Adolescence, transitional phase of growth and development between childhood and adulthood. The period going from conception to the first 2 years of life -encompassing life in utero, infancy and early childhood- is a critical window for development . This period is characterized by the maturation of metabolic, endocrine, neural, and immune pathways, which eventually determine growth and development during childhood. These pathways are strongly inter-related and influenced by external (environmental) factors such as under and over nutrition, infectious processes and other factors. Early-life exposure to famine triggers persistent epigenetic changes which cause vascular inflammation and structural changes in the cardiovascular system the same exposure increases the preference for fatty food and induces an atherogenic profile  and insulin resistance. On the other hand maternal obesity associates with metabolic syndrome in the offspring and the maternal BMI and gestational diabetes predict offspring adiposity. Early insulin resistance during foetal life and after birth appears to be a key event in the adverse health effects of maternal over nutrition.

Thus, insulin resistance is a common trait in the offspring of under-nourished and over-nourished mothers. Carotid intima thickness (cIMT) is a robust indicator of the atherosclerosis process, from the pre-clinical to the clinical stages. Framingham risk factors including old age, hyperlipidaemia, hypertension, smoking, diabetes, obesity all impinge upon this biomarker and several non-traditional risk factors for atherosclerosis.  Even though the association between low birth weight, a consequence of maternal exposure to famine, and atherosclerotic complications in adults has already been demonstrated. the cardiovascular consequences of exposure to famine after birth remain uncertain . Therefore, the association of an early indicator of atherosclerosis like cIMT with exposure to famine may provide an insight of the effect of famine on the vascular system in childhood.