The Correlation between Early Stages of Life Exposed to Chinese Famine and Cognitive Decline in Adulthood: Nutrition of Adulthood Plays an Important Role in the Link?

Abstract

Objective: The aim of this study was to investigate whether people exposed to the Chinese Famine in fetal period or in multiple stages of childhood are associated with cognitive decline in adulthood. Furthermore, the nutritional environment of adulthood was explored as an important factor in this correlation.Methods: 1162 adults born between 1952 and 1964 were recruited. They were divided into five groups which were non-exposed group, fetal-exposed group, early childhood-exposed group, mid childhood-exposed group and late childhood-exposed group. Cognitive function was measured by using a comprehensive neuropsychological battery test, including Montreal cognitive assessment-Beijing version, mini-mental state examination, auditory verbal learning test, digit span forward, digit span backward, trail making test, and digit symbol test. Semi-quantified food frequency questionnaire (FFQ) was used to assess the dietary nutrition in their adulthood. The dietary nutrient consumption pattern was identified by Two-step and K-means cluster analysis.Results: The significant differences in cognitive function were manifested in different groups. Compared with non-exposed group, subjects in fetal-exposed group had a higher risk of mild cognitive impairment (MCI) (OR 1.51 95% CI 1.02–2.23, P = 0.039) and global cognitive decline (OR 1.68 59% CI 1.02–2.77, P = 0.044). The similar result was also observed in subjects of early childhood-exposed group. Otherwise, subjects who were classified in high nutrient consumption pattern had higher risk of cognitive decline. Moreover, the higher consumption of several nutrients such as fat, carbohydrate and manganese were associated with worse performance on digit span forward, digit span backward, trail making test A, trail making test B and digit symbol.Conclusion: Early stages of life exposed to the Chinese Famine were associated with higher risk of cognitive decline in adulthood. The stronger associations were manifested in the people with high nutrient consumption pattern. The consumption of fat, carbohydrate and manganese were associated with multiple domains cognitive decline.

Exposure to Chinese famine in early life and the risk of sensory impairment in adulthood

“…Our findings revealed that exposure to Chinese famine during the prenatal period and late childhood increased the risk of hearing and dual sensory impairments in late life. Together with our previous findings, 19 23 it was indicated that the starting point of hearing, vision and cognition impairments in midlife could date back to younger age. Our results showed that the prevalence of hearing and dual sensory impairments in the fetal-exposed group was higher than that in the unexposed group (although the difference was not statistically significant in table 2).…”

The Interplay Between Nutrition and Stress in Pregnancy: Implications for Fetal Programming of Brain Development

“…In humans, extreme cases of nutritional deprivation during pregnancy, such as in times of famine, have provided insight into the protracted impact of malnutrition on brain development (18). For example, middle-aged offspring of mothers exposed to undernutrition during the Dutch and Chinese famines were found to exhibit reduced cognitive capabilities (19,20). Specific nutrient deficiencies or dietary imbalances may also produce adverse neurodevelopmental effects, such as neural tube defects (21), language delay (22,23), reduced cognitive abilities (24), and mental and neurodevelopmental disorders (25,26).…”

Impact of Early Life Exposure to Environments with Unimproved Sanitation on Education Outcomes: Evidence from Bangladesh

“…Pathania (2009) found that external shocks such as a drought at birth were associated with a 0.3 centimeter (cm) drop in height among upper-caste women in rural India between the years 1950 and 1999, mostly driven in utero. Rong et al (2017) found that early life exposure to famine in China between 1959 and 1961 contributed to a cognitive decline among adults. Almond et al (2007), who studied the same famine in China, also found that those individuals who were most exposed to famine were more likely to be illiterate, unemployed, and disabled.…”

“…Failure to maximize a child's development during this phase could have negative impact later in life in areas such as education, earnings, as well as mental health (Walker et al, 2007). Evidence indicates that poor health conditions early in life are associated with higher mortality (Bengtsson & Lindstörm, 2000) and poor adult cognitive development (Rong et al, 2017;Vogl, 2014). Children who are healthy early in life have better educational outcomes (Case & Paxson, 2010) and subsequently better economic outcomes (Lawson & Spears, 2016;Vogl, 2014;Cutler et al, 2010).…”