Fasting during Ramadan and subsequent long term impact on health of children: Comparing the Foetal Origin and Predictive Adaptive Response Hypotheses

Husain, Zakir and Mukherjee, Diganta and Dutta, Mousumi and Mukhopadhyay, Susmita (2016): Fasting during Ramadan and subsequent long term impact on health of children: Comparing the Foetal Origin and Predictive Adaptive Response Hypotheses.

Abstract

The Foetal Origin Hypothesis (FOH) states that exposure to nutrition deficiency at the foetal stage results in poor anthropometric growth and a pre-disposition to have cardiac diseases, nephrological problems and diabetes at early middle age. While this hypothesis made us aware of the possibilities that health can be pre-programmed during the foetal stage, methodological problems implied that the hypothesis could not be accepted with certainty. This study is based on a primary survey of Muslim women and their children, and examines the impact of nutritional shock to the foetus in teh form of Ramadan fasting. The survey was undertaken in Basanti block, in South 24 Parganas. Lying in the Sunderban areas, this block is a chronically under-deprived area where nutrition deficiency is a common feature of life. The programming received through exposure to nutrition deficiency at the foetal stage, therefore, prepares the organism for its later life environment through its plasticity. This is called Predictive Adaptive Response (PAR). The primary survey, undertaken in 2013-2014, covered Muslim youth aged 18-22 years. The impact of foetal starvation was measured through anthropometric measurements. In all 27 indicators were studied. Simultaneously, the mothers of the respondents were surveyed. We collected information about education levels of the parents, the past occupation and standard of living, current occupation and standard of living, and information regarding the conceptions. After ascertaining using old Muslim calendars whether the foetal stage coincided with Ramadan, we also clarified whether the mother had fasted during Ramadan. This enabled us to successfully distinguish between the study and control group. Analysis of the data using multivariate regressions showed that the difference in measurements for most indicators was not statistically significant. In those cases, where the difference was found to be significant, it was those exposed to Ramadan fasting at the foetal stage who were found to be “fitter”. This is taken as preliminary evidence in support of PAR. Further testing provides evidence in support of Predictive Adaptive Response.

• Item Type: MPRA Paper
• Language: English
• Keywords: Foetal Origin Hypothesis, Predictive Adaptive Response, Genetic programming, Anthropometric development, Nutrition, India
• Subjects: I - Health, Education, and Welfare > I3 - Welfare, Well-Being, and Poverty > I31 - General Welfare, Well-Being; Z - Other Special Topics > Z1 - Cultural Economics ; Economic Sociology ; Economic Anthropology > Z13 - Economic Sociology ; Economic Anthropology ; Social and Economic Stratification

References

Adair, L.S. and A.M. Prentice (2004) “A critical evaluation of the foetal origins hypothesis and its implications for developing countries”. The Journal of Nutrition, 134: 191-193.

Almond, D. (2006) “Is the 1918 Influenza Pandemic Over? Long-Term Effects of in utero Influenza Exposure in the Post-1940 U.S. Population.” Journal of Political Economy, 114(4): 672–712.

Almond, D. and J. Currie (2011a) “Human Capital Development Before Age 5.” In O. Ashenfelter and D. Card (eds.) Handbook of Labor Economics, Vol. 4b, Elsevier V.B.: North Holland, pp. 1315–1486.

Almond, D. and J. Currie (2011b) “Killing me softly: The foetal origins hypothesis”. The Journal of Economic Perspectives, 25(3): 153-172.

Almond, D. and B. Mazumder (2011) “Health capital and the prenatal environment: The effect of Ramadan observance during pregnancy”. American Economic Journal: Applied Economics, 3: 56-85.

Alwasel, S.H., Z. Abotalib, J.S. Aljarallah, C. Osmond, S.M. Alkharaz, I.M. Alhazza, G. Badr, D.J.P. Barker (2010) “Changes in placental size during Ramadan”. Placenta, 31(7), 607–610.

Arab, M. (2004) “Ketonuria and serum glucose of fasting pregnant women at the end of a day in Ramadan”. Acta Medica Iranica, 42(3): 209–212.

Arab, M. and S. Nasrollahi (2001) “Interrelation of Ramadan fasting and birth weight”. Medical Journal of Islamic Academy of Sciences, 14(3): 91–95.

Banerjee, A., E. Duo, G. Postel-Vinay and T. Watts (2010) “Long-run health impacts of income shocks: Wine and phylloxera in nineteenth-century France”. Review of Economics and Statistics, 92(4): 714-728.

Barker D.J.P. and C. Osmond (1986) “Infant mortality, childhood nutrition and ischaemic heart disease in England and Wales”. Lancet, 1(84889): 1077-81.

Barker, D.J.P. (1990) “The foetal and infant origins of adult disease: The womb may be more important than the home”. British Medical Journal, 301, 17 November: 1111-1111.

Barker, D.J.P. (1997) “Foetal nutrition and cardiovascular disease in later life”. British Medical Bulletin, 53(1): 96–108.

Barker, D.J.P., (2002) “Foetal programming of coronary heart disease”. Trends in Endocrinology & Metabolism, 13 (9): 364–368.

Bateson, P. and P. Gluckman (2011) Plasticity, Robustness, Development and Evolution. Cambridge: Cambridge University Press.

Bharati, P. and A. Basu (1990) “Fertility, mortality and maternal anemic status in a village population of West Bengal, India”. Annals of Human Biology, 17(4): 331-335.

Cunha, Flavio and J.J. Heckman (2008) “Formulating, Identifying and Estimating the Technology of Cognitive and Noncognitive Skill Formation.” Journal of Human Resources, 43(4):738–82.

Cunha, F., J.J. Heckman and S.M. Schennach (2010) “Estimating the Technology of Cognitive and Noncognitive Skill Formation.” Econometrica, 78(3): 883–931.

De Onis, M., M. Blossner and J. Villar (1998) “Levels and patterns of intrauterine growth retardation in developing countries”. European Jounal of Clinical Nutrition, 52 (Supplement 1): S5-S15.

Ewjik, R. van (2011) “Long term effects on the enxt generation of Ramadan fasting during pregnancy”. Journal of Health Economics, 30: 1246-1260.

Gluckman, P. and M. Hanson (2005) The Foetal Matrix: Evolution, Development and Disease. Cambridge: Cambridge University Press.

Godfrey, K.M. and Barker, D.J.P. (2000) “Foetal nutrition and adult disease”. The American Journal of Clinical Nutrition, 71(Suppl.): 1344S–1352S.

Grossman, M. (1972) “On the Concept of Health Capital and the Demand for Health.” Journal of Political Economy, 80(2): 223–55.

Harding, J.E. (2001) “The nutritional basis of the foetal origins of adult disease”. International Journal of Epidemiology, 30: 15–23.

Heckman, J.J. (2007) “The Economics, Technology, and Neuroscience of Human Capability Formation.” PNAS: Proceedings of the National Academy of Sciences, 104(33): 13250–55.

Hermann, T.S., A.M. Siega-Riz, C.J. Hobel, C. Aurora and C. Dunkel-Schetter (2001) “Prolonged periods without food intake during pregnancy increase risk for elevated maternal corticotropin-releasing hormone concentrations”. American Journal of Obstetrics and Gynecology, 185(2): 403–412.

Hobel, C.J. and J. Culhane (2003) “Role of psychosocial and nutritional stress on poor pregnancy outcome”. The Journal of Nutrition, 133 (Supplement: Nutrition as a Preventive Strategy against Adverse Pregnancy Outcomes): 1709S–1717S.

Hornstra, G. and R. Uauy (2005) The impact of maternal nutrition on the offspring. Basel: Karger Publishers. Horton, S. (1999) “Opportunities for Investments in Nutrition in Low-income Asia, Asian Development Review”. 17(1, 2): 246-273.

International Institute for Population Sciences (IIPS) and Macro International (2007) National FamilyHealth Survey (NFHS-3), 2005–06: India: Volume I. Mumbai: IIPS.

Joosoph, J., J. Abu and S.L. Yu (2004) “A survey of fasting during pregnancy”. Singapore Medical Journal, 45(12): 583–586.

Kelley, E. (2011) “The Scourge of Asian Flu: In utero Exposure to Pandemic Influenza and the Development of a Cohort of British Children”. Journal of Human Resources, 46(4): 669–694.

Landro, L. (2010) “Healthy living, for two”. The Wall Street Journal, September 9.

Lucas, A., M.S. Fewtrell and T.J. Cole (1999) “Foetal origins of adult disease – the hypothesis revisited”. British Medical Journal, 319: 245-249.

Lenz, W. Von and K. Knapp (1962). “Die thalidomid-embryopathie. Deutsche Medi-zinishe Wochenschrift”. 87(24): 1232-1242.

Lin, Ming-Jen (2011) “Does “in Utero” Exposure to Illness Matter? The 1918 Influenza Epidemic in Taiwan as a Natural Experiment?” SSRN Working Paper. Accessed at http://homepage.ntu.edu.tw/~mjlin/influenza%201918_Jan2011.pdf.

Malhotra, A., P.H. Scott, J. Scott, H. Gee and B.A. Wharton (1989) “Metabolic changes in Asian Muslim pregnant mothers observing the Ramadan fast in Britain”. British Journal of Nutrition, 61: 663–672.

Mcbride, W.G. (1961) “Thalidomide and congenital abnormalities”. The Lancet, 278(7216): 1358-1358.

Mirghani, H.M., S.D. Weerasinghe, J.R. Smith and M. Ezimokhai (2004) “The effect of intermittent maternal fasting on human foetal breathing movements”. Journal of Obstetrics and Gynaecology, 24(6): 635–637.

Mirghani, H.M., S.D. Weerasinghe, S. Al-Awar, L. Abdulla and M.Ezimokhai (2005) “The effect of intermittent maternal fasting on computerized foetal heart tracing”. Journal of Perinatology, 25, 90–92.

Moore, S.E., I. Halsall, D. Howarth, E.M. Poskitt and A.M. Prentice (2001) “Glucose, insulin and lipid metablosim in rural Gambians exposed to early nutrition”, Diabetics Medicine, 18: 646-653.

Nandi Foundation (2011) HUNGaMA: Fighting Hunger and Malnutrition. Hyderabad: Nandi Foundation.

Neelsen, S. and T. Stratmann (2011) “Long-Run Effects of Prenatal Influenza-Exposure: Evidence from Switzerland”. SSRN Working Paper. Available at: http://ssrn.com/abstract=1856310.

Nelson, R.E. (2010) “Testing the Foetal Origins Hypothesis in a Developing Country: Evidence from the 1918 Influenza Pandemic.” Health Economics, 19(10): 1181–92.

Paneth, N. and M. Susser (1995) “Early Origins of Coronary Heart Disease: The Barker Hypothesis.” British Medical Journal , 310(2): 411–12.

Prentice, A.M., A. Prentice, W.H. Lamb, P.G. Lunn and S. Austin (1983) “Metabolic consequences of fasting during Ramadan in pregnant and lactating women”. Human Nutrition (Clinical Nutrition 37C): 283–294.

Roseboom, T.J., J.H.P. van der Meulen, C. Osmond, D.J.P. Barker, A.C.J. Ravelli, J.M. Schroeder-Tanka, G.A. van Montfrans, R.P.J., Michels and O.P. Bleker (2000) “Coronary heart disease after prenatal exposure to the Dutch famine, 1944–45”. Heart, 84: 595–598.

Schulz, L.C. (2010) “The Dutch Hunger Winter and the Developmental Origins of Health and Disease”. PNAS: Proceedings of the National Academy of Sciences, 107(39): 16757–58.

Seckl, J.R. and M.C. Holmes (2007) “Mechanisms of disease: glucocorticoids, their placental metabolism and foetal ‘programming’ of adult pathophysiology”. Nature Clinical Practice. Endocrinology & Metabolism, 3: 479–488.

Sen, A.K. and J. Dreze (2011) “Putting growth in its place”, Outlook 14 November: 50-59.

St. Clair, D. M. Xu, P. Wang, Y. Yu, Y. Fang, F. Zhang, X. Zheng, N. Gu, G. Feng, P. Sham, and L. He (2005) “Rates of adult schizophrenia following prenatal exposure to the Chinese famines of 1959-1961”. Journal of the American Medical Association, 294(5): 557-562.

Stein, Z., M. Susser, G. Saenger and Francis Marolla (1975) Famine and Human Development: The Dutch Hunger Winter of 1944–1945. New York: Oxford University Press.

Wells, J.C.K. (2012) A critical appraisal of the predictive adaptive response hypothesis. International Journal of Epidemiology, 41: 229-235.

World Health Organization/Food and Agricultural Organization (2003) Diet, nutrition and prevention of chronic diseases. WHO Technical Report Series 916, Geneva, Switzerland: World Health Organization.