I would submit that this epidemiological analysis is a good candidate for application of the P:E theory. Regardless of whether the children in the market town ate meat and dairy, potentially one of the major influences not analyzed is the distorted P:E (protein to energy) consumption ratio. Just a guess, the children in the market town were eating a lot of energy in the form of carbs and unhealthy fats compared to the rural children. Just a guess . . . .