Diet and disease in Tomar, Portugal: Comparing stable carbon and nitrogen isotope ratios between skeletons with and without signs of infectious disease

Publication date: May 2019

Source: Journal of Archaeological Science, Volume 105

Author(s): Ana Curto, Patrick Mahoney, Anne-France Maurer, Cristina Barrocas-Dias, Teresa Fernandes, Geraldine E. Fahy


This study explored the correspondence between stable isotope ratios and indicators of non-specific (periostitis and/or osteomyelitis) and specific (venereal syphilis) disease in a sample of human skeletons from a Portuguese archaeological collection. Additionally, this study examined stable carbon (δ13C) and nitrogen (δ15N) isotope ratios between individuals at different disease stages.

Materials and methods

δ13C and δ15N data from previously analysed skeletons without signs of infectious disease or physiological stress (n = 32) were compared to new data from skeletons with active (n = 6), healed (n = 7) or a combination of both lesions (n = 10). Skeletons with lesions (n = 23) were also grouped as having only healed tibial periostitis (n = 7), generalised non-specific (n = 5) and generalised specific infections (n = 2). The skeletons with lesions that did not fit into these groups (n = 9) were not used in this analysis.


The δ15N from skeletons with non-specific generalised infections in several bones differed significantly when compared to skeletons that had either only healed tibial periostitis or were without lesions. Skeletons with venereal syphilis had similar mean δ13C and δ15N to either skeletons without signs of disease or those with only healed tibial periostitis.


These results suggest different diets may be linked into an individual’s susceptibility to these pathogens. Diet influences resistance to infectious disease, while infections decrease nutrient availability, increase malabsorption and resting energy expenditure. Potentially therefore, combining isotopic evidence of diet with pathology may contribute to a new understanding of health and lifestyle in the past.