Babies who are small or disproportionate at birth, or who have altered placental growth are now known to be at an increased risk of developing coronary heart disease, hypertension and diabetes during adult life. This has led to the suggestion that these diseases are 'programmed' by an inadequate supply of nutrients to the developing fetus. The phenomenon of 'programming', whereby undernutrition in early life permanently changes body structure and function, is well documented in animals. As yet, relatively little is known about the maternal influences that alter fetal and placental growth, and underlie the programming of adult cardiovascular disease during fetal development. There are, however, interesting indications that maternal nutrition may be important.