ArticleJournal of health, population, and nutrition2026
Association of famine exposure in early life with the risk of mortality in later life among Chinese population: a prospective cohort study.
Article in Journal of health, population, and nutrition, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectiveTo investigate the association of early-life exposure to famine with the risk of mortality in later life, as well as to assess the mediating effect of BMI in adulthood on the relationship between early-life famine exposure and long-term mortality risk.
methodsThe China Health and Nutrition Survey (CHNS) served as the basis for the study's data analysis. A total of 8,085 individuals participated in this study. All subjects were categorized into five groups: no exposure group, fetal exposure group, early childhood exposure group, mid-childhood exposure group, and late childhood exposure group. The association of famine exposure with mortality was analyzed using Cox proportional hazards regression models.
resultsExposure to famine in mid-childhood and late childhood exposure was significantly associated with an increased mortality risk (HR: 2.453 and 3.016, 95%CI: 1.532-3.927 and 1.830-4.971, P < 0.001 and < 0.001, respectively). BMI mediated the association of famine exposure with mortality in mid-childhood (P = 0.004) and late childhood exposure (P < 0.001), the mediated proportion were 15.01% for exposure in mid-childhood and 10.22% for exposure in late childhood. However, when the sample was restricted to individuals with a narrower age range for enhanced comparability, the effect of fetal exposure became statistically significant (HR: 2.483, 95% CI: 1.346-4.579, P = 0.004).
conclusionExposure to China's Great Famine during mid- and late childhood resulted in a higher long-term mortality rate. Additionally, BMI acted as a mediator between famine exposure and the mortality. Moreover, the age-limited analysis highlighted the significant effect of fetal exposure on mortality.
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