Submitted by Foxs-In-A-Trenchcoat t3_zgk9bh in askscience
If a person was chronically undernourished throughout childhood, but became food secure at age 18, are there markers in their bones that would show up on x-ray that shows the history of malnourishment? How long would the markers be visible?
Only in severe cases where you develop rickets, and even then it might only show possible evidence. At that point you MAY see see early signs of arthritis and suffer from symptoms similar to arthritis and be more prone to fractures. Unfortunately there are many causes of this including but not limited to autoimmune conditions, thyroid/parathyroid conditions and bone cancer, so it is hard to go straight to malnutrition being the cause.
You could also be found to have reduced growth compared to your expected, eg height, weight. But there's also so many other factors dictating growth.
Malnutrition in childhood has been found to have higher rates of widespread conditions in adulthood including diabetes, heart disease and arthritis. Doesn't mean you will develop them but you would be at higher risk of it. And again the issue is that there's many factors causing those conditions as well.
Teeth say more about that than bones. Bone matter gets swapped out constantly and will show more signals about what the recent diet was than historic (unless it was bad enough to cause permanent bone deformations)
Enamel hypoplasia is commonly used as an indicator of "stress" during development in archeology and anthropology. It's not perfect by far, but when several children have the same sequence of defects as their teeth developed it's more of a sign of general illness or malnutrition than a single physical trauma to that tooth.
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I'm interested in hearing more about this. Do you have resources?
Rickets is not (just?) Calcium deficiency. It's vitamin D deficiency. Vitamin D is the sunshine vitamin. In some northern countries the sun isn't strong enough for your body to make vitamin D all year round.
That's why commercially available milk tends to have vitamin D added to it.
Your physiology still requires sunlight to activate the vitamin D. You can drink all the vitamin D fortified milk you want, but if you completely avoid sunlight, you will be deficient in the active form of vitamin D.
Can you differentiate calcium deficiencies in skeletons from malnutrition vs the effluxion of calcium in bones due to inappropriate pth release?
That's why I mentioned it would be hard to solely diagnose childhood malnutrition on xrays.
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Not true!
Sun (or more specifically, UV-B) exposure only generates the inactive cholecalciferol, the same stuff you can get from diet (diet can also give you ergocalciferol, the plant-based version, which works too). The activation process is two enzyme hydroxylation steps, first in the liver and second in the kidneys.
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Yes bone density affected when nutritional requirements not met over significant periods of time . Is like scar tissue that over time may fade but never goes away
I can attest. Grew up in the sub-Arctic and my vitamin D test = zero. Also super common to have low D in places where sunscreen use is common, like in Australia.
Malnutrition also causes the crowding of teeth, forcing misalignment and twisted teeth.
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I was told by a dentist that there was evidence in my teeth I had been malnourished as a child, but he didn't elaborate. Some years later my mother told me I had been malnourished as a child and for a time a public health nurse dropped in to check on me. I actually have one memory of the nurse being in the kitchen while I played on the floor.
I asked my current dentist about this but he didn't seem to be aware of teeth showing evidence of malnutrition. I expect this isn't covered in dental school these days in the US.
Growth arrest lines can be a sign of chronic malnutrition during skeletal development. Basically your bones want to grow but lack the nutrients to accomplish it, and that leaves something like a tree ring at the end of the bones. Other things can cause them, too.
Thank you! This is what I was looking for!
Nowadays, rickets is only an issue for breastfed babies. We can't produce vitamin D. Pediatricians recommend to keep baby out of the sun until six months. So they usually have to take a supplement until they start eating solids and spending 30 min or more outside. If you wear sunscreen, you don't get the vitamin D.
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Would you be able to explain the physiology of this and how specific/sensitive this finding is for malnutrition?
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While I agree with most of this, I believe that it is recommended that people take vit d supplements daily at all ages, unless they spend the entire day outside. Naked. With no sunscreen (not recomended either though). Otherwise you can use more.
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The issue is that there can be several reasons for teeth to form imperfectly and not all teeth look the same anyway. Then there's the fact that by the time you're an adult signs of poor hygiene usually outweigh poor nutrition. It's not cut and dry.
That seems like it would be hard to prove, given how commonplace braces are among wealthy populations who would probably not be malnourished.
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Most definitely. We see it all the time here in Guatemala. For example, Rickets (osteomalacia) or other significant deficiencies lead to arrest lines in the bones that show up clearly on an x-ray or other imaging. You can also see chronic malnutrition in the joints, as it often leads to excessive wear and break-down.
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That is because it is not the ONLY cause. Malnourished people grow slower as bones are slower to form. If the teeth erupt before the jaw is developed enough to receive them, crowding occurs. Most misalignment is inherited.
Do these arrest lines stay for life, or does bone remodeling eventually fade them? How long would that take?
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