Summary and Conclusions


This meeting was the first international workshop to be organized on the long term consequences of famine in human populations. The meeting included 35 participants from China, Finland, Germany, the Netherlands Russia, Sweden, the Ukraine, and the United States. The workshop was attended by investigators from a wide range of scientific disciplines and was convened by Dr L.H.Lumey, Columbia University, New York, to enable researchers to share their expertise and identify priorities for further research. Other aims of the meeting were to raise awareness of ongoing studies in the field, foster collaborations between studies, and to start a network to develop innovative approaches in this area. It is expected that follow-up studies of human famines can increasingly be used to address fundamental questions of normal human development and be applicable to public health policy.


The famine studies presented at the meeting can be identified by three important characteristics: the nature of the exposure, the timing and duration of exposure in relation to critical periods during development, and specific outcomes studied. Study commonalities and contrasts were examined with respect to these characteristics. The nature of the exposure is generally based on historical records of the duration and the location of specific events and their severity or sometimes established by self-report. Pre and post-famine conditions can sometimes be taken into account. The timing is defined by an individualís age during exposure, ranging from the period of conception and pregnancy to early childhood, adolescence, and young adulthood. Specific outcomes under investigation include size at birth, morbidity (cardiovascular risk, diabetes, cancer, schizophrenia and other mental illness), biopsychosocial risk factors (anthropometry, cardio-metabolic risk profile, cognition, fertility, quality of life, socio-economic status) and mortality, from all causes or from specific diseases. The relation of famine exposure of parents and grandparents to mortality in successive generations has been examined in some studies. Recent work has identified epigenetic and dermatoglyphic markers of exposures around conception and in the early pregnancy period.


After the meeting, participants plan to further collaborate as a network. They will prepare for publication a comprehensive overview of current studies, classified by the nature of exposures, the timing in relation to critical periods, and studied health outcomes.This will be useful to synthesize currently available study findings and for a summary evaluation as to which associations between famine exposures at specific development periods and later health show a consistent pattern. The overview will provide needed guidance for further research into biological pathways. Once critical periods have been established, additional studies may help guide interventions for current and future famine relief work.


Further work will be needed to establish the relevance of findings fromacute famine studies for populations exposed to recurrent famine or to chronic suboptimal nutrition. Severe nutritional deprivation and famine is still present worldwide and is likely to continue in conditions of political unrest and economic turmoil. Studies of acute famine may be highly relevant however to learn about the consequences of less extreme variations in nutrition as may occur in developed nations among certain segments of the population. It is necessary to thoroughly explore these additional questions using available study cohorts, and to develop new techniques and collect additional data where needed and possible.


Summaries of studies presented at the workshop with key references and of the meeting presentations are available online. Further information can be obtained from the coordinator (


It is a pleasure to acknowledge the generous support from the Lorentz Center for this workshop and the thoughtful assistance provided at all stages by the Center staff. The meeting was organized while Dr Lumey was a 2008-2009 Lorentz Fellow at the Netherlands Institute for Advanced Study in the Social Sciences and Humanities in Wassenaar (NIAS).