The role of dietary calcium in the etiology of childhood rickets in the past and the present.

For more than two centuries, lack of sunlight has been understood to cause vitamin D deficiency and documented as a primary cause of rickets. As such, evidence of rickets in the archeological record has been used as a proxy for vitamin D status in past individuals and populations. In the last decade, a clinical global consensus has emerged wherein it is recognized that dietary calcium deficiency also plays a role in the manifestation of rickets and classic skeletal deformities may not form if dietary calcium is normal even if vitamin D is deficient. This disease is now clinically called "nutritional rickets" to reflect the fact that rickets can take calcium deficiency-predominant or vitamin D deficiency-predominant forms. However, there are currently no paleopathological studies wherein dietary calcium deficiency is critically considered a primary etiology of the disease. We review here the interplay of calcium, vitamin D, and phosphorous in bone homeostasis, examine the role of dietary calcium in human health, and critically explore the clinical literature on calcium deficiency-predominant rickets. Finally, we report a case of rickets from the late Formative Period (~2500-1500 years ago) of the Atacama Desert and argue the disease in this infant is likely an example of calcium deficiency-predominant rickets. We conclude that most archeological cases of rickets are the result of multiple micronutrient deficiencies that compound to manifest in macroscopic skeletal lesions. For clinicians, these factors are important for implementing best treatment practice, and for paleopathologists they are necessary for appropriate interpretation of health in past communities.

Macroscopic features of scurvy in human skeletal remains: A literature synthesis and diagnostic guide.

The past two decades have seen a proliferation in bioarchaeological literature on the identification of scurvy, a disease caused by chronic vitamin C deficiency, in ancient human remains. This condition is one of the few nutritional deficiencies that can result in diagnostic osseous lesions. Scurvy is associated with low dietary diversity and its identification in human skeletal remains can provide important contextual information on subsistence strategy, resource allocation, and human-environmental interactions in past populations. A large and robust methodological body of work on the paleopathology of scurvy exists. However, the diagnostic criteria for this disease employed by bioarchaeologists have not always been uniform. Here we draw from previous research on the skeletal manifestations of scurvy in adult and juvenile human skeletal remains and propose a weighted diagnostic system for its identification that takes into account the pathophysiology of the disease, soft tissue anatomy, and clinical research. Using a sample of individuals from the prehistoric Atacama Desert in Northern Chile, we also provide a practical example of how diagnostic value might be assigned to skeletal lesions of the disease that have not been previously described in the literature.

Let's talk about stress, baby! Infant-feeding practices and stress in the ancient Atacama desert, Northern Chile.

AIMS AND OBJECTIVES: The transition to an agricultural economy is often presumed to involve an increase in female fertility related to changes in weaning practice. In particular, the availability of staple crops as complementary foods is hypothesized to allow earlier weaning in agricultural populations. In this study, our primary aim is to explore whether this model fits the agricultural transition in the Atacama Desert using incremental isotopic analysis. A secondary aim of this study is to identify isotopic patterns relating to weaning, and assess how these may be differentiated from those relating to early life stress. MATERIALS AND METHODS: We use incremental isotopic analysis of dentine to examine changes in δ15 N and δ13 C values from infancy and childhood in sites of the Arica region (n = 30). We compare individuals from pre-agricultural and agricultural phases to establish isotopic patterns and relate these patterns to maternal diet, weaning trajectory and physiological stress. RESULTS: We find that there is no evidence for systematic temporal or geographic variation in incremental isotopic results. Instead, results from all time periods are highly variable, with weaning completed between 1.5 and 3.5 years. Characteristics of the incremental profiles indicate that both in utero and postnatal stress were a common part of the infant experience in the Atacama. DISCUSSION: In the Atacama Desert it appears that the arrival of agricultural crops did not result in uniform shifts in weaning behavior. Instead, infant and child diet seems to have been dictated by the broad-spectrum diets of the mothers, perhaps as a way of mitigating the stresses of the harsh desert environment.

Scurvy at the agricultural transition in the Atacama desert (ca 3600-3200 BP): nutritional stress at the maternal-foetal interface?

Studies of contemporary populations have demonstrated an association between decreased dietary diversity due to resource scarcity or underutilization and an increase in diseases related to poor micronutrient intake. With a reduction of dietary diversity, it is often the women and children in a population who are the first to suffer the effects of poor micronutrient status. Scurvy, a disease of prolonged vitamin C deficiency, is a micronutrient malnutrition disorder associated with resource scarcity, low dietary diversity, and/or dependence on high carbohydrate staple-foods. The aim of this paper is to assess the potential impact of nutritional transition on the prevalence of diseases of nutritional insufficiency in an archaeological sample. Here, we report palaeopathological findings from an Early Formative Period transitional site located in coastal Northern Chile (Quiani-7). The subadult cohort from this site is composed of four perinates who exhibit a number of non-specific skeletal changes suggestive of a systemic pathological condition. One of these is associated with an adult female exhibiting diagnostic skeletal lesions of scurvy. We argue that the lesions exhibited by these perinates may represent maternal transmission of vitamin C deficiency but acknowledge that there are difficulties in applying current diagnostic criteria for scurvy to individuals this young.

Levels of total arsenic in edible fish and shellfish obtained from two coastal sectors of the Atacama Desert in the north of Chile: use of non-migratory marine species as bioindicators of sea environmental pollution.

The Camarones (CB) and Vitor (VB) Bays are situated in the middle of Atacama Desert, and their economies are based on activities entirely associated with the extraction of marine produce. The aim of this study was to determine the total arsenic content in three species of fish and seven species of shellfish from these two bays. The quantification of the total arsenic content in these products was performed by Hydride-Generation Atomic Absorption Spectrometry, HG-AAS. The results showed that marine species associated with the CB sector had higher total arsenic levels than the same species in the area of VB, a finding attributed to much higher total arsenic concentrations in the water and soils of CB than VB. The species with the highest total arsenic concentration was the Venus antique (7.50 mg kg (-1)) from the CB, and the lowest total arsenic content was found in Cheilodactylidae variegatus (0.34 mg kg(-1)) from VB.

[Origins of Changos. Mitochondrial DNA analysis suggests Chinchorro culture fishermen ancestry]. / Origen de los Changos. Análisis de ADNmt antiguo sugiere descendencia de pescadores de la cultura Chinchorro (7.900 - 4.000 A.P.).

Sophisticated molecular genetics techniques allow the typification and posterior comparison of antique haplogroups and mitochondrial DNA sequences from prehistoric groups with contemporary populations. This adds a chronological dimension to these studies and contributes to have a better knowledge of the genetic composition of the Chilean population. This article gives scientific support, using molecular methodology, to the alleged biological links that joined the descendants of proto historic Chango fishermen from Paposo cove, a place located 15 kilometers north of Taltal, with prehistoric fishermen from Chinchorro culture, that developed in Northern Chile and Southern Peru between 7900 and 4000 A.C.

Possible influence of the ENSO phenomenon on the pathoecology of diphyllobothriasis and anisakiasis in ancient Chinchorro populations.

Current clinical data show a clear relationship between the zoonosis rates of Diphyllobothrium pacificum and Anisakis caused by the El Niño Southern Oscillations (ENSO) phenomenon along the Chilean coast. These parasites are endemic to the region and have a specific habitat distribution. D. pacificum prefers the warmer waters in the northern coast, while Anisakis prefers the colder waters of Southern Chile. The ENSO phenomenon causes a drastic inversion in the seawater temperatures in this region, modifying both the cool nutrient-rich seawater and the local ecology. This causes a latitudinal shift in marine parasite distribution and prevalence, as well as drastic environmental changes. The abundance of human mummies and archaeological coastal sites in the Atacama Desert provides an excellent model to test the ENSO impact on antiquity. We review the clinical and archaeological literature debating to what extent these parasites affected the health of the Chinchorros, the earliest settlers of this region. We hypothesise the Chinchorro and their descendants were affected by this natural and cyclical ENSO phenomenon and should therefore present fluctuating rates of D. pacificum and Anisakis infestations.

Possible influence of the ENSO phenomenon on the pathoecology of diphyllobothriasis and anisakiasis in ancient Chinchorro populations

Current clinical data show a clear relationship between the zoonosis rates of Diphyllobothrium pacificum and Anisakis caused by the El Niño Southern Oscillations (ENSO) phenomenon along the Chilean coast. These parasites are endemic to the region and have a specific habitat distribution. D. pacificum prefers the warmer waters in the northern coast, while Anisakis prefers the colder waters of Southern Chile. The ENSO phenomenon causes a drastic inversion in the seawater temperatures in this region, modifying both the cool nutrient-rich seawater and the local ecology. This causes a latitudinal shift in marine parasite distribution and prevalence, as well as drastic environmental changes. The abundance of human mummies and archaeological coastal sites in the Atacama Desert provides an excellent model to test the ENSO impact on antiquity. We review the clinical and archaeological literature debating to what extent these parasites affected the health of the Chinchorros, the earliest settlers of this region. We hypothesise the Chinchorro and their descendants were affected by this natural and cyclical ENSO phenomenon and should therefore present fluctuating rates of D. pacificum and Anisakis infestations.

Origen de los Changos: Análisis de ADNmt antiguo sugiere descendencia de pescadores de la cultura Chinchorro (7.900 - 4.000 A.P.) / Origins of Changos: Mitochondrial DNA analysis suggests Chinchorro culture fishermen ancestry

Sophisticated molecular genetics techniques allow the typification and posterior comparison of antique haplogroups and mitochondrial DNA sequences from prehistoric groups with contemporary populations. This adds a chronological dimension to these studies and contributes to have a better knowledge of the genetic composition of the Chilean population. This article gives scientific support, using molecular methodology, to the alleged biological links that joined the descendants of proto historic Chango fishermen from Puposo cove, a place located 15 kilometers north of Taltal, with prehistoric fishermen from Chinchorro culture, that developed in Northern Chile and Southern Peru between 7900 and 4000 A.C.

Arseniasis and teratogenic anomalies in the atacama desert coast of ancient Chile / Arsenicismo y anomalías teratógenas en la costa del desierto de atacama en Chile prehispánico / Arsenicismo y anomalias teratógenas em populações da costa do deserto de atacama no Chile prehispánico

The model that chronic arsenic (As) exposure causes many teratogenic consequences is tested. Ancient northern Chilean populations appear to be optimal to undertake such a study as these populations are believed to have been largely stationary and ingested significant As levels over time. The Camarones River water, along the Atacama Desert, has extreme As values, 100 times above the norm. We tested the hypothesis that ancient populations, starting with the Chinchorro culture, 5000 years B.C., were significantly affected by this heavy metal and massive arsenic contamination played a role in the origin of Chinchorro artificial mummification practices. We examined 199 skeletons, housed at the Museo Arqueológico San Miguel de Azapa, Universidad de Tarapacá, Arica, Chile, searching for seven teratogenic related pathological conditions: cleft palate, polydactyly, syndactyly, spina bifida, club foot, eye malformations, and hip joint dislocation. Of the seven pathological conditions under assessment, only spina bifida was clearly found in the surveyed sample. Thus, the As teratogenic hypothesis cannot be fully demonstrated. However, the presence of spina bifida in the three valleys suggests a genetic-environmental interplay within the populations. The endemic presence of As in both the Chinchorro mummies and their material culture do strongly support the As hypothesis as a valid explanation for why the Chinchorro first began to anthropogenically mummify their dead.

En este trabajo se evalúa el modelo que la exposición crónica al arsénico (As) juega un rol importante en el desarrollo de anomalías teratógenas. Las poblaciones ancestrales del norte de Chile son adecuadas para ello, ya que por varios milenios han estado expuestas a cantidades importantes del elemento y tienen continuidad biocultural. El agua del río de Camarones, en el Desierto de Atacama, contiene niveles de As muy elevados, 100 veces lo recomendado por normas internacionales, por lo cual se testeó la hipótesis que los primeros habitantes de esta zona, los Chinchorros, estaban afectados por este metal a partir del 5000 A.C. y que el mismo influyó en el origen de complejas prácticas de momificación. Fueron examinados 199 esqueletos del Museo Arqueológico San Miguel de Azapa, Universidad de Tarapacá, Arica, Chile, buscando evidencias de siete patologías supuestamente teratógenas y relacionadas al As: labio leporino, polidactilia, sindactilia, espina bífida, pie equino, deformaciones de los ojos y dislocación de la cadera. Los hallazgos revelan que el impacto del As varía regionalmente y que las poblaciones del valle de Camarones tuvieron mayores frecuencias de lesiones a la piel y espina bífida. Los datos no avalan la hipótesis teratógena, ya que solo se encontró espina bífida en las poblaciones estudiadas. Sin embargo, la presencia de espina bífida en los tres valles muestreados implica una compleja interacción genética y medioambiental. La presencia endémica del As en las momias y en su cultura material refuerza la hipótesis del As para explicar el surgimiento de la compleja momificación artificial en poblaciones Chinchorro.

Neste trabalho foi avaliado o modelo de que a exposição crônica ao arsênico ("As") desempenha um papel importante no desenvolvimento de anomalias teratógenas. As populações ancestrais do norte do Chile são adequadas para isso, já que por vários milênios têm estado expostas a quantidades importantes do elemento e têm continuidade biocultural. A água do rio de Camarones, no Deserto de Atacama, contêm níveis de "As" muito elevados, 100 vezes o recomendado por normas internacionais, pelo qual foi testada a hipótese de que os primeiros habitantes desta zona, os Chinchorros, tinham sido afetados por este metal a partir de 5000 A.C. e que o mesmo influiu na origem de complexas práticas de mumificação. Foram examinados 199 esqueletos do Museu Arqueológico San Miguel de Azapa, Universidade de Tarapacá, Arica, Chile, procurando por evidências de sete patologias supostamente teratógenas e relacionadas ao "As": lábio leporino, polidactilia, sindactilia, espinha bífida, pé equino, deformações dos olhos e deslocamento da cadeira. Os achados revelan que o impacto do "As" varia regionalmente e que as populações do vale de Camarones tiveram maiores frequências de lessões na pele e espinha bífida. Os dados não validam a hipótese teratógena, já que somente achou-se espinha bífida nas populações estudadas. No entanto, a presença de espinha bífida nos três vales amostrados implica uma complexa interação genética e meio-ambiental. A presença endêmica do "As" nas múmias e em sua cultura material reforça a hipótese do "As" para explicar o aparecimento da complexa mumificação artificial em populações Chinchorro.

Influence of cranial deformation on facial morphology among prehistoric South Central Andean populations.

Calculating biodistances among South American populations using cranial measurements is often hindered, as many available skeletal collections exhibit deformation. Acknowledging vault modifications, researchers have sought measurements in other regions which are unaffected by deformation. In the 1970s, a set of 10 "relatively" unaffected facial measurements was identified in Argentinean crania that later became the basis of numerous South American biodistance studies. These measurements include: minimum frontal breadth, bizygomatic breadth, orbit height, orbit breadth, palate breath, palate length, upper facial height, basion-prosthion length, nasal height, and nasal breadth. Palate length was excluded from the present analysis due to considerable measurement error. The suitability of these measurements in populations other than Argentineans has not been rigorously tested. Using a sample of 350 prehistoric crania from the Museo Arqueológico San Miguel de Azapa (MASMA, Arica, Chile), this project tested the hypothesis that these measurements are unaffected by either annular or tabular deformation. Results obtained from MANOVA analysis indicate this hypothesis cannot be fully supported. Among males, only 3 of the 9 measurements are unaffected by either form of deformation (palate breadth, basion-prosthion length, and nasal breadth), while analysis of females indicates that 4 of the 9 measurements remain unaltered (minimum frontal breadth, orbit breadth, basion-prosthion length, and nasal breadth). Additionally, analogous to the vault, facial measurements display patterns consistent with the deformation applied. Two implications can be drawn from this research: 1) previous studies using these measurements must be interpreted cautiously, and 2) researchers using these measurements must explicitly test their suitability in each population.