, and the Hertfordshire Cohort Study GroupThe Hertfordshire Cohort Study based in the U.K. was the first to report associations between fetal or infant growth and the prevalence of adult glucose intolerance and diabetes. Many studies have replicated the findings with respect to birth weight, but there have been fewer observations in relationship to infant growth, because this is infrequently recorded in routine datasets. Recently, we carried out glucose tolerance tests in a more recently born group of men and women from the Hertfordshire Cohort Study. The objective was to determine whether the associations with weights at birth and 1 year of age reported in the original study of people born between 1920 and 1930 were observed in people born between 1931 and 1939. Birth weight was inversely related to the overall prevalence of diabetes (comprising newly diagnosed as well as existing cases) in men and women. However, weight at 1 year of age was not associated with diabetes in either sex. Analysis of data from the glucose tolerance tests showed that both sexes had evidence of higher insulin and glucose concentrations in people who were small at birth or during infancy. Finally, direct comparison of 2-h plasma glucose concentrations in the previous and current Hertfordshire study suggested that both surveys showed broad similarity of the trends in glucose tolerance with birth or infant weights; most differences arose at the extremes of the birth weight, possibly because of the small numbers of subjects studied in these groups. Diabetes 54 (Suppl. 2):S145-S150, 2005 S tudies originating in the Hertfordshire cohort in the U.K. were the first to show that low birth and infant weights are linked with a higher prevalence of impaired glucose tolerance and type 2 diabetes in adult life (1,2). The studies showed strong and continuous associations between early growth and the prevalence of these conditions. For example, the prevalence of men with impaired glucose tolerance fell progressively from 26% among those who had weighed Յ18 lb (Յ8.16 kg) at 1 year of age to 13% among those who had weighed Ն27 lb (Ն12.25 kg). Corresponding figures for diabetes were 17% and nil. The associations appear to be independent of known adult risk factors for diabetes, including adult BMI. These findings spawned the fetal origins hypothesis, which proposes that the birth and infant weight associations result from fetal undernutrition (3). It is suggested that fetal undernutrition causes longterm changes in body composition and physiology, which in turn predispose to adult glucose intolerance and diabetes. The hypothesis is strongly supported by a large body of data from animal experiments that show that experimental undernutrition during gestation in a variety of species, including rodents, sheep, and guinea pigs, leads to altered glucose tolerance in the offspring (4).In light of these findings, a number of studies have been carried out in Europe, North America, and developing countries (5). These broadly confirm the Hertfordshire findings, a...