Exposure to famine in utero can have a lifelong impact on the risk of catching infectious diseases, according to a study investigating the repercussions of a major food crisis in mid-twentieth century China.
The research into the Great Chinese Famine, which lasted from around 1958 to 1962, also showed that this vulnerability passed down through generations.
The findings demonstrate the lifelong effects of prenatal famine exposure on the body and suggest adequate prenatal nutrition could reduce the burden of infectious diseases through generations.
“Our study highlights the long-term and intergenerational impacts of large-scale societal shocks that may threaten food security on the risks of infectious diseases,” the researchers reported in the Proceedings of the National Academy of Sciences of the United States of America (PNAS).
Prenatal exposure to malnutrition is already known to have a long-term impact on the risk of noncommunicable diseases such as diabetes and hypertension, through mechanisms that include interrupted fetal programming, abnormal development of some organs, and altered metabolism.
These adverse effects could also be passed down due to persistent epigenetic changes established during early embryonic development that carry into the next generation, as well as unhealthy behaviors learned by the children of those directly exposed to severe food shortages.
The researchers investigated the effects of famine on infectious diseases during the Great Chinese Famine, which was driven by natural disasters and massive institutional and policy changes during the Great Leap Forward, and which they say is the most devastating famine in human history.
China’s annual grain production decreased from 200 to 140 million tons during this time, resulting in widespread undernutrition and around 15 to 43 million extra deaths together with a reduction in births by about 30 million between 1958 and 1961.
Qu Cheng, PhD, from Huazhong University of Science and Technology and co-workers specifically studied more than 4.4 million cases of 11 notifiable infectious diseases from 2005 to 2022 in Sichuan Province, which has relatively high levels of infectious diseases such as HIV and tuberculosis and which experienced the most severe famine of all Chinese provinces.
The team found that the risk of acquiring any of these infectious diseases was 13% higher for people born between 1958 and 1962—during the famine—than for those born beforehand or afterwards.
The risk of these infectious diseases was also eight percent higher for the potential children with parents born during the famine than for those born at other times.
The researchers pointed out that the magnitude of excess infectious disease risk was positively associated with a measure of local famine severity.
“Our study highlights the long-term and intergenerational impacts of large-scale societal shocks that may threaten food security on the risks of infectious diseases,” they further noted.
“In light of the global COVID-19 aftermath and widening global conflicts that may threaten food security and trigger famines, it is crucial for public health programs and international organizations to acknowledge these long-term consequences and develop strategies to mitigate the adverse health effects of famine that may persist for generations.”
