Diet and Health

理解贫富之间的鸿沟在今天具有特别重要的意义，尽管现代临床发展在过去一个世纪里改善了英国(和世界)人口的健康1，但社会经济地位仍然是健康的重要决定因素2。这一点在一个社会中最年轻的成员身上表现得最为明显，他们的健康最能反映这些社会不平等，生命的头1000天为成年人的疾病模式奠定了基础，这些疾病可能会在几代人之间产生共鸣。良好的健康基础的关键是孩子的喂养方式。在18世纪，富人和穷人在产妇健康和婴儿喂养方面的差异从未像现在这样明显。历史资料记载了富人为了更时尚的配方奶粉而放弃母乳，以及在新的工业工厂为工作母亲提前断奶和奶瓶喂养。但这种趋势到底有多普遍呢？只有通过分析妇女和儿童本身的骨骼遗骸，才能直接证明这些文化转变的全面程度及其对健康的影响。在过去人口中母婴保健的理论方法方面的最新进展，或母婴关系9，10突出了了解多种相互关联的因素的重要性。为了解决社会经济地位、文化喂养习惯、母亲饮食、婴儿喂养和健康之间的相互作用，我将问以下问题：产前母亲的饮食是否影响胎儿的健康？现代英格兰早期放弃母乳喂养的意义有多大？不同的文化婴儿喂养做法在古病理学记录中和在牙列中的同位素特征中是否可见？这些模式是否反映了母亲及其子女的社会经济地位的广泛差异？识别宫内压力仍然充满复杂因素，而且很难确定将社会经济地位与子宫内饮食和健康联系起来的证据。尽管如此，新的古病理学方法提供了机会，找到将糟糕的母亲饮食与胎儿健康联系起来的直接证据。这些方法在英国早期环境中的应用将使我们能够更好地理解社会经济地位与母胎饮食和健康之间的关系，弥补了历史文献和生物考古证据之间的差距。研究样本将包括育龄妇女(25-35岁)的骨骼以及断奶前和断奶后(0-3岁)的幼儿。选择了两个早期的现代墓地：萨里郡的圣约翰红山(n=168)和伦敦的圣詹姆斯(n=800)，这两个墓地都在公元1750年至1900年之间使用(Raynor，pers.com.)。埋葬在墓地不同区域的地位低下和地位高的个人将被挑选出来。一小部分人(n=40)将被抽样进行稳定的同位素分析。除了治愈和活跃的筛眶畸形、维生素D缺乏症(软骨病和骨软化症)和维生素C缺乏症(坏血症)，釉质缺陷将根据古病理学文献的宏观和放射学标准进行诊断。将评估患有软骨病和坏血病的胎儿和围产儿(26-46周)以及有乳牙上门牙釉质缺陷的儿童的宫内饮食压力。

Understanding the gulf between rich and poor has particular relevance today, and while modern clinical developments have improved the health of the British (and world) population over the last century 1, socioeconomic status is still a strong determinant of health 2. This is most evident in a society's youngest members whose health best reflects these social inequalities, with the first 1000 days of life setting the scene for adult patterns of disease that can resonate through generations. Key to a good foundation in health is the way children are fed. Differences in maternal health and infant feeding between the rich and poor have never been more stark than in the eighteenth century. Historical sources document the abandonment of breastmilk for more fashionable formulas by the rich, and early weaning and bottle feeding for working mothers in new industrial factories. But how ubiquitous was this trend? Direct evidence for the full extent of these cultural transitions and its impact on health is only available through the analysis of the skeletal remains of women and children themselves. Recent advances in the theoretical approach to maternal and infant health in past populations, or the mother-infant nexus 9,10 have highlighted the importance of understanding multiple interrelated factors. To address the interplay between socioeconomic status, cultural feeding practices, maternal diet, infant feeding, and health I will ask the following:Did the prenatal maternal diet affect the health of the fetus? How significant was the abandonment of breastfeeding in early modern England?Are different cultural infant feeding practices visible in the palaeopathological record and through isotopic signatures in the dentition? Do these patterns reflect broad variation in socioeconomic status of mothers and their children?Identifying in-utero stress is still fraught with complications and evidence linking socioeconomic status with diet and health in utero is difficult to determine. Despite this, new palaeopathological approaches provide the opportunity to find direct evidence linking poor maternal diet and fetal health. The application of these methods in early modern British contexts will allow us to better comprehend the relationship between socioeconomic status and maternal-foetal diet and health, bridging the gap in the historical literature and bioarchaeological evidence.The study sample will comprise skeletons of reproductive age women (25-35 years), and young children of pre and post weaning age (0-3 years). Two early modern cemeteries have been selected: St John's Redhill, in Surrey (n=168) and St. James, London (n=800) both cemeteries were in use between AD 1750 and 1900 35 (Raynor, pers.comm.). Low and high-status individuals buried in different areas of the cemetery will be selected. A smaller subset of individuals (n=40) will be sampled for stable isotope analysis.Enamel defects in addition to healed and active cases of cribra orbitalia, vitamin D deficiency (rickets and osteomalacia) and vitamin C deficiency (scurvy) will be diagnosed following macroscopic and radiographic standards from the palaeopathological literature. In-utero dietary stress will be assessed in fetuses and perinates (26-46 weeks) with rickets and scurvy and children with enamel defects on the deciduous maxillary incisors.