Plasma lipid profiles in adults after prenatal exposure to the Dutch famine

Background: Small body size at birth has been reported to be associated wit h an atherogenic lipid profile in humans, and animal experiments have shown that undernutrition during pregnancy permanently alters cholesterol metabo lism in the offspring. There is no direct evidence in humans that maternal malnutrition during pregnancy affects the lipid profiles of the offspring. Objectives: We assessed the effects of maternal malnutrition during specifi c periods of gestation on plasma lipid profiles in persons aged approximate to 50 y. Design: This was a follow-up study of men and women born at term as singlet ons in a university hospital in Amsterdam between I November 1943 and 28 Fe bruary 1947 around the time of a severe famine. Results: Persons exposed to famine in early gestation had a more atherogeni c lipid profile than did those who were not exposed to famine in utero. The ir LDL-HDL cholesterol ratios were significantly higher (by 13.9%; 95%CI: 2 .6-26.4%). Additionally, their plasma HDL-cholesterol and apolipoprotein A concentrations tended to be lower, and their plasma total cholesterol, LDL- cholesterol, and apolipoprotein B concentrations tended to be higher, altho ugh these differences were not statistically significant. The effect of fam ine was independent of size at birth and adult obesity. Conclusions: An atherogenic lipid profile might be linked to a transition f rom poor maternal nutrition in early gestation to adequate nutrition later on. This suggests that maternal malnutrition during early gestation may pro gram lipid metabolism without affecting size at birth.