EDITOR—Leon et al claim that their study is “the most persuasive evidence of a real association between size at birth and mortality from ischaemic heart disease.”1 However, the study is open to different interpretations and, in my view, inflicts a serious wound on the birth measurement and adult disease hypothesis.

Their table 3shows that there was no significant association between birth weight and all cause mortality in either sex. Both sexes showed a positive association between birth weight and death from neoplasms and respiratory disease, though none of these were significant. The negative association between birth weight and deaths from circulatory disease was significant only in men. In women there were no significant associations between birth weight and any cause of death. Subsequently, most of the analysis concentrates on the association of death from ischaemic disease and birth measurements in men.

This study is …