Epidemiological evidence for the developmental origins of health and disease: effects of prenatal undernutrition in humans

Abstract

This paper describes the findings of studies among men and women who were born around the time of the Dutch famine of 1944–1945, investigating the effects of undernutrition during critical periods of development on later health and disease. The Dutch famine was remarkable in several ways and its unique features have allowed scientists to investigate the long-term consequences of prenatal undernutrition in humans. The effects of undernutrition 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. The effects of famine were widespread and affected the structure and function of many organs and tissues, resulted in altered behaviour and increased risks of chronic degenerative diseases, which in turn led to reduced participation in the labour market and increased mortality. Also, the effects of famine were independent of size at birth, which suggests that programming may occur without altering size at birth. Studies in other settings show that those faced with undernutrition during the critical earliest stages of development have increased rates of chronic generative disease in adult life. This suggests that these findings reflect biologically fundamental processes that describe human plasticity. These findings teach us the fundamental importance of a good start in life. 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.

La nutrición materna y la programación metabólica: el origen fetal de las enfermedades crónicas degenerativas en los adultos

“…a) La desnutrición: es una condición patológica inespecífica, sistémica y reversible en potencia debido a la deficiente utilización de los nutrimentos por el organismo y presenta diferentes grados de intensidad (Márquez-González et al, 2012). Los primeros estudios epidemiológicos en relacionar una deficiente nutrición materna y sus efectos sobre la salud en la vida adulta del hijo se realizaron en sujetos que sufrieron la hambruna holandesa de finales de la Segunda Guerra Mundial (1944 a 1945) (Roseboom, 2019). Los hombres que padecieron la hambruna en la etapa postnatal temprana presentaron una menor tasa de obesidad en la vida adulta en comparación con aquellos expuestos durante la primera mitad del embarazo.…”

Sult

“…En slik dokumentert og tidsbegrenset nedgang i kaloriinntak kombinert med et (tross alt) velfungerende helsevesen og etterfølgende normaltilstand ga grunnlaget for «The Dutch Famine Study» (7). Gjennom den har man kunnet følge personer som var i ulike stadier av fosterutviklingen under blokaden (7). Resultatene viser at underernaering i fosterlivet fører til økt risiko for en hel rekke sykdommer, spesielt overvekt, diabetes og hjertesykdommer, men antakelig også alvorlige psykiske lidelser (7).…”

“…Gjennom den har man kunnet følge personer som var i ulike stadier av fosterutviklingen under blokaden (7). Resultatene viser at underernaering i fosterlivet fører til økt risiko for en hel rekke sykdommer, spesielt overvekt, diabetes og hjertesykdommer, men antakelig også alvorlige psykiske lidelser (7). Også de aller første årene av et barns liv er kritiske.…”

Unheard, unseen and unprotected: DOHaD council’s call for action to protect the younger generation from the long-term effects of COVID-19

“…Men and women who had been prenatally exposed to the Dutch famine of 1944-45, for example, have increased rates of chronic degenerative diseases such as type 2 diabetes, obstructive airway disease, depression and cardiovascular disease. 9 They have smaller brains, poorer cognitive function, lower participation on the labour market and lower income. Similarly, men and women prenatally exposed to the 1918 flu pandemic had increased rates of cardiovascular disease and lower participation in the labour market.…”