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Lamer M, Veselka B, Schrader S, Hoogland M, Brickley MB. Precarious adolescence: Adolescent rickets and anterior sacral angulation in two Dutch skeletal collections from the 18th-19th centuries. INTERNATIONAL JOURNAL OF PALEOPATHOLOGY 2023; 40:63-69. [PMID: 36586233 DOI: 10.1016/j.ijpp.2022.12.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 12/13/2022] [Accepted: 12/22/2022] [Indexed: 06/17/2023]
Abstract
OBJECTIVE This project aims to provide an objective approach to suggesting cases of adolescent rickets using the presence of anterior sacral angulation and interglobular dentine. MATERIALS Sacra from 49 individuals from Hattem and 150 individuals from Middenbeemster, and second and third molars from five individuals from Hattem were analyzed. Both sites date to the 17th to 19th centuries. METHODS The sacra were visually assessed for sacral angulation and measured to quantify anterior sacral angulation. The sampled molars were thin sectioned to look for the presence of interglobular dentine. RESULTS Metric analysis determined that seven individuals had significantly anteriorly angled sacra. Three of the five individuals with sampled molars had interglobular dentine formed during adolescence. CONCLUSIONS Adolescent rickets may be associated with anterior sacral angulation. SIGNIFICANCE Anterior sacral angulation may help identify possible cases of adolescent rickets in archaeological human remains. LIMITATIONS The small sample size for the molars prevented the identification of more individuals with interglobular dentine present during adolescence. Several individuals with visibly angled sacra were unmeasurable due to post-mortem damage and lacked molars. SUGGESTIONS FOR FURTHER RESEARCH Research on a larger sample would allow us to understand better the association between anterior sacral angulation and adolescent rickets.
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Affiliation(s)
- M Lamer
- Department of Anthropology, McMaster University, Hamilton, Ontario, Canada; Department of Anthropology, The University of British Columbia, Vancouver, Canada.
| | - B Veselka
- Chemistry Department, Vrije Universiteit Brussel, Brussels, Belgium; Archaeology Department, Vrije Universiteit Brussel, Brussels, Belgium
| | - S Schrader
- Faculty of Archaeology, Universiteit Leiden, Leiden, the Netherlands
| | - M Hoogland
- Faculty of Archaeology, Universiteit Leiden, Leiden, the Netherlands
| | - M B Brickley
- Department of Anthropology, McMaster University, Hamilton, Ontario, Canada
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Pitre MC, Mant M, Abel T, Wood LJ. Forgotten and found: A case of childhood rickets in the 19th-century settler village of Heuvelton, New York. INTERNATIONAL JOURNAL OF PALEOPATHOLOGY 2023; 40:77-86. [PMID: 36621088 DOI: 10.1016/j.ijpp.2023.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Revised: 12/23/2022] [Accepted: 01/01/2023] [Indexed: 06/17/2023]
Abstract
OBJECTIVE To evaluate pathological lesions suggesting the presence of rickets and to place the diagnosis into bioarchaeological and historical context. MATERIALS The remains of a 3-year ± 12-month-old child discovered during a rescue excavation in Heuvelton, New York. METHODS We examined the individual macroscopically and conducted a differential diagnosis following established protocols in the palaeopathological literature. RESULTS Bony change on the orbits, mandible, ribs, clavicles, left scapula, humerii, radii, ulnae, femora, tibiae, fibulae (e.g., porosity, diaphyseal thickening, flaring, bowing), and dental lesions were recorded. CONCLUSIONS We demonstrate that the child likely presented with vitamin D deficiency rickets during crawling and as they learned to walk. SIGNIFICANCE This example offers an important contribution to the bioarchaeological literature, as few cases of rickets have been recorded in rural North America using updated diagnostic criteria and little is known of the health and lifeways of early settlers in 19th-century upstate New York. LIMITATIONS It is not possible to ascertain the precise aetiology of this child's rachitic state and to compare this individual with others in the population. SUGGESTIONS FOR FURTHER RESEARCH Examination (and re-assessment) of other North and South American skeletal assemblages for signs of vitamin D deficiency rickets following current bioarchaeological standards.
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Affiliation(s)
- Mindy C Pitre
- Department of Anthropology, St. Lawrence University, 23 Romoda Drive, 114 Piskor Hall, Canton, NY 13617, United States.
| | - Madeleine Mant
- Department of Anthropology, University of Toronto Mississauga, 3359 Mississauga Road, Mississauga, ON L5L 1C6, Canada.
| | - Timothy Abel
- Consulting Archaeologist, 33512 State Route 26, Carthage, NY, United States.
| | - Linda Johnson Wood
- Heuvelton and Oswegatchie Historian, Heuvelton Historical Association, 83 N State St, Heuvelton, NY 13654, United States
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Abstract
The ubiquity of vitamin D metabolising enzymes and vitamin D receptors in mammalian organisms suggests that vitamin D has pleiotropic effects. There are quite a few studies indicating the anticancer, cardioprotective and antidiabetic effects of vitamin D; however, the best-documented actions of vitamin D are the regulation of Ca-phosphate balance and its effect on immune function.Vitamin D levels in organisms are modulated by many environmental and non-environmental factors. One potential factor that may influence vitamin D levels and effects is the sex of the individuals studied. This review focuses on the scientific evidence indicating different synthesis and metabolism of vitamin D in females and males, mainly from PubMed database sources. The article verifies the sex differences in vitamin D levels reported around the world. Moreover, the different effects of vitamin D on the musculoskeletal, cardiovascular, nervous and immune systems, as well as cancer in males and females, were discussed.Most studies addressing sex differences in vitamin D levels and effects are observational studies with conflicting results. Therefore, carefully designed clinical trials and experiments on animal models should be carried out to determine the role of non-environmental factors that may differentiate vitamin D levels in females and males.
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Age estimation using vertebral bone spurs; testing the efficacy of three methods on a European population. FORENSIC SCIENCE INTERNATIONAL: REPORTS 2022. [DOI: 10.1016/j.fsir.2022.100301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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Schats R. Cribriotic lesions in archaeological human skeletal remains. Prevalence, co-occurrence, and association in medieval and early modern Netherlands. INTERNATIONAL JOURNAL OF PALEOPATHOLOGY 2021; 35:81-89. [PMID: 34757296 DOI: 10.1016/j.ijpp.2021.10.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Revised: 09/22/2021] [Accepted: 10/18/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVE This paper studies the prevalence, co-occurrence, and association of cribra orbitalia, cribra humeri, and cribra femora to contribute to the complex debate on cribriotic lesions and their relationship with one another. MATERIALS 179 adults and 53 non-adults from the medieval/early modern Netherlands (800-1600 CE) for whom all three lesions could be observed are included in this study. METHODS Presence or absence of cribriotic lesions was studied macroscopically. Prevalence, co-occurrence, and association of lesions and their link to sex and age-at-death were assessed. RESULTS A clear link between prevalence of the lesions and age-at-death is found. Co-occurrence and association of all three lesions is uncommon. There is a significant moderate correlation for cribra humeri-femora in non-adults. CONCLUSIONS Lesion prevalence is connected to age-at-death. However, while a similar age distribution and associations between pairs of lesions are noted, due to limited co-occurrence of the three lesions, the presence of a 'cribrous syndrome' cannot supported. SIGNIFICANCE This is the first study investigating the prevalence, co-occurrence and association of cribra orbitalia, cribra humeri, and cribra femora in non-adults and adults contributing to discussions about the nature and the much-debated aetiology of these commonly encountered skeletal lesions. LIMITATIONS The number of non-adults in this study is limited, potentially obscuring meaningful patterns, as the cribrous lesions are significantly more common in younger individuals. SUGGESTIONS FOR FURTHER RESEARCH More research into the prevalence of the post-cranial lesions and their co-occurrence as well as into bone growth and remodelling is warranted.
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Affiliation(s)
- Rachel Schats
- Leiden University, Faculty of Archaeology, Laboratory for Human Osteoarchaeology, Einsteinweg 2, 2333CC Leiden, The Netherlands.
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Interglobular dentine attributed to vitamin D deficiency visible in cremated human teeth. Sci Rep 2021; 11:20958. [PMID: 34697324 PMCID: PMC8545959 DOI: 10.1038/s41598-021-00380-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2021] [Accepted: 10/05/2021] [Indexed: 11/26/2022] Open
Abstract
Vitamin D deficiency has hugely impacted the health of past societies. Its identification in skeletal remains provides insights into the daily activities, cultural habits, and the disease load of past populations. However, up till now, this approach remained impossible in cremated bones, because temperatures reached during cremations destroyed all macroscopic evidence of vitamin D deficiency. This precluded the analyses of a large fraction of the archaeological record, as cremation was an important burial ritual from the Late Neolithic until the Early Medieval period in Europe. Here, the identification of interglobular dentine (IGD), a dental mineralisation defect attributed to vitamin D deficiency, in experimentally burnt teeth, demonstrates this deficiency to be observable in human teeth burned to temperatures as high as 900 °C. In most cases, it becomes even possible to assess the ages-of-occurrence as well as the severity of the IGD and possibly vitamin D deficiency intensity. This study represents a major step forward in the fields of biological anthropology, archaeology, and palaeopathology by opening up a variety of new possibilities for the study of health and activities related to sunlight exposure of numerous past populations that practiced cremation as their funerary ritual.
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Veselka B, Brickley MB, Waters-Rist AL. A joint medico-historical and paleopathological perspective on vitamin D deficiency prevalence in post-Medieval Netherlands. INTERNATIONAL JOURNAL OF PALEOPATHOLOGY 2021; 32:41-49. [PMID: 33276206 DOI: 10.1016/j.ijpp.2020.10.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/02/2020] [Revised: 10/30/2020] [Accepted: 10/31/2020] [Indexed: 06/12/2023]
Abstract
OBJECTIVE By applying a joint medico-historical and paleopathological perspective, this paper aims to improve our understanding of factors influencing past vitamin D deficiency in ten Dutch 17th to 19th-century communities of varying socioeconomic status and settlement type. MATERIALS Vitamin D deficiency is evaluated in 733 individuals of both sexes and all age groups: Silvolde (n = 16), Rotterdam (n = 23), Rhenen (n = 24), Noordwijkerhout (n = 27), Gouda1and 2 (n = 40; n = 59), Roosendaal (n = 51), Den Haag (n = 93), Hattem (n = 113), and Beemster (n = 287). METHODS Rickets and residual rickets are macroscopically assessed using established criteria. Hypotheses formulated based on medico-historical texts are investigated via multivariate statistical analysis of vitamin D deficiency prevalence. RESULTS Vitamin D deficiency prevalence ranges from 13.7 % (7/51) in Roosendaal to 48.1 % (13/27) in Noordwijkerhout, with an onset of < 4 years, and higher rates in cities, conforming to medico-historical texts. Patterns of child labor are likely key. In contrast, socioeconomic status did not statistically significantly influence vitamin D deficiency prevalence rates. CONCLUSION Systematically collected paleopathological data enabled evaluation of medico-historical texts and provided insights into the role that socioeconomic status and settlement type played on the prevalence of vitamin D deficiency. SIGNIFICANCE Combining medico-historical texts and large-scale paleopathological data enables disease patterning to be embedded in a comprehensive biocultural perspective. LIMITATIONS Comparisons may be limited by the small sample size of high socioeconomic status nonadults and some of the collections. SUGGESTIONS FOR FUTURE RESEARCH Analysis of more individuals and sites would improve our understanding of disease patterns.
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Affiliation(s)
- Barbara Veselka
- Vrije Universiteit Brussel, Department of Art, Sciences, and Archaeology, Maritime Cultures Research Institute, Belgium; Leiden University, Faculty of Archaeology, Human Osteology Laboratory, the Netherlands.
| | - Megan B Brickley
- McMaster University, Faculty of Social Sciences, Department of Anthropology, Canada
| | - Andrea L Waters-Rist
- Leiden University, Faculty of Archaeology, Human Osteology Laboratory, the Netherlands; The University of Western Ontario, Social Science Centre, Department of Anthropology, Canada
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Bouillon R, Antonio L. Nutritional rickets: Historic overview and plan for worldwide eradication. J Steroid Biochem Mol Biol 2020; 198:105563. [PMID: 31809867 DOI: 10.1016/j.jsbmb.2019.105563] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2019] [Revised: 11/10/2019] [Accepted: 12/02/2019] [Indexed: 02/01/2023]
Abstract
Rickets was first described in great detail in the mid 17th century and was affecting a great number of children in major European cities. The disease, however, existed already in the Roman times. The etiology of this disease remained enigmatic until the 1920s when two different mechanisms, lack of exposure to sunlight and lack of a dietary factor were finally solved by the discovery of vitamin D and its dual origin. Soon thereafter, the implementation of vitamin D supplementation for all infants and small children largely eliminated nutritional rickets in Europe and North America. It took nearly a century to elucidate the complex chemistry, metabolism, mode and spectrum of activity of the vitamin D endocrine system. Nutritional rickets, whether due to simple vitamin D or calcium deficiency or both, remains widely ravaging many infants and children around the world. Asian countries and the Middle East are mainly confronted with vitamin D deficiency whereas many African and some Asian countries face calcium deficiency rickets. Immigrants and refugees or in general people with a darker skin living in moderate climate zone are also confronted with this disease. There is great consensus how this disease could be prevented or cured. In collaboration with most international professional societies, we prepare a memorandum, in line with the successful battle against iodine deficiency disorders, to convince the World Health Organization and its member states to start an implementation program to eradicate nutritional rickets by 2030.
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Affiliation(s)
- Roger Bouillon
- Laboratory of Clinical and Experimental Endocrinology, Department of Chronic Diseases, Metabolism and Ageing, KU, Leuven, Belgium.
| | - Leen Antonio
- Laboratory of Clinical and Experimental Endocrinology, Department of Chronic Diseases, Metabolism and Ageing, KU, Leuven, Belgium
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Veselka B, Brickley MB, D'Ortenzio L, Kahlon B, Hoogland MLP, Waters‐Rist AL. Micro-CT assessment of dental mineralization defects indicative of vitamin D deficiency in two 17th-19th century Dutch communities. AMERICAN JOURNAL OF PHYSICAL ANTHROPOLOGY 2019; 169:122-131. [PMID: 30882907 PMCID: PMC6593783 DOI: 10.1002/ajpa.23819] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/26/2018] [Revised: 02/25/2019] [Accepted: 02/25/2019] [Indexed: 12/25/2022]
Abstract
OBJECTIVES This study investigates vitamin D deficiency patterns in individuals from birth to the beginning of adolescence. Microscopic computed tomography (micro-CT) evaluation of interglobular dentine (IGD) in teeth provides information on the age of disease onset and the number of deficient periods per individual, which will increase our understanding of factors influencing vitamin D deficiency prevalence, including sociocultural practices and latitude. MATERIALS AND METHODS Beemster and Hattem, two Dutch 17th-19th century communities, yielded relatively high prevalences of rickets (15-24%) and residual rickets (15-24%). From the affected individuals, a subsample of 20 teeth were selected for micro-CT scanning. Thin sections were made of 17 teeth, consisting of 6 teeth with and 11 teeth without observable IGD on micro-CT that were included for method comparison. RESULTS About 19 out of 29 (65.5%) individuals (one tooth was deemed unobservable) presented with IGD on micro-CT. Eight of the 11 (72.7%) individuals without IGD on micro-CT demonstrated histologically visible IGD. In 40.7% (11/27) of the affected individuals (combined micro-CT and histology results), vitamin D deficiency was recurrent, and in four individuals, some episodes occurred at approximately annual intervals suggesting vitamin D deficiency was seasonal. In three individuals, IGD occurred in the dentine formed around birth, suggesting maternal vitamin D deficiency. DISCUSSION Micro-CT analysis of IGD is found to be a valuable non-destructive method that can improve our understanding of the influence of sociocultural practices and latitude on disease development within age and sex groups in past communities.
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Affiliation(s)
- Barbara Veselka
- Faculty of Archaeology, Human Osteoarchaeology LaboratoryLeiden UniversityLeidenThe Netherlands
| | | | - Lori D'Ortenzio
- Department of AnthropologyMcMaster UniversityHamiltonOntarioCanada
| | - Bonnie Kahlon
- Department of AnthropologyMcMaster UniversityHamiltonOntarioCanada
| | - Menno L. P. Hoogland
- Faculty of Archaeology, Human Osteoarchaeology LaboratoryLeiden UniversityLeidenThe Netherlands
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Brickley MB, Mays S, George M, Prowse TL. Analysis of patterning in the occurrence of skeletal lesions used as indicators of vitamin D deficiency in subadult and adult skeletal remains. INTERNATIONAL JOURNAL OF PALEOPATHOLOGY 2018; 23:43-53. [PMID: 30573165 DOI: 10.1016/j.ijpp.2018.01.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/07/2017] [Revised: 01/04/2018] [Accepted: 01/04/2018] [Indexed: 06/09/2023]
Abstract
Paleopathological investigations of conditions linked to vitamin D deficiency have increased in the last twenty years, and a suite of skeletal lesions has been established to aid in the diagnosis of vitamin D deficiency disease in subadults and adults. This paper analyzes the occurrence of these lesions in a large skeletal series comprising 3541 Roman period individuals (1st-6th century AD). Sixteen lesions reported in rickets in subadults, and 13 associated with residual rickets and osteomalacia in adults, were analyzed. Among subadults, there were clear associations among post-cranial lesions. Porotic cranial changes were associated with each other, but not with post-cranial lesions. A range of conditions could have produced the cranial lesions. There was a general paucity of correlations between indicators found in adults, and the difficulty in recording bending deformities was clear. Pseudofractures appear to provide a useful means of investigating osteomalacia in adults. In general, a simple algorithmic approach using presence or absence of lesions is unlikely to provide an adequate means of diagnosing vitamin D deficiency in paleopathology. Knowledge and consideration of the underlying physiological mechanisms involved in lesion formation, combined with individual judgement, will be required to differentially diagnose cases.
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Affiliation(s)
- Megan B Brickley
- Department of Anthropology, McMaster University, 1280 Main Street West, Hamilton, L8S 4L9, Canada.
| | - Simon Mays
- Historic England, Fort Cumberland Rd, Portsmouth, PO4 9LD, United Kingdom.
| | - Michele George
- Department of Classics, McMaster University, 1280 Main Street West, Hamilton, L8S 4L9, Canada.
| | - Tracy L Prowse
- Department of Anthropology, McMaster University, 1280 Main Street West, Hamilton, L8S 4L9, Canada.
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van der Pligt P, Willcox J, Szymlek-Gay EA, Murray E, Worsley A, Daly RM. Associations of Maternal Vitamin D Deficiency with Pregnancy and Neonatal Complications in Developing Countries: A Systematic Review. Nutrients 2018; 10:E640. [PMID: 29783717 PMCID: PMC5986519 DOI: 10.3390/nu10050640] [Citation(s) in RCA: 63] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2018] [Revised: 04/16/2018] [Accepted: 05/12/2018] [Indexed: 01/01/2023] Open
Abstract
Pregnant women in Asia, the Middle East, Africa and Latin America are at risk of vitamin D deficiency (VDD) and prevalence throughout these regions are among the highest, globally. Maternal VDD has been associated with increased risk of a number of adverse maternal and neonatal health outcomes, yet research from developing countries is limited. We assessed the associations of maternal VDD during pregnancy with adverse health outcomes by synthesizing the literature from observational studies conducted in developing countries. Six electronic databases were searched for English-language studies published between 2000 and 2017. Thirteen studies from seven countries were included in the review. Prevalence of VDD ranged from 51.3% to 100%. Six studies assessed both maternal and neonatal outcomes, four studies assessed only maternal outcomes and three studies assessed only neonatal outcomes. Ten studies showed at least one significant association between VDD and adverse maternal and/or neonatal health outcomes including pre-eclampsia (n = 3), gestational diabetes mellitus (n = 1), postpartum depression (n = 1), emergency cesarean section delivery (n = 1), low birth weight babies (n = 4), small for gestational age (n = 2), stunting (n = 1). However most of these studies (n = 6) also showed no association with multiple health outcomes. Vitamin D assessment methods, criteria applied to define VDD, season and trimester in which studies were conducted varied considerably across studies. In conclusion, this study highlights the need to improve maternal vitamin D status in developing countries in an effort to support best maternal and child health outcomes across these regions. Future research should focus on more unified approaches to vitamin D assessment and preventative approaches that may be embedded into already existing antenatal care settings.
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Affiliation(s)
- Paige van der Pligt
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong 3220, Australia.
| | - Jane Willcox
- School of Exercise and Nutrition Sciences, Deakin University, Burwood 3125, Australia.
- School of Allied Health, College of Science, Health and Engineering, La Trobe University, Bundoora 3083, Australia.
| | - Ewa A Szymlek-Gay
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong 3220, Australia.
| | - Emily Murray
- School of Exercise and Nutrition Sciences, Deakin University, Burwood 3125, Australia.
| | - Anthony Worsley
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong 3220, Australia.
| | - Robin M Daly
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong 3220, Australia.
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