The Fetal Matrix: Evolution, Development and Disease

摘要

The test of a good hypothesis, curiously, is not that it shouldrnbe true. Philosophers of science say that proof is impossible,rnthe highest accolade being a long-running failure to refute.rnWe can also look at the amount of research and debate thatrnit generates, and on this basis David Barker’s fetal originsrnhypothesis is a cracker. For our hunter–gatherer ancestorsrnthere were advantages in having the unborn programmedrnphysiologically for a nutritionally deprived environment,rnbut such preparation works less well when babies grow uprnin a world with fast-food outlets on every corner. Readersrnseeking something more formal by way of description of thernBarker hypothesis could try the 1995 wording: ‘fetalrnundernutrition in middle to late gestation, which leads torndisproportionate fetal growth, programmes later coronaryrnheart disease’.1 Barker’s new way of thinking has the addedrnmerit of acting as a counterweight to the argument that badrnlifestyle choices are almost entirely to blame forrncardiovascular disease, diabetes and so on. However, atrnleast something can be done about such choices—smoking,rnunhealthy diets, lack of exercise. It is far less clear what werncan do about the adult ills that stem from the fetus’s receiptrnof misleading signals about what extrauterine life wouldrnreally be like.