Syn: thrifty phenotype hypothesis. A hypothesis proposed in 1990 by the British epidemiologist David Barker (b. 1939) that intrauterine growth retardation, low birth weight, and premature birth have a causal relationship to the origins of hypertension, coronary heart disease, and non-insulin-dependent diabetes, in middle age. Barker's hypothesis derived from a historical cohort study that revealed a significant association between the occurrence of hypertension and coronary heart disease in middle age and premature birth or low birth weight. The hypothesis is not supported by evidence from low-income countries, where intrauterine growth retardation and low birth weight are common but hypertension and coronary heart disease are less prevalent than in high-income countries. The evidence is presented in Barker's book Fetal and Infant Origins of Adult Disease (1992).