Thursday, 25 August 2011

Early nutrition shapes future health

The BBC website leads with a health headline: Future heart health 'shaped by diet'.

Whilst some people might look at this headline and say 'wow', I think many people would probably glance at it and say 'we know already'. Certainly those who might be interested in things like the Barker hypothesis recently explored by the BBC Horizon programme and the suggestion that right back to maternal nutrition during pregnancy, what is eaten (or not) can affect the future health of offspring, will know that diet throughout the lifespan is important.

The current study by Annet van Abeelen and colleagues* appears in the European Heart Journal. The crux of their study was to look at over 7,000 women survivors of the Dutch famine of 1944-1945 (the 'Hongerwinter') towards the endgame of WW2. Looking at women survivors who were aged up to 21 years old at the time of the famine, researchers found that those women who were categorised as being 'severely' exposed to the famine presented with a 27% greater risk of coronary heart disease than those unaffected. The risk increased to nearly 40% if girls were aged between 10-17 years at the start of the famine.

This is not the first time that this research group has looked at nutrition based on this sad, but unique period of recent history. In this paper they reviewed some of the studies undertaken on health following the Dutch famine. As per the recent post on the Barker hypothesis, they provide some interesting observations on maternal nutrition related to things like type-2 diabetes. Perhaps more interesting to me are the various studies indicating a potential association between famine babies and rates of schizophrenia and schizophrenia spectrum disorders as exemplified by this study. Indeed other studies of different famines have indicated similar elevated risk of schizophrenia; this paper detailing rates following prenatal exposure to the Chinese famine of 1959-1961.

Through these accumulated studies, there are perhaps a few points that require further investigation:

  • If famine / calorific restriction during childhood and particularly during the teenage years has the ability to increase the risk of future health problems, what does this potentially mean for those children presenting with feeding disorders such as anorexia nervosa?
  • What are the implications of this work for populations where famine is still a fairly regular feature of modern life such as the on-going state in the Horn of Africa?
  • If there is a link between prenatal exposure to famine and later psychiatric effects like schizophrenia, is the die cast or can we modify the risk of any association at various stages after birth? How?
  • Does the shared physical and psychiatric effects of famine provide a template as to how diet can, long-term, affect body and mind? [There is considerable debate on the elevated risk of cardiovascular mortality in cases of schizophrenia].

Whilst I don't want to make too many 'associations' from what is still quite limited data, already I start to think about the recent MIND study on the possible role of nutrition and SNPs suggested in relation to some autism spectrum conditions. Please don't assume that I am making any direct connection because I am not. I am wondering however whether a closer look at the nutritional value of our modern-day foods is in order and as this recent paper by Bakare and Munir ** inquired, what the rates of autism might be in areas more prone to famine, and why, in these times of plenty (for most of us), our food might not be delivering what it should.

* van Abeelen A. et al. Cardiovascular consequences of famine in the young. European Heart Journal. August 2011. doi:10.1093/eurheartj/ehr228

** Bakare MO & Munir KM. Autism spectrum disorders (ASD) in Africa: a perspective. African Journal of Psychiatry. August 2011.