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Pre-eclampsia is considerably more prevalent in low and middle income, rather than affluent communities. Two striking exceptions have been identified. First, more than 50 years ago, a low prevalence of pre-eclampsia was reported from Ethiopia where the diet, among other features, contained high levels of calcium; second, the observation in 1980 that Mayan Indians in Guatemala, who traditionally soaked their corn in lime (calcium carbonate) before cooking, had a low incidence of pre-eclampsia and eclampsia. In the 1980s, these data stimulated interest in the concept that an important link between poverty and pre-eclampsia might be dietary calcium deficiency.