mismatch between a fetal/early life metabolism and that in middle age
rapid change in some risk factors that may confer risk e.g. Punjabis in Southall had a mean serum cholesterol of 6.5 mmol/l compared with 4.9 mmol/l for their siblings in Punjab, India. By inference, migration had led to a rise in cholesterol by 1.6 mmol/l. This rapid rise in a risk factor for ischaemic heart disease could be very important (1)
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