Medicosnext
Mourya Sen Thapa
The Great Bengal famine of 1943 is one of history’s biggest catastrophes. The death of nearly 3 million Indians and starvation of many more lead to contemporary historians blaming the British reign and Weinstein Churchill’s lack of consideration of the populace and calling it an atrocity. Opposition to these arguments exists, but either way it changes nothing about the historical relevance between the famines and the epigenetic makeup of major parts of India.
Research now holds a causal theory on exposure to rationing diets during conception that can increase type 2 diabetes two times more likely than other populations. In western parts of the world diabetes is more of a geriatric disease, but in India it can begin as early as 25 years of age. Currently India and China hold the greatest number of diabetics on the planet, as both countries do have a large population size and have had a history of droughts and famines. Scientists suggest that the major reason for this being the genetic alteration by famines during the colonial years.
Epigenetics is the modification of gene expression through environmental changes. The environment in a food scarce society over a long period could have contributed to generational developments within the human body, often as a way for the body to adapt to the barrenness and scarcity of food supplies, thereby modifying how the body stores fat. This adaptation likely involved the body becoming more efficient at storing fat and generating energy from scarce food resources, a trait that, in today’s era of food abundance, contributes to a higher prevalence of type 2 diabetes and other metabolic conditions among South Asians. Much like the experience of enslaved Africans brought to the United States, where only those who could endure the brutal conditions of the transatlantic voyage survived and reproduced, this was a resilience back then, but it had lasting effects. The descendants of these individuals inherited a predisposition to retain salt, a trait that was once vital for survival during the voyage. Today, this genetic legacy contributes to the disproportionately high rates of hypertension, or high blood pressure, observed among Black Americans.
This adaptation for a short period causes the body to slow down the metabolic rate in order to preserve energy, i.e., fat in the body, however within several generations this causes numerous problems when the body that has adapted to frequent famines is exposed to an abundance of calories. Years of adaptation to fewer calories meant that the body processes insulin differently; insulin is a resourceful hormone that converts food into energy, it gets released every time we eat; but with a starvation adapted body the function of insulin is altered to store energy and retain it as long as possible. This sharp increase in diabetes in India like everywhere else was expected in the city areas, confoundingly there seem to be spikes even in the rural segments. No longer can we consider diabetes a rich man’s disease.
The vocabulary used by experts for this gene expression is the “thrifty genes”. The compilation of genes that carry out one very important task of keeping the body alive in the face of scarcity. However, the modern world seems to be anything but scarce in resources. The thrifty genes can also be altered by the increased use of stimulants like alcohol and smoking before and during pregnancy. After the ‘green revolution’ starting from the 60’s where food production slowly became abundant and subsequently less families suffered from malnutrition in developing countries, the world was drowning in another problem. This abundance of food and the thrifty genes now is responsible for millions of diabetics across India and other parts of Asia. Now it’s not just the wheat and the grains that have exacerbated the issue; in other words the doctor’s orders for a clean and healthy diet isn’t the problem, but the never ending supply of packaged and processed foods containing high sugar and insidious calories are the main culprits. In any other body this should have been fine, but in bodies adapted to famine, it becomes remarkably easy for people to spiral into future heart disease and kidney failures.
Research led by Brown University supports this theory, revealing that individuals born during famine conditions are at a significantly higher risk of developing hyperglycemia and type 2 diabetes later in life. You can read more on this in a news article titled “Famine alters metabolism for successive generations”. This effect isn’t just limited to those directly exposed to the famines; even the offspring of famine survivors have shown increased susceptibility to these conditions. The idea is that epigenetic changes passed down through generations alter how the body processes nutrients, leading to an increased risk of metabolic disorders like diabetes.
Dr Mubin Syed, a 56-year-old radiologist from Ohio, USA, who also works in vascular and obesity medicine, states that although the lifestyle of South Asians and a number of factors are thought to be behind higher risk of diabetes, the famines faced by the early generations may be the missing link.
South Asians are known to have endured at least 31 famines, particularly throughout the 18th and 19th centuries. This frequent exposure to extreme scarcity led to the development of a “starvation-adapted” physiology, where the body became more inclined to store fat rather than burn it off. As a result, many South Asians have a lower lean muscle mass, Dr. Syed explains. Research indicates that such large-scale starvation can have lasting effects on subsequent generations. Dr. Syed, who has been studying this field for over five years, noted, “Exposure to even a single famine can have multi-generational consequences, leading to metabolic disorders such as diabetes, hyperglycemia, and cardiovascular diseases. Now, consider the impact of experiencing at least 24 major famines within a 50-year span.”
The Indian diet consists of an abundant usage of oil and ghee that can make your average vegetarian-based diet more calorie dense that defeats the very purpose of eating veggies, I mean for health purposes. However, blaming something more complex to simply one sort of diet is also misleading, as increase in alcohol and smoking needs to be taken into consideration, alongside western based fast, easy and cheap meals. Takeout and home delivery services have become cheaper and well organised to feed masses, but we must take into consideration that this doesn’t become a lifestyle and should be more of a rewarding act.
Despite this article targeting the general public of India, there is with little doubt that this is an issue that is anything but endemic. The problem with diabetes is that it is now a global problem that captures much of the world’s middle aged population, a crisis that is surely to cause further disruptions in private life and the economy. Where the rest of the world’s population faces this disease somewhere in their mid-life, the people of India –and of Indian origins– may find that their youths are equally vulnerable as their adults.
References
https://www.nature.com/articles/485S14a
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4935697/
