Eduardo Sanchez, M.D., M.P.H., FAAFP, American Heart Association Chief Medical Officer for Prevention copyright American Heart Association "The studies that suggest that there might be an epigenetic effect, I think, are corroborated by other studies that we know say that there are environmental factors that trigger genes to turn on and/or off. It should be no surprise, I don't think, that that kind of switching on and/or off might even occur in the fetus."