Figure.

Conceptual framework for fetal, infant, childhood, and adult influences on risk of cardiovascular disease at age 49-51 years. Pathways 1-5 are direct effects of each stage of lifecourse on carotid intima-media thickness, and pathways A-D are indirect effects mediated through later stages of lifecourse. Adult lifestyle and behaviour variables are cigarette smoking, alcohol consumption, exercise level, physical inactivity, and percentage total energy from fat. Adult biological risk markers are waist to hip ratio, systolic blood pressure, concentrations of serum low density lipoprotein cholesterol, serum high density lipoprotein cholesterol, serum triglycerides, plasma fibrinogen, 2 hour plasma glucose, and fasting insulin at time of screening