Cohort Profile: The Dutch Hunger Winter Families Study
Abstract
The winter of 1944–45 is known as the ‘Hunger Winter’ in The Netherlands, which was occupied by the Germans in May 1940. Beginning in September 1944, Allied troops had liberated most of the South of the country, but their advance towards the North came to a stop at the Waal and Rhine rivers and the battle of Arnhem. In support of the Allied war effort, the Dutch government in exile in London called for a national railway strike to hinder German military initiatives. In retaliation, in October 1944, the German authorities blocked all food supplies to the occupied West of the country. Despite the war, nutrition in The Netherlands had generally been adequate up to October 1944.1 Thereafter, food supplies became increasingly scarce. By November 26, 1944, official rations, which eventually consisted of little more than bread and potatoes, had fallen below 1000 kcal per day, and by April 1945, they were as low as 500 kcal per day. Widespread starvation was seen especially in the cities of the western Netherlands.1–5 Food supplies were restored immediately after liberation on May 5, 1945. On the basis of these historical data it is possible to accurately define the beginning and the end of the famine period. The famine affected fertility, weight gain during pregnancy, maternal blood pressure, infant size at birth and central nervous system development.6–11 The reduction in fertility was greater among manual workers than among those in other occupations.2 A decline in mean birth weight of 300 g was seen among those exposed to maternal undernutrition during the third trimester.2,,6,7,9,12 After liberation and the restoration of food supplies, birth weights and other measures of infant size rapidly rebounded to pre-famine levels.12 Because the Dutch population was typically well fed before and after the Hunger Winter, the circumstances of the famine created what can be regarded as a ‘natural experiment’ in which exposure to famine is assigned based on an individual's time and place of birth. This design was used to examine how maternal undernutrition during specific gestational time windows may affect the subsequent life course of offspring who experienced the famine in-utero.
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The increased incidence of cardiovascular and metabolic disease observed in F1 adults is not due to the transmission of epigenetic information through the maternal germline, but a direct consequence of the exposure in utero.
“The increased incidence of cardiovascular and metabolic disease observed in F1 adults17 is not due to the transmission of epigenetic information through the maternal germline, but a direct consequence of the exposure in utero, a phenomenon called “fetal programming” or—if fetal germ cells and F2 offspring are affected—“intergenerational inheritance”.”
From A critical view on transgenerational epigenetic inheritance in humans (2018) · cites this paper as [17]
The maternal environment can have long-lasting effects on our health.
“The maternal environment can have long-lasting effects on our health.”
From A critical view on transgenerational epigenetic inheritance in humans (2018) · cites this paper as [17]
In the Dutch hunger winter, severe undernourishment affected pregnant women, their unborn offspring and the offspring's fetal germ cells.
“In the Dutch hunger winter, for example, severe undernourishment affected pregnant women, their unborn offspring and the offspring’s fetal germ cells.”
From A critical view on transgenerational epigenetic inheritance in humans (2018) · cites this paper as [17]
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- Authors
- Lumey, L., Stein, A. D., Kahn, H. S., van der Pal-de Bruin, K. M., Blauw, G., Zybert, P. A., & Susser, E. S.
- Affiliations
- Columbia University (US)
- Emory University (US)
- Centers for Disease Control and Prevention (US)
- Leiden University Medical Center (NL)
- New York State Psychiatric Institute (US)
- Corresponding author
- Lumey, L.
- Venue
- International Journal of Epidemiology
- Publisher
- Oxford University Press (OUP)
- Published
- 2007-06-25
- Volume
- 36
- Issue
- 6
- Pages
- 1196-1204
- ISSN
- 0300-5771 (ISSN-L)
- 1464-3685
- OpenAlex
- W2110752103
- Cited by
- 385
- References
- 55
- Citations by year
- 2026: 10 · 2025: 15 · 2024: 21 · 2023: 12 · 2022: 15 · 2021: 30 · 2020: 31 · 2019: 34 · 2018: 23 · 2017: 19 · 2016: 22 · 2015: 29 · 2014: 27 · 2013: 23 · 2012: 19
- FWCI
- 13.73
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- International Journal of Epidemiology (publishedVersion)
- PubMed (publishedVersion)
- TNO Repository (submittedVersion)
- Repository hosted by TU Delft Library (TU Delft) (submittedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- Funders
- Wake Forest University
- University of Bristol
- Universiteit Leiden
- Leids Universitair Medisch Centrum
- Syddansk Universitet
- National Institutes of Health
- National Heart, Lung, and Blood Institute (R01HL067914)
- Topics
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Birth, Development, and Health
- Health Sciences › Health Professions › General Health Professions › Maternal and Neonatal Healthcare
- Health Sciences › Nursing › Nutrition and Dietetics › Child Nutrition and Water Access
- Keywords
- Dutch Hunger Winter, famine, maternal undernutrition, prenatal exposure, birth weight, offspring development, life course epidemiology, natural experiment
- MeSH terms
- Female, Follow-Up Studies, Humans, Infant, Newborn, Male, Netherlands, Pregnancy, Prenatal Exposure Delayed Effects, Starvation, Warfare, Case-Control Studies, Maternal Nutritional Physiological Phenomena, World War II
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