How diet influences mortality: dietary reconstruction of epidemic and non-epidemic populations in 19th century Italy

Diet and nutrition strongly influence susceptibility to infectious disease morbidity and mortality. Dietary reconstruction of epidemic populations may point to dietary heterogeneity underlying disease susceptibility. Cholera is known to be a disease that preys on impoverished industrializing populations with few sanitary regulations, but little research has investigated the effect of malnourishment on disease mortality from cholera. This study compares dietary variation of cholera victims from 19th century Benabbio with a non-cholera cemetery from Pieve dei Monti di Villa used as a “healthy” control population. The goal of this study is to characterize dietary heterogeneity underlying cholera mortality, establishing a link between diet and health in the past in context with infectious disease risk. Dental microwear analysis and stable isotope analysis were used to reconstruct diet for each population to determine if there are any significant differences between the adult diets of cholera victims and non-cholera victims. Dental features were analyzed by collecting surface images of the distal-buccal cusp at 100X magnification and counting features (e.g., pit number, scratch length) using Microwear 4.0 software. Although previously published stable isotope data indicates dietary differences between Benabbio (δ¹³ C = -19.8, δ¹⁵N = 8.3) and Pieve dei Monti Di Villa (δ¹³C = -18.8, δ¹⁵N = 7.8), dental microwear between the two populations was indistinguishable. These results imply homogeneity in food preparation and cooking techniques in 19th century Italy with regional variation in food consumed. Based on this research, adult diet alone appears to have little influence on susceptibility towards infectious diseas