Infants born to starving mothers during and after the height of the Germans' 900-day siege of Leningrad, Russia, in World War II appear to be at no greater risk of heart disease or diabetes as adults than those whose mothers were well fed. The finding, published in the 24 November issue of the British Medical Journal, undermines the theory that stressful conditions in the womb can predispose offspring to chronic disease.

The so-called fetal origin hypothesis, first proposed in the early 1990s by epidemiologist David Barker at the University of Southampton in the United Kingdom, is based on studies showing a relationship between variables such as low birth weight with chronic health conditions in adulthood.

People born during the Leningrad siege are an ideal population for testing the fetal origin hypothesis, says physician John Yudkin at University College London Medical School. Working with the Russian Academy of Medical Science in St. Petersburg (formerly Leningrad), Yudkin's group examined the health of 169 people who were in utero between November 1941 and June 1942, when mothers were rationed to 300 calories worth of bread a day. The researchers compared these to 192 adults who were malnourished as infants but were born to well-fed mothers shortly before the siege.

Nearly all of more than 14 physiological indicators for heart disease, such as hypertension and cholesterol levels, were similar between the two groups. However, the group malnourished in utero had a significantly higher concentration of one marker, known as the Willebrand factor, associated with damage to blood vessel linings. While Yudkin does not think this one factor alone can be linked to chronic diseases, he is now looking for additional evidence of blood vessel damage.

Proponents of the fetal origin hypothesis are not swayed by the Leningrad study. Nick Hales, a clinical biochemist at the University of Cambridge, says more differences might have emerged if a larger sample had been examined.