Early Childhood Malnutrition and Adult Obesity: Evidence from the 1959-61 China Famine

Developing countries today face the paradoxical dual burden of malnutrition and obesity. It has been hypothesized that early childhood malnutrition leads to a higher risk of adult obesity, though evidence is mixed. I study the health outcomes and health behaviors of adult men and women who were born during the 1959-61 China Famine. I find that women who as infants were exposed to famine have on average a higher body mass index (BMI) of 0.84 kg/m (3.7% higher) and are more likely to be obese (5 percentage points more) than women who were not exposed to famine. The effect of early childhood famine exposure increases along the BMI distribution. I do not find significant effects on obesity for men. I also find no evidence that the increase in BMI is differentially greater for the famine cohorts who are exposed to a food-rich environment in adult life than for the famine cohorts who are not. Using detailed individual-level data on food intake and physical activities, I show that the increase in BMI for famine-exposed women is not due to higher caloric or fat intakes nor to more sedentary lifestyles. A biological rather than a behavioral mechanism appears to underlie the association between early childhood malnutrition and adult obesity. JEL Codes: I10, I12, J13, J16, O12, O53