes of fat deposition at several tissue sites in women but not in men (P for interaction 0.01). Measures of length and linear proportion were not associated with exposure to famine. Conclusion: Reduced food availability may lead to increased adiposity later in life in female offspring.Am J Clin Nutr 2007;85: 869 -76.

We compared blood pressure of individuals (mean age 59 y) born in western Holland between January 1945 and March 1946 (mothers exposed to the Dutch Famine before or during gestation; n = 359) to blood pressure of unexposed individuals born before or conceived after the famine (n = 299) or same-sex siblings of subjects in series 1 or 2 (n = 313). Mean (SD) systolic and diastolic blood pressure were 140.3 (20.3) and 85.8 (11.0) mmHg, respectively; prevalence of hypertension (prior diagnosis of hypertension or with measured systolic/diastolic blood pressure above 140/90 mmHg) was 61.8%. Birth weight was inversely related to systolic (-4.14 mmHg per kg; 95% confidence interval (CI) -7.24, -1.03; p < 0.01) and diastolic (-2.09 mmHg per kg; 95% CI -3.77, -0.41; p < 0.05) blood pressure and to the prevalence of hypertension (odds ratio 0.67 per kg, 95% CI: 0.49, 0.93) (all age- and sex-adjusted). Any famine exposure of at least 10 weeks duration was associated with elevated systolic (2.77 mmHg; 95% CI 0.25, 5.30; p < 0.05) and diastolic (1.27 mmHg; 95% CI -0.13, 2.66; p = 0.08) blood pressure and with hypertension prevalence (odds ratio 1.44; 95% CI 1.04, 2.00; p < 0.05) in age- and sex-adjusted models. Exposure to famine during gestation may predispose to the development of hypertension in middle age.

There are potential negative consequences of hypervigilance to a strict gluten-free diet. Clinicians must consider the importance of concurrently promoting both dietary adherence and social and emotional well-being for individuals with CD.

Even under famine conditions, birth size and body proportions vary only with late pregnancy exposure. HC for body size has the added disadvantage that late pregnancy exposure effects vary drastically with choice of measure. We do not recommend the use of birth size or body proportions as a proxy for fetal nutritional status in the study of adult disease.

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Health professionals should be aware of the widely disseminated vaccination information available on the Internet and should appreciate its possible effect on the public.

OBJECTIVES: This study evaluated a multicomponent educational intervention to increase ophthalmic examination rates among African Americans with diabetes. METHODS: A randomized trial was conducted with 280 African Americans with diabetes, enrolled from outpatient departments of 5 medical centers in the New York City metropolitan area, who had not had a dilated retinal examination within 14 months of randomization (65.7% female, mean age = 54.7 years [SD = 12.8 years]). RESULTS: After site differences were controlled, the odds ratio for receiving a retinal examination associated with the intervention was 4.3 (95% confidence interval = 2.4, 7.8). The examination rate pooled across sites was 54.7% in the intervention group and 27.3% in the control group. CONCLUSIONS: The intervention was associated with a rate of ophthalmic examination double the rate achieved with routine medical care.