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. 2021 Mar 4;11(3):e042078. doi: 10.1136/bmjopen-2020-042078

Table 2.

Dutch famine birth cohort study waves, including the mean ages of the participants at examination, the outcome measures and a description of attrition rates

Phase Measurement Lost to follow-up
Wave I
1994–1996		 Wave 1a birth data collection/exposure definition/mortality status.  
Wave I
(age 50)
1994–1996		 Wave Ib (home interview)

  • Questionnaires (General information, medical information, life style factors, physical activity, weight history, reproductive history, EPIC Food frequency questionnaire, self-perceived health and medication use).41 68

  • Anthropometrics.45

  • Blood pressure.42 69


Wave Ic (hospital visit)

  • Blood pressure.42 69

  • Glucose tolerance test.31

  • ECG.33

  • Lung function.39

  • Urine collection.38

  • Lipid profile and clotting factors.35 37

 912 (90%) of the 1018 selected participants were interviewed at their homes (Wave Ib), 741 (81%) agreed to visit the AMC clinic (Wave Ic). There were no differences in the mean birth weight of the 741 who attended the clinic and the 2414 children in the original cohort.
Wave II
(Age 58)
2002–2004		 Wave IIa (hospital visit)

  • Questionnaires (General information, medical information, lifestyle factors, physical activity, weight history reproductive history, transgenerational effects, self-perceived health and medication use).40 46 51 53 70–73

  • Glucose tolerance test.36 74

  • Anthropometrics.

  • Blood pressure.

  • ECG.34

  • Urine collection.38

  • Cognitive function.44

  • Ultrasound examinations of the arterial walls of the carotid and femoral arteries.75 76

  • Physical function.77

  • Psychological Stress tests.43 78 79

  • Genomic DNA from blood plasma.80–84


Wave IIb (hospital visit)

  • Intravenous glucose tolerance test in a subsample (n=94).85


Wave IIc (hospital visit)

  • Synacthen test in a subsample (n=98).86

 860 (60%) of 1423 eligible candidates agreed to participate. There were no differences in mean birth weight between responders and non-responders.
Wave III
(age 63)
2008–2009

  • Questionnaires (General information, medical information, lifestyle factors, physical activity, weight history reproductive history, transgenerational effects, self-perceived health and medication use).87–89

  • Transgenerational effects based on F2 questionnaire (General information, birth characteristics, self-perceived health, exercise, medical information, lifestyle factors).54

  • F0-F1-F2 (grandmother-parent-child) buccal swab for DNA methylation.

 601 (44%) of 1372 eligible candidates agreed to participate. 483 F2s (grandchildren) were willing to participate, of which 360 (74.5%) completed the questionnaire. Birth weight or gestational age did not differ between F1 participants and F1 non-participants.
Wave IV
(age 68)
2012–2013

  • Questionnaires (General information, medical information, lifestyle factors, physical activity, weight history reproductive history, transgenerational effects, self-perceived health and medication use).

  • Anthropometrics.

  • Blood pressure.

  • Glucose concentration (non-fasting).

  • Lipid profile (non-fasting).

  • Cognitive function.

  • Brain imaging (MRI) (white matter hyper intensities, cerebral micro bleeds, total cortical, hippocampal and lacunar volume, brain perfusion, resting brain state conditions, Brain age, brain perfusion).48–50

  • Ageing parameters (Stroke incidence, fractures and osteoporosis, physical performance, visual acuity, cataract, hearing).52

  • Cellular ageing (telomere length).90

 Equal samples were drawn randomly from each of the groups (1307 eligible candidates in total) until the number of 50 people per exposure group (born before famine, exposed in early gestation, conceived after famine) agreeing to participate was reached. A total number of 151 participants of an eligible group of 268 cohort members (56%) were visited at home. There was a difference in birth weight between the participants (n=150) and the nonparticipants (n=1157) of the eligible group (n=1307), 3438 vs 3346 g; p=0.03.
Wave V
(age 73)
2018–2019

  • Questionnaires (including self-perceived health, daily life functioning, pain complaints, mood, memory, attention, and cognition, diseases, tasks and activities in daily life, social activities, quality of life, medical care consumption, stressful events, health problems resulting from stressful events, and childhood experiences).

 595 (49%) of 1207 eligible candidates agreed to participate. Data analyses are currently ongoing.
Wave VI
(age 74)
2019–2020

  • Questionnaires (General information, medical information, lifestyle factors, physical activity, weight history reproductive history, transgenerational effects, self-perceived health and medication use).

  • Anthropometrics.

  • Glucose (non-fasting).

  • Lipid profile (non-fasting).

  • Blood pressure.

  • Cognitive function.

  • Brain Imaging (MRI) (white matter hyper intensities, cerebral micro bleeds, structural total and area brain volumes, brain perfusion, BrainAge, resting brain state conditions, active brain state conditions during Stroop selective attention task).

 Cohort members who underwent MRI scanning in Wave IV were re-invited for this study. A total of 92 participants were seen in this study. Data analyses are currently being set up.

AMC, Academic Medical Centre; EPIC, European Prospective Investigation into Cancer and Nutrition.