Associations between hydration status, body composition, sociodemographic and lifestyle factors in the general population: a cross-sectional study.

BACKGROUND: Whole-body hydration status is associated with several health outcomes, such as dehydration, edema and hypertension, but little is known about the nonclinical determinants. Therefore, we studied the associations of sex, age, body composition, nutrition, and physical activity on several body hydration measures. METHODS: We assessed sociodemographic variables, dietary habits, and physical activity by questionnaire and body composition by bioelectric impedance analysis (BIA). We compared determinants between the sexes and calculated associations between determinants and BIVA hydration measures by multivariable linear regressions. RESULTS: A total of 242 adults from the general population (age 18-94, 47% women) were included. Women were younger, smaller, lighter, and had a smaller BMI (kg/m2) than men (p < 0.05). Women had less muscle mass, less visceral fat mass and less extracellular and intracellular water than men (p < 0.001). Women showed less intracellular water per extracellular water than men, while men showed higher phase angle values than women (both p < 0.001). Men had a stronger association of hydration measures with physical activity than women. Both sexes showed a decrease in hydration measures with age. CONCLUSIONS: Sex, age, body composition, and physical activity influence body hydration. There seem to be differences in body water regulation between the sexes. Especially interesting are factors susceptible to preventive measures such as physical activity.

Bronze Age population dynamics and the rise of dairy pastoralism on the eastern Eurasian steppe.

Recent paleogenomic studies have shown that migrations of Western steppe herders (WSH) beginning in the Eneolithic (ca. 3300-2700 BCE) profoundly transformed the genes and cultures of Europe and central Asia. Compared with Europe, however, the eastern extent of this WSH expansion is not well defined. Here we present genomic and proteomic data from 22 directly dated Late Bronze Age burials putatively associated with early pastoralism in northern Mongolia (ca. 1380-975 BCE). Genome-wide analysis reveals that they are largely descended from a population represented by Early Bronze Age hunter-gatherers in the Baikal region, with only a limited contribution (∼7%) of WSH ancestry. At the same time, however, mass spectrometry analysis of dental calculus provides direct protein evidence of bovine, sheep, and goat milk consumption in seven of nine individuals. No individuals showed molecular evidence of lactase persistence, and only one individual exhibited evidence of >10% WSH ancestry, despite the presence of WSH populations in the nearby Altai-Sayan region for more than a millennium. Unlike the spread of Neolithic farming in Europe and the expansion of Bronze Age pastoralism on the Western steppe, our results indicate that ruminant dairy pastoralism was adopted on the Eastern steppe by local hunter-gatherers through a process of cultural transmission and minimal genetic exchange with outside groups.

First-time complete visualization of a preserved meningeal artery in the mummy of Nakht-ta-Netjeret (ca. 950 BC).

The preservation of the meningeal artery in ancient mummified bodies, particularly in anthropogenic Egyptian mummies, is a highly controversial topic in neuroscience and anthropological research. A recent (2015) debate between Wade and Isidro, based on the interpretation of the meningeal grooves and cast in a skull from the necropolis of Kom al-Ahmar Sharuna (Egypt), highlighted both the necessity of having clear radiological descriptions of this anatomical structure and of assessing large collections of mummified crania. Here, we present for the first time an instance of extremely well-preserved middle meningeal artery in the mummy of the ancient Egyptian dignitary Nakht-ta-Netjeret (ca. 950 BC), still inside the meninx, using paleo-radiological techniques. We finally link this find with experimental data from the neurological literature on the methodology of excerebration implemented by ancient Egyptian embalmers.

The earliest known case of frontal sinus osteoma in man.

Frontal sinus osteoma is a relatively common finding in the modern clinical setting. Although, its paleopathological record is not in dispute, its presence in Ancient Egypt has never been clarified. The aim of this article is to contribute to the debate. An Egyptian mummy head from the Musée d'Éthnographie de Neuchâtel (Switzerland) was studied radiologically and the obtained evidence was contextualized in the wider frame of multidisciplinary paleopathology. A 128-slice CT scanner was used for further investigation; datasets were processed with OsiriX-64 bit (version 5.8.5), and multiplanar (MPR) and volumetric reconstructions were performed. A small hyperdense and well-defined structure, most likely an osteoma, was identified in the right frontal sinus. Frontal sinus osteoma definitely existed in Ancient Egypt. Finally, this represents the oldest case in anatomically modern humans so far reported. Clin. Anat.32:105-109, 2019. © 2018 Wiley Periodicals, Inc.

Greater family size is associated with less cancer risk: an ecological analysis of 178 countries.

BACKGROUND: Greater family size measured with total fertility rate (TFR) and with household size, may offer more life satisfaction to the family members. Positive psychological well-being has been postulated to decrease cancer initiation risk. This ecological study aims to examine the worldwide correlation between family size, used as the measure of positive psychological well-being, and total cancer incidence rates. METHODS: Country specific estimates obtained from United Nations agencies on total cancer incidence rates (total, female and male rates in age range 0-49 years and all ages respectively), all ages site cancer incidence (bladder, breast, cervix uteri, colorectum, corpus uteri, lung, ovary and stomach), TFR, household size, life expectancy, urbanization, per capita GDP PPP and self-calculated Biological State Index (Ibs) were matched for data analysis. Pearson's, non-parametric Spearman's, partial correlations, independent T-test and multivariate regressions were conducted in SPSS. RESULTS: Worldwide, TFR and household size were significantly and negatively correlated to all the cancer incidence variables. These correlations remained significant in partial correlation analysis when GDP, life expectancy, Ibs and urbanization were controlled for. TFR correlated to male cancer incidence rate (all ages) significantly stronger than it did to female cancer incidence rate (all ages) in both Pearson's and partial correlations. Multivariate stepwise regression analysis indicated that TFR and household size were consistently significant predictors of all cancer incidence variables. CONCLUSIONS: Countries with greater family size have lower cancer risk in both females, and especially males. Our results seem to suggest that it may be worthwhile further examining correlations between family size and cancer risk in males and females through the cohort and case-control studies based on large samples.

A Case of Sudden Death in Decameron IV.6: Aortic Dissection or Atrial Myxoma?

Giovanni Boccaccio's Decameron contains a novella that details the sudden death of a young man called Gabriotto, including a portrayal of the discomfort that the protagonist experienced and a rudimentary autopsy performed by local physicians. The intriguing description of symptoms and pathologies has made it possible to read a 7-century-old case through the modern clinical lens. Thanks to the medical and philological analysis of the text-despite the vast difference between modern and medieval medicine-2 hypothetical diagnoses have emerged: either an aortic dissection or an atrial myxoma.

Untargeted metabolomics-like screening approach for chemical characterization and differentiation of canopic jar and mummy samples from Ancient Egypt using GC-high resolution MS.

In Ancient Egypt it was common practice to embalm corpses and specific internal organs to ensure eternal life. The exact nature of the employed embalming fluids, particularly for organ preservation within the canopic jars, is debated. Therefore, the aim of the current study, was to chemically characterize and differentiate canopic jars (n = 28) and mummies (n = 6) using gas chromatography - high resolution mass spectrometry (GC-HR MS) with a new untargeted metabolomics-like screening approach; as part of a larger minimal-invasive transdisciplinary study on Ancient Egyptian human tissues. Post-analytical data processing included deconvolution, screening against the NIST 14 spectral database as well as a high resolution metabolomics library, and positive peak evaluation. In the majority of samples the presence of a coniferous resin was indicated by the detection of longiborneol in combination with abietadiene acid derivatives and guajacol. Beeswax, proposedly used for symbolic reasons and/or as a binding agent, was detected in 10 samples. Previously not mentioned in the literature, but identified in the current sample set, were medical-related substances like aniseed constituents, salicylic acid, chamazulene and jacobine. By applying an untargeted metabolomics-like approach to archaeological samples for the first time, extensive statistical analysis was made possible (using both identified and non-identified features; adding up to 4381 features), which showed significant differences in the overall chemical composition of canopic jar and mummy samples using principle component analysis (PCA) and partial least square-discriminant analysis (PLS-DA). This emphasizes the necessity for more extensive canopic jar studies in the future in order to interpret findings correctly.

Gout in Duke Federico of Montefeltro (1422-1482): a new pearl of the Italian Renaissance.

The article examines the truthfulness of historical accounts claiming that Renaissance Duke Federico of Montefeltro (1422-1482) suffered from gout. By direct paleopathological assessment of the skeletal remains and by the philological investigation of historical and documental sources, primarily a 1461 handwritten letter by the Duke himself to his personal physician, a description of the symptoms and Renaissance therapy is offered and a final diagnosis of gout is formulated. The Duke's handwritten letter offers a rare testimony of ancient clinical self-diagnostics and Renaissance living-experience of gout. Moreover, the article also shows how an alliance between historical, documental and paleopathological methods can greatly increase the precision of retrospective diagnoses, thus helping to shed clearer light onto the antiquity and evolution of diseases.

Egyptian Canopic Jars at the Crossroad of Medicine and Archaeology: Overview of 100 Years of Research and Future Scientific Expectations.

Ancient Egyptian human remains have been of interest in the fields of both medical and Egyptological research for decades. However, canopic jar holders for internal organs (liver, lungs, stomach, intestines) of Egyptian mummies appear to be but a very occasional source of data for such investigations. The few medical approaches focusing on the content of these jars are summarized and listed according to pathogens and diseases to give a structured overview of this field of study. An extensive search of the literature has been conducted from different bibliographic databases with a total of n = 26 studies found. The majority of diseases found consisted of infectious diseases and internal medicine conditions such as schistosomiasis or emphysema. These are just 2 examples of many that, instead of primarily affecting bone, muscle or skin, specifically target internal organs. Hence, a better understanding of the evolution of diseases that still affect mankind could be gained. In conclusion, this reassessment shows that canopic jars represent a highly underestimated source for histological, radiological and ancient DNA examination of Ancient Egyptian remains and should, thus, be more and more brought back into the focus of retrospective medical research.

2,000 Year old ß-thalassemia case in Sardinia suggests malaria was endemic by the Roman period.

OBJECTIVES: The island of Sardinia has one of the highest incidence rates of ß-thalassemia in Europe due to its long history of endemic malaria, which, according to historical records, was introduced around 2,600 years ago by the Punics and only became endemic around the Middle Ages. In particular, the cod39 mutation is responsible for more than 95% of all ß-thalassemia cases observed on the island. Debates surround the origin of the mutation. Some argue that its presence in the Western Mediterranean reflects the migration of people away from Sardinia, others that it reflects the colonization of the island by the Punics who might have carried the disease allele. The aim of this study was to investigate ß-globin mutations, including cod39, using ancient DNA (aDNA) analysis, to better understand the history and origin of ß-thalassemia and malaria in Sardinia. MATERIALS AND METHODS: PCR analysis followed by sequencing were used to investigate the presence of ß-thalassemia mutations in 19 individuals from three different Roman and Punic necropolises in Sardinia. RESULTS: The cod39 mutation was identified in one male individual buried in a necropolis from the Punic/Roman period. Further analyses have shown that his mitochondrial DNA (mtDNA) and Y-chromosome haplogroups were U5a and I2a1a1, respectively, indicating the individual was probably of Sardinian origin. CONCLUSIONS: This is the earliest documented case of ß-thalassemia in Sardinia to date. The presence of such a pathogenic mutation and its persistence until present day indicates that malaria was likely endemic on the island by the Roman period, earlier than the historical sources suggest.

Temporal trends, regional variation and socio-economic differences in height, BMI and body proportions among German conscripts, 1956-2010.

OBJECTIVE: We analyse temporal trends and regional variation among the most recent available anthropometric data from German conscription in the years 2008-2010 and their historical contextualization since 1956. Design/setting/subjects The overall sample included German conscripts (N 13 857 313) from 1956 to 2010. RESULTS: German conscripts changed from growing in height to growing in breadth. Over the analysed 54 years, average height of 19-year-old conscripts increased by 6·5 cm from 173·5 cm in 1956 (birth year 1937) to 180·0 cm in 2010 (birth year 1991). This increase plateaued since the 1990s (1970s birth years). The increase in average weight, however, did not lessen during the last two decades but increased in two steps: at the end of the 1980s and after 1999. The weight and BMI distributions became increasingly right-skewed, the prevalence of overweight and obesity increased from 11·6 % and 2·1 % in 1984 to 19·9 % and 8·5 % in 2010, respectively. The north-south gradient in height (north = taller) persisted during our observations. Height and weight of conscripts from East Germany matched the German average between the early 1990s and 2009. Between the 1980s and the early 1990s, the average chest circumference increased, the average difference between chest circumference when inhaling and exhaling decreased, as did leg length relative to trunk length. CONCLUSIONS: Measuring anthropometric data for military conscripts yielded year-by-year monitoring of the health status of young men at a proscribed age. Such findings contribute to a more precise identification of groups at risk and thus help with further studies and to target interventions.

Multivariable analysis of total cholesterol levels in male Swiss Armed Forces conscripts 2006-2012 (N = 174,872).

BACKGROUND: Cholesterol is an important contributor to morbidity and mortality risks due to its association with obesity, cardiovascular disease, and cancer. A system of mandatory military conscription is a useful tool for disease-risk monitoring in a given male population. Swiss military conscription data are representative for more than 90% of a given male birth cohort (with Swiss citizenship). The medical examination also includes voluntary laboratory testing, for which approximately 65% of the young men present at conscription give consent. METHODS: Here we present the temporal and subgroup analyses of total serum cholesterol levels (TCL) among Swiss conscripts from 2006 to 2012 (N = 174,872; mean age = 19.75 years). The voluntary blood samples were tested by a central laboratory (Viollier AG) with identical measurement standards and strict quality control. To test differences in TCL by socioeconomic occupational status, sports test performance, Body Mass Index (BMI), age, and place of residence of the conscripts we used a multivariable regression model with TCL as dependent variable. RESULTS: Mean TCL decreased significantly, by 0.125 mmol/l (95% CI 0.108-0.142, p < 0.001) from 4.225 mmol/l (95% CI 4.210-4.240) in 2006 to 4.100 mmol/l (95% CI 4.091-4.109) in 2012. Similarly, the prevalence of conscripts with an elevated TCL ≥ 5.17 mmol/l decreased from ≥ 10.2% prior to 2011 to 6.9% in 2011 and 8.2% in 2012. Multivariate regression showed an association between elevated TCL and lower socioeconomic occupational status, lower sports test performance, higher BMI, higher age, and area of residence. There was no longer a significant increase in mean TCL among the three grades of obesity (BMI ≥ 30.0 kg/m2) as defined by the WHO. Within the BMI categories of normal weight and overweight, TCL was stratified by sports performance (better sports performance = lower TCL). CONCLUSION: Decreasing TCL in 2011 and 2012 fits the known pattern of conscripted persons' stabilizing BMI and sports test performance of the conscripts in recent years. However, small temporal drifts within the laboratory analyses cannot be ruled out as confounding factors. In conclusion, identifying subgroups with unfavorable lipid profiles will contribute to the continuing success of intensified public health programs.

Palaeopathology: Current challenges and medical impact.

Palaeopathology is the science which studies ancient human diseases. Throughout its relatively young history it underwent tremendous technological and methodological improvements (from pure morphology and histology to CT scanning) that have constantly reshaped its scientific rationale. Among other achievements, the study of mummies and fossilized hominids has allowed to effectively extract ancient DNA, prove the existence of atherosclerosis in ancient times, demonstrate the presence of disease vectors, better clarify the etiology of infectious diseases otherwise only postulated on the basis of ancient accounts as well as to show the presence of spine pathology in our hominid ancestors. The research levels in this discipline are three: basic research, individual cases, population. The first and the third levels contribute most to the discipline, while the second is the one more appealing to the general public on account of its description of important cases reports. In addition, a recently introduced sub-specialty of palaeopathology, pathography is aiming to use an interdisciplinary approach to find traces of diseases in ancient literary sources and artistic representations. In spite of its discoveries, palaeopathology is not always viewed positively by clinicians because certain old-fashioned techniques are still due to technical restrictions. The authors provide a set of suggestions on how to strengthen the scientific recognition of this subject and explain at length how it could contribute to the progress of medical research. Clin. Anat. 29:816-822, 2016. © 2016 Wiley Periodicals, Inc.

Body height of mummified pharaohs supports historical suggestions of sibling marriages.

Body height is an important factor in reconstructing health conditions and it serves as an indicator of socio-economic status. Researchers rely on ancient data to analyze evolutionary aspects of human health and its interrelation with environmental influences. This study presents body height estimates from all periods of ancient Egyptian history and compares the general population with the existing mummies of the members of royal families. A sample of 259 adult Egyptian mummies originating from various collections and published sources with body lengths (long bone measures or/and overall measurements, CT data) were analyzed, and royal mummies were scored with respect to the level of consanguinity. Male royals were taller than males in the general ancient Egyptian population, while female royals were shorter than females in the general population. The body height variation of the royals is significantly reduced when compared with a pool of non-royal mummies. This provides evidence for inbreeding resulting from consanguineous marriages. However, there appears to be no correlation between the level of inbreeding and individual body height. The random sample of general population does not show signs of inbreeding. Due to the present lack of larger, technically and ethically challenging genetic studies, the selected non-invasive approach of body height is the most reliable indicator of sibling marriages of pharaohs based on direct physical evidence.

Radiological findings in an ancient Iranian salt mummy (Chehrabad ca. 410-350 BC).

OBJECTIVE: To study pathologies, peri- and postmortal alterations as well as the general preservation state of an ancient Iranian salt mummy. MATERIALS AND METHODS: Several mummified remains from two different time periods (1500-2500 BP) were found in the Chehrabad salt mine in Iran. Computed tomography was performed on Salt Man #4 (410-350 BC), the best preserved out of the six salt mummies (Siemens, Sensation 16; 512 × 512 matrix; 0.75-5 mm slice thickness, 240-mA tube current, 120-kV tube voltage, and 0.976-mm pixel size). RESULTS: Radiological analyses showed an excellent state of preservation of an adolescent body. Several normal variants such as aplasia of the frontal sinus as well as a rare congenital deformation of the 5th vertebral body (butterfly vertebra) have been observed. The individual shows multiple fractures, which is consistent with the theory that he died due to a collapse in the ancient salt mine. CONCLUSIONS: The salt preserved the soft tissue as well as parts of the inner organs remarkably well. However, further investigations including histology are needed to reveal additional details of the health status of this unique salt mummy.

Modern diet and metabolic variance--a recipe for disaster?

OBJECTIVE: Recently, a positive correlation between alanine transaminase activity and body mass was established among healthy young individuals of normal weight. Here we explore further this relationship and propose a physiological rationale for this link. DESIGN: Cross-sectional statistical analysis of adiposity across large samples of adults differing by age, diet and lifestyle. SUBJECTS: 46,684 19-20 years old Swiss male conscripts and published data on 1000 Eskimos, 518 Toronto residents and 97,000 North American Adventists. MEASUREMENTS: Serum concentrations of the alanine transaminase, post-prandial glucose levels, cholesterol, body height and weight, blood pressure and routine blood analysis (thrombocytes and leukocytes) for Swiss conscripts. Adiposity measures and dietary information for other groups were also obtained. RESULTS: Stepwise multiple regression after correction for random errors of physiological tests showed that 28% of the total variance in body mass is associated with ALT concentrations. This relationship remained significant when only metabolically healthy (as defined by the American Heart Association) Swiss conscripts were selected. The data indicated that high protein only or high carbohydrate only diets are associated with lower levels of obesity than a diet combining proteins and carbohydrates. CONCLUSION: Elevated levels of alanine transaminase, and likely other transaminases, may result in overactivity of the alanine cycle that produces pyruvate from protein. When a mixed meal of protein, carbohydrate and fat is consumed, carbohydrates and fats are digested faster and metabolised to satisfy body's energetic needs while slower digested protein is ultimately converted to malonyl CoA and stored as fat. Chronicity of this sequence is proposed to cause accumulation of somatic fat stores and thus obesity.

Intraskeletal isotopic compositions (δ(13) C, δ(15) N) of bone collagen: nonpathological and pathological variation.

Paleodiet research traditionally interprets differences in collagen isotopic compositions (δ(13) C, δ(15) N) as indicators of dietary distinction even though physiological processes likely play some role in creating variation. This research investigates the degree to which bone collagen δ(13) C and δ(15) N values normally vary within the skeleton and examines the influence of several diseases common to ancient populations on these isotopic compositions. The samples derive from two medieval German cemeteries and one Swiss reference collection and include examples of metabolic disease (rickets/osteomalacia), degenerative joint disease (osteoarthritis), trauma (fracture), infection (osteomyelitis), and inflammation (periostitis). A separate subset of visibly nonpathological skeletal elements from the German collections established normal intraindividual variation. For each disease type, tests compared bone lesion samples to those near and distant to the lesions sites. Results show that normal (nonpathological) skeletons exhibit limited intraskeletal variation in carbon- and nitrogen-isotope ratios, suggesting that sampling of distinct elements is appropriate for paleodiet studies. In contrast, individuals with osteomyelitis, healed fractures, and osteoarthritis exhibit significant intraskeletal differences in isotope values, depending on whether one is comparing lesions to near or to distant sites. Skeletons with periostitis result in significant intraskeletal differences in nitrogen isotope values only, while those with rickets/osteomalacia do not exhibit significant intraskeletal differences. Based on these results, we suggest that paleodiet researchers avoid sampling collagen at or close to lesion sites because the isotope values may be reflecting both altered metabolic processes and differences in diet relative to others in the population.

"From growth in height to growth in breadth": the changing body shape of Swiss conscripts since the late 19th century and possible endocrine explanations.

Because Swiss conscription has been mandatory and standardized since 1875 and measurement procedures for height and weight have not changed, recruitment data (representative for 80-100% of the living young men) provide a solid foundation for a detailed study of changes of young men in Switzerland over the past 140 years. The average Swiss body height increased markedly by 15 cm between the 1870s and the 1970s (birth years). Improvements in living conditions are likely to have been among the main environmental determinants of this increase, but there are other likely candidates, all of which worked via the endocrine system. First, widespread iodine deficiency at the end of the 19th century helps to account for an overrepresentation of very short conscripts, for the low level of average height in Switzerland in general as well as for the tremendous regional variation in average height. Second, the doubling of annual per capita milk consumption between 1875 and 1900 was probably a key factor in the height increase, operating directly on IGF-1 concentration. Third, public-health measures, such as the iodine-deficiency prophylaxis via weekly iodine tablets for schoolchildren and via iodized table salt, introduced in the 1920s, may have been largely responsible for the dramatic increase in height during the interwar period. Since the 1970s (birth years), the positive height trend slowed down, body shape in Switzerland has evolved from growth in height to growth in breadth. Precisely how today's complex of genetic, epigenetic, environmental, and endocrine factors limiting height growth and promoting body breadth and excess weight operates has yet to be completely understood.

"Modeling ancient Egyptian embalming": radiological assessment of experimentally mummified human tissue by CT and MRI.

OBJECTIVE: To assess changes in different tissues during the process of artificial mummification by natron using computed tomography (CT) and magnetic resonance imaging (MRI), and to translate the results to image interpretation in paleoradiological studies of ancient mummies. MATERIALS AND METHODS: A human lower limb (LL) was amputated from a female donor 24 h post-mortem and mummified by artificial natron (54 % NaCl, 16 % Na2SO4, 18 % Na2CO3 12 % NaHCO3) in ancient Egyptian style. The LL was kept in a fume hood at 16-25 °C and 30-75 % relative humidity. CT and MRI were performed at specific intervals with quantitative evaluation of Hounsfield units (HU) and signal intensities (SI). RESULTS: Evaluated tissues showed different HU and SI changes during the experimental mummification. All tissues revealed an overall but varying increase of HU in CT examinations. All tissues except for the compact bone revealed an overall but varying decrease of SI in the IR and T2-weighted sequences of the MRI. Typical findings included a distinct increase of HU in the cutis at the end of the study and a temporary increase of SI in the IR and T2-weighted sequences in all muscle groups. CONCLUSIONS: Radiological findings showed a regular, controlled and effective dehydration by the applied natron without detectable putrefaction. Evaluated tissues revealed different radiological changes during the experiment, which altogether led to preservation of the tissues without radiologically identifiable destruction. The cutis revealed radiological signs of direct interaction with the natron in the form of covering and possibly permeation.