28 Villar J, Smeriglio V, Martorell R, Brown CH, Klein RE. Heterogeneous growth and mental development of intrauterine growth retarded infants during the first 3 years of life. Paediatrics 1984;74:783-91 Results-Men and women who had had a small abdominal circumference at birth had raised serum concentrations of total and low density lipoprotein cholesterol and apolipoprotein B. This was independent of the duration of gestation. Serum concentrations of total cholesterol fell by 0 25 mmol/l (95% confidence interval 0 09 to 0.42) with each 1 in (2.54 cm) increase in abdominal circumference. The corresponding figure for serum low density lipoprotein cholesterol was 0-26 mmol/l (0.11 to 0 42) and for serum apolipoprotein B 0 04 g/l (0.02 to 0 07).

Recent epidemiological studies in people whose birth weights were recorded many years ago suggest links between impaired growth during early life and the development of diseases, including diabetes, much later in life. The long-term effects of retarded early growth are proposed to result from malnutrition at critical periods of fetal or infant development leading to reduction in the growth of organs and permanent changes in their metabolism or structure, or both. In order to investigate this, a rat model was established which involved feeding either a diet containing 200 g protein/kg or an isoenergetic diet containing 80 g protein/kg to pregnant and lactating rats. In addition, cross-fostering techniques were employed which allowed a separate evaluation of the prenatal or the postnatal periods. The offspring were studied at 21 d of age or were weaned onto a normal laboratory chow and studied at 11 months of age. The 80g protein/kg diet during pregnancy did not affect the overall reproductive performance although more subtle differences were evident. Permanent growth retardation was evident in offspring subjected to maternal protein restriction during the postnatal period. At 21 d of age the offspring of protein-restricted mothers exhibited selective changes in organ growth: compared with the body weight, the lung and brain experienced a smaller decrease in weight; the heart, kidney and thymus decreased proportionately; whereas, the pancreas, spleen, muscle and liver showed a greater reduction in weight. In older animals the muscle weight was lower in the male rats and the relative weight of pancreas was increased in the female rats.Maternal diet: Growth: Nutritional programming

Objective-To examine whether method of infant feeding is associated with adult serum lipid concentrations and mortality from ischaemic heart disease.Design-Follow up study of men born during 1911-30. Setting-Hertfordshire, England. Subjects-5718 men, for 5471 of whom information on infant feeding had been recorded by health visitors and 1314 of whom had died. 485 of the men born during and still living in Hertfordshire who had blood lipid measurements.Main outcome measures-Death from ischaemic heart disease; serum cholesterol and apolipoprotein concentrations.Results-474 men had died from ischaemic heart disease. Standardised mortality ratios were 97 (95% confidence interval 81 to 115) in men who had been breast fed and had not been weaned at 1 year, 79 (69 to 90) in breast fed men who had been weaned at 1 year, and 73 (59 to 89) in men who had been breast and bottle fed. Compared with men weaned before one year men not weaned had higher mean serum concentrations of total cholesterol (6-9 (not weaned) v 6-6 (weaned) mmol/l), low density lipoprotein cholesterol (5.0 v 4-6 mmol/l) and apolipoprotein B