The aim of this thesis is to examine the Developmental Origins of Health and Disease (DOHaD) theory and its usefulness in the analysis of past populations. The DOHaD hypothesis states that many...Show moreThe aim of this thesis is to examine the Developmental Origins of Health and Disease (DOHaD) theory and its usefulness in the analysis of past populations. The DOHaD hypothesis states that many modern day diseases and a negative health in adulthood can be attributed to stressful events that happened earlier in pregnancy, infancy or childhood. This thesis analyses if individuals that were affected by physiological stress during childhood were more likely to develop tuberculosis. Individuals from two Dutch skeletal collections are studied: Middenbeemster, a post medieval rural community and Alkmaar, a medieval city. To identify childhood stress in the past, several non-specific indicators of stress are examined in juveniles and adults: stature, Harris lines, cribra orbitalia and dental enamel hypoplasia. Although these skeletal markers have multiple and overlapping aetiologies, the presence and severity of these skeletal lesions may provide insight into the resistance to stress and which sort of environmental stress could have been a risk factor to tuberculosis. Further, it is examined if any of the skeletal markers can be associated with a specific category of tuberculous lesions. Skeletal tuberculosis is divided in definitive, probable and possible lesions. Statistical analyses were performed to determine if there was a difference in the prevalence of each stress marker in the group affected with tuberculosis (definitive, possible or probable cases) and the group of individuals that was not affected by this infection. Statistical results demonstrates that delayed growth may have been a risk factor to tuberculosis in the Alkmaar population, though it was not statistically significant. The prevalence rates of Harris lines, cribra orbitalia (CO) and dental enamel hypoplasia (DEH) were high in the Alkmaar population, in contrast to the Middenbeemster population. However, these three stress markers were associated with tuberculosis in the Middenbeemster sample, in contrast to Alkmaar. CO and DEH were particularly associated with possible tuberculous lesions (new bone formation on the ribs and vascularization of or pits/grooves on the vertebral bodies). Additionally, CO could also be associated with definitive tuberculous lesions. Results show that childhood stresses, such as poor nutrition or disease could have been a risk factor that made individuals more susceptible to tuberculosis. This thesis also discusses the interpretational and methodological limitations of using the DOHaD on the skeletal remains of past populations. Factors that may have influenced the interpretation if early stress increases the risk to tuberculosis are considered.Show less
