Despite a strong genetic component to diabetes and obesity, the rapidly rising prevalence of these disorders is due to adaptation to a changing environment. The epicentre of the ‘diabetes epidemic’ is in South Asia and this is reflected in the migrant populations in Europe. Current prevention strategies are focused on adult life and target over-nutrition in high-risk adults. However, for many population groups across the globe, these strategies ignore many key principles that underlie the increasing global prevalence of these diseases. A substantial portion of the South Asian people, living in their home countries experience nutrition deprivation, while after migration to Europe, may encounter nutritional abundance resulting in imbalance during their lifecourse. These conditions are of particular importance during foetal and early developmental stages where environmental insults may interact with genetic risk to induce ‘foetal programming’ of adult metabolic disease. Few groups have targeted early life programming as an opportunity for the prevention of diabetes/obesity in childhood and subsequent adult life and there are limited guidelines on this topic. The proposed grant will bring together a unique group of investigators in South Asia (India, Bangladesh and Pakistan) and Europe (UK, Norway, Germany and Finland) with SMEs of complementary expertise (Germany and Spain) combining prevention strategies, state-of-the-art genomics, social sciences and public health that focus on these early life predictors of disease. The major objective behind this collaborative and multi-disciplinary approach is to combine knowledge from the work packages on lifestyle, nutrition and genomics to both inform public health policy through guideline development and design a large-scale pragmatic intervention to prevent the metabolic syndrome, obesity and diabetes in South Asian populations aimed at early life taking into account multi-generational effects.