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

J Endocrinol. 2019 Jul 1;242(1):T135-T144. doi: 10.1530/JOE-18-0683.


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.

Keywords: diabetes; famine; nutrition; pregnancy; prenatal.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Diabetes, Gestational / epidemiology
  • Famine
  • Female
  • Humans
  • Male
  • Malnutrition / epidemiology
  • Maternal Nutritional Physiological Phenomena / physiology*
  • Pregnancy
  • Prenatal Exposure Delayed Effects