Glucose, insulin and lipid metabolism in rural Gambians exposed to early malnutrition

Aims There is now substantial evidence to suggest that susceptibility to ce rtain non-communicable diseases may be increased by early undernutrition. I n rural Gambia, an annual hungry season reduces birth weight by 200-300 g a nd increases the prevalence of low birth weight (< 2500 g) from 11 % to 24 %. The aim of this study was to investigate whether fetal nutritional stres s (using season of birth as a proxy measure for prenatal growth retardation ) or early childhood malnutrition (using historical anthropometric records) had a residual influence on risk factors for cardiovascular disease in a c ohort of rural Gambian adults. Methods Two hundred and nineteen adults (mean age = 35.8 years; mean body m ass index = 21.3 kg/m(2); women = 181) for whom month of birth and infant a nthropometric records were available participated in this study. Risk facto rs for cardiovascular disease were measured. Results No differences were found between season of birth groups (hungry vs . harvest) and fasting measures of glucose, insulin, lipids, fibrinogen or cortisol, or against 30 and 120 min glucose and insulin levels following an oral glucose tolerance test, or blood pressure. Similarly, these risk fact ors for adult disease were not related to the subjects' weight-for-age as c hildren. Conclusions Moderate-to-severe fetal and childhood malnutrition in rural Ga mbia caused no detectable impairment of the glucose/insulin axis, or of oth er cardiovascular disease risk factors in adults remaining lean and fit on a low-fat diet.