Fetal and infant origins of adult disease

Background. Many human fetuses and infants have to adapt to a limited supply of nutrients, and in doing so they permanently change their physiology and metabolism. These programmed changes may be the origins of a number of diseases in later life, including coronary heart disease, stroke, diabetes and hypertension. Coronary heart disease. We have become accustomed to the idea that coronary heart disease,the commonest cause of death in the Western world, may result from the "unhealthy" lifestyle that is associated with increasing affluence. The influences of this "unhealthy" lifestyle (e. g. obesity, cigarette smoking, dietary fat, stress), however, go only a small way towards explaining why increasing affluence in the Third world is so regularly followed by epidemics of the disease, or why in the Western world these epidemics have risen steeply to become the commonest cause of death but thereafter have declined. Neither do they explain why the highest rates of coronary heart disease in Western countries occur among the poor? Fetal origins. Answers to these questions may come from an understanding of how the structure-of the heart and processes such as blood pressure regulation and the way the body handles sugar and fat a re established in the womb. The "fetal origins" hypothesis stares that coronary heart disease and the disorders related to it - hypertension,adult-onset diabetes and stroke - originate through. adaptations that the fetus makes when it is under-nourished Unlike adaptations made in adult life those made during early development tend to have permanent effects on the body's structure and function - a phenomenon sometimes referred to as programming. They allow the fetus to survive and continue to grow but at the price of a shortened life.