OBJECTIVES: To investigate whether nutritional, life-style or behavioural interventions during pregnancy or early life alter risk factors of developing metabolic syndrome and diabetes mellitus and to gain knowledge about the burden of the disease in population of Bangladesh, India and Pakistan. METHODS: A systematic search, using controlled and free terms (i.e.- metabolic-syndrome, glucose-intolerance, diabetes-mellitus, pregnancy, fetal development, life-style, nutrition) was conducted in Medline, Centre for Reviews and Dissemination and Cochrane Library databases. It was completed by pearling and hand-searching. Two reviewers assessed independently the results retrieved in the search, to adopt a decision on inclusion/exclusion. The quality of included papers was appraised with STROBE checklist for observational studies and Centre for Evidence Based Medicine checklists for any other study design. The present review is part of the GIFTS project funded by Seventh Framework Programme of European Commission. RESULTS: The search strategy identified a total of 3,278 papers. After exclusion by title, abstract or duplicated 424 full text articles were retrieved. Up to now we have assessed the 138 latest published papers, excluding 37. Of the 101 included articles 8 were randomized controlled trials, mainly focused on improving maternal and fetal outcomes with nutritional supplementation, but also with community-based interventions. There were another 47 observational studies, including long term follow-up cohorts, which established relationship between fetal development and posterior increased risk of metabolic syndrome for mothers and offspring. The other ones are reviews, most of them narrative reviews, heightening the burden of disease in these countries, the relevance of the pregnancy period, and the necessity of implement preventing strategies. CONCLUSIONS: Metabolic syndrome is a health problem of great magnitude in Bangladesh, India and Pakistan. As early life determinants of the disease are clearly stated, it would be important to now design feasible and cost-effective interventions to prevent  disease.