The relation between fetal malnutrition and chronic disease in later life

Good nutrition and lifestyle matter from womb to tomb

David Barker's group has greatly increased our understanding of the factors contributing to chronic diseases in later life. In over 50 papers1 the group has presented evidence from British populations that low birth weight at term and, in some cases, low weight at 1 year of age are associated with an increased adult risk of hypertension, coronary heart disease, non-insulin dependent diabetes, and autoimmune thyroid disease.2 The importance of these findings is that they provide overwhelming evidence that malnutrition at a very early age (in utero and in infancy) in Britain this century resulted in earlier and more severe adult chronic disease. This week Barker and Finnish colleagues provide further data and offer an explanation for the epidemic of heart disease that accompanies Westernisation.3

The Barker group's initial observations were so surprising that they met considerable scepticism. Some suggested that birth weight was reflecting other socioeconomic factors, not just maternal malnutrition, while others doubted the generalisability of the findings. But, no matter what combination of poor nutrition and other environmental factors is responsible for fetal growth retardation, the concept of fetal origins of adult disease is …