Abstract:
The Lancet has rightly drawn attention to the goals of reducing the burden of maternal and childhood undernutrition,1 focusing mainly on short-term outcomes such as infant survival and stunting.2 However, the longer term effects on adult health3 of a poor start to life suggest a further perspective. Developmental effects have been viewed traditionally in the context of major disruptions such as caused by teratogens, prematurity and growth retardation, but there is increasing appreciation of the role of developmental plasticity, which provides individuals with the flexibility to adjust their trajectory of development to match their environment. Plasticity operates across the entire range of environment, from undernutrition to excessive nutritional environments associated with gestational diabetes or maternal obesity, [4] and [5] leading to multigenerational cycles of disease.6 Intervention strategies need to take account of these complexities....