During World War 2, a unique natural experiment took place in the Netherlands. What we can learn from the Dutch Hunger Winter?

World War II. The Netherlands. A huge natural experiment took place over the winter of 1944-1945, and it changed how we view pregnancy and stress forever.

In general, we think of women as needing about 2,000 kcal per day, and men 2,500. But during the war, this amount was cut severely. Daily food rations in large cities were already a meagre 750 kcal, but things got even worse for the western cities when a blockage cut off food supplies from the farm towns. Rations were cut even more and by April 1945, each person was allocated just one loaf of bread and five potatoes for an entire week.

Around 20,000 people would die of starvation in a modern, wealthy, educated country.

And as quickly as it started, it ended. The Germans surrendered and food supplies were restored. This short, sharp famine in a country with meticulous medical records provided perfect data for scientists to delve into decades later.

It turns out that babies who were conceived during that winter were particularly affected. As adults, they become more susceptible to diabetes, obesity, high blood pressure, cardiovascular disease, depression and schizophrenia and more. They also died earlier than people born before or after the famine.

And it didn’t stop with them. In a phenomenon known as intergenerational inheritance, the babies who were girls grew up to give birth to babies smaller than average, with an increased risk of health issues when they grew up.

How this works is likely through epigenetics.

We’ve all heard of genes, but you may not know that some genes can be dialled up or down depending on their environment. Imagine it like turning the volume up or down on a TV set.

The famine turned the volume up and down on different genes in the developing babies, and those changes persisted throughout their lifetime. And in the case of the girl babies, beyond their lifetime. This is probably because girls are born with all of their eggs already in place, so the eggs themselves underwent epigenetic changes while the girl babies were still in utero.

I often think of it like this: the developing baby was starved, so it dialled up genes to hold on to any calories it could get. When the babies were then abruptly put back into an environment where food was abundant, they gained weight and held on to it.

60 years later, they were still suffering the effects of stress that occurred before they were even born.

I’m fascinated by the entire thing and what we can infer and learn from it. The critical periods of development, the incredible adaptive mechanisms the body can put into place that become maladaptive in a different environment, the sheer length of time those mechanisms are present for, the idea that you are (at least partly) what your parents, and even grandparents, ate…

And how we can apply these things to our lives today.

I often talk about the body’s adaptive response to ‘starvation’ when dieting, and how it protects itself from weight loss. The decrease in metabolism (adaptive thermogenesis) can last for years after the initial dieting period. The body is much more sophisticated that the simple “calories in, calories out” mantra implies.

But I wonder what happens to the children born of mothers who have spent decades trapped in a starve-binge diet cycle. We know they are mentally impacted by seeing their parents diet, but how are they affected physiologically?

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