The effects of prenatal exposure to the dutch famine 1944-1945 on health across the lifecourse

Poor nutrition during critical periods of early human development has lasting negative consequences for growth, development, and health. This chapter summarizes the evidence from studies investigating the effects of prenatal exposure to the Dutch famine on later mental and physical health. The Dutch famine was remarkable in several ways, and its unique features have contributed to the fact that it has most often been used in studies examining the long-term consequences of prenatal undernutrition. The Dutch famine was an acute period of undernutrition that was clearly circumscribed in time and place; it had an abrupt beginning and end and struck a population that was previously and subsequently well nourished. Also, the administration was well organized and records were kept allowing researchers to investigate the consequences of starvation in the decades that followed. All these characteristics make the Dutch famine uniquely suited for such studies, and allow researchers to take a quasi-experimental design to address a question that would otherwise be impossible to answer in a human setting. The effects of famine depended on its timing during gestation and the organs and tissues undergoing critical periods of development at that time. Early gestation appeared to be the most vulnerable period which may not be surprising considering the fact that all organs are laid down within 12 weeks after fertilization. The effects of famine were widespread and affected structure and function of organs and tissues, resulted in altered behavior and increased disease risks, which in turn led to reduced participation in the labor market and increased mortality. The effects of famine were apparent in the absence of any effects on size at birth. Some effects of prenatal undernutrition were more pronounced or even limited to one sex, but generally the effects applied to both men and women. There is preliminary evidence to suggest that the effects of famine may not to be limited to those affected prenatally, but were passed on to the next generation, both through the maternal and paternal line. Studies in other settings show similar effects and suggest that the findings are not uniquely linked to the characteristics and setting of the Dutch famine, but reflect biologically fundamental processes that describe human plasticity. We expect that adequately feeding women before and during pregnancy will allow future generations to reach their full potential and lead healthier and more productive lives, ultimately leading to healthier and more equal future.