Long-term health effects in adults born during the Holocaust.
BACKGROUND
Previous studies suggest that exposure to starvation and stress between conception and early infancy may have deleterious effects on health later in life; this phenomenon is termed fetal origin of adult disease.


OBJECTIVE
To determine whether exposure to the Holocaust from preconception to early infancy is a cause of chronic morbidity in adulthood.


METHODS
This pilot study involved 70 European Jews born in countries under Nazi rule (exposed group) during the period 1940-1945 who were interviewed to determine the presence of chronic diseases. A control group of 230 Israeli-born individuals of the same descent, age, and gender distribution were extracted from the Israel National Health Interview Survey-2 (unexposed group). The prevalence of selected risk factors and chronic diseases was compared between the groups.


RESULTS
The prevalence of cardiovascular risk factors and morbidity was significantly higher in the exposed group: body mass index (BMI) (29.06 +/- 3.2 vs. 26.97 +/- 4.42, P = 0.015), hypertension (62.9% vs. 43%, P = 0.003), dyslipidemia (72.9% vs. 46.1%, P < 0.001), diabetes (32.9% vs. 17.4%, P = 0.006), angina pectoris (18.6% vs. 4.8%, P = 0.001) and congestive heart failure (8.6% vs. 1.7%, P = 0.013). The prevalence of cancer (30.0% vs. 8.7% P < 0.001), peptic ulcer disease (21.4% vs. 7%, P = 0.001), headaches/migraines (24.3% vs. 12.6%, P < 0.001) and anxiety/depression (50.0% vs. 8.3%, P < 0.001) was also higher in the exposed group.


CONCLUSIONS
These results suggest that exposure to Holocaust conditions in early life may be associated with a higher prevalence of obesity, dyslipidemia, diabetes, hypertension, cardiovascular morbidity, malignancy and peptic diseases in adulthood. These findings set the stage for further research, which might define those exposed as a high risk group for chronic morbidity.
Eyal
E
Bercovich
Lital
L
Keinan-Boker
Shaul M
SM
Shasha
D000368:Aged; D002908:Chronic Disease / Q000453:epidemiology*; D003430:Cross-Sectional Studies; D004641:Emigration and Immigration; D005060:Europe / Q000208:ethnology; D005260:Female; D006304:Health Status; D006306:Health Surveys; D017767:Holocaust; D006801:Humans; D007557:Israel / Q000453:epidemiology; D007585:Jews / Q000706:statistics & numerical data*; D008297:Male; D010865:Pilot Projects; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects / Q000453:epidemiology; D015995:Prevalence; D012307:Risk Factors; D013217:Starvation / Q000150:complications; D013315:Stress, Psychological / Q000150:complications; D017741:Survivors / Q000706:statistics & numerical data*; D047789:World War II