A new research paper suggests the Civil War could yet live on in Southern hearts — in the form of heart disease.

In the paper, Ohio State University economist Richard Steckel, PhD, suggests decades of war-induced poverty and malnutrition in the South left later generations unprepared, biologically speaking, for flusher times. That could be a reason, Steckel argues, for the high rates of heart disease there. (All but two states with the highest rate of death from heart disease in 2010 fall below the Mason-Dixon line.)

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It’s not as preposterous as it sounds. Several studies have found people conceived during famines are more likely to have cardiovascular disease and diabetes.

"When building major organs," Steckel and his co-authors write, "the fetus responds to signals via the placenta that forecast post-natal nutrition. A mismatch between expectations and reality creates physiological stress and elevates several noninfectious chronic diseases."

Steckel points to data showing that heart disease deaths were higher in states that rose quickly out of poverty between 1950 and 1989.

"Several generations of poverty from the Civil War onwards: You had mothers, grandmothers, great grandmothers, whose offspring — I won't say learned — but received signals, anticipating a lean world,” he told the Washington Post.

When food suddenly became less scarce, the types of foods traditionally favored by Southerners didn't help. "The traditional southern diet was a disaster for heart disease when accompanied by a decline in physical labor and habits that eschewed recreational exercise," write the authors.

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The study has its limitations, as Steckel and his co-author acknowledge. They looked at only one racial group (whites), and they didn’t trace any individual families or people, only heart disease deaths among people born before the economy turned around.

Still, according to the Post, the findings mean doctors may want to ask this question when taking a medical history: Did your parents grow up in poverty?

This question has resonance for me since I’m from the South and both my parents grew up impoverished. My father’s family, who lost their land during the Depression, became sharecroppers and spent one winter living on nothing but peas and cornmeal. My father recalled the day when his mother managed to get a little lard and made pea “sausages” as a special treat. “I was too young to remember better days,” he said, “but when my brother Durrell realized the sausages were only peas, he just sat down and cried.”

It’s impossible to say whether poverty’s ripples have affected my health, but heart disease definitely took a toll on my extended family, including Durrell, who as a teen was so disappointed by the faux pea sausages that he left home to work in a cotton mill. Decades later, he had a triple bypass.

The rapid-rise-from-poverty phenomenon may be playing out now in other places around the world. "The fetal origins hypothesis has especially relevant implications for the developing world, where vast numbers of poor families are on the verge of experiencing significant increases in income," the authors conclude. "Chronic adult illness such as heart disease are likely to increase dramatically in the once-poor but now rapidly growing countries."

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Diana is an award-winning writer and editor with more than 20 years' experience in magazine, video, book and digital journalism, with a specialty in health coverage. She was a longtime writer and news editor at the Center for Investigative Reporting; has written for publications from the Washington Post to the Times of London syndicate; and has served as a senior and/or consulting editor at Time Inc. Health, Hippocrates, HealthDay News Service and Reporting on Health. She was also editor in chief of Consumer Health Interactive, a national health and medical web site, and has reported on finance for Blueshift Research and PBS Frontline. Before joining SafeBee, she was editor of Bioenergy Connection, a national magazine about bioenergy at UC Berkeley. Her favorite safety tip: Wear a bike helmet.