Pattern of early growth was shown to reflect future health of an individual. These facts have given insights to early origins of adult diseases and introducing new avenues of primordial/primary prevention of such illnesses. Barker thought effects were due to exposure to an adverse environment in utero resulting in failure to grow and it shows that when they continue to get exposed to an “adverse environment” in life, it produces the effects attributed to “programming” in utero. In India and China many babies born were small but coronary heart disease or diabetes mellitus was NOT prevalent, especially during the last century. Coronary heart disease and diabetes in India and China have begun to increase recently, perhaps with the LBW cohorts getting exposed to - high calorie diets and low physical activity environments. Nutrition and socio economic transition could be the “ADVERSE ENVIRONMENT”. Prof. Pujitha Wickramasinghe in this interesting topic highlights the need for proper nutrition, not in excess not in less, guided by close growth monitoring and allowing growing along the birth centile would be helpful in controlling NCD.