Individuals who were small at birth have an increased risk of cardiovascular disease in later life. Barker has put forward a hypothesis to explain this and other associations, known as the 'fetal origins theory of adult disease'. It is proposed that chronic disease is the long-term outcome of physiological adaptations the unborn baby makes when it is undernourished, a process referred to as 'programming'. Maternal nutrition is thought to be a major influence on programming, and growth in childhood as well as obesity in later life may modulate the propensity for disease acquired in the womb. While robust evidence to support specific nutritional interventions during pregnancy is currently lacking, the theory in general affirms broader public health nutritional strategies and policies to improve the social and economic status of women.