Revisiting the Forsdahl-Barker hypothesis]

The hypothesis about the influence of the environment in early life for later health and development has been the basis for several hundred studies over the last two decades. Despite some diverging results in different studies and methodological shortcomings, including selection and confounding from socio-economic and other factors, there seems to be substantial evidence to the effect that the environment in early life is essential for later health and development. The association of low birthweight and risk of cardiovascular disease later in life is the most consistent finding, though the causal pathways for this connection have not been traced. Permanent damage caused by inadequate nutrition in critical periods of early life expressed as chronic disease later in life is a favoured hypothesis. To further elucidate potential mechanisms, there is a need for refining the measurement parameters for early experience. Placenta function, quality of nutrition, infections, hormonal and genetic factors may also play a role. The course-of-life approach claims that early life is an important period in human life, but not the only one. Continuous life events and socio-economic circumstances may modify early life experiences. Such an approach may be useful in order to see early life events in the right perspective.