Black Death Reveals Link Between Childhood Malnutrition and Adult Health

The Black Death and Its Long-Term Health Impacts

The Black Death, one of the most devastating pandemics in human history, reached England in May 1348. Over the course of less than two years, it spread across the country, claiming the lives of an estimated 2 million people. Caused by the bacterium Yersinia pestis, this deadly disease left a profound mark on society, prompting officials in London and other cities to open new cemeteries where hundreds of bodies were buried daily.

A recent study has uncovered intriguing insights into how the experiences of those who lived through the Black Death might inform modern understanding of health. Specifically, researchers are exploring how malnutrition during early life can influence health outcomes later in adulthood. This research, published in the journal Science Advances, offers a unique perspective on the long-term effects of historical events on human biology.

A Surprising Discovery

Sharon DeWitte, a professor at the University of Colorado Boulder and lead author of the study, explains that the findings challenge previous assumptions about the relationship between early-life nutrition and long-term health. Her team analyzed chemical traces found in the teeth of nearly 275 individuals buried in English cemeteries before, during, and after the Black Death.

What they discovered was unexpected: individuals who experienced malnutrition during childhood or adolescence appeared to have better survival rates during the plague compared to their peers, at least until they reached young adulthood—roughly age 30. However, these advantages seemed to diminish significantly as they aged further.

“This suggests that surviving early nutritional stress could shape development in ways that are beneficial in the short term but may lead to negative health outcomes later in life,” DeWitte said.

Understanding the Link Between Nutrition and Health

The connection between early-life experiences and long-term health is complex. For example, studies of modern populations have shown that low birth weight, often linked to nutritional stress, can increase the risk of conditions such as cardiovascular disease and diabetes in adulthood.

The Black Death, also known as the second pandemic of plague, provides a valuable opportunity to study these patterns. Mortality rates varied widely across Europe, with some regions losing up to 75% of their population. This variation raises important questions about why certain groups were more vulnerable than others.

Using Teeth as a Historical Record

DeWitte and her team turned to teeth for answers. What people eat during infancy and childhood leaves a subtle imprint on the development of their adult teeth, altering the isotopes of carbon and nitrogen present in the dentin. When individuals experience extreme nutritional stress, their bodies begin to break down fat and muscle, which have different isotopic signatures than food consumed.

In this study, the researchers examined isotopes in the teeth of hundreds of individuals buried in English cemeteries between 1100 and 1540 AD. They included remains from the East Smithfield Black Death Cemetery in London, where mass burials of plague victims took place.

While the results are not definitive—due to limited records about the individuals studied—the findings suggest that early-life malnutrition may influence adult health in nuanced ways. It’s not simply a matter of being good or bad; the impact depends on the context.

Adapting to Changing Environments

When children face periods of starvation, their bodies may adapt in ways that help them survive in times of scarcity. For instance, they may develop a more efficient metabolism to make the most of limited resources. These adaptations can be advantageous in environments where food is scarce but may become problematic when conditions improve.

After the Black Death, for example, laborers in England saw improved economic conditions as wages increased. However, individuals who had experienced nutritional stress as children may have struggled to adjust to this abundance, potentially leading to health issues like excessive fat storage and related complications.

Lessons from the Past

For DeWitte, this research highlights the value of studying historical populations to understand modern health challenges. “I’ve always been interested in why some people thrive while others in the same society don’t,” she said.

The study also underscores the importance of considering social and environmental factors in shaping health outcomes. By learning from the past, scientists hope to identify key points of intervention that can help reduce health disparities today.

Collaborative Efforts

This research was conducted by a team of experts, including Julia Beaumont and Jacqueline Towers from the University of Bradford in the UK, Brittany Walter from the Defense POW/MIA Accounting Agency, and Emily Brennan from the University of South Carolina.

For more information, visit the study titled Childhood nutritional stress and later-life health outcomes in medieval England: evidence from incremental dentine analysis in Science Advances. The full article is available at www.science.org/doi/10.1126/sciadv.adw7076.