Commentary: Fetal origins of cardiovascular risk-nutritional and non-nutritional.

Abstract

The study by Barker has added to the already long list of papers which show an association between small size at birth and cardiovascular risk in later life. Barkers idea of the fetal origins has survived and strengthened throughout the last decade albeit undergoing a degree of metamorphosis to include contributions from childhood growth. In this paper the author reviews several studies that would negate Barkers conclusion. He stresses that findings to date suggest that there could be a multitude of mechanisms by which the intrauterine environment could influence adult disease. It is noted that there is little information on factors like intrauterine infections in relation to future cardiovascular risk. Thus it is suggested that more evidence is needed about the gene-environment interaction (nutritional and non-nutritional) during the intrauterine period before one can plan for public health interventions for primordial prevention.