The international community is in a dilemma over whether to provide food aid to North Korea, which has taken the unusual step of begging for help even from such poor countries as Zimbabwe.
But the hardline communist state remains defiant in not wanting to give up its illicit nuclear arms.
It also refuses to apologize for a deadly artillery attack on South Korea and a blamed torpedo attack on a South Korean warship that left 46 sailors dead.
International experts who did a rare study of the food situation in the reclusive country said they found evidence of food shortages and alarming malnutrition, including people foraging for wild grasses and herbs.
The team of five aid agencies which conducted the research last month recommended that North Korea be considered for emergency food assistance targeting children, pregnant and lactating women, and other vulnerable groups.
But can North Korean leader Kim Jong Il's regime be trusted with food aid, which in the past was diverted to the military, redistributed as gifts for elites, or resold at steep profits to vendors in the country's markets?
Grain of salt
Some analysts caution that reports about North Korea's hunger threats should be taken with a grain of salt.
"Such reports appear every year, and so far, every such alarm has been eventually proven to be false," said Andrei Lankov, a Russian expert on North Korea teaching at Kookmin University in Seoul.
He said groups involved in providing humanitarian assistance regularly send such messages about the threat of hunger because "in the current uneasy international situation, alarmism helps to get more aid."
Lankov agreed that the food situation in North Korea has deteriorated in the past two to three months but cautioned that "the annual outbursts of alarmist reporting about the looming food crisis should be taken with a pinch of salt."
North Korea has relied on outside help to feed its 24 million people since natural disasters and mismanagement devastated its economy in the 1990s, when hundreds of thousands died in a famine.
Officials from the U.N.'s World Food Program and Food and Agriculture Organization are in North Korea to assess the food situation. They are expected to brief diplomats and international agencies in Pyongyang at the weekend.
After a survey of 45 North Korean sites, U.S. aid agencies said that they saw "evidence of malnutrition, food shortages" among families that depend on the public food distribution system.
Shortage to worsen?
The United States, a top food aid provider to North Korea in the past, said it is watching the situation closely but made it clear that it will not resume aid "without a thorough assessment of actual needs and adequate program management."
Washington suspended food handouts to the impoverished North in 2009 after Pyongyang expelled its aid monitors who were there to make sure the food gets to the children, nursing mothers, and elderly who most needed it.
The communist government is suspected of diverting foreign assistance to support its huge military force. There were also reports of food aid redistributed as gifts for elites or resold at a steep profit to vendors in markets.
U.S. Republican lawmaker Ileana Ros-Lehtinen, who heads the House of Representatives Foreign Affairs Committee, said she has "grave concerns" about North Korea's intentions in the food request.
Referring to the 100th anniversary next year of the birth of Kim Jong Il's father, she said "there is the danger that aid provided would be diverted for this spectacle."
Ros-Lehtinen, who chaired a congressional hearing on North Korea on Thursday, also called for an accounting of how North Korea distributed previous U.S. food aid left over when the regime booted out nongovernmental organizations two years ago.
But senior Democratic legislator Howard Berman said every effort should be made to provide humanitarian assistance and food aid to the North Korean people on condition that "adequate monitoring" is allowed to ensure that such aid is not diverted or misused.
Resume food aid
Victor Cha, a former White House Asia expert, said U.S. President Barack Obama's administration should consider resuming food aid if Washington obtains access for monitoring terms as good as or better than the ones expelled in 2008, and after close consultations with Seoul.
"Bags of rice floating around North Korea with the American flag and written Korean saying 'Gift of the American people' cannot be bad," he said.
Historically, Cha said, food assistance to North Korea has opened a path back to larger diplomacy, which was critical to containing the unpredictable regime's nuclear weapons program.
"Restarting food aid may sound like the same old story—rewarding bad behavior that will only elicit more bad behavior. The alternative is to do nothing on nuclear diplomacy or human rights, which is good posturing."
"But it will buy you a runaway nuclear program with rampant proliferation potential."
Some conservatives in South Korea are already suggesting that South Korea also go nuclear or are calling for the United States to reinsert tactical nuclear weapons into the country.
"This hardly seems like a good alternative," Cha said.