The Association of Early-life exposure to the Chinese Famine and healthy lifestyle behavior for elderly hypertensive patients in China

Abstract Objective: Early life exposure plays a key role in a person's life. However, little is known about whether such effects will influence healthy lifestyle behaviors(HLBs) in later life. The study aimed to investigate the impact of early-life famine exposure on HLBs in elderly hypertensive patients. Methods: This study included 18284 elderly hypertensive patients who were surveyed from 11 July to 31 August 2023, in Jia County, Henan Province. Famine exposure subgroups were categorized by birth year: infancy and toddler (1956-1958), preschool (1953-1955), school-aged (1947-1952), adolescent (1942-1946), and adult (before 1942). The outcome was six HLBs, including no smoking, no alcohol consumption, physical activity, sleep duration, body mass index (BMI), and waist circumference (WC). Logistic regression evaluated the associations of each outcome with early-life exposure. Further analyses were stratified by gender and sensitivity analysis was verified. Results: The average age of the study population was 73.4 years, and 57.7% were predominantly women. After adjustment for potential confounding, compared with adult exposure groups, infancy and toddler exposed showed a decreased risk of no smoking, no alcohol consumption, healthy BMI, healthy WC, and an increased OR for healthy physical activity and sleep duration (all P<0.05). Preschooler-exposure has the same results as infants and toddlers exposed (P<0.05). Only the school-aged child exposed group and the adolescent exposed group had no statistical significance between sleep duration. Conclusions: Early-life exposure to famine was associated with HLBs, such as smoking, alcohol consumption, BMI, WC, physical activity and sleep duration in hypertensive patients. These associations are stronger among participants who have experienced infancy exposure. Our findings would provide useful knowledge for other countries suffering from famine as a result of natural disasters, helping public health workers to target interventions.