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It has been proposed that fetal nutrition is an important determinant of adult health and of inequalities in health between different social groups. Evidence for the 'fetal origins' hypothesis, currently, comes almost exclusively from observational studies relating indices of birth size (which in part reflects fetal nutrition) to adult disease or disease risk markers. Observational associations may not be causal and may have arisen through confounding by factors associated with both smaller size at birth and later disease risk. An experimental study conducted in Birmingham 25 years ago showed that protein-energy supplementation amongst nutritionally at risk mothers increased offspring birth size. The experimental design means that this association is unlikely to have arisen through confounding. Adult offspring of mothers participating in this study are now being assessed to determine effects of supplementation on their current health. This will provide important evidence of the potential to improve public health through improving the nutrition of pregnant women. © 2004 British Nutrition Foundation.

Original publication




Journal article


Nutrition Bulletin

Publication Date





310 - 316