Type 2 diabetes, obesity and the metabolic syndrome are rapidly escalating in progressively younger individuals, leading to increased mortality, morbidity and healthcare costs. Research into preventing as well as treating these conditions is of the utmost importance. The link between low birth weight and the subsequent increased risk of developing Type 2 diabetes and obesity, as well as other features of the metabolic syndrome such as hypertension, is well established. This review discusses the evidence from both epidemiological studies and animal models supporting this link, as well as potential mechanisms. More recently, increasing focus has been on the detrimental effect of rapid postnatal growth after poor fetal growth. Improving prenatal nutrition and maintaining a steady and appropriate growth rate in early life could dramatically decrease the rates of Type 2 diabetes, obesity and other metabolic complications. Individuals who are at high risk because of their fetal and prenatal growth could, if informed, be able to make improved life choices. A combination of improved fetal and early-life nutrition and appropriate risk management for high-risk individuals could reduce the huge clinical burden of these conditions. This review will focus on the evidence suggesting a link between fetal and early-life growth and the risk of developing Type 2 diabetes, obesity and other factors of the metabolic syndrome in adult life. This evidence exists from a wide range of epidemiological studies as well as from a variety of animal models. Interventions both during pregnancy and early life as well as informed life choices in those at risk could dramatically reduce the huge clinical burden of obesity and its comorbidities.
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