Scurvy in the tropics: Evidence for increasing non-adult micronutrient deficiency with the transition to agriculture in northern Vietnam

Objective

Scurvy in non-adults was assessed at the Pre-Neolithic site of Con Co Ngua and the Neolithic site of Man Bac in northern Vietnam to investigate nutritional stress during the agricultural transition in Mainland Southeast Asia (MSEA).

Materials

One hundred and four human skeletons under the age of 20 years old were assessed.

Methods

Lesions were recorded macroscopically and radiographically. Differential diagnosis using prior established paleopathological diagnostic criteria for scurvy was conducted.

Results

There was no clear evidence for scurvy at Con Co Ngua and a high burden of scurvy was present at Man Bac (>79% diagnosed with probable scurvy). Scurvy levels were high across all non-adult ages at Man Bac indicating significant burden throughout childhood and adolescence.

Conclusions

No scurvy at Con Co Ngua is consistent with widely available food sources at the peak of the Holocene thermal maximum. High levels of scurvy at Man Bac corresponds with decreased dietary diversity, high pathogen load, and increased population stress with the transition to agriculture around the time of the 4.2 ka desertification event.

Significance

This is the first systematic population-level non-adult investigation of specific nutritional disease in MSEA and demonstrates an increase in nutritional stress during the Neolithic transition in northern Vietnam.

Limitations

Subperiosteal new bone deposits can be due to normal growth in infants and young children, therefore, identification of scurvy in children under the age of 4 years needs to be considered critically.

Suggestions for Further Research

Further work in diagnosing specific nutritional disease in other non-adult cohorts throughout MSEA is required.