8 Also identified were changes in reproductive functions, early menopause,

and increased incidence of breast and colon malignancy.9–11 The famine in five Channel Islands off Normandy, involving 60,000 islanders: In 1940 these islands were demilitarized by the British government, with a fifth of the population being evacuated (children, Inhibitors,research,lifescience,medical women, and Jews). A five-year-long German repression followed. The co-operation of locals with the occupiers was recorded, as was the betrayal of a few hiding Jews. The invasion of Normandy in 1944 by-passed the islands. The food supply from the continent was cut, and by the end of 1944/early 1945 it became critical. The health consequences were studied only in those born before the war.12 Infants exposed to sub-nutrition in 1944–45 were found with increased cardiovascular morbidity, delays in puberty, and an increase in breast cancer (although statistically non-significant). This Inhibitors,research,lifescience,medical population was compared with the cohort evacuated to England.13 The mechanism of “in utero programming” of adult illnesses was proposed by Lucas in 1990. It reads as follows: “an early stimulus or insult, operating at a critical or sensitive period results

in permanent or long term changes in the structure or function of the organism.”4 This theory was researched in different geographical Inhibitors,research,lifescience,medical and environmental conditions and was also confirmed experimentally.7,14–16 Lucas applied his concept of pre- and postnatal nutritional influence to the development of bone mineralization.17 Inhibitors,research,lifescience,medical It was presented as “programming” future osteopenia, and the risk of fractures was more definitively established in the twenty-first century.18,19 In the presence of sub-nutrition, the mechanism of rapid growth in the second gestational term requires adaptation, namely a slowed down osteoblastic division. It was established that the earlier in life the malnutrition

occurred, the greater the likelihood of permanent effects on bone selleck demineralization. This concept was further promoted by describing the relationship Inhibitors,research,lifescience,medical between maternal diet, birth weight, and vitamin D receptor genotype alteration, all as a programmer of osteopenia. The predictive value of growth hormone on bone density in elderly women was also established.20–22 A recent study in Australia, MTMR9 the third largest country with Holocaust survivors, attracted attention to the topic and discussed the specific needs for geriatric management.23 The authors have also reviewed metabolic details in a group of survivors in Australia.24 Example of one family of survivors with four siblings: The immediate effects of starvation on bone metabolism and fractures were established in 1941–42 in a detailed study in the Warsaw Ghetto. Fractures in children were found not to heal, making surgical treatment inexpedient.