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The Endowment for Human Development
The Endowment for Human Development
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What the Experts Say

"Low birthweight [in relation to duration of gestation, not prematurity] is now known to be associated with increased rates of coronary heart disease and the related disorders, stroke, hypertension, and adult-onset diabetes. These associations have been extensively replicated in studies in different countries and are not the results of confounding variables."1

David J.P. Barker, M.D., Ph.D.
First proponent of the "fetal origins of disease" hypothesis

"David Barker has been the leading proponent of the thesis that health is, in part, programmed by prenatal life. Surprisingly, this concept has been accepted only slowly in spite of significant biological observation and powerful societal comparison. However, today, the weight of evidence is so strong that it cannot be resisted."2

Claude Lenfant, M.D.
Executive Editor: Lung Biology in Health and Disease Series, Volume 151

Director, National Heart, Lung and Blood Institute
National Institutes of Health

"One of the two goals of the new agenda for medical research set out in this book is to lessen these epidemics [coronary heart disease and Type 2 diabetes] by improving the body composition and nutrition of girls and young women and by protecting the growth of young children. There is already sufficient evidence to begin implementing new public health policies without further delay, but a deeper understanding of the biological processes is needed to refine these policies. The other goal of fetal origins research is earlier detection and better treatment of disease."3

David J.P. Barker, M.D., Ph.D.
Editor: Fetal Origins of Cardiovascular and Lung Disease, 2001

"…It is evident that the fetal environment is of tremendous importance during the developmental period in determining health throughout the life of the individual."4

Dr. Hugo T. Bergen
Associate Professor
Department of Anatomy and Cell Science
University of Manitoba

"Programming is now known to be an important underlying feature of many systemic adult diseases including coronary heart disease, hypertension, insulin resistance syndromes and osteoporosis."5

Peter W. Nathanielz
Kent L. Thornberg
Center for Women’s Health Research
New York University Medical School

"The promise of the fetal origins paradigm is that attending to the health of women of reproductive age will have profound impact on the wellbeing of their offspring."6

Johan G. Eriksson
National Public Health Institute
Department of Epidemiology and Health Promotion
Diabetes and Genetic Epidemiology Unit
Helsinki, Finland

"Work over the last 15 years has now provided unequivocal evidence that, in addition to the classic risk factors such as smoking and obesity, impaired fetal growth is also associated with the development of coronary heart disease."7

Omar A Khan, et al.
Department of Cardiovascular Surgery
Southampton General Hospital
Southampton, UK

"The accumulated research evidence suggests that prevention efforts against toxic exposures to environmental chemicals should focus on protecting the embryo, foetus and small child as highly vulnerable populations. Given the ubiquitous exposure to many environmental chemicals, there needs to be renewed efforts to prevent harm. Healthier solutions should be researched and proposed in future work. Prevention should not await definitive evidence of causality when delays in decision-making would lead to the propagation of toxic exposures and their long-term, harmful consequences. Current procedures, therefore, need to be revised to address the need to protect the most vulnerable life stages through greater use of precautionary approaches to exposure reduction."8

Statement from the International Conference on Fetal Programming and Developmental Toxicity
Tórshavn, Faroe Islands

1 Barker DJ, 2004. 1359.
2 Barker DJP. 2001. iv.
3 Barker DJP. 2001. vii.
4 Bergen HT, 2006. 11.
5 Nathanielsz PW, Padmanabhan V, 2006. 3.
6 Eriksson JG, 2005. 1096.
7 Barker DJ, 1995. 1040.
8 Grandjean P et al., 2007. 75.


Bergen HT. 2006. Exposure to Smoke During Development: Fetal Programming of Adult Disease. Tobacco Induced Diseases. Vol. 3, No. 2:5-16.
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Barker DJ. 2004. The developmental origins of well-being. Philos Trans R Soc Lond B Biol Sci. Sep 29;359(1449):1359-66.
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Barker DJ. 1995. Fetal origins of coronary heart disease. BMJ. Jul 15;311(6998):171-4.
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Nathanielsz PW, Padmanabhan V. 2006. Developmental origin of health and disease. J Physiol. 2006 Apr 1;572(Pt 1):3-4. Epub 2006 Feb 23.
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Eriksson JG. 2005. The fetal origins hypothesis--10 years on. BMJ. May 14;330(7500):1096-7.
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Grandjean P, Bellinger D, Bergman A, Cordier S, Davey-Smith G, Eskenazi B, Gee D, Gray K, Hanson M, van den Hazel P, Heindel JJ, Heinzow B, Hertz-Picciotto I, Hu H, Huang TT, Jensen TK, Landrigan PJ, McMillen IC, Murata K, Ritz B, Schoeters G, Skakkebaek. 2007. The faroes statement: human health effects of developmental exposure to chemicals in our environment. Basic Clin Pharmacol Toxicol. Feb;102(2):73-5.
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Barker DJP. 2001. Fetal origins of cardiovascular and lung disease. David J. P. Barker (editor), Claude Enfant (executive editor). Lung Biology in Health and Disease, Volume 151. New York: Marcel Dekker.
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