The long-term consequences of early life exposure to tsunami and conflict on adolescents in Sri Lanka

The consequences for adolescent health due to early life exposure to natural disasters combined with war are not known. We collected data from adolescents aged 12-13 years in Sri Lanka whose mothers were pregnant during the Indian Ocean tsunami in 2004 in a tsunami-affected region (n = 22), conflict-affected region (n = 35), conflict-plus-tsunami-affected region (n = 29), or controls in areas unaffected by either (n = 24). Adjusted BMI-for-age z-scores were 1.3 (95% confidence interval [CI] 0.4, 2.2), 1.0 (95% CI 0.2, 1.9), and 2.0 (95% CI 1.1, 2.9) for conflict, tsunami, and conflict-plus-tsunami, respectively, compared with the control group. Greater skinfold thickness and higher diastolic blood pressure were found in adolescents born in the conflict zone but no differences were found in height, head circumference, and waist circumference, or blood results, with the exception of serum insulin. Being born after a natural disaster or during conflict was associated with increased adolescent BMI and body fat, which are associated with longer-term risk of noncommunicable disease.