Although the short-term effects of famines on health have been well documented, the long-term effects have been more difficult to study owing to the decades that typically elapse between famine exposure and the development of disease. Previous studies have used famines in the Netherlands (1), Austria (2), China (3), and Nigeria (4) as natural experiments and linked malnutrition during pregnancy with increased risk of developing diabetes later in life. On page 667 of this issue, Lumey et al. (5) add to this evidence and report a dose-response relationship between severity of prenatal exposure to the Ukraine famine of 1932–1933 and increased risk of adult type 2 diabetes. One possible explanation for this finding is fetal programming (6), which posits that fetal exposure to poor nutrition triggers metabolic changes that prepare the body for a nutritionally poor environment. This then increases the risk for metabolic disorders in a more nutritious environment. […]

P. Klimek, S. Thurner, The lasting effects of famine, Science 385(6709) (2024), 606-607.