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The physician and epidemiologist David Barker, who has died aged 75, posited the initially controversial but now widely accepted idea that common chronic illnesses such as cancer, cardiovascular disease and diabetes result not always from bad genes and an unhealthy adult lifestyle, but from poor intrauterine and early postnatal health. In one of his last public speeches, he argued: "The next generation does not have to suffer from heart disease or osteoporosis. These diseases are not mandated by the human genome. They barely existed 100 years ago. They are unnecessary diseases. We could prevent them had we the will to do so."The physician and epidemiologist David Barker, who has died aged 75, posited the initially controversial but now widely accepted idea that common chronic illnesses such as cancer, cardiovascular disease and diabetes result not always from bad genes and an unhealthy adult lifestyle, but from poor intrauterine and early postnatal health. In one of his last public speeches, he argued: "The next generation does not have to suffer from heart disease or osteoporosis. These diseases are not mandated by the human genome. They barely existed 100 years ago. They are unnecessary diseases. We could prevent them had we the will to do so."
He believed that public health medicine was failing and that its cornerstone should be the protection of the nutrition of young women. The "Barker hypothesis" or "foetal programming hypothesis" proposed that the environment of the foetus and infant – determined by the mother's nutrition and the baby's exposure to infection after birth – determines the pathologies of later life. David drew an analogy between human beings and cars: "Across the world there is now general agreement that human beings are like motor cars. They break down either because they are being driven on rough roads or because they were badly made in the first place. Rolls-Royce cars do not break down no matter where they are being driven. How do we build stronger people? By improving the nutrition of babies in the womb. The greatest gift we could give the next generation is to improve the nutrition and growth of girls and young women."He believed that public health medicine was failing and that its cornerstone should be the protection of the nutrition of young women. The "Barker hypothesis" or "foetal programming hypothesis" proposed that the environment of the foetus and infant – determined by the mother's nutrition and the baby's exposure to infection after birth – determines the pathologies of later life. David drew an analogy between human beings and cars: "Across the world there is now general agreement that human beings are like motor cars. They break down either because they are being driven on rough roads or because they were badly made in the first place. Rolls-Royce cars do not break down no matter where they are being driven. How do we build stronger people? By improving the nutrition of babies in the womb. The greatest gift we could give the next generation is to improve the nutrition and growth of girls and young women."
David's ideas led to an explosion of research worldwide into the complex processes of nutrition and growth during intrauterine and early postnatal life, and how these cause adult disease. Always an idealist and motivated by the desire to alleviate human suffering, David believed that the poorer health of people in lower socioeconomic groups was linked to neglect of the welfare of mothers and babies.David's ideas led to an explosion of research worldwide into the complex processes of nutrition and growth during intrauterine and early postnatal life, and how these cause adult disease. Always an idealist and motivated by the desire to alleviate human suffering, David believed that the poorer health of people in lower socioeconomic groups was linked to neglect of the welfare of mothers and babies.
David was born in London, son of Hugh, an engineer, and Joye, a concert cellist. At Oundle school, David's scientific career was sparked by an exceptional biology teacher, Ioan Thomas, who gave him freedom to roam the fields, woods, and riverbanks around the school, where he developed his interest in British beetles. He was given after-hours access to the biology classrooms and used the equipment to classify his finds. When he left school, the Natural History Museum asked him to mount an expedition to collect plant specimens from the Icelandic offshore island of Grimsey.David was born in London, son of Hugh, an engineer, and Joye, a concert cellist. At Oundle school, David's scientific career was sparked by an exceptional biology teacher, Ioan Thomas, who gave him freedom to roam the fields, woods, and riverbanks around the school, where he developed his interest in British beetles. He was given after-hours access to the biology classrooms and used the equipment to classify his finds. When he left school, the Natural History Museum asked him to mount an expedition to collect plant specimens from the Icelandic offshore island of Grimsey.
He undertook medical training at Guy's hospital, London, but maintained his interest in science throughout, and had his first paper published in Nature in 1961. In 1963, a year after qualifying, he became a research fellow in the department of social medicine at Birmingham University, studying under Tom McKeown, a social epidemiologist.He undertook medical training at Guy's hospital, London, but maintained his interest in science throughout, and had his first paper published in Nature in 1961. In 1963, a year after qualifying, he became a research fellow in the department of social medicine at Birmingham University, studying under Tom McKeown, a social epidemiologist.
In 1969, with a grant from the MRC, David took his first wife, Angela, and four young children to Uganda, to research Mycobacterium ulcerans infection ("Buruli ulcer"). Little was known about this disabling infection, but David questioned the received wisdom that it was mosquito-borne. With the Scottish surgeon Wilson Carswell, he demonstrated that wounds caused by the razor-sharp reeds growing near the river Nile were behind the transmission of Buruli ulcer. David's stay in Uganda was cut short when President Idi Amin plunged the country into crisis and he gathered up his wife and children and drove them by night to safety in Kenya.In 1969, with a grant from the MRC, David took his first wife, Angela, and four young children to Uganda, to research Mycobacterium ulcerans infection ("Buruli ulcer"). Little was known about this disabling infection, but David questioned the received wisdom that it was mosquito-borne. With the Scottish surgeon Wilson Carswell, he demonstrated that wounds caused by the razor-sharp reeds growing near the river Nile were behind the transmission of Buruli ulcer. David's stay in Uganda was cut short when President Idi Amin plunged the country into crisis and he gathered up his wife and children and drove them by night to safety in Kenya.
In 1979 David became professor of clinical epidemiology at the University of Southampton medical school, and in 1984 he was appointed director of the Medical Research Council Environmental Epidemiology Unit, now the MRC Lifecourse Epidemiology Unit.In 1979 David became professor of clinical epidemiology at the University of Southampton medical school, and in 1984 he was appointed director of the Medical Research Council Environmental Epidemiology Unit, now the MRC Lifecourse Epidemiology Unit.
It was during this period that he made his observation that maps of the UK showing, county by county, neonatal and post-neonatal mortality in the 1910s and 20s showed a strong geographical correlation with maps showing death from heart disease 60 to 70 years later. For the first time, he was hit with the realisation that an adverse environment in the womb and during infancy might be linked to the risk of chronic disease in later life. This field – developmental origins of health and disease, or DOHaD – proved the focus for the rest of his life's work. Evidence to support his hypothesis has since come from populations as far apart as Finland and India, and draws together foetal physiologists, zoologists, placentologists and nutritionists.It was during this period that he made his observation that maps of the UK showing, county by county, neonatal and post-neonatal mortality in the 1910s and 20s showed a strong geographical correlation with maps showing death from heart disease 60 to 70 years later. For the first time, he was hit with the realisation that an adverse environment in the womb and during infancy might be linked to the risk of chronic disease in later life. This field – developmental origins of health and disease, or DOHaD – proved the focus for the rest of his life's work. Evidence to support his hypothesis has since come from populations as far apart as Finland and India, and draws together foetal physiologists, zoologists, placentologists and nutritionists.
David was a warm, humorous man who created an academic environment where science could prosper but which at the same time was alive with banter and fun. He published more than 500 research papers and 10 books, was a fellow of the Royal College of Physicians, the Royal College of Obstetricians and Gynaecologists and the Royal College of Paediatrics and Child Health. Among many other honours, he was made a fellow of the Royal Society and of the Academy of Medical Sciences in 1998 and made a CBE for his services to preventative medicine in 2006.David was a warm, humorous man who created an academic environment where science could prosper but which at the same time was alive with banter and fun. He published more than 500 research papers and 10 books, was a fellow of the Royal College of Physicians, the Royal College of Obstetricians and Gynaecologists and the Royal College of Paediatrics and Child Health. Among many other honours, he was made a fellow of the Royal Society and of the Academy of Medical Sciences in 1998 and made a CBE for his services to preventative medicine in 2006.
Angela died in 1980. David is survived by his second wife, Jan; his three sons and two daughters from his first marriage; a stepson and two stepdaughters from his second; and 13 grandchildren.Angela died in 1980. David is survived by his second wife, Jan; his three sons and two daughters from his first marriage; a stepson and two stepdaughters from his second; and 13 grandchildren.
• David James Purslove Barker, physician and epidemiologist, born 29 June 1938; died 27 August 2013• David James Purslove Barker, physician and epidemiologist, born 29 June 1938; died 27 August 2013
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