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Lecture 4 Study Notes

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Department
Health Studies
Course Code
HLTC23H3
Professor
Jason Ramsay

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Lecture #4: Early ExposureLatent Effects
Monday, January 31st/2011
The Dutch Hunger Winter, 1944-1945
During WWII, the advance to push the German army from Western Europe combined with a a
very harsh winter to cut off most of the Netherlands from food supply
The Dutch had to severely ration food and scrounge for essentials
A famine ensued which lasted for a 5 month period
Retrospective cohort research shows that the famine had a profound effect on the gestating fetus
How much food did they get?
Canals had frozen and food could not be transported overland
By November 1944, rations had fallen to about 1000 calories per day
Between December 44 and April 45, rations had fallen to 400-800 calories
Eventually, the extra rations for pregnant women were not available
Timing and Development
This terrible famine had a specific course
Therefore, the effects of various levels of caloric restriction can be studied
In some ways, it is like a naturalistic experiment because the differential interaction of critical
periods and caloric deficit can be examined
What were the immediate effects?
Had a profound effect on the health of the general population
Mortality increased 2X over 1939
Extra death rate due o starvation
However, women were still conceiving and giving birth to babies
It is in these babies that we can see the effect of early malnutrition on health in adult life
Prenatal Exposure to Famine
www.notesolution.com
All babies (no twins) born between Nov.1, 1943 and Feb. 28th, 1947 were eligible for inclusion in
the study
Of the total cohort 1018 people living close to or in Amsterdam were approached
912 agree to be interviewed
741 consented to undertake glucose resistance testing
Average age was 50.
Effects of early famine on later health
It turned out that meticulous birth records had been kept
They had info on mothers weight and health and the size of the baby and placenta
The baby was exposed to famine if the average daily ration during a 13 week period of gestation
was below 1000 calories
How was the group divide?
The group was divided into:
oLate gestation exposure
oMid-gestation exposure
oEarly gestation exposure
Control group consisted of participants born before or after the famine period
In the analysis of the data, they controlled for other factors such as gender SES, smoking and BMI
What were the effects at birth?
Babies exposed to famine in late or mid gestation were lighter, shorter, thinner and had a smaller
head circumference
Exposure menat a smaller placenta
Babies exposed to famine in early gestation were slightly heavier and larger on average
Later Effects
People exposed to famine had impaired glucose tolerance, meaning that they had a much higher
risk for diabetes
www.notesolution.com

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Description
Lecture #4: Early Exposure Latent Effects Monday, January 31 2011 The Dutch Hunger Winter, 1944-1945 During WWII, the advance to push the German army from Western Europe combined with a a very harsh winter to cut off most of the Netherlands from food supply The Dutch had to severely ration food and scrounge for essentials A famine ensued which lasted for a 5 month period Retrospective cohort research shows that the famine had a profound effect on the gestating fetus How much food did they get? Canals had frozen and food could not be transported overland By November 1944, rations had fallen to about 1000 calories per day Between December 44 and April 45, rations had fallen to 400-800 calories Eventually, the extra rations for pregnant women were not available Timing and Development This terrible famine had a specific course Therefore, the effects of various levels of caloric restriction can be studied In some ways, it is like a naturalistic experiment because the differential interaction of critical periods and caloric deficit can be examined What were the immediate effects? Had a profound effect on the health of the general population Mortality increased 2X over 1939 Extra death rate due o starvation However, women were still conceiving and giving birth to babies It is in these babies that we can see the effect of early malnutrition on health in adult life Prenatal Exposure to Famine www.notesolution.com
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