higher life expectancy but on the whole suffering more disabilities in 2. FETAL DEVELOPMENT older age than men. 2.1 Fetal 'programming' This report presents a summary of the life course events, which determine the ageing process. It is acknowledged that the elements may not be The life course begins when we are still in the womb, and the influences sequential, but a chronological order has been chosen for practical we are exposed to during this time may leave a lasting mark on it purposes. Although some of the factors are presented individually, they Current research strongly suggests that adverse influences during fetal are often inter-linked and rarely occur in isolation. life, including undernutrition and lack of oxygen, prompt the fetus to make numerous adaptations to sustain its development. These adapta Bibliography ions may result in persisting changes to organ structure and metabolism, which are called 'programmed. They are thought to lead to disease in 1. The World Health Magazine No 4, July-August 1997 adult life, such as circulatory diseases, diabetes, chronic airflow obs- truction and disorders of lipid metabolism Figure 2. 1 shows that the risk for coronary heart disease and stroke falls with increasing birthweight, a surrogate marker for growth in the womb People who have been undernourished in the womb may therefore be Figure 2.1: Relative Risk of non-fatal coronary heart disease and stroke according to birthweight Age adjusted relative risk B irt mwe ight(pounds) (Source: Barker DIP. Mothers, Babies and Health in Later Life. Churchill Livingston, 1998)5 Bibliography 1. The World Health Magazine No 4, July-August 1997 higher life expectancy but on the whole suffering more disabilities in older age than men. This report presents a summary of the life course events, which determine the ageing process. It is acknowledged that the elements may not be sequential, but a chronological order has been chosen for practical purposes. Although some of the factors are presented individually, they are often inter-linked and rarely occur in isolation. Figure 2.1: Relative Risk of non-fatal coronary heart disease and stroke according to birthweight           ! %LUWKZHLJKWSRXQGV $JHDGMXVWHGUHODWLYHULVN (Source: Barker DJP. Mothers, Babies and Health in Later Life. Churchill Livingston, 1998) 2. FETAL DEVELOPMENT 2.1 Fetal ‘programming’ The life course begins when we are still in the womb, and the influences we are exposed to during this time may leave a lasting mark on it. Current research strongly suggests that adverse influences during fetal life, including undernutrition and lack of oxygen, prompt the fetus to make numerous adaptations to sustain its development. These adapta￾tions may result in persisting changes to organ structure and metabolism, which are called ‘programmed’. They are thought to lead to disease in adult life, such as circulatory diseases, diabetes, chronic airflow obs￾truction and disorders of lipid metabolism. Figure 2.1 shows that the risk for coronary heart disease and stroke falls with increasing birthweight, a surrogate marker for growth in the womb. People who have been undernourished in the womb may therefore be