The Rankin Scale is not a pure handicap measure but should be viewed as a global functional health index with a strong accent on physical disability. The index is useful as a simple and time-efficient outcome measure in largescale multicenter trials. It is argued that at present there is no clear need to assess handicap as the primary outcome in medically oriented stroke intervention studies.

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Objective We previously showed that maternal under-nutrition during gestation is associated with increased metabolic and cardiovascular disease in the offspring. Also, we found increased neonatal adiposity among the grandchildren of women who had been undernourished during pregnancy. In the present study we investigated whether these transgenerational effects have led to altered body composition and poorer health in adulthood in the grandchildren.Design Historical cohort study.Setting Web-based questionnaire.Population The adult offspring (F2) of a cohort of men and women (F1) born around the time of the 1944-45 Dutch famine.Methods We approached the F2 adults through their parents. Participating F2 adults (n = 360, mean age 37 years) completed an online questionnaire.Main outcome measures Weight, body mass index (BMI), and health in F2 adults, according to F1 prenatal famine exposure.Results Adult offspring (F2) of prenatally exposed F1 fathers had higher weights and BMIs than offspring of prenatally unexposed F1 fathers (+4.9 kg, P = 0.03; +1.6 kg/m², P = 0.006). No such effect was found for the F2 offspring of prenatally exposed F1 mothers. We observed no differences in adult health between the F2 generation groups.Conclusions Offspring of prenatally undernourished fathers, but not mothers, were heavier and more obese than offspring of fathers and mothers who had not been undernourished prenatally. We found no evidence of transgenerational effects of grandmaternal under-nutrition during gestation on the health of this relatively young group, but the increased adiposity in the offspring of prenatally undernourished fathers may lead to increased chronic disease rates in the future.