Enamel hypoplasia and early mortality: Bioarcheological support for the Barker hypothesis


  • George J. Armelagos,

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    • George J. Armelagos is Goodrich C. White Professor of Anthropology at Emory University, Atlanta, Georgia. His research has focused on diet and disease in prehistory. He was the Viking Medal Medalist (Wenner-Gren Foundation) in 2005, received The Franz Boas Award for Exemplary Service to Anthropology from the American Anthropological Association in 2008, and The Charles Darwin Award for Lifetime Achievement to Biological Anthropology from the American Association of Physical Anthropologist in 2009.

  • Alan H. Goodman,

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    • Alan Goodman is the immediate past president of the American Anthropological Association (AAA) and the vice president of academic affairs, dean of faculty, and professor of biological anthropology at Hampshire College in Amherst, Massachusetts. His research focuses on developing measures of health and nutrition and the biological consequences of racism, poverty, and inequality. Goodman co-directs the AAA's public education project/Understanding Race/including an award winning museum exhibit and website (understandingrace.org).

  • Kristin N. Harper,

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    • Kristin Harper is a Robert Wood Johnson Health & Society Scholar at Columbia University. Her research centers on the role that common factors such as malnutrition and exposure to pollution play in molding our susceptibility to disease. Currently, she is investigating the relationship between trace metal levels, mutation rates, and the risk of developing diseases such as schizophrenia and cancer.

  • Michael L. Blakey

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    • Michael L. Blakey is National Endowment for the Humanities Professor of Anthropology, Professor of American Studies, and Founding Director of the Institute for Historical Biology at the College of William and Mary. Blakey is a key advisor on prominent museum projects including the Race Exhibition of the American Anthropological Association and the National Museum of African American History and Culture of the Smithsonian Institution, where he held several prior research positions at the Natural History Museum. He was Scientific Director of New York City's colonial African Burial Ground archaeological site that has become a National Monument. He has numerous publications in flagship journals on bioarchaeology, race, racism, ethics, and the history of anthropology. Michael Blakey held professorships at Spelman College, Columbia, Brown, Rome and Howard University where he founded the W. Montague Cobb Biological Anthropology Laboratory.


The Barker hypothesis asserts that stressful events early in the life history of an individual have negative health consequences later in adulthood. The hypothesis initially focused on prenatal stressors as indicated by birth weight and related outcomes. This initial concern with the fetal phase of development led to its description as the “fetal programming” or “fetal origins” hypothesis. The realization that stressors in the postnatal phase had similar impacts on adult health has led to its latest characterization as the Developmental Origins of Health and Disease Hypothesis (DOHaD). In this paper, we review the history and evidence in support of the DOHaD hypothesis. We then introduce an untapped source of information on early life stress: enamel hypoplasias and other developmental defects of enamel. Enamel defects are nearly indelible records of physiological perturbations, or stress, to developing ameloblasts (enamel-forming cells). Furthermore, the location of the defects translates to specific periods of growth, providing a permanent temporal record of early life stressors from in utero to approximately twelve years of age. As we discuss, a handful of studies of different populations reveals that individuals with enamel defects that developed in utero and early in infant-childhood development tend to be subject to earlier adolescent or adult mortality.