The dramatic emergence of non-communicable diseases (NCDs) in Asia has coincided with the rapid socioeconomic and nutritional transition taking place in the region, with the prevalence of diabetes rising five-fold in Singapore in less than four decades. One unique aspect of the epidemic has been the significant ethnic differences in predisposition among Asians and in the ethnic variation between BMI and the risk of developing insulin resistance. Apart from genetic factors, the differences in diet, lifestyle, cultural and religious practices might have altered the developmental programming through effects on the mechanisms of developmental plasticity. A center piece of this study is to examine how epigenetic change at birth both reflects past developmental influences and, in association with other factors, influences future trajectories of development and its relationship to NCDs. The longitudinal GUSTO birth cohort study allow us to examine associations between genomic variation and developmental-environmental interactions in the three distinct ethnic groups, Chinese, Malays and Indians, present in the Singaporean population.