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Waterlow's suggestion was developed by Hales and Barker who referred to individuals with bodies and metabolisms adapted to a low level of nutrition as having a “thrifty phenotype” (6).

A given genotype may give rise to different phenotypes depending on the state of the environment early in development.

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Fetal experience determines some of the characteristics of human adults.

Well-nourished mothers have offspring who are adapted to affluent conditions; mothers on a low level of nutrition have offspring who are adapted to lean environments.

If the mother's forecast of her offspring's future environment is incorrect, the health of her offspring may suffer severely.

The developmental plasticity that accounts for the ill health of humans who are living in conditions of rapid economic change is commonplace in biology.

Understanding the evolutionary background sets the developmental origins of ill health in humans in context and has profound implications for public health.

Members of the same species, the same sex, and the same age sometimes differ dramatically from each other.

The variation commonly arises because each individual has the capacity to respond in more than 1 way according to the state of the local environment or his or her own body (1).

Individuals have many latent capacities that are expressed only under certain conditions.

The developmental processes of plasticity that are elicited by those conditions normally provide useful adaptations to the environment.

The individual may be likened to a juke box, capable of playing many tunes but, in the course of its life, possibly playing only 1 of a set (2).

The particular suite of adaptations that is expressed is elicited by the conditions in which it grows up or even by the conditions to which its parents and grandparents were exposed (3).

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