In the spring of 1348, the Black Death—a catastrophic pandemic caused by the bacterium Yersinia pestis—made landfall on England’s shores. Within a mere two years, it had spread throughout the country, claiming the lives of an estimated two million people. This staggering death toll overwhelmed urban centers like London, where officials resorted to opening new cemeteries that witnessed the interment of hundreds of bodies daily. While the plague’s immediate devastation is well-documented, a groundbreaking study now suggests that the health struggles faced during this period hold critical insights for contemporary questions about human development and long-term health outcomes.
Led by Sharon DeWitte, a professor at the University of Colorado Boulder’s Institute of Behavioral Science and Department of Anthropology, the new research probes a question that resonates far beyond the medieval era: how does malnutrition during early life influence an individual’s health trajectory well into adulthood? Contrary to longstanding assumptions, the findings reveal a complex and nuanced relationship between childhood nutritional stress and later life survival, challenging the notion that early deprivation unequivocally undermines health over the long term.
The research team focused their investigation on chemical signatures secreted in dental tissues—specifically, the isotopic composition within the dentine of adult teeth. Nearly 275 individuals who had been buried in cemeteries across England before, during, and after the Black Death were examined. This sampling included the notorious East Smithfield Black Death Cemetery in London, a mass burial site opened in 1348, where plague victims were interred en masse without the usual funerary rites.
Isotopes of carbon and nitrogen embedded in dentine act as biochemical archives, preserving records of dietary intake and physiological stress during the formative years of life. When the body encounters periods of malnutrition, it begins metabolizing its own fat and muscle reserves, shifting the isotope ratios in ways detectable centuries later. By analyzing these markers, DeWitte and her colleagues could retrospectively assess nutritional stress experienced by individuals during infancy and childhood, correlating those early life hardships with mortality patterns during the tumultuous years marked by plague outbreaks.
Surprisingly, the study uncovered that individuals who endured nutritional stress early in life exhibited higher rates of survival during acute health threats like the Black Death, at least up until around age 30. This counterintuitive advantage suggests that early deprivation may induce physiological and metabolic adaptations that confer resilience against epidemic diseases in youth and young adulthood. However, the data also indicate that these benefits do not extend indefinitely; as individuals aged into middle and late adulthood, those same early-life hardships appeared to predispose them to poorer health outcomes.
DeWitte interprets these findings through the lens of developmental plasticity. When bodies face famine or nutritional scarcity during critical periods of growth, they may recalibrate development to optimize energy usage and survival in harsh environments. Such “programming” could manifest as altered metabolism, enabling more efficient utilization of limited calories. While advantageous in periods of scarcity, these adaptations may become maladaptive if the individual later encounters an environment rich in resources—offering a possible explanation for the increased disease susceptibility observed in later life stages.
This theory gains further traction when considering the post-Black Death societal upheavals in England. Following the dramatic population decline, survivors often found themselves in improved economic circumstances, with labor shortages driving up wages and access to food. The juxtaposition of a physiologically “scarred” metabolism shaped by childhood scarcity against newfound nutritional abundance may have precipitated chronic health problems, including cardiovascular diseases associated with excessive fat accumulation.
Beyond providing intriguing evolutionary and historical insights, this research has profound implications for modern epidemiology and public health. The Black Death, with its vast mortality variability across regions of Europe—from roughly 30% in parts of England to 75% in Florence, Italy—serves as a natural experiment illuminating how early life conditions interact with social and environmental factors to influence longevity and disease resistance. Understanding these mechanisms could inform strategies to mitigate health disparities that persist today alongside social inequalities.
It is important to note, as DeWitte emphasizes, that the study’s conclusions are drawn from an archaeological context where critical biographical details are lacking. Without precise medical records or cause-of-death information, fully disentangling the myriad factors influencing survival and health remains challenging. Nonetheless, the bioarchaeological approach adopted here—intersecting isotopic chemistry with demographic analyses—opens the door to refining our grasp of how childhood experiences echo through a lifetime in subtle yet significant ways.
This line of inquiry dovetails with modern clinical research that links low birth weight and early life malnutrition with elevated risks of metabolic syndrome, diabetes, and heart disease. By grounding such observations within a deep historical framework, DeWitte’s work enriches our understanding of the biological underpinnings that bridge past and present health phenomena. Moreover, it highlights the complex, sometimes paradoxical, nature of adaptation—where traits beneficial at one life stage may portend vulnerabilities at another.
Crucially, this research transcends academic curiosity by underscoring the potential for targeted social interventions. Identifying periods of developmental vulnerability and environmental mismatch could inform public health policies aiming to reduce disease burden in today’s populations, particularly those affected by poverty and nutritional insecurity. DeWitte expresses hope that lessons gleaned from 700 years ago might inspire efforts to address health inequalities that continue to challenge modern society.
At its core, this study reiterates a fundamental question that has perennially fascinated scientists and clinicians alike: why do some individuals thrive in the face of adversity while others succumb, even within the same social and ecological milieu? While definitive answers remain elusive, the evidence suggests that early life nutritional stress imprints upon human physiology in ways that both protect and imperil, with the balance shifting over time and context.
As DeWitte and her collaborators prepare to publish their findings in the esteemed journal Science Advances on July 30, 2025, their work invites renewed attention to the interplay between environment, biology, and health across the human lifespan. It is a compelling reminder that the past, with its tales of survival and loss, continues to inform and illuminate the pathways toward healthier futures.
Subject of Research: The influence of childhood nutritional stress on long-term health outcomes in medieval England, using isotopic analysis of dentine to infer early life malnutrition and its effects on mortality during and after the Black Death.
Article Title: Childhood nutritional stress and later-life health outcomes in medieval England: evidence from incremental dentine analysis.
News Publication Date: Not explicitly stated; article scheduled for publication on July 30, 2025.
Web References:
- Science Advances Journal – DOI: 10.1126/sciadv.adw7076
- Institute of Behavioral Science, University of Colorado Boulder: https://ibs.colorado.edu/
- Department of Anthropology, University of Colorado Boulder: https://www.colorado.edu/anthropology
References:
DeWitte, S.N., Beaumont, J., Towers, J., Walter, B., & Brennan, E. (2025). Childhood nutritional stress and later-life health outcomes in medieval England: evidence from incremental dentine analysis. Science Advances. DOI: 10.1126/sciadv.adw7076.
Keywords: Black Death, Yersinia pestis, malnutrition, childhood nutrition, dentine isotopes, medieval England, bioarchaeology, long-term health, developmental plasticity, epidemiology, metabolic adaptation, mortality patterns.
