title: Chronic health conditions in Jewish Holocaust survivors born during World War II.
abstract: BACKGROUND
  Findings of studies addressing outcomes of war-related famine in non-Jewish populations in Europe during the Second World War (WWII) confirmed an association between prenatal/early life exposure to hunger and adult obesity, diabetes, hypertension, cardiovascular disease and the metabolic syndrome. Fetal programming was suggested as the explanatory mechanism.
  
  
  OBJECTIVE
  To study the association between being born during WWII in Europe and physical long-term outcomes in child Holocaust survivors.
  
  
  METHODS
  We conducted a cross-sectional study on all Jewish Clalit Health Services (CHS) North District members born in 1940-1945 in Europe ('exposed', n = 653) or in Israel to Europe-born parents ('non-exposed', n = 433). Data on sociodemographic variables, medical diagnoses, medication procurement, laboratory tests and health services utilization were derived from the CHS computerized database and compared between the groups.
  
  
  RESULTS
  The exposed were significantly more likely than the non-exposed to present with dyslipidemia (81% vs. 72%, respectively), hypertension (67% vs. 53%), diabetes mellitus (41% vs. 28%), vascular disease (18% vs. 9%) and the metabolic syndrome (17% vs. 9%). The exposed also made lower use of health services but used anti-depressive agents more often compared to the non-exposed. In multivariate analyses, being born during WWII remained an independent risk marker for hypertension (OR = 1.52), diabetes mellitus (OR = 1.60), vascular disease (OR = 1.99) and the metabolic syndrome (OR = 2.14).
  
  
  CONCLUSIONS
  The results of this cross-sectional study based on highly validated data identify a high risk group for chronic morbidity. A question regarding potential trans-generational effects that may impact the 'second generation' is also raised.
authors.forename: Lital
authors.initials: L
authors.lastname: Keinan-Boker
authors.forename: Hadas
authors.initials: H
authors.lastname: Shasha-Lavsky
authors.forename: Sofia
authors.initials: S
authors.lastname: Eilat-Zanani
authors.forename: Adi
authors.initials: A
authors.lastname: Edri-Shur
authors.forename: Shaul M
authors.initials: SM
authors.lastname: Shasha
mesh_terms: D000368:Aged; D000928:Antidepressive Agents / Q000627:therapeutic use; D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus / Q000453:epidemiology; D005260:Female; D054624:Health Status Disparities; D017767:Holocaust; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D007557:Israel / Q000453:epidemiology; D007585:Jews / Q000706:statistics & numerical data*; D008297:Male; D024821:Metabolic Syndrome / Q000453:epidemiology; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects / Q000453:epidemiology*; D012307:Risk Factors; D017741:Survivors / Q000706:statistics & numerical data; D047789:World War II
chemical_list: D000928:Antidepressive Agents