Class Notes (810,860)
Canada (494,337)
Health Studies (1,162)
HLTC23H3 (86)
Lecture 6

HLTB02 - Lecture 6.docx

6 Pages
Unlock Document

University of Toronto Scarborough
Health Studies
Caroline Barakat

10/24/2012 HLTB02 Issues in Child Health and Development Lecture 6: Determinants of child health – Early exposures - Origin of disease later in life lies in some sort of impairment that occurs for an individual prenatally o Organs during development (in utero) is rapid  Illness can cause impairments to the organs - The Dutch Hunger Winter (1944-1945) o Exposure in utero and how it cascades across the lifetime of a child o Period were little food supply was available  Had to ration food distribution o Famine lasted about 5-months o Sequence of events also occurred during this timeframe  Basic necessity could not brought to the community (because of the War)  Canals were frozen (could not obtain fresh water) o Resulted in retrospective cohort research  Famine took place and eventually the children were born  Children progress through their lifespan  Later on in life, researchers assessed these individuals and retrospectively assessed the impact of famine on child development  How do we measure the food intake of a typical pregnant female during this timeframe? • November 1944 o Rations were about 1000 calories per day • December 1944 – April 1945 o Rations were 400-800 calories per day • During this timeframe (peak of famine), extra rations were no longer available for pregnant women • Typical daily rations: potatoes, bread, and sugar beets (not very nutritious) 1 10/24/2012 o Timing and development  Five month period of famine • Looked at early, middle, and late conception of a child (amount of exposure to famine)  Effect of various levels of caloric restriction on health  This study was in some ways a naturalistic observation o Immediate effects of famine  Profound effects on the health of the general population • Entire population was influenced by the famine  Double rates of mortality during this timeframe (in comparison to 1939)  Increased death rate due to starvation o Prenatal exposure to famine  Painter et al. (2005) • All babies born between November 1 , 1943 and February 28 , 1947 (no twins) • 1019 people living close to or in Amsterdam o 912 agreed to be interviewed o 741 consented to undertake glucose resistance testing • Average age of participants was 50 • Birth records were kept throughout this timeframe (maintained throughout the years) o Contained the health of the mother o Placenta size o Birth weight of the infant • Enables us to control for these variables • Baby exposed to famine, if their average daily ration during the 12 week period of gestation was below 1000 calories • Three groups used to divide the participants: late gestation, mid-gestation, and early gestation exposure 2 10/24/2012 • Control group was used (children born before or after the famine in Netherlands) • In the analysis, researchers controlled for gender of the participants and BMI of the mother • What were the effects at birth? o Generally, their size was different  Exposed to famine in late or mid gestation caused the participants to be lighter, shorter, and thinner  Head circumference was also smaller  Smaller placenta (across all gestation timeframes when exposed to famine) o Exposed to famine in early gestation were slightly heavier, and larger on average (compared to other gestation levels and control) • Effects of famine later in life (long-term effects) o People that were exposed to famine in late-gestation had an impaired glucose tolerance  Individuals were at a higher risk for diabetes  IGT (impaired glucose tolerance) o Exposure in mid-gestation was related to an increase in obstructive airway disease o Babies that were exposed to famine in the first trimester (early-gestation) shoed the most striking effects  Babies were 3 times more likely to develop some form of coronary heart disease  Atherogenic lipid profile (greater risk for clots and plaque in the veins)
More Less

Related notes for HLTC23H3

Log In


Don't have an account?

Join OneClass

Access over 10 million pages of study
documents for 1.3 million courses.

Sign up

Join to view


By registering, I agree to the Terms and Privacy Policies
Already have an account?
Just a few more details

So we can recommend you notes for your school.

Reset Password

Please enter below the email address you registered with and we will send you a link to reset your password.

Add your courses

Get notes from the top students in your class.