Bone quantity and quality in past populations.

BACKGROUND

The study of osteoporosis in past populations offers valuable insight into the patterns and prevalence of the disease in both the past and in the present.

METHODS AND RESULTS

A review is made of different paleopathological studies better to understand bone loss in past populations and to examine the contribution such studies can make to our knowledge of osteoporosis in modern populations. The review includes studies of bone mass in past populations from different geographic regions. Nutritionally based hypotheses, traditionally used to explain bone loss in past populations, are reviewed and assessed against the current clinical and epidemiological findings. In general, the various studies have revealed different degrees of low bone mass in past populations; however, the pattern of bone loss and fragility seen in age-related and postmenopausal osteoporosis today is not evident in the past. Bone loss in earlier populations is often found in both sexes, whereas significant bone loss in females occurs often among the young-age categories. In addition, a prevalence of osteoporotic fracture is absent.

CONCLUSIONS

We suggest that, despite influences that may have reduced bone mass in past populations, a protection of bone quality may have occurred, reducing the likelihood of bone fragility and fracture typically seen in modern osteoporotics. It seems evident that, although reduced bone mass may be prevalent in past history, clinically recognized osteoporosis is not.