Higher obesity rates prevail among Dutch women exposed to famine in utero

Researchers at the University of Amsterdam looked at a group of 741 men and women, now 50 years of age, who had been exposed in utero to the Dutch famine of 1944-45 which followed on the Nazi occupation. Middle-aged women especially had an increased rate of obesity, as meausured by Body Mass Index (BMI, or body weight [kg] divided by height[m]squared) and waist circumference.

Characteristic of these female subjects was an abdominal deposition of body fat associated with the so-called "metabolic syndrome": a tendency to high cholesterol levels, hypertension, diabetes and cardiovascular disease. Women whose mothers were exposed to the famine early in their pregnancies were especially prone to later obesity, and the investigators conclude that this difference cannot be accounted for by increases in food intake or other lifestyle factors such as socioeconomic status, smoking or alcohol. Increased obesity may result, rather, from altered metabolic regulation of accumulated body fat later in life.

Exposure to famine, especially for the unborn, depends very much on its timing, with early gestation being a particularly vulnerable period. According to the authors, "the Dutch famine was a unique nutritional challenge. It started and ended abruptly, lasted only 5 months, and was preceded and followed by more or less adequate nutrition. The Dutch famine is therefore hardly comparable with other famine periods..." During the famine, rations varied between 400 and 880 clories per day and rose about 1000 calories after the May 12, 1945 liberation by Allied forces. After the Allied liberation, the Dutch famine was immediately followed by a period of comparative affluence. In this study, 50 year old women exposed to famine in early gestation were by far the most affected, whereas men showed relatively mild effects.

Ravelli, ACJ et al. Obesity at the age of 50 y in men and women exposed to famine prenatally. Am J. Clin Nutr 1999, 70: 811-16.

Corresponding Author : Jan HP van der Meulen
University of Amsterdam, The Netherlands
E-mail address: jvdm@mrc.soton.ac.uk