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Barker and nowadays can be




epigenetic phenomenon (9). The

essentials of the hypothesis

state that undernutrition of the

mother effects fetal growth and

might result in chronic diseases

such as coronary heart disease

in adulthood of the offspring. In

the original publication Barker

presented a table summarising





‘disproportional fetal growth’

(reproduced below in Table 1).

The hypothesis is based on the







Sweden and the United States.

The results of the




development of children into adults whose mothers were exposed

to severe starvation during the ‘Dutch Hunger Winter’ are another

well known example along with Barker’s hypothesis. In September

1944 the Second World War was in its final phase. The allied forces had landed at Normandy in

France and had also already liberated part of Western Netherlands from the occupying German

forces. At the end of the Second World War the exiled Dutch government suggested a railway

strike within the still occupied parts of the Netherlands in order to make it difficult for the

German army to transport much needed war equipment to the front. The strike was initiated, and

the Germans retaliated with a blockade of the still occupied parts of the Netherlands, cutting off

food supply to the more urbanized areas still under German rule. The blockade was given up in

November 1944, but at that time it already was too late to bring food into the urban west from

the rural east of the country due to the onset of a very harsh winter, frozen waterways (which in

fact had been allowed to be used again by the German army) and a largely destroyed

infrastructure (10). Before early 1945 about 18.000 people had died mainly because of

starvation, and this only ended with the liberation of the Netherlands in May 1945.

Research in the aftereffects of the Dutch Hunger Winter

A great deal of research has been done to investigate the effects on the children of women

who were pregnant during the Dutch Hunger Winter. One study involved a cohort of about 2400

singletons aged 50 years old and born around the time of the starvation in 1944 to 1945. The

results from those born during the exact time of the famine were compared with those from

individuals born before and after the famine. The unexposed had been born from 1 November,

1943, up to 6 January, 1945, and from 9 December, 1945, up to 28 February, 1947. The exposed

were therefore born between 7


April, 1944, and 8 December, 1945. Compared with those not

exposed, the exposed people were found to have more coronary heart disease, raised lipids

Table 1 Summary of Barker’s

hypothesis (9)