More than 20 years ago, Wood et al. (Curr Anthropol 33:343–370, 1992) published “The Osteological Paradox: Problems of Inferring Prehistoric Health from Skeletal Samples,” in which they challenged bioarchaeologists to consider the effects of heterogeneous frailty and selective mortality on health inferences in past populations. Here, we review the paper’s impact on bioarchaeology and paleopathology, focusing on recent advancements in studies of ancient health. We find the paper is often cited but infrequently engaged in a meaningful way. Despite an initial decade of limited progress, numerous researchers are now addressing components of the Paradox in more informed ways. We identify four areas of fruitful research: (1) intrasite, contextual perspectives, (2) subadults, (3) associating stress markers with demographic phenomena, and (4) skeletal lesion-formation processes. Although often seen as a problematic assumption, understanding the sources of heterogeneous frailty within human populations is a worthy research question in and of itself, and one that clearly links past and present health research within a global framework.

The Osteological Paradox 20 Years Later: Past Perspectives, Future Directions

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Human Skeletal Remains Excavation Analysis Interpretation

The chief focus of this chapter is the dentition, with reviews of associated structures where relevant. Dental development, including the dentin and enamel, is discussed in the first section, followed by disturbances in the dentin and enamel in the second section. The third section looks at the identification of oral disease, including caries, alveolar lesions, antemortem tooth loss (AMTL), and periodontal disease. The fourth section focuses on interpreting oral health, particularly in the context of sex differences and major demographic transitions. The fifth discusses dental chemistry in terms of paleodietary reconstruction, breastfeeding and weaning, stress and disease, and finally mobility and migration. The final section examines dental calculus in the context of microparticles and then chemical analyses of calculus, with aDNA and protein analyses of dental calculus also reviewed.

The dentition: Development, disturbances, disease, diet and chemistry

Objectives
Childhood is a unique stage in human life history, in which subadults have completed their weaning process but are still dependent on older individuals for survival. Although the importance of food provisioning during childhood has been intensively discussed, childhood diet in the past has rarely been studied in a systematic manner.

Methods
In this study, a meta-analysis of carbon and nitrogen stable isotope ratios of post-weaning children (PWC) in Holocene human populations around the world is presented. The isotope ratios of PWC were standardized with those of adult females and males in the same population, and they were analyzed in terms of the difference in subsistence.

Results
Results of this study indicate that diets of PWC and adults were generally similar (most differences were within the range of ±1‰), which is consistent with the universal feature of food provisioning to PWC in humans. In hunter—gatherer populations, there is no significant difference between PWC and adult isotope ratios. In non-hunter—gatherer populations, however, PWC probably consumed significantly larger proportions of foods from lower trophic levels than did the adults, and such foods would be terrestrial C3 plants.

Conclusions
Potential factors relating to the dietary differences among PWC and adults are presented from a perspective of balance between food provisioning and self-acquisition by PWC. Significant isotopic differences between PWC and adults in non-hunter—gatherer populations revealed in this study have implications for declined health during the subsistence transition in Holocene, isotopic studies using human tooth enamel, and “δ15N dip” of subadults after weaning.

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Post-weaning diet in archaeological human populations: A meta-analysis of carbon and nitrogen stable isotope ratios of child skeletons.

A comparative study of human reproduction

A longer breastfeeding duration provides various positive effects in subadult health because of abundant immunological factors and nutrients in human breast milk, and decreases the natural fertility of a population through lactational amenorrhea. In this study, we measured stable carbon and nitrogen isotope ratios in the bone collagen of three adults and 45 subadults from the Yuigahama-minami site (from 12th to 14th century) in Kamakura, the early medieval capital of Japan. Marine foods, C3 -based terrestrial foods, and freshwater fish are the primarily protein sources for adults. The changes in the nitrogen isotope ratios of subadults suggest that the relative dietary protein contribution from breast milk started to decrease from 1.1 years of age and ended at 3.8 years. The age at the end of weaning in the Yuigahama-minami population was greater than that in the typical non-industrial populations, a premodern population in the Edo period Japan, and medieval populations in the UK. Skeletons of townspeople from medieval Kamakura indicate severe nutritional stress (e.g., enamel hypoplasia and cribra orbitalia), yet this longer duration of breastfeeding did not compensate adverse effects for nutritional deficiency. The longer breastfeeding period may have been a consequence of complementary food shortage and bad health of subadults. Kamakura experienced urbanization and population increase in the early medieval period. The younger age-at-death distribution and high nutritional stresses in the Yuigahama-minami population and later weaning, which is closely associated with longer inter-birth interval for mothers, suggests that Kamakura developed and increased its population by immigration during urbanization.

Akina Shimomi

Papers

Infant feeding practice in medieval Japan: stable carbon and nitrogen isotope analysis of human skeletons from Yuigahama-minami.

Isotopic evidence of breastfeeding and weaning practices in a hunter–gatherer population during the Late/Final Jomon period in eastern Japan