Association between early life exposure to the great famine and possible sarcopenia in older Chinese adults: a national cross-sectional study

Ting Wu; Xiaojin Yan; Yunfei Liu; Ning Ma; Jiajia Dang; Panliang Zhong; Di Shi; Shan Cai; Hao Cheng; Yi Song; Patrick W C Lau

doi:10.1136/bmjopen-2022-065240

Association between early life exposure to the great famine and possible sarcopenia in older Chinese adults: a national cross-sectional study

BMJ Open. 2023 Mar 1;13(3):e065240. doi: 10.1136/bmjopen-2022-065240.

Authors

Ting Wu^{1

2}, Xiaojin Yan³, Yunfei Liu^{1

2}, Ning Ma^{1

2}, Jiajia Dang^{1

2}, Panliang Zhong^{1

2}, Di Shi^{1

2}, Shan Cai^{1

2}, Hao Cheng⁴, Yi Song^{5

2}, Patrick W C Lau^{6

7}

Affiliations

¹ Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing, China.
² National Health Commission Key Laboratory of Reproductive Health, Beijing, China.
³ Institute of Population Research, Peking University, Beijing, China songyi@bjmu.edu.cn yanxiaojin@pku.edu.cn.
⁴ National Academy of Innovation Strategy, China Association for Science and Technology, Beijing, China.
⁵ Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing, China songyi@bjmu.edu.cn yanxiaojin@pku.edu.cn.
⁶ Department of Sport, Physical Education and Health, Hong Kong Baptist University, Hong Kong, China.
⁷ Laboratory of Exercise Science and Health, BNU-HKBU United International College, Zhuhai, China.

Abstract

Objectives: We used data from the China Health and Retirement Longitudinal Study (CHARLS) to investigate how an early life famine exposure affected possible sarcopenia (PS) and to explore the extent to which a sex difference exists in the association among older Chinese adults, as well as whether risk factors modify the association.

Design: Cross-sectional study.

Setting: 28 provinces of China.

Participants: Considering that the Great Chinese Famine lasted from the spring of 1959 to the fall of 1961, 3557 participants were selected and categorised into four subgroups based on their date of birth: unexposed group (1 October 1962 to 30 September 1964), fetal exposed group (1 October 1959 to 30 September 1961), infant exposed group (1 January 1958 to 31 December 1958) and preschool exposed group (1 January 1956 to 31 December 1957).

Outcome measure: PS was defined as having low muscle strength or low physical performance.

Methods: We used multivariable logistic models to analyse the association between early life famine exposure and the risk of PS in elderly life.

Results: The prevalences of PS among individuals in the unexposed, fetal, infant and preschool exposed groups were 15.1%, 14.4%, 23.6% and 21.9%, respectively. Compared with the unexposed group, the infant (OR: 1.55; 95% CI 1.17 to 2.05) and preschool exposed (OR: 1.46; 95% CI 1.17 to 1.82) groups exhibited significantly higher risks of PS. In men, the infant (OR: 2.15; 95% CI 1.40 to 3.31) and preschool exposed (OR: 1.78; 95% CI 1.23 to 2.57) groups were more likely to have PS, but no significant increase was seen in women. In both sexes, prevalence of PS was unrelated to early life famine exposure in the urban, underweight and normal weight subgroups.

Conclusions: Early life exposure to the Great Chinese Famine was associated with a higher risk of PS in older adults. Keeping normal nutritional status in elderly life might help avoid the risk of PS, whatever the effect of early famine exposure.

Keywords: geriatric medicine; nutrition; public health.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Aged
Child, Preschool
Cross-Sectional Studies
East Asian People
Famine*
Female
Humans
Infant
Longitudinal Studies
Male
Middle Aged
Sarcopenia* / etiology