¹Department of Epidemiology and Health Promotion, Diabetes and Genetic Epidemiology Unit, National Public Health Institute, Helsinki, Finland

Correspondence: Professor JG Eriksson, Department of Epidemiology and Health Promotion, Diabetes and Genetic Epidemiology Unit, National Public Health Institute, Mannerheimintie 166, Helsinki 00300, Finland. E-mail: jern@ktl.fi

Abstract

Experiences during critical periods of development through the mechanisms of programming have consequences on later health outcomes. Observations worldwide linking a small body size at birth with adult health outcomes have greatly added to our understanding of the early origins of several non-communicable diseases like coronary heart disease (CHD) and type 2 diabetes. The pattern of growth predisposing to CHD is characterized by a small body size at birth and thinness through infancy up to 2 years of age, followed by accelerated gain in weight and body mass index (BMI) later in childhood. The early growth patterns of individuals who later develop type 2 diabetes very much resemble the growth patterns of CHD, that is, a small body size at birth and thinness at 1 year of age followed by higher body mass indices later in childhood. Numerous studies support the importance of events during critical periods of growth in the pathogenesis of many non-communicable diseases like CHD and type 2 diabetes. There are several possible mechanisms through which a non-optimal early growth associated with accelerated weight gain in childhood could lead to these diseases. To get a better understanding of the patterns of growth affecting adult health outcomes, a life-course approach to the development of chronic diseases needs to be taken.