Famine Is Never A Good Thing, But a Food Shortage, Maybe

There is no doubt that a severe food shortage is never beneficial to public health. One of the surprising results of the Dutch "hunger winter" in 1944 and 1945 was that not only did children born mothers who were pregnant during this time fail to grow to expected height and weight as adults, but their children also were smaller than normal even though they were conceived during a time of prosperity. The Chinese Great Leap Forward famine of 1959 through 1961 resulted in changes in the reproductive health not only of women who were in their child-bearing years during that time, but also in their children. And the famines in Ethiopia during the 1970's resulted in totally unexpected reactions to nutritional supplementation. Aid workers were horrified to learn that parasites in children's bodies could be awakened, often with fatal consequences, by the sudden restoration of normal nutrition--sometimes with as little as a single dose of an iron supplement.

None of these long-term biological changes seem to have resulted from the widespread calorie deprivation of Cubans during their economic crisis from the late 1980's to the mid-1990's. The key difference between the Cuban experience and the famines of many other countries during the twentieth century seems to have been that the Cubans were deprived, but not starved. Obesity became very rare indeed, but many people managed to maintain normal, even slightly higher than "ideal" weight. They did this in the context of getting lots of exercise, as fuel shortages required people to walk for transportation and to carry heavy loads by hand.

So what's the take-away from the studies of food shortages in Cuba? Here are the conclusions of research:

• The benefits of having less food appear in weeks or months, not years or decades. It only took a matter of a month of two for certain kinds of disease rates in Cuba to plummet.
• Starvation is not beneficial to anyone. Not having as much food as one wants, however, tends to be associated with less diabetes and less heart disease. (Cuban cancer rates were not significantly affected by the food shortage.)
• The lowest rates of mortality occur in people who have a body mass index (BMI) of 24 to 29--slightly above "ideal" weight. A little extra weight is especially beneficial to small children and the elderly.

Eating a little more than your body's basic needs, but not so much as to become obese, seems to be key to good health. And sharing food with one's neighbors seems to compensate for the effects of minor shortages on public health.