Epigenetics and fetal metabolic programming: a call for integrated research on larger cohorts

Fetal metabolic programming is a concept firstsuggested by Barker and Hales (1,2) in the early1990s. On the basis of compelling epidemiologi-cal evidence, they hypothesized that fetal and perinatal events, such as maternal undernutrition, were central to determine one’s risk to develop chronic meta-bolic diseases. Such conditions, including obesity, di-abetes, and cardiovascular diseases, have become a very important population health concern. Since the first in-troduction of this concept, it has been corroborated by many animal but only few human studies (3). Therefore, a number of key issues remain to be clarified, with the most important being our knowledge of the mechanisms involved in fetal metabolic programming. In brief, more research is needed in human models of fetal metabolic programming. One such promising model is gestational diabetes mellitus (GDM). GDM is a form of diabetes first diagnosed during preg