The foetal origins of adult health

Life course epidemiology examines the biological, behavioural and psychosocial processes that operate throughout an individual’s life and influence the risk of disease. This approach is based on the foetal origins hypothesis, which examines how early life exposures can have long-term effects on adult health. This theory emerged from research that demonstrated the association between low birth weight and cardiovascular disease in adults. However, many criticisms were raised, as these initial studies did not provide a biological explanation for this association. More recently, animal and human nutritional studies have provided putative mechanisms linking the irreversible changes that occur during the perinatal period to adult health. Further, epigenetic studies have also provided support for the foetal origins hypothesis, as it has been demonstrated that permanent structural DNA modifications can occur early in life. Importantly, there are several methodological issues at play that challenge the life course study design, and the interpretation and relevance of results must be discussed. This article will explore the development of the foetal origins hypothesis and examine its supporting evidence, as well as discussing the methodological constraints and applications of this approach.