Prenatal exposure to famine significantly increases the risk of developing Type 2 diabetes mellitus (T2DM) in adulthood, according to a new study of people impacted by the 1932-1933 Holodomor famine in Ukraine. While the immediate and short-term effects of famines on mortality and morbidity are well-documented, deciphering famines' long-term health consequences – as this study did – has been more difficult. Previous research has suggested a link between prenatal nutrition and adult health outcomes, including metabolic disorders like diabetes. However, these studies were limited by small sample sizes and uncertainties of famine exposure. The Holodomor famine in Ukraine, which was caused by Soviet policies and resulted in the deaths of millions through extreme food scarcity, presents a unique opportunity to examine this link due to its extreme severity, well-defined time frame, large population size, and extensive documentation. Here, L. H. Lumey and colleagues studied individuals born during this period, investigating how severe nutritional deprivation in early gestation impacts health decades later. Lumey et al. conducted an ecological study using data from 128,225 type-2 diabetes mellitus (T2DM) cases diagnosed between 2000 and 2008 among more than 10 million individuals born in Ukraine between 1930 and 1938. They found that individuals born in early 1934, who were in early gestation during the peak famine period in mid-1933, had a more than two-fold increased likelihood of developing T2DM in adulthood compared to those unexposed to the famine. Notably, no T2DM increase was seen among infants exposed to famine in mid or late gestation or in the first years of life. The findings identified a critical time window for when severe prenatal malnutrition has the greatest impact on future health, highlighting the importance of early gestational nutrition. In a Perspective, Peter Klimek and Stefan Thurner discuss the study and the implications of its findings on understanding and preventing global health threats related to food scarcity.
Podcast: A segment of Science's weekly podcast with L. H. Lumey, related to this research, will be available on the Science.org podcast landing page after the embargo lifts. Reporters are free to make use of the segments for broadcast purposes and/or quote from them – with appropriate attribution (i.e., cite "Science podcast"). Please note that the file itself should not be posted to any other Web site.
