Summary

longitudinal Australian birth cohort that has serially assessed the offspring of 2900 pregnant women from 18 weeks gestation in utero to 17 years old. 2. The Raine Study data have shown that low birth weight is a surrogate for poor in utero growth from 18 weeks gestation. 3. A U-shaped relationship between birth size and cardio-metabolic risk exists in this Western Australian cohort, implying that both low and high birth weight are associated with increased risk. 4. High birth weight is a risk factor for cardio-metabolic risk, particularly for females. 5. Lifetime adiposity trajectories are better at predicting metabolic risk of the offspring than birth size or current BMI. Therefore, early life programming is an ongoing process, starting in utero and undergoing at least some level of modification in parallel with changes in adiposity, during early childhood. 6. Maternal smoking during pregnancy, maternal obesity, hypertension and diabetes increase the risk for metabolic risk in the offspring. Breast feeding is protective for cardio-metabolic risk in this Australian cohort