Associations between Early-Life Food Deprivation and Risk of Frailty of Middle-Age and Elderly People: Evidence from the China Health and Retirement Longitudinal Study.

backgroundThe association between childhood food deprivation (FD) and health in later life has been extensively studied; however, studies on the association between childhood food deprivation and frailty are scarce. This study assessed the associations between childhood FD and the risk of frailty at middle-age and old age.

methodsThree waves of the China Health and Retirement Longitudinal Study (CHARLS), including 11,615 individuals aged over 45 years, were used for this research. Frailty was operationalized according to the FRAIL scale as a sum of fatigue, resistance, ambulation, illness, and the loss of weight. Childhood FD experiences and levels were measured by self-reported FD and historical content. Logistic mixed-effects models and proportional odds ordered logistic regression models were used to analyse the association between childhood FD and frailty.

findingsChildhood FD increased the odds of frailty at old age (1.30, 95% CI: 1.26-1.36). Compared with subjects with mild FD, those with extreme FD experiences had increased risks of frailty (1.34, 95% CI: 1.26-1.43). Subjects exposed to hunger at different ages all had an increased risk of frailty, and subjects who had FD during ages 6-12 (1.15, 95% CI: 1.09-1.22) were more likely to have an increased risk of frailty than those who had experienced FD in younger ages. The interaction of experience of FD at ages 0-6 and the experience of FD at ages 6-12 is not statistically significant after adjusting all covariates.

conclusionsOur findings suggest that childhood FD exerts long-lasting effects on frailty among older adults in China. The prevention of childhood FD may delay or even avert the emergence of frailty in people of middle-age and old age.