Heart disease, the biggest killer of men in the UK, is linked to nutrition in the womb and in the first years of life, according to scientists.

David Barker, professor of epidemiology at Southampton University, told a conference in Lausanne in Switzerland yesterday that much greater consideration should be given to the health of mothers-to-be.

Efforts to tackle heart disease in adults had had little success because far too little attention had been paid to factors influencing the baby in the womb and early life that might be behind the epidemic.

"Until recently the general view of coronary heart disease and stroke and other chronic diseases was that they were the product of the way we lived as adults. These ideas have not held up," he told the European Society of Human Reproduction and Embryology.

Prof Barker and his colleagues looked back at the birthweight and weight and height in infancy of more than 5,500 men in their 50s and 60s who died or were admitted to hospital in Finland as a result of heart disease. They found a remarkable pattern.

Those who had been small babies and infants, and had put on a lot of weight as children, were far more likely to develop heart disease; if none had been thin at birth, and if they had all reached average height and weight at age one, the number who developed coronary heart disease might have been halved.

What was happening, Prof Barker said, was that the babies were adapting. "If you under-nourish a foetus, you will permanently change the way it circulates blood, and how it handles fat and glucose. These are very successful tricks, but adaptations in the first years of life are permanent."

The liver would be particularly affected, changing the way it regulated cholesterol. Muscle, on the other hand, was laid down at 30 weeks' gestation and the amount the baby had would never change. Reduced nutrition limited cell growth, so a thin baby would have fewer of all cells, from muscle cells to kidney cells.

What happened next was still conjecture, but it was possible that a high energy, high fat western diet might overload this reduced number of cells. Certainly, Prof Barker said, people who had been small babies should be wary of becoming overweight. It was vital, he said, to focus on the health of women before they became pregnant -not just on food eaten when pregnant, but how the body metabolised food.

His department has begun a study that will seek to enroll every woman in Southampton, logging her weight, size and diet, and following up any pregnancy and child she might have. So far 10,000 women have been recruited.

From Guardian.co.uk