EPI 390 Lecture 22Outline of Last Lecture I. Further Implications of CJD and BSEII. Testing for BSEIII. Response to the First US Case of BSEIV. Cases in North AmericaOutline of Current Lecture I. Nutritional ConsequencesII. Porotic hyperostosisIII. Cribra OrbitaliaIV. Connection between Dietary Constituents and Dental Anatomy V. CBC and it’s relation to IDACurrent LectureI. Nutritional Consequencesa. The need to have your wisdom teeth removed has to do with nutritional consequences from your ancestors.b. The Health and Agricultural revolution introduced a variety of new diseases.i. Nutritional consequences to human health are primarily due to missing nutrients1. Reduced growth/developmenta. Lack of essential nutrients leads to smaller body sizeb. Hard tissues can provide excellent ways of assessing macro-level dietary changes and associated nutritional deficits – however – lack of specificity with respect to acute vs. chronic episodes remains an interpretive shortcomingc. Modern difficulty in determining if nutritional problems are due to acute or chronic nutritional deficiency.i. No need for anyone in developed countries/high SES to have chronic malnutrition but third world countries often have cases of chronic malnutrition punctuated by cases of acute malnutrition.d. Chronic malnutrition significantly impacts physical development – i.e. stunted stature. Especially large consequences during key periods of growth.These notes represent a detailed interpretation of the professor’s lecture. GradeBuddy is best used as a supplement to your own notes, not as a substitute.i. Example: Nutritional consequences of Iron Deficiencye. Iron deficiency and anemia (IDA): can manifest to the cranium as porotic hyperostosis and/or in the eye orbits as cribra orbitalia.i. If you know dietary habits and physical/clinical manifestation is, you can determine causality.1. When patterns happen over and over again, have a strong association. Biological plausibility that is essentially inescapable. 2. Produce ¾ of red blood cells in skull. A weird appearance in the skull can determine what a specific dietary deficiency was. (this is porotic hyperostosis).II. Porotic hyperostosisa. Porotic hyperostosis: cranial bones become porous as the marrow cavities expand from RBC (red blood cell) production. i. If you take 90 degree cross-sections, there’s a dense outer portion, and dense inner portion of the skull – the compact bone) and in between those 2 layers is trabeculae bone. b. The spongy bone inside the cranium is called diploe, which is where 90% of red blood cells (RBCs) are made. i. If you’re chronically anemic, the body increases production in diploe, causing it to expand, so head gets bigger. ii. Instead of pushing endocranial surfaces, the diploe perforates skull. III. Cribra Orbitaliaa. In eye sockets, D1 is easier to identifyb. Cribra Orbitalia – (cribra = perforated), thin layer of cortical bone along the superior eye sockets becomes porous as the marrow cavities expand from RBC production (compensatory adaption via feedback loop).c. Porotic hyperostosis and cribara orbitalia – lower frequency in Hunter-Gatherersd. Higher frequency in agriculturalists (i.e. vegetarians or vegans are cutting out essential nutrients.IV. Connection between Dietary Constituents and Dental Anatomya. Carious lesions – develop as a result of carb-rich diet. Enamel is …do a thingi. Carb-rich diets = more prone to cavity (because the carbs are broken down to sugar)ii. Infection – i.e. bacillus or staph – goes through enamel into bone, so can enter other locations in body) b. Baby bottle mouth – babies fall asleep with bottles in mouth and the sugar from the milk rots their teeth.c. People need wisdom teeth extraction because faces are too small for teeth. For millennia (since common ancestors with apes), people have had same number ofteeth (32). In that same amount of time, face has become 25% smalleri. But morphology changes didn’t happen.ii. Have gone from diet full of grit and undercooked/uncooked material to our current. So mandible is no longer as muscular. 1. When musculature is smaller, we no longer need long jaws to support the muscles, so skull becomes smaller as well. V. CBC and it’s relation to IDAa. CBC stands for Complete Blood Count b. It measures:i. The number of red blood cells (RBC count)ii. The number of white blood cells (WBC count)iii. The total amount of hemoglobin in the bloodiv. The fraction of the blood composed of red blood cells (hematocrit)v. The average red blood cell size (MCV)vi. The hemoglobin amount per red blood cell (MCH)vii. The amount of hemoglobin relative to the size of the cell (hemoglobin concentration) per red blood cell (MCHC). c. Relation to IDAi. Determining hemoglobin might indicate the severity of IDA hypertrophy –an increase in RBC production leads to manifestation of diseases listed