Early-life famine exposure increases the risk of subsequent physical disability: evidence from a national population-based survey

BackgroundDue to ethical constraints, famines, which can lead to severe malnutrition, are often viewed as natural experiments to assess the impact of early-life nutritional malnutrition on adverse health outcomes in adulthood. However, evidence regarding the effect of early-life famine exposure on l...

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Main Authors: Shiwei Cao, Yao Wu, Tengfei Niu, Xiyu Chen, Jie Xiang, Hao Li, Ziyi Chen, Qianying Shi, Yu Du
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-07-01
Series:Frontiers in Public Health
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Online Access:https://www.frontiersin.org/articles/10.3389/fpubh.2025.1587680/full
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author Shiwei Cao
Yao Wu
Tengfei Niu
Xiyu Chen
Jie Xiang
Hao Li
Ziyi Chen
Qianying Shi
Yu Du
Yu Du
author_facet Shiwei Cao
Yao Wu
Tengfei Niu
Xiyu Chen
Jie Xiang
Hao Li
Ziyi Chen
Qianying Shi
Yu Du
Yu Du
author_sort Shiwei Cao
collection DOAJ
description BackgroundDue to ethical constraints, famines, which can lead to severe malnutrition, are often viewed as natural experiments to assess the impact of early-life nutritional malnutrition on adverse health outcomes in adulthood. However, evidence regarding the effect of early-life famine exposure on later-life physical disability remains scarce. This study aims to investigate the association between early-life famine exposure and physical disability in the Chinese population.MethodsThis study is based on survey data from the China Health and Retirement Longitudinal Study released in 2018. Famine exposure was determined based on participants’ birth years, and all individuals were categorized into four groups: non-exposed, fetal exposed, preschool exposed, and school-age exposed. Logistic regression analysis was conducted to examine the association between early-life famine exposure and physical disability. Stratified analyses were further performed by gender, residence, and severity of early-life famine exposure.ResultsAfter adjusting for all covariates, fetal exposure to famine was associated with a 1.57-fold increased risk of severe disability compared to the non-exposed group. Among males, older people with fetal exposure to famine was significantly associated with a 1.69-fold increased risk of severe disability compared to the non-exposed group. Among females, older populations with famine exposure during the school-age period was associated with a 1.52-fold increased risk of severe disability compared to the non-exposed group. In areas with less severe famine exposure, those with fetal exposure was linked to a 1.66-fold increased risk of severe disability compared to the non-exposed group. In areas with more severe famine exposure, older individuals exposed during the preschool period had a 1.57-fold higher risk of mild disability. In rural areas, older adults who were exposed to famine during the fetal period had a 1.65-fold increased risk of severe disability compared to their non-exposed counterparts. In urban areas, those exposed to famine during the preschool period exhibited a 1.63-fold higher risk of mild disability than their non-exposed counterparts.ConclusionThe findings underscore the critical role of early-life adversity and nutritional status in shaping health outcomes in later life, highlighting the need for public health policies to prioritize nutritional interventions during early developmental stages.
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spelling doaj-art-6b75034b04834916bb6d7c7d5fe82f6c2025-08-20T03:28:15ZengFrontiers Media S.A.Frontiers in Public Health2296-25652025-07-011310.3389/fpubh.2025.15876801587680Early-life famine exposure increases the risk of subsequent physical disability: evidence from a national population-based surveyShiwei Cao0Yao Wu1Tengfei Niu2Xiyu Chen3Jie Xiang4Hao Li5Ziyi Chen6Qianying Shi7Yu Du8Yu Du9The Second Clinical College, Chongqing Medical University, Chongqing, ChinaInternational Medical College, Chongqing Medical University, Chongqing, ChinaDepartment of Basic Courses, Chongqing Medical and Pharmaceutical College, Chongqing, ChinaThe First Clinical College, Chongqing Medical University, Chongqing, ChinaThe Second Clinical College, Chongqing Medical University, Chongqing, ChinaCollege of Foreign Languages, Chongqing Medical University, Chongqing, ChinaCollege of Traditional Chinese Medicine, Chongqing Medical University, Chongqing, ChinaThe Fifth Clinical College, Chongqing Medical University, Chongqing, ChinaThe Second Clinical College, Chongqing Medical University, Chongqing, ChinaDepartment of Orthopedic Surgery, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, ChinaBackgroundDue to ethical constraints, famines, which can lead to severe malnutrition, are often viewed as natural experiments to assess the impact of early-life nutritional malnutrition on adverse health outcomes in adulthood. However, evidence regarding the effect of early-life famine exposure on later-life physical disability remains scarce. This study aims to investigate the association between early-life famine exposure and physical disability in the Chinese population.MethodsThis study is based on survey data from the China Health and Retirement Longitudinal Study released in 2018. Famine exposure was determined based on participants’ birth years, and all individuals were categorized into four groups: non-exposed, fetal exposed, preschool exposed, and school-age exposed. Logistic regression analysis was conducted to examine the association between early-life famine exposure and physical disability. Stratified analyses were further performed by gender, residence, and severity of early-life famine exposure.ResultsAfter adjusting for all covariates, fetal exposure to famine was associated with a 1.57-fold increased risk of severe disability compared to the non-exposed group. Among males, older people with fetal exposure to famine was significantly associated with a 1.69-fold increased risk of severe disability compared to the non-exposed group. Among females, older populations with famine exposure during the school-age period was associated with a 1.52-fold increased risk of severe disability compared to the non-exposed group. In areas with less severe famine exposure, those with fetal exposure was linked to a 1.66-fold increased risk of severe disability compared to the non-exposed group. In areas with more severe famine exposure, older individuals exposed during the preschool period had a 1.57-fold higher risk of mild disability. In rural areas, older adults who were exposed to famine during the fetal period had a 1.65-fold increased risk of severe disability compared to their non-exposed counterparts. In urban areas, those exposed to famine during the preschool period exhibited a 1.63-fold higher risk of mild disability than their non-exposed counterparts.ConclusionThe findings underscore the critical role of early-life adversity and nutritional status in shaping health outcomes in later life, highlighting the need for public health policies to prioritize nutritional interventions during early developmental stages.https://www.frontiersin.org/articles/10.3389/fpubh.2025.1587680/fullearly-life famine exposurephysical disabilitymalnutritionCHARLSmiddleaged and older adults
spellingShingle Shiwei Cao
Yao Wu
Tengfei Niu
Xiyu Chen
Jie Xiang
Hao Li
Ziyi Chen
Qianying Shi
Yu Du
Yu Du
Early-life famine exposure increases the risk of subsequent physical disability: evidence from a national population-based survey
Frontiers in Public Health
early-life famine exposure
physical disability
malnutrition
CHARLS
middleaged and older adults
title Early-life famine exposure increases the risk of subsequent physical disability: evidence from a national population-based survey
title_full Early-life famine exposure increases the risk of subsequent physical disability: evidence from a national population-based survey
title_fullStr Early-life famine exposure increases the risk of subsequent physical disability: evidence from a national population-based survey
title_full_unstemmed Early-life famine exposure increases the risk of subsequent physical disability: evidence from a national population-based survey
title_short Early-life famine exposure increases the risk of subsequent physical disability: evidence from a national population-based survey
title_sort early life famine exposure increases the risk of subsequent physical disability evidence from a national population based survey
topic early-life famine exposure
physical disability
malnutrition
CHARLS
middleaged and older adults
url https://www.frontiersin.org/articles/10.3389/fpubh.2025.1587680/full
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