2019 Bioarchaeology and Social Schrader - Activity, Diet and Social

Bioarchaeology and Social Theory
Series Editor: Debra L. Martin
Sarah Schrader
Activity, Diet
and Social
Practice
Addressing Everyday Life in Human
Skeletal Remains
Series editor
Debra L. Martin
Professor of Anthropology
University of Nevada
Las Vegas, NV, USA
More information about this series at http://www.springer.com/series/11976
Sarah Schrader
Activity, Diet and Social

Practice
Addressing Everyday Life in Human Skeletal
Remains
Sarah Schrader
Faculty of Archaeology
Leiden University
Leiden, Zuid-Holland, The Netherlands
ISSN 2567-6776 ISSN 2567-6814 (electronic)

ISBN 978-3-030-02543-4 ISBN 978-3-030-02544-1 (eBook)
https://doi.org/10.1007/978-3-030-02544-1
Library of Congress Control Number: 2018959117
© Springer Nature Switzerland AG 2019

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For RES
Foreword
Sarah Schrader has produced a unique bioarchaeological study that integrates a

great deal of data in a way that paints a rich and complex picture of everyday life
and social practice. Using a large number of individuals (over 800) from ancient
Nubia, she brings their lives into sharp focus using innovative methodologies com-
bined with strong theoretical framing. One of the findings interrogated here is that
colonization by the Egyptians of local Nubian communities resulted in inequalities.
While this is not surprising, what Sarah goes on to reveal is a day-to-day sense of
what life was like on the ground for the colonized. Data show that it is likely that
Nubians were engaged in hard labor from mining and quarrying, an agenda imposed
by the colonizing Egyptians. Yet, her study also reveals that early on in the process,
Nubians were not powerless and demonstrated agency and even resistance as they
chose to continue to eat solely “Nubian foods” and to not engage in trade with the
Egyptians. In later time periods, the flexibility of the imposed Egyptian social struc-
tures permitted expression of Nubian cultural practices. But, Nubians also began
adopting some Egyptian customs as well, and this process of hybridity instead of
complete assimilation is just one of the nuances her study brings out regarding dif-
ferent aspects of colonization.
The main goal of the volume is beautifully rendered here, and that was to illus-
trate the applicability of bioarchaeology (the excavation and analysis of human
skeletal remains) to the study of everyday practice. In addition to this, Sarah pro-
vides a methodological framework for investigating ordinary and routine experi-
ences in the past through skeletal analysis. The theoretical approach using practice
theory provided a strong directional force and foundation for this work. Thus, while
we learn a great deal about interactions between Nubia and Egypt during the Middle
and New Kingdoms 4000 years ago, we also learn about everyday life and decisions
people made on the ground about how they wished to deal with imposed cultural
changes during times of colonization. The case study highlights how daily and unre-
markable activities by the populace are incredibly important to the overall story of
their lives.
This volume is a great example of the power of case studies to broaden our
notions about what modern bioarchaeology is and the ways that it can be expanded
vii
viii Foreword
into new areas by using theoretical approaches that have not been routinely used in
bioarchaeology. Bioarchaeology is unique in its application of expertise and knowl-
edge regarding skeletal tissue. Therefore, using multiple methodologies to recon-
struct the living biological system from the skeletonized remains has great potential
to provide insight about daily practice. Human remains can be used to clarify the
important day-to-day activities and practices of people in the past, but it takes inno-
vative integration of multiple lines of evidence. As Sarah convincingly demon-
strates, everyday life can be examined through “biosocial materialization” manifest
in skeletal remains.
This volume is an excellent introduction to the ways that empirical data from
entheseal analysis, dietary reconstruction, interpretations of skeletal indicators of
stress, and reconstructing archaeological context can be used together to highlight
aspects of human life that are generally not focused upon in our quest to understand
who we are and where we came from. This study offers us something new, and I can
imagine a generation of bioarchaeologists continuing in her footsteps.
Bioarchaeology and Social Theory Debra L. Martin

University of Nevada, Las Vegas,
Las Vegas, NV, USA
Acknowledgments
It was only with the support and encouragement of multiple people and organizations
that I was able to complete this research. I am particularly grateful to Dr. Debra Martin
for inviting me to join the Bioarchaeology and Social Theory series and for providing
invaluable feedback, encouragement, and advice. I also appreciate the comments
three anonymous reviewers provided, which greatly improved this manuscript.
This research would not have been possible without funding from the National
Science Foundation, the Global Research Synergy Grant from Purdue University,
and the Purdue University Foundation Grant.
I would like to thank Drs. Michele Buzon and Stuart Tyson Smith for their contin-
ued support and collaboration. The National Corporation for Museums and Antiquities
(NCAM), Director General Abdl al-Rahman, Professor Ali Osman M. Salih, and al-
Hassan Ahmed Mohamed have facilitated my research in Sudan. This acknowledge-
ment would also be remiss, without commending the local people of Tombos and
Abu Fatima. This community has whole heartedly welcomed our team into their lives
and greatly helped with excavation.
I was fortunate enough to be able to collect comparative skeletal data at several
international institutions. I would like to thank the Panum Institute at the University of
Copenhagen, Denmark, and in particular Dr. Niels Lynnerup for his support. Dr. Marta
Lahr facilitated my research at the Duckworth Collection at the University of
Cambridge. Dr. Daniel Antoine of the British Museum graciously provided access to
the Department of Ancient Egypt and Sudan’s excellent skeletal collections.
Last, but certainly not least, I would like to thank my friends and family who
have been a constant source of encouragement and comfort. Dr. Katie Smith, Dr.
Carolyn Jost-Robinson, Dr. Verity Whalen, Dr. Rachel Schats, Felicia Fricke, and
Jessica Palmer have all provided love, support, and countless conversations about
my research. My family members, including my Aunt Barbara Schrader and
Grandfather Ralph Schrader, have always served as perpetual sources of inspiration.
I would particularly like to thank my parents, Brenda and Bruce Schrader, who have
always supported me wherever my interests happened to take me. It was only with
their humble sacrifice, hard work, and constant enthusiasm that I have been able to
accomplish all that I have.
ix
Contents
1 The Anthropology and Bioarchaeology

of Quotidian Experiences�� 1
Who Studies the Everyday? �� 2
Archaeology of the Everyday�� 3
What Can Bioarchaeology Contribute? �� 6
Organization of the Chapters �� 9
References�� 11
2 Social Practice and Theoretical Integration
of Everyday Life�� 19
Bringing Everyday Life to the Fore �� 19
Situating Practice �� 20
Bourdieu�� 21
Giddens�� 24
de Certeau�� 25
Embodiment�� 27
Anthropological and Archaeological Perspectives
on Foodways and Labor�� 30
Foodways �� 30
Labor�� 38
Summary�� 41
References�� 41
3 Bioarchaeological Approaches to Activity Reconstruction�� 55
Osteoarthritis�� 56
Characteristics of Osteoarthritis�� 56
Etiology of Osteoarthritis�� 60
Previous Bioarchaeological Approaches to Osteoarthritis�� 63
Ongoing Bioarchaeological Debates: Definitions,
Data, and Statistics�� 70
Entheseal Changes �� 73
The Physiological Structure of Entheses �� 73
xi
xii Contents
Etiology of Entheseal Change�� 77

Previous Bioarchaeological Approaches to Entheseal Change�� 80
Ongoing Bioarchaeological Debates: Terminology,
Scoring, and Statistics�� 87
Combination Studies�� 93
Osteoarthritis, Entheseal Changes, and Everyday Life�� 95
Summary�� 108
References�� 109
4 Examining Diet and Foodways via Human Remains �� 127
Stable Isotope Analysis�� 129
Other Bioarchaeological Methods of Dietary Reconstruction�� 132
Compound Specific Isotope Analysis�� 132
Dental Calculus�� 133
Dental Wear�� 134
Dental Decay�� 135
An Example of Daily Life Foodways�� 135
How Do We Know What Ancient Egyptians
and Nubians Ate? �� 137
Who Were the C-Group Nubians? �� 141
What Were the C-Group and Pharaonic Samples Eating? �� 144
Summary�� 148
5 Day-to-Day Life in Ancient Nubia�� 165
Situating Tombos in a Transitional Sociopolitical Landscape �� 165
Tombos in Context �� 169
Osteology, Structure, and Agency�� 172
Osteology �� 173
Structure and Agency�� 178
Summary�� 188
6 Conclusions and Future Directions�� 195
Future Directions �� 200
Summary�� 203
Index�� 211
Chapter 1
The Anthropology and Bioarchaeology
of Quotidian Experiences
This book draws attention to the significance of day-to-day experience and in doing
so calls for a “Bioarchaeology of the Everyday.” Everyday actions—things that
people do on a daily basis, such as getting dressed, going to work, making dinner,
spending time with friends and family—while seemingly mundane are actually
vitally important to shaping our social identities and selves (Bourdieu 1977; Giddens
1991). While certain dramatic life events (e.g., marriage, war, injury/illness, death
of loved one) may be particularly memorable and leave a marked impression on an
individual and impact a broader social memory, it is mundane experiences that, with
time, form the pith of life experience. As Robin contends, “these day-to-day experi-
ences are a nexus of activities and interactions that both give shape and meaning to
the world and give people the ability to shape their world and make it meaningful”
(Robin 2013:5). For archaeologists questioning “What was life like in the past?”,
“What did people eat?”, “What jobs did they have?”, addressing day-to-day life is a
central research question.
Going beyond understanding how people actually live(d), scholars have drawn
attention to the importance of daily life in establishing and transforming the broader
social structure (Bourdieu 1977; de Certeau 1984; Giddens 1984; Lefebvre 1971,
2004; Scott 1990). According to these scholars, it is in daily actions, or practice, that
people accept or reject, consciously or unconsciously, existing social, political, eco-
nomic, and power relations. Furthermore, some argue that by confronting and alter-
ing these daily actions, these social, political, economic, and power relations can be
negotiated, thereby actively changing the social structure (de Certeau 1984; Giddens
1984). Quotidian experience is important because, as de Certeau writes, “if every-
day practices, ‘ways of operating’ or doing things, no longer appear as merely the
obscure background of social activity, and if a body of theoretical questions, meth-
ods, categories and perspectives, by penetrating this obscurity, make it possible to
articulate them,” we can begin to address how individuals maintain agency in prac-
tice (de Certeau 1984:xi).
Archaeologists are particularly well positioned to address the quotidian because
so much of the material record is a product of day-to-day life. Midden deposits,
© Springer Nature Switzerland AG 2019 1

S. Schrader, Activity, Diet and Social Practice, Bioarchaeology and Social Theory,
https://doi.org/10.1007/978-3-030-02544-1_1
2 1 The Anthropology and Bioarchaeology of Quotidian Experiences
architecture, debitage, landscape modification, utilitarian ceramics, and evidence of

food preparation are all examples of the materiality of everyday practice. As
Lightfoot notes, “it is the little routines that people performed day in and day out
that produced much of the material remains recovered in the archaeology record”
(Lightfoot 2005:17). Furthermore, archaeologists are able to assess how everyday
life changes from a diachronic perspective, providing great insight to how societies
change through time. Archaeologists can frame their research questions with theo-
retical perspectives that highlight the importance of the quotidian, but equally,
archaeologists can use methodological approaches that directly examine the materi-
ality of day-to-day experience (Robin 2013). In this chapter I discuss why it is
important to study everyday life, what disciplines are engaged in this research, how
archaeology fits into this broader discussion, and, perhaps most importantly, how
bioarchaeology can contribute to and strengthen quotidian studies.
Who Studies the Everyday?
Several social science and humanities disciplines strive to examine, characterize,

and draw conclusions from everyday life. Historians have reconstructed everyday
life using written records (Bell and Hollows 2006; Casey and Martens 2007; Crane
1994; Foyster and Whatley 2010; Kyvig 2002; Longmate 2002; Lüdtke 1989;
Marker et al. 2010; Moranda 2010; Pinto and West 2017). Sociologists have exam-
ined the quotidian within specific cultural and temporal contexts, addressing topics
such as consumption, labor, mobility, and political activism (Back 2015; Borland
and Sutton 2007; Browning 2005; Bryson 2008; Douglas 1971; Glassner and Hertz
1999; Peterson 2018; Sargisson 2010; Shortell 2018; Shortell and Brown 2014;
Sundberg 2008). Lefebvre, for example, has written extensively on the transforma-
tion of le quotidian, specifically regarding consumerism and capitalism in France
after the Second World War (Lefebvre 1971; Shields 1999). De Certeau is perhaps
one of the most well known quotidian scholars. In his groundbreaking work The
Practice of Everyday Life he discusses how mundane acts, particularly those cen-
tered upon consumption, can be a creative outlet as well as a mode of resistance (see
de Certeau 1984).
Anthropologists contribute to this discussion by assessing humans and their
ancestors through time and space (Attfield 2000; Gibson and Rodan 2005; Lavie
and Swedenburg 1996; McIafferty and Preston 2010). An anthropological approach
is particularly valuable to quotidian studies because we can draw on multiple
sources of information (e.g., written historical documentation, interviews, partici-
pant observation, archaeological remains) to contextualize everyday life within a
broader sphere of cultural interaction, past events, and biocultural materialities.
Using ethnographic documentation, sociocultural anthropologists have been inter-
ested in the everyday lives of modern peoples. In fact many of the architects of
anthropological thought, including Bronisław Malinowski, Ruth Benedict, and
Margaret Mead, were interested in learning about and documenting the day-to-day
Archaeology of the Everyday 3
lives of distant cultures (Benedict 1934; Malinowski 1922; Mead 1928). Malinowski
was one of the first proponents of living and coexisting with participants for
extended periods of time in the field (i.e., fieldwork) and developed participant
observation as a method for thoroughly understanding mundane life; according to
Robben and Slukka (quoting Malinwoski) “An ethnographer must not be satisfied
with describing the structural features of culture, but must also have an eye for the
‘imponderabilia of actual life’ discovered through close presence and participation”
(Robben and Sluka 2012:54, quoting Malinowski 1922:16).
While much of this foundational research was framed by questions of “the other,”
more recent sociocultural anthropology has looked to investigating the everyday
experience from a more inclusive perspective (de Genova 2002; Madden 2017;
Markowitz 2018; Zavella 2011). Nancy Scheper-Hughes has performed multi-sited,
ethnographic, and medical human rights oriented studies, which address how forms
of everyday violence are perpetrated upon the vulnerable and disenfranchised. For
example, she has examined infant and child neglect, organ trafficking, and sexual
abuse (Scheper-Hughes 1993; Scheper-Hughes and Wacquant 2003). Asokaraj
studied the reproduction of everyday life through the examination of children’s
social reality (e.g., family, peers, popular culture, and religious practices), in an
Internally Displaced Persons Camp (IDPC) during the Sri Lankan Civil
War (Asokaraj 2011). Gupta addressed the quotidian of corruption within local
bureaucracies in his ethnography of the Indian governmental state (Gupta 1995).
This research illustrates how, through scrutinizing day-to-day events, anthropolo-
gists can inform lifeways and lived experiences. These same principals can, and
should, be applied to our understanding of the ancient world.
Archaeology of the Everyday
Archaeology, a subdiscipline of anthropology, can contribute to this conversation by

examining day-to-day practice in the longue durée. Through meticulous excavation,
archaeologists are able to document how material outcomes of the everyday, such as
built space, midden deposits, and modes of production, change through time
(Blanton 1994; Brumfiel 1986; Hendon 1996; Joyce 2004; Shillito et al. 2011). This
theoretical interest in everyday life within archaeology can be linked to the proces-
sual movement,1 where scholars began to question what everyday life was like for
ordinary people (Binford 1962; Trigger 2006). Examples include an increased inter-
est in settlements and domestic architecture (Binford 1980; Blanton 1978; Flannery
1976; Steadman 1996; Trigger 1968; Willey 1974), ethnoarchaeological perspec-
tives (Binford 1967, 1978; Kent 1984), and scientific approaches (Binford 1981;
Harris 1979; Hastorf and Popper 1989; Redman 1973, 1987; Schiffer 1987; Watson
et al. 1971, 1984). Critiques of processualism, which argued that processual
1
Although some have argued that this is a product of (1) a broader social movement beginning in
the 1960s (Löfgren 2015), and (2) western secularized modernity (Gullestad 1991).
perspectives were environmentally deterministic, lacked human agency, viewed

culture as homeostatic, and failed to take social and individual factors (e.g., gender,
ethnicity, identity social relations) into account, gave rise to the post-processual
movement in the 1980s (Flannery 1982; Hodder 1985, 1986; Raab and Goodyear
1984; Shanks and Tilley 1987). As a product of post-processualism, feminist, agen-
tive, phenomenological, social identity, and practice approaches began to be inte-
grated into research questions and design (Barrett 2001; Brumfiel 1992; Conkey
and Spector 1984; Dobres and Robb 2000; Hodder 1991; Meskell 2001; Tilley
1994, 1997; Wylie 1997).
With the development of processual and post-processual archaeology, archaeolo-
gists are not only interested in the daily lives and settlements of ancient people but
also are asking questions relating to social interaction, identity, experience, and
practice. In Cynthia Robin’s book, Everyday Life Matters: Maya Farmers at Chan,
she centers her discussion of archaeology and everyday life on three subfields: (1)
household archaeology, (2) spatial archaeology, and (3) feminist archaeology
(Robin, 2013:45–66). Each of these archaeological subfields has become prominent
since the 1980s and has significantly contributed to our understanding of day-to-day
lived experience.
Household archaeology focuses on the material remains, including architecture,
artifacts, and features, of domestic life and can speak to how domestic space was
used (Allison 1999; Hendon 2004; Wilk and Rathje 1982; Wilson 2008). Hendon
explores how material remains of everyday life can elucidate social memory in
ancient Honduras (Hendon 2010). By excavating in and around ancient houses in
three contexts (Copan, Cerro Palenque, and Cuyumapa; seventh to eleventh centu-
ries CE), Hendon is able to assess how cooking, crafting, and ritual events all reflect
larger social processes (i.e., remembering and forgetting). She demonstrates how
practices of everyday life “turn domestic spaces into places of memory with impor-
tant consequences for the production of social difference, the entrenchment of social
hierarchies, and the ability of some to exert control over others” (Hendon 2010:5).
Everyday actions, including crafting objects, exchanging goods, and feasting, are
ways in which memories, histories, and subjectivities were constructed and the
household can be viewed as a locus of these events.
Going beyond buildings, the organization and use of space can also be telling
about everyday life (Canuto and Yaeger 2000; Gillespie 2000; Hendon 1996, 1997;
Joyce 2000; Love 1999). As Robin points out “while the domestic domain may be
an important location of everyday life, people do not check their everyday lives at
the door when they leave home” (Robin 2013:55). Robin critiques Western precon-
ceived and dichotomous notions of domestic versus agricultural space, inside versus
outside, and private versus public—concepts that are often associated with everyday
life (Robin 2002). In an analysis of late Classic Maya farmsteads at Chan Nòohol,
Belize, Robin illustrates that everyday life, assessed through the remains of habita-
tion structures as well as footpaths imprinted in the porous soil, fluidly combined
domestic and agricultural tasks. Structures were built and oriented in such a way
that people could see, hear, and speak to others who were in other work/habitation
areas, facilitating “interaction and communication rather than division” (Robin
Archaeology of the Everyday 5
2002:258). She concludes that everyday life at Chan Nòohol was characterized by
inclusive (men, women, and children) working and farming areas, which were situ-
ated in a fluid scape that was not altogether outside/inside or public/private. The
preservation of footprints at Chan Nòohol was unexpected and fortuitous; nonethe-
less, it presents a very interesting perspective on the everyday lives, movements, and
interactions of people in this community. Archaeologists interested in space and
place can turn to yards, pathways, streets, workspaces, markets, stores, parks, fields,
forests, and entire landscapes to quotidian experience in the past (Robin 2013).
Feminist and gender archaeologists also incorporate everyday life into their
research by questioning gendered assumptions relating to status, power, and prac-
tice (Brumfiel 1991, 1992; Gero and Conkey 1991; Ghisleni et al. 2016; Gilchrist
1999; Meskell 1999; Meskell and Joyce 2003; Voss 2000, 2008a, b; Whitehouse
2007; Wilkie 2003). This began with the specific task of “finding” women in the
archaeological record, but later developed into a broader interest in how gender
identities (male, female, other genders) are contextually defined and the signifi-
cance they hold in other societies (Søresnen 2007). Robin states, “feminist house-
hold archaeologists were among the first to show that the contemporary Western
division between ‘domestic/house/private/female/consumption/passive’ and the
active public world of male politics and production was not universal” (Robin
2013:53). An excellent example of gender archaeology is Rosemary Joyce’s Gender
and Power in Prehispanic Mesoamerica (Joyce 2000). She examines gender, with-
out binary assumptions, in Prehispanic Mesoamerica via the material record (imag-
ery, figurines, text, costume ornaments). She firmly critiques the notion that gender
is biological/natural; “if gender is not a fixed and biologically grounded identity,
then in fact the fixing of specific gendered performance in everyday life and in rep-
resentation takes on a slightly different significance and raises other questions”
(Joyce 2000:7). Through a detailed diachronic analysis of the archaeological record
(Early Formative to Postclassic Periods), Joyce argues that gender and power were
complexly interwoven in Prehispanic Mesoamerica and also varied depending on
the function and audience of representation (e.g., small-scale versus large-scale
images). A feminist perspective on everyday life in the ancient past is vital because
feminist archaeology (1) aims to be all-inclusive, examining individuals who are
elite/non-elite, male/female/other gender, etc. and (2) critically rejects western
assumptions, such as gendered labor (e.g., presumption that females are associated
with domestic spheres).
As discussed above, this archaeological interest in everyday life has both theo-
retical and methodological roots. Methods including, but not exclusive to, land-
scape modification, stratigraphy, paleoethnobotany, midden formation, and debitage
studies, have been used to address broader research questions related to day-to-day
life (Bar-Yosef and van Peer 2009; Fladmark 1982; Fuller et al. 2014; Hastorf 1999;
Hendon 2010; Lentz 2000; Matthews et al. 1997; Needham and Spence 1997).
Diane Gifford-Gonzalez discusses how zooarchaeology can contribute to this dis-
cussion given that animals play a significant role, either as food, labor, economic
capital, and/or symbolic value, in the daily lives of many people (Gifford-Gonzalez
2007). Furthermore, recent technological advancements have allowed a rchaeologists
to address everyday life via soil chemistry, stable isotope analysis, and chemical
residue analysis (Eberl et al. 2012; Evershed 2008; Gregg et al. 2009; Lopez Varela
and Dore 2010; Middleton 2004; Middleton and Price 1996). Investigations into
day-to-day events have proved to be an enduring goal within archaeological
research—I contend that human skeletal remains, as embodied artifacts and sources
of multiscalar data, can significantly contribute to this discussion.
What Can Bioarchaeology Contribute?
While archaeology of the everyday has made and continues to make great strides in
better understanding the quotidian, bioarchaeology can provide another perspective
on day-to-day life—one that speaks directly to the lived experience of individuals,
groups, communities, and populations. In particular, I view embodiment theory and
a multiscalar perspective as two distinct advantages of Bioarchaeology of the
Everyday. Like archaeology, bioarchaeological studies can address the everyday
both through research design (i.e., questioning what everyday life was like in a par-
ticular context and how that shaped the broader social structure) and methodologi-
cal approaches (i.e., exploring new ways in which human skeletal remains can shed
light on everyday practice). While bioarchaeological approaches have contributed
to current anthropological and archaeological theoretical debates (e.g., gender,
identity, violence, life course, agency; Agarwal 2016; Crandall and Martin 2014;
Geller 2008, 2009; Gowland and Knüsel 2009; Knudson and Stojanowski 2008;
Martin et al. 2012; Martin and Harrod 2015; Velasco 2014), we, as bioarchaeolo-
gists, have only begun to discuss everyday life.
Skeletal tissue changes throughout the life course, recording dramatic and acute
events like violent encounters and pathological conditions, but also mundane and
gradual processes such as physical activity and diet. The chronicle of life events
transcribed on bones is a product of ongoing, complex, biosocial interactions with
the extracorporeal milieu. When human remains are viewed as the material traces of
embodied experience they become much more than static objects—they are accounts
of daily action, agentive choice, inequalities, identities, and power relations. From
this perspective, skeletal analysis can uniquely enhance our understanding of lived
experience in the ancient past by both drawing upon and augmenting social theoreti-
cal developments (Sofaer 2006). Human skeletal remains can be considered the
physical remnants of lived social experience, a nexus of biology and culture. As
Sofaer discusses, “the division between nature and culture is one of the most funda-
mental distinctions in archaeology,” with bodies typically conceptualized as purely
biological/natural, fixed, and immutable (Sofaer 2006:51; see also Ingold 1998).
However, a closer examination of the underlying biological processes within the
skeleton in concert with a broader consideration of the materiality of the body,
accentuate the fluidity between social meaning and corporeal physicality.
Bones consist of roughly 70% mineral hydroxyapatite and 30% organic colla-
gen, providing both the rigidity required to support the human body, but also the
What Can Bioarchaeology Contribute? 7
ability to adapt (Mays 2010). Through the cellular process of osteoblast construc-
tion and osteoclast destruction, skeletal material is constantly undergoing a process
of transformation (Marks and Odgren 2002). Collagen turnover experiments have
shown that adult human bones completely remodel approximately every 10 years
(Hedges et al. 2007). Bone functional adaptation research also support the argument
that the skeleton changes with activity, stress, and age (Ruff et al. 2006; Stock and
Macintosh 2016). Thus, as the human body undergoes certain stressors, bones react
and record—or embody—the social experience (Krieger 2005). Bioarchaeologists
are able to look beyond: calculating the frequency of broken bones, identifying
pathological conditions, examining activity patterns—and address social topics,
including, but not limited to, structural violence, socioeconomic status, and lived
experience (Agarwal and Glencross 2011; Klaus 2012; Sofaer 2011). In this light,
bones become much more than biology—they become a highly informative data
source that embodies practice, agency, and sociality.
An embodiment perspective also implies that, unlike archaeological artifacts,
human bones respond to external social stimuli. This is a distinct advantage of a
Bioarchaeology of the Everyday approach. Human skeletal remains are plastic in
life, that is to say they are adaptable; they are imprinted with pathological condi-
tions, indicators of physical activity, and molecular traces of diet, which are directly
related to ones social and economic experiences. I do not mean to imply that humans
do not engage with artifacts (e.g., ceramic sherds, spindle whorls, lithic tools, beads,
weaponry) and features (e.g., postholes, hearths, structures, storage pits).
“Objects, like people, are said to have histories, biographies and social lives (Appadurai
1986; Hoskins 1998; Kopytoff 1986), or act as metaphors for the self, standing in for people
in the absence of a body (Hoskins 1998). Objects are said to be ‘active’ (Tilley 1999). More
recently they have also been identified as ‘animate’ and ‘social’ in the same way as people,
since they are always bound up in their social projects (Jones 2002).” (Sofaer 2006:63)
However, we also cannot ignore the fact that human remains are the product of both
biology and culture (Armelagos 2003). Embodiment theory has gained momentum
in bioarchaeological research over the past decade (Agarwal and Glencross 2011;
Nystrom 2014; Schepartz 2017; Tiesler 2014; Torres-Rouff 2003; Zuckerman et al.
2014). This continued interest in and application of embodiment theory in bioar-
chaeology speaks to the relevance and significance of this perspective on our field.
Additionally, the embodied skeleton can be examined on multiple scales—the
individual, groups, and entire populations. Stodder and Palkovich (2012) have
addressed, via multiple case studies, how the skeleton of a single individual can be
highly informative and contribute to questions relating to identity, life history, and
social roles. This osteobiographical approach, skeletal analysis at the level of the
individual that is bolstered by archaeological, archival, and/or contextual data, has
become increasingly popular in bioarchaeology (Boutin 2012; Castro et al. 2017;
Mayes and Barber 2008; Tourigny et al. 2016). Bioarchaeologists can also examine
multiple individuals, ranging from groups to entire populations (Geller 2012; Martin
and Harrod 2016). This multiscalar perspective is something that archaeologists
strive for (Covey 2015; Dornan 2002; Lightfoot et al. 1998). One could argue that
osteological data is actually better suited for multiscalar analysis. Bioarchaeologists

are able to identify individuals in prehistory (i.e., a skeleton). Several of the archae-
ological methods discussed above (e.g., middens, households, space) cannot speak
to individuals—only groups of people. Archaeologists can study these communal
artifacts diachronically and glean important information, though they are unable to
parse out an individual’s day-to-day practice.
There have been a few bioarchaeological studies where everyday practice has
been addressed. Wesp focuses on the materiality of daily life in her publication
“Bioarchaeological Perspectives on the Materiality of Everyday Life Activities”
(Wesp 2015). She analyzed 17 skeletons from the Postclassic (1300-1500 CE) site
of Xaltocan in Central Mexico and discusses physical activity and pathological con-
ditions, specifically entheseal changes and osteoarthritis, as they relate to embodied
everyday practice. By assessing each of the 17 individuals independently, she is able
to discern activities and life experiences, which possibly include spinning, weaving,
grinding corn, fishing, and carrying heaving loads. Through the lens of materiality,
Wesp views the body, including skeletal remains, as “created and recreated over
time through the actions of everyday life” (Wesp 2015:145).
Gagnon discusses osteological traces of day-to-day life in her dissertation,
“Daily Life and the Development of the State in the Moche Valley of North Coastal
Perú: A Bioarchaeological Analysis” (Gagnon 2006). In analyzing dental caries,
wear, and abscesses, periodontal disease, antemortem tooth loss, and dental trauma
coupled with stable isotopic and dental calculus analysis, she addresses how
inequality, power, and identity skeletally and dentally materialize throughout the
state formation and development process. At the site of Cerro Oreja (1800 BCE-
400 CE; n = 750), she found that agricultural intensification, indicated by: increas-
ingly positive δ13C values, decreasing δ15N values, an increase in dental disease as a
byproduct of carbohydrate consumption (i.e., corn), and changes to dental wear
patterns due to increasingly soft foods, was an important factor in the development
of the Moche State. Chica consumption, assessed via an increase in dental disease
associated with starch diets and a δ13C signature indicative of corn, did not differ
between elite and non-elite individuals. Gender, rather than socioeconomic status,
was correlated with maize dependence; everyday consumption of maize and chica
seems to have been gendered in that females and children were consuming more
carbohydrate-rich agricultural produce, while men were supplementing their diet
with marine resources and chica. The frequency of localized dental wear, anterior
tooth trauma, and craft related fibers preserved in dental calculus did not change
through time or between the sexes, suggesting that craft specialization, as an every-
day activity, was consistent throughout the state development process. Lastly, coca
use, reflected by coca phytoliths and changes to dental disease prevalence, seems to
have varied diachronically and, like maize dependence and chica consumption, was
a gendered component of everyday life for men. When Cerro Oreja was ruled by
groups from the highlands, indicators of coca use decreased as this occupation lim-
ited access and use of coca, particularly for low status individuals. Gagnon argues
that through these daily actions, i.e., food consumption and activity, people affected
large-scale economic, social, and political change (Gagnon 2006).
Organization of the Chapters 9
These two studies illustrate how bioarchaeology can contribute to a better under-
standing of everyday life in the ancient societies. Using very different approaches
(activity patterns, dental disease, dental wear, and calculus), Wesp and Gagnon shed
light on embodied quotidian experiences, including physical labor (e.g., spinning,
grinding corn, carrying heavy loads) and consumption (e.g., chica, corn).
Furthermore, they contextualize this within the broader regional history (Postclassic
Central Mexico and State Formation in the Moche Valley of North Coastal Peru).
Wesp conducts this analysis at the level of the individual, while Gagnon focuses on
diachronic changes to the population at Cerro Oreja; this illustrates how flexible and
multiscalar skeletal data are.
This book continues this line of inquiry: How can bioarchaeology contribute to
our understanding of day-to-day life? What methods are in our toolkit that can speak
to these quotidian events? What can these data tell us about the experiences of indi-
viduals and groups in the past? What can we infer about social structure from these
data? Assuming that there is social structure, there is also agency—can we detect
agency from these data? I address these questions using examples from my own
research on Ancient Nubian (southern Egypt, northern Sudan) skeletal remains.
Using case studies from multiple populations throughout Nubia, the questions
above will be discussed and a framework for future bioarchaeological analysis of
the everyday will be presented.
Organization of the Chapters
Building upon this introduction to Bioarchaeology of the Everyday, I present theo-

retical perspectives, methodological advancements, and case studies that further
support osteological analysis of daily practice in the past. As Wesp and Gagnon
illustrate, bioarchaeologists can elucidate everyday life from the vantage of physical
activity and food consumption. These are actions, imbued with social, economic,
political, and symbolic significance, that are performed on a day-to-day basis and
also are embodied in human skeletal remains. Throughout the book, I will continue
to discuss how and why activity and consumption are important daily practices that
can be examined in skeletal collections. I will also address other methods bioar-
chaeologists can employ to further this discussion.
Chapter 2, Social Practice and Theoretical Integration of Everyday, highlights
the applicability of practice theory to investigations into day-to-day life. Practice
theory, in the broadest sense, aims to address the relationship between an overarch-
ing and confining social structure and the agentive individual. Practice theorists,
such as Pierre Bourdieu, Anthony Giddens, and Michel de Certeau, discuss how a
social system is produced, maintained, and altered; equally important, they also
address how individuals assert agency within these systems. Do they have agency in
producing, maintaining, or altering social structures? Are they conscious or uncon-
scious about these actions? Practice theory scholars would argue that this is done
through mundane, daily practice. Archaeologists have employed this perspective in
the past, but given that everyday life is, to some degree, embodied in the human
skeleton, bioarchaeologists are ideally situated to employ practice theory as well. It
is through daily practices that humans, construct, perceive and modify their world.
Here, practice is addressed through bodily reconstruction of foodways as well as
physical activity, both of which can be viewed as daily actions. Chapter 2 presents
a theoretical background on the anthropology and archaeology of food and labor,
which serves as a springboard for additional discussion in later chapters.
Chapter 3, Bioarchaeological Approaches to Activity Reconstruction, focuses on
osteological methods for addressing physical activity. Osteoarthritis and entheseal
changes are examples of skeletal adaptations to musculoskeletal stress. Proponents
of these methods acknowledge the complex etiologies of these conditions and incor-
porate the enormous amount of previous bioarchaeological and clinical research
that has been conducted into their research. I review these subjects and discuss the
current state of osteoarthritis and entheseal changes research in bioarchaeology. The
case study in this chapter focuses on the Upper Nubian cemetery, Kerma. Drawing
on skeletal data from the large tumuli at the Kerma necropolis (1650–1500 BCE),
I compare the frequency and severity of osteoarthritis and entheseal changes
between the elite and non-elite burials. Socioeconomic status, as assessed via burial
practices, in this state-level society does appear to have influenced the day-to-day
physical activities of these individuals.
In Chap. 4, Examining Diet and Foodways via Human Remains, I discuss the
ways in which bioarchaeologists can address food consumption in the past. In recent
decades, carbon and nitrogen stable isotope analysis has become increasingly popu-
lar and widely accepted. There are also several other methods bioarchaeologists use
to examine diet, including compound specific isotope analysis, dental calculus, den-
tal wear, and dental decay. I use carbon and nitrogen isotopic data to infer diet dur-
ing the Middle Kingdom Egyptian colonization of Lower Nubia (2050–1500 BCE).
By examining two populations, the C-Group sample, who are indigenous Nubians
that maintained their Nubian identity despite Egyptian invasion, and the Pharaonic
sample, who are Nubians that took on a more Egyptian identity with colonization,
I am able to couch these isotopic results in a discussion of power, structure,
and agency in this colonial setting.
Chapter 5, Day-to-Day Life in Ancient Nubia, presents a case study that incorpo-
rates both physical activity and diet in a diachronic examination of daily life at the
Upper Nubian town, Tombos. Tombos functioned as an Egyptian imperial outpost
during the New Kingdom (1500–1070 BCE) and later thrived as a post-imperial
community during the Third Intermediate and Napatan Periods (1450-660 BCE).
Using entheseal changes, osteoarthritis, and carbon and nitrogen stable isotope data
I interpret these findings in light of Bourdieu’s theory of habitus, while incorporat-
ing social structure and agency. This presents a very interesting opportunity to
examine the differences between daily life under a colonial regime (New Kingdom)
and daily life in a thriving post-colonial community (Third Intermediate/Napatan
Period). Interesting and unexpected patterns emerge that speak to the imperial
approach to colonization, independence associated with state-formation, as well as
cultural hybridity through multiple centuries.
References 11
Chapter 6, Conclusion and Future Directions, sums up the findings of the case
studies from Ancient Nubia. I show how, through dietary and activity reconstruc-
tion, bioarchaeologists can address everyday life in the past and why this is impor-
tant. I also discuss the potential for future research, as this book is only one example
of what bioarchaeologists can do.
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Chapter 2
Social Practice and Theoretical Integration
of Everyday Life
In Chap. 1, I illustrated why examining everyday life is important. I discussed what

other disciplines study day-to-day life and how the quotidian emerged as a focal
point of research within archaeology. I argued that bioarchaeology, by incorporating
embodiment theory and multiscalar perspectives, can significantly contribute to
archaeological knowledge about everyday life in the past. In this chapter, I will
bolster this introduction with an in-depth discussion of practice theory, which puts
premier importance upon mundane, quotidian actions. In short, practice theory is
concerned with the dialectic between social structure and individual agency. Many
scholars argue that negotiating ones social structure is achieved through daily prac-
tice, in that individuals can maintain or alter said daily practices as a form of
endorsement or resistance. If we frame skeletal products of everyday practice (e.g.,
activity and dietary reconstruction; Chaps. 3 and 4), which are the embodiment of a
larger social environment, with practice theory, then we can examine social struc-
ture and agentive actions in archaeological contexts. To that end, I also include
sections on the anthropology and archaeology of food and labor to frame later dis-
cussions of these everyday practices and the significance they hold for individuals,
communities, and societies.
Bringing Everyday Life to the Fore
Before scholars like Bourdieu and Giddens, Lefebvre highlighted the importance of
everyday life and in doing so lay the groundwork for future researchers. As Robin
notes in Everyday Life Matters: Maya Farmers at Chan, Lefebvre was not the first
person to address everyday life (Robin 2013); there is a long line of early- to mid-
twentieth-century thinkers, Surrealists, Dadaists, Freudians, and others, who dis-
cussed everyday life at length (Aragon 1926; Breton 1924, 1928; Freud 1914;
Goffman 1959). However, Lefebvre was the first to critically engage with the
quotidian and reject imposed dichotomies (everyday versus the exceptional/

https://doi.org/10.1007/978-3-030-02544-1_2
20 2 Social Practice and Theoretical Integration of Everyday Life
momentous/memorable). Born in France in 1901, Lefebvre made the argument that

scholars should go beyond documenting daily life, as many anthropologists and
sociologists of the early twentieth century were doing (see Chap. 1). Everyday life,
according to Lefebvre, is the “connective tissue” of all conceivable human thoughts
and activities (Gardiner 2000). By conceptualizing everyday life as the foundation
of human society, rather than a backdrop or a footnote, Lefebvre convincingly
argues that everyday life is “profoundly related to all activities…it is their meeting
place, their bond, their common ground” (Lefebvre 2008:97). He argued that the
Enlightenment had dismissed everyday life, instead prioritizing higher intellectual
traditions such as philosophy, science, and art, and thus, in some respects, was
defending the importance of, and scholarly return to, everyday life (Robin 2013:25).
Lefebvre was also committed to combining theoretical perspectives and empirical
research (Lefebvre 2008:5). With his well-developed theoretical perspective, he
advocated for a detailed attention to everyday life and its materiality, something that
could not be achieved in a short ethnographic interview, for example. He also
encouraged the use of case studies and examples that clearly illustrate the practice
of everyday life and its meaning (Lefebvre 2008). Later researchers would also sup-
port Lefebvre’s argument that everyday actions have the ability to both maintain
social structures as well as change them (Lefebvre 2008). Lefebvre’s interests in
empirical data, his attentiveness to the minutiae of everyday experience, as well as
his exaltation of daily life align well with the priorities and interests of archaeology.
While it would be decades before these ideas were adopted by archaeologists,
Lefebvre’s work did pave the way for practice theorists.
Situating Practice
Practice theory illustrates the significance that everyday actions have in both the
maintenance and modification of cultural systems as well as the negotiation of
social identities. By bridging the gap between broader social structures and indi-
vidual agents, this theoretical perspective achieves what other social theories have
lacked. For example, traditional structuralist approaches viewed society as an
organism that operates mechanistically via interrelated parts (i.e., norms, customs,
traditions, institutions; see Levi-Strauss 1963). Structuralism has been criticized for
not acknowledging individual actors as agents as well as not accounting for social
change. At the other end of the spectrum, methodological individualism contends
that all cultural phenomena are attributable to individual action (see Elster 1982).
These perspectives lack an adequate dialogue between social structures and the
individuals existing within them. Practice theory mediates these two perspectives by
developing a theoretical discourse between the influence of social structure and the
power and agency of individuals.
Practice theory contends that within any given society, there exist institutions
and activities, which are regulated by societal rules and norms. Human actions are
carried out within the framework of a preexisting social structure and, therefore, are
Bringing Everyday Life to the Fore 21
somewhat confined. Succinctly stated by Ortner, “modern practice theory seeks to

explain the relationship(s) that obtain between human action, on the one hand, and
some global entity which we may call ‘the system,’ on the other” (Ortner 1984:148).
The system is conceived of as an overarching and all-encompassing condition,
composed of social, economic, political, religious, and ideological norms, tradi-
tions, and perspectives, which inherently restricts individuals that are operating
within it. The degree of confinement is contextual and goes beyond the material,
political, and even physical by permeating the cultural and psychological
(Dornan 2002).
Individuals are not powerless in these settings; they maintain some degree of
agency via practice. This capacity can manifest in subtle movements (e.g., manner-
isms, tastes, etiquette, utterances) or everyday activities (e.g., food preparation and
consumption, bargaining, gift exchange) and can result in distinct long-term devel-
opments (e.g., institutional/social change; Bourdieu 1977; Dreyfus 1991; Taylor
1985). When one considers the individuals existing within these contexts, activities
performed become meaningful strategies rather than just monotonous actions.
Because of this, the importance of everyday life is often conceptualized as a pillar
of modern practice theory; it is with mundane, innocuous, and domestic actions that
agency is enacted and systems are (re)produced (de Certeau 1984). With this, there
has also been an academic refocusing toward ordinary people; “it has come to signal
a special interest in the commonplace and the seemingly trivial routines and activi-
ties of daily life as well as a focus on ‘ordinary people’ as creative actors rather than
passive consumers or objects of domination” (Löfgren 2015:323). Furthermore,
practice has the potential to reproduce or change the system by either agentively
maintaining it or altering practices so deeply that the structure itself is changed
through time (Giddens 1984). Social worlds are created via daily practices and are,
to some degree, limited due to structural constraints and power relations—however,
individuals are able to use these same daily practices to resist, reject, or change
these systems.
Perhaps the most cited practice theorists—Pierre Bourdieu, Anthony Giddens,
and Michel de Certeau—differ in their views of subconscious versus intentional
action and the mechanisms of systemic change through time, they propose an over-
arching, constraining structure and explore how agentive actors act within it.
Bourdieu
Bourdieu uses the concepts of habitus, capital, doxa, and field to situate agentive
action within the broader social structure. According to Bourdieu, habitus is a sys-
tem of acquired habits, skills, and dispositions, which are both the product of objec-
tive conditions (i.e., structure) as well as subjective experience (i.e., agency;
Bourdieu 1977). Wacquant, a student of Bourdieu’s, describes habitus as “the way
society becomes deposited in persons in the form of lasting dispositions, or trained
capacities and structured propensities to think, feel and act in determinant ways,
which then guide them” (Wacquant 2005:316). Habitus is acquired through embod-
ied practice, which Bourdieu considers to be anything that people do on a day-to-
day basis. Thus, through socialization, individuals acquire learned habits, skills, and
dispositions through everyday practice. Socialization not only occurs in schools, at
work, and so on, Bourdieu argues that the home is a “critical arena for the produc-
tion and reproduction of social life” (Robin 2013:27). Rather than assuming the
home is a static and socially void space, Bourdieu highlights the importance of
everyday experience in everyday spaces. In theory, habitus makes one suited for
familiar social scenarios; however, given a new social environment, an individual’s
habitus may inhibit successful navigation through a new social field. Habitus is
shaped by past events structures, but equally, shapes current practices and structures
(Bourdieu 1984).
Bourdieu argues that beyond economic capital, cultural capital and social capital
also inform an individual’s habitus. Bourdieu explores cultural and social capital
thoroughly in his book Distinction: A Social Critique of the Judgement of Taste
(Bourdieu 1984; also Bourdieu 1986). Cultural capital can be summarized as “what
an individual knows” and “what an individual has.” There are three types of cultural
capital: embodied, objectified, and institutionalized. Embodied cultural capital is a
form deeply embedded knowledge and practice, including skills, accents, tastes,
and mannerisms, which in certain social settings are viewed as being of higher capi-
tal. For example, an upper class British accent might be interpreted to be of higher
capital than a Cockney accent. Objectified cultural capital includes material things
that have a particular cultural significance. For example, a Rolls Royce is objectified
in that the brand, in and of itself, holds value in Western society. This is of course
contextual and varies between societies. Lastly, institutionalized cultural capital
includes symbols of knowledge and authority, such as credentials and qualifica-
tions. Titles, such as Dr., and university degrees, particularly from prestigious insti-
tutions, are examples of institutionalized cultural capital. Individuals that share
cultural capital can form collectives with similar backgrounds, values, and identi-
ties, perpetuating expectations for embodied, objectified, and institutionalized indi-
cators of cultural capital. It is important to note that cultural capital can be created
or transferred from other forms of capital and provides a means for a non-economic
form of power and hierarchy. This is of particular interest to archaeologists as cul-
tural capital underpins inequality, which continues to be a central research topic
(Ames 2007; Arbuckle 2014; Bowles et al. 2010; Cuéllar 2013; Hayden 2001a;
Luley 2016; McGuire and Paynter 1991; Pokutta et al. 2015; Price and Feinman
1995; Quinn and Beck 2016; Spencer and Redmond 2015; Torres-Rouff et al. 2015).
While inequality can, of course, take the form of economic capital, inequality
becomes more difficult to define and identify when it takes the form of cultural
capital.
Social capital can be summarized as “who an individual knows.” It is social rela-
tionships that provide an individual with social capital. An individual’s social capi-
tal increases with (1) the more people that person knows and/or (2) the higher the
social capital of their social network. For example, a person can have few personal
connections; however, if that network possesses increased social capital, this will in
turn result in increased social capital for the individual. Like cultural capital, groups
of people can also share social capital as collective capital, making it advantageous
for an individual to have a large and well-connected social network. Like cultural
capital, social capital is also of interest to archaeologists. With recent advances in
applications of social network theory to archaeological data sets, we can begin to
address social capital in the ancient past (Golitko et al. 2012; Knappett 2011, 2013;
Mills et al. 2013).
Bourdieu views social space as being divided up into multiple arenas, otherwise
known as fields (e.g., art, education, religion, law; also social groups, work places,
institutions). When an individual enters a field, economic, social, and cultural capi-
tals are automatically transformed into symbolic capital. Each field has its own set
of rules, practices, and expectations, otherwise known as doxa. Doxa combines
both orthodox and heterodox norms; it is “an adherence to relations of order which,
because they structure inseparably both the real world and the thought world, are
accepted as self-evident” (Bourdieu 1984:471). In other words, behavior that is so
thoroughly routinized that it continues unquestioned can be considered doxa.
Individuals do have agency in that they can break with doxa. As individuals navi-
gate these fields, their habitus and symbolic capital determines their position in
said field.
Thus, an individual, complete with habitus, interacts in multiple and overlapping
social spaces, or fields. There are various social agents, each with their own habitus,
within any given field. Members of a field are aware, unconsciously, of the rules and
expectations, or doxa, of said field. How successful that individual is in a field, or
social situation, is dependent upon how well suited their habitus, as a product of
capital, is to the field. In essence, the habitus is the locus of the objective field and
subjective action; in this way, Bourdieu is attempting to remove the long-standing
divide between objective and subjective. There is an element of social reproduction
in this process in that an individual’s habitus is highly influenced by their social
context and yet this social context limited by their habitus. The social setting in
which an individual was raised and lives provide a primer for being successful in
that particular setting, generating dispositions that are compatible that setting (e.g.,
art, literature, food, music; Bourdieu 1993). The individual will then go on to per-
petuate the habitus gained from this social structure, thereby reproducing it. This is
not to suggest that an individual is permanently confined to their current social
structure, habitus, and field(s). An individual can acquire new capital, alter their
habitus, and with time and experience be successful in novel fields. “Habitus is not
fixed or permanent, and can be changed under unexpected situations or over a long
historical period” (Navarro 2006:16).
Bourdieu’s attention to the home, agency, and daily life has made practice theory
particularly appealing to archaeologists. Silliman uses a practice theory framework
in his analysis of material remains from California Native Americas from Rancho
Petaluma (Silliman 2001). Rancho Petaluma was a land grant offered by Mexico to
Mariano G. Vallejo for his military service. It is estimated that as many as 1000
Native Americans lived and worked on this land between 1834 and the early 1850s.
They likely would have been involved in herding and slaughtering cattle, plowing
and harvesting fields, manufacturing goods, as well as processing and preparing

food. A dense residential midden proved to be an excellent resource for native
domestic and laboring practices. Silliman chose to focus his interpretations on the
lithic material because “of the high diversity and quantity of lithic materials and
their strong association with the numerous other material classes at the site”
(Silliman 2001:201). He argues that the large quantity of lithic material found in this
midden (n = 3009) indicates that Native Americans at Rancho Petaluma were agen-
tively maintaining this indiginous way of life. Rather than choosing any one of a
number of new material and technological alternatives (e.g., glass, metal, ceramics,
mass-produced items), Native Americans continued their traditional quotidian prac-
tices. Silliman suggests this choice was a distinctly political one—the persistence of
these lithic practices were a point of contestation and resistance in this colonial
scenario. According to Silliman, lithic technology would have been securely located
in doxa, “it was the accepted way to manufacture hard, durable or sharp imple-
ments” (Silliman 2001:202). The fact that Native Americans chose to continuing
using lithic technology despite access to other materials illustrates an instance of
fractured doxa, a persistence of daily practice in the face of colonialism.
Giddens
Like Bourdieu, Giddens attempts to mediate the subjectivist–objectivist divide by

developing a theory that explains how social structure influences agency and vice
versa. Giddens balances the concepts of social structure and agency in his theory of
structuration (Giddens 1984). He views social systems as “an active constituting
process, accomplished by, and consisting in, the doings of active subjects” (Giddens
1993:121). Structuring properties (i.e., rules and resources) of a given society enable
the continuation of the social system (Giddens 1984). Agents within these systems
draw upon memory traces, deeply embedded cultural memory, to conduct social
action (Giddens 1979). According to Giddens, “structure is both the medium and
outcome of reproduction of practices” (Giddens 1979:5). However, individual
agents can contest these norms by altering their daily practices. These quotidian
actions are performed as a means of maintaining existing identities and cultures, but
are altered with interaction and time, leading to new practices, identities, and cul-
tures (Giddens 1984; Smith 2014). For Giddens, the most routinized of actions,
even in scenarios of political and social instability (e.g., revolution), are highly
meaningful; “Routine persists through social change of even the most dramatic
type, even if, of course, some aspects of taken-for-granted routines may be compro-
mised” (Giddens 1993:87).
There is a mutual dependence between the two components (i.e., structure and
agency), what Giddens refers to as the duality of structure, in which social struc-
tures allow social action, while simultaneously, social action via agency can modify
the broader social structure (Giddens 1984). From this perspective, even the most
routine, agent-based, activities can be considered maneuvers that define individuals,
informing social practice, negotiation, and identity through time (Barrett 2001).
Further, Giddens broadens agency to include those actions that are both subcon-
scious and unintentional (akin to Bourdieu) as well as practices that are performed
by tacit and informed actors. For Bourdieu, conscious contemplation of one’s habi-
tus is possible, it is not typical. For Giddens, actors can reflexively consider their
actions and identities and act accordingly. This is essential and potentially transfor-
mative part of the duality of structure.
Gardner applies Giddens’ concept of structuration to material finds from late
Roman-period Britain (fourth and early fifth centuries CE; Gardner 2002). He
argues that the concept of social identity, which is not a central component to
Giddens’ work, could contribute to the theory of structuration (Jenkins 2008).
Drawing on data from the built environment, pottery, coins, small finds, and faunal
bones, he found complex and overlapping identities, not simply confined to
“military” or “civilian.” Gardner contends that archaeology is particularly applica-
ble to structuration and identity studies, “the complexity of human identities, as
negotiated through material cultures (including writing), is indicated by cross-cut-
ting patterns in different fields of activity” (Gardner 2002:331). Everyday activities,
traced by material remains, such as exchanging, appearing, dwelling, working, and
eating, can be linked to the production and reproduction of social identities (Gardner
2002:336). These identities are informed both by agents and structures, which is
central to Giddens’ duality of structure. Using a multiscalar and multi-tempo
approach, Gardner argues that continuity and change in material practices repre-
sents the negotiation of social identities. Assuming that these social identities are
the coalescence of agents and institutions, “they can be readily conceptualized as
the fulcrum of the duality of structure, and thus as the driving force of structure as
social process” (Gardner 2002:345). Archaeology has been accused of taking
theoretical models from other disciplines and applying them to the ancient past
(Keene 1983). Gardner’s incorporation of identity and materiality into structuration
theory are excellent examples of what archaeology can offer to other disciplines and
theoretical perspectives.
de Certeau
De Certeau wrote The Practice of Everyday Life, drawing on anthropology, history,

classics, sociology, philosophy, and linguistics, which highlighted the importance of
the repetitive and unconscious nature of everyday life (de Certeau 1984). De
Certeau’s research focused on the details, the minutiae, of daily life, which other
scholars, such as Lefebvre had acknowledged, but had not fully addressed (Gardiner
2000). Rather than focusing on the logic or generation of practice, as Bourdieu had
done, de Certeau was interested in the social products of practice. He contended that
everyday practices are how people understand their world around them. Like other
practice theorists, de Certeau proposed that these everyday practices were con-
structed by socioeconomic and power relationships (de Certeau 1984); however,
these constraints would never be total or all encompassing. To illustrate this point,
de Certeau uses the example of “voyeurs” and “walkers” in his chapter “Walking to
the City” (de Certeau 1984:92–111). Here, he introduces two groups of people, the
voyeurs and the walkers, who have different vantages of everyday practices. A voy-
eur can stand on top of a skyscraper and view an entire city; while s/he can see the
walkers on the street, s/he does not have the ability to truly appreciate the everyday
lives of those walking the street. Walkers on the other hand walk the streets, know
the landscape, and have a deep understanding of those day-to-day actions that de
Certeau considers of utmost importance. While the organization of the city, the
leaders, and the institutions might, to some extent, limit the everyday lives of the
walkers— the walkers have the ability to take shortcuts and act in ways the govern-
ments, corporations, and other institutional bodies do not account for.
Robin draws on de Certeau in her analysis of the Classic Maya farmstead at Chan
Nòohol, Belize (briefly discussed in Chap. 1; Robin 2002). She contextualizes her
analysis of households and the settlement of Chan with de Certeau’s interpretation of
place and space. de Certeau conceptualizes place as ordered settings, created by peo-
ple, which in turn give meaning to people’s lives (Robin 2002:249). Space refers to
experiences of being and doing in a place and continually define and redefine places
(Robin 2002:249). Thus, space, according to de Certeau depends upon place, and,
equally, place is inactive unless there is space (de Certeau 1984). This perspective is
particularly well suited for Robin’s analysis of daily practice and it facilitates theori-
zation of place/space organization in archaeology; “de Certeau (1984:xv) noted how
all practices in the world are indeed spatial practices, and from such a perspective we
can move the study of people’s practices squarely into the domain of a spatial archae-
ology, instead of conceptualizing archaeological evidence as the impoverished resi-
dues of the people and practices we cannot access directly” (Robin 2002:248).
It is important to draw attention to the fact that while the works of Bourdieu,
Giddens, and de Certeau have played an important role in the introduction and pro-
liferation of practice theory, they are certainly not the exclusive products of this
body of work. Ortner draws attention to this by noting an American preoccupation
with European scholars, what she has termed “Eurofetishism” (Ortner 2001a:276).
Other noteworthy contributors to theories of practice include Sahlins (re cultural
encounters, Sahlins 1981), Foucault (re power, Foucault 1979), Smith (re feminist
sociological approach to daily practice, Smith 1987, 1992), and Ortner herself (re
history of theory, agency, Ortner 1984, 2001b, 2006). There is also a substantial
literature on the archaeology of agency as well (Dobres and Robb 2000; Gardner
2004; Hodder 1992; Joyce and Lopiparo 2005; Ortner 2006; Pauketat and Alt 2005;
Robb 2010; Schatzki et al. 2005).
Practice theory, framed with day-to-day activities and events, bridges the gap
between an overbearing social structure and individual agents. According to some,
it is these very mundane and quotidian actions, which transform the social structure.
Practice theory is pertinent here because it (1) highlights the importance of the
everyday life and (2) acknowledges the confining nature of social, political, and
economic systems that are in place, but equally highlights the power of individual
agency. As discussed in Chap. 1, everyday life is the foundation of lived experience.
Embodiment 27
Archaeologists play a key role in examining day-to-day life in ancient populations

and reconstruct a lost voice of neglected histories. In fact a central question of
archaeological research is—how and why do cultures, societies, and peoples’ lives
change? Practice theory perspectives can help to address this point, while account-
ing for individual actors in the larger system. But how do we apply practice theory,
something that is largely theoretical, to bioarchaeology, a field that is centered upon
the empirical analysis of human skeletal remains? As discussed in Chap. 1, the
answer to this lies in the concept of embodiment. If we conceive of the human
skeleton as the embodied product of lived experience, we can begin to assess those
experiences and tease apart social structure and agency in the ancient past.
Embodiment
The anthropological concept of embodiment addresses how physical bodies are

shaped by social factors and, thus, should be conceptualized as much more complex
than mere biological entities. Embodiment refers to how we “literally incorporate,
biologically, the material and social world in which we live” (Krieger 2001:672). In
this way, the body, which is structured by the plastic and embodied skeletal frame,
can be viewed as the site of lived experience (Meskell 2000). The biosocial nature
of human skeletal remains facilitates the application of embodiment theory to osteo-
logical research and can elucidate the individual, social, and political bodies of the
past (Jones 1997). Bones are the biological remnants of individuals that archive
social events (e.g., pathological conditions, physical activities, diet), enabling the
examination of broader topics such as health, manual labor, and food choice
(Buikstra and Scott 2009; Knudson and Stojanowski 2008). Due to skeletal plastic-
ity, human remains can embody social actions and lived experiences similar to
archaeological artifacts (e.g., ceramic sherds, lithics, textiles), and therefore, reflect
both the natural and cultural surroundings of the individual (Butler 1993; Meskell
and Joyce 2003).
From a phenomenological perspective, it is the body of the individual that
engages with other individuals and the broader social world. The biological mani-
festations of health, disease, and well-being, from an embodiment-oriented theoreti-
cal perspective correspond with the social, political, and economic relations of the
self. It is the physicality of the body that allows for: repetitive movement for labor,
engagement in warfare and interpersonal violence, and interaction with other peo-
ple. The observable skeletal correlates of this engagement include: muscle attach-
ment sites and osteoarthritis, perimortem and antemortem traumas, and
communicable pathological conditions (e.g., syphilis, tuberculosis), respectively.
This list is far from exhaustive, but it provides a few examples of the ways in which
skeletal methodologies speak to the body and, moreover, elucidate social being.
Thus, embodiment is directly aligned with bioarchaeological objectives that
highlight the social nature of skeletal remains and directly applies to the examina-
tion of everyday life in the ancient past.
The “body,” from an anthropological perspective, has been categorized into three
groups: the individual body, the social body, and the body politic (Scheper-Hughes
and Lock 1987). The individual body applies to the lived experiences and the self-
conceptualization of the individual. The social body addresses how the body is
interpreted within a social system. The body politic concerns social control, both
individual and collective, over the body. These components of “self” have been used
throughout cultural and medical anthropology (see Csordas 1990; Lock and Kaufert
1998; van Wolputte 2004) and to some extent within archaeology (see Joyce 2005;
Lesure 2005; Meskell 2000). Bioarchaeology has the potential to speak to the indi-
vidual body, the social body, and the body politic, given appropriate contextual
information. Zuckerman et al. frame their analysis of the 18th–19th Century
Mississippi State Asylum skeletal collection with the body politic (Zuckerman et al.
2014; more specifically, they address the oppression of the physical bodies of these
individuals who reflect the marginalized, disenfranchised, and impoverished.
Importantly, Zuckerman and colleagues couch this theoretical contribution within a
broader discussion of bioarchaeological ethics.
The concept of embodiment has been well studied in cultural anthropology, yet
bioarchaeological research has only recently incorporated embodiment into theo-
retical discourse, despite its applicability (Knudson and Stojanowski 2008). In Body
as Material Culture: A Theoretical Osteoarchaeology, Sofaer addresses embodi-
ment through the examination of human skeletal remains (Sofaer 2006). Sofaer pro-
poses that human bodies are literally created through social practices and, thus, the
skeleton can be regarded as a form of material culture akin to an archaeological
artifact:
“While archaeologists are familiar with the idea that objects are created by bodies and that
ideas and attitudes, rather than occupying a separated domain from the material, may be
inscribed in objects, they are perhaps less routinely aware that the body is itself created in
relation to a material world that includes objects as well as other people.” (Sofaer 2006:xv).
As discussed in Chap. 1, human bones, unlike artifacts are constantly in a state of

adaptation. It is important to remember that during life, bones are plastic, flexible,
and in a constant state of change. Not only does Sofaer acknowledge a dialogue
between the social and the biological, she advances the theoretical conceptualiza-
tion of skeletal remains as embodied artifacts. Thus, rather than simply providing
demographic (e.g., age, sex, population size) or paleopathological information,
from this perspective, bioarchaeology has the ability to address both the biological
and social past.
Bioarchaeologists employing embodiment theory have tended to focus on the
body as an inscriptional surface, an active means of personal expression. Just as
clothing, jewelry, and weaponry, have been associated with embodied identity per-
spectives in the archaeological record (Bayman 2002; Fisher and DiPaolo Loren
2003; Gilchrist 1997; Joyce 1999, 2002; Wobst 1977), body ornamentation and
modification have similarly been used in the osteological record (Blom 2005; Robb
1997; Tiesler 2012, 2014; Torres-Rouff 2002, 2003). When grounded in identity
theory, these forms of expression are, by definition, exterior and public; they can
Embodiment 29
serve as material symbols of group identity that are visible and widely interpretable
(Joyce 2005).
However, by establishing an embodied “exterior” (i.e., visible, public), a dichot-
omous “interior” is also implied (Rautman and Talalay 2000). Joyce problematizes
the question “Is ‘surface’ to ‘interior’ as ‘public’ is to ‘private’?” through her dis-
cussion of the body, costume, and dress (Joyce 2005); while archaeologists once
conceived of body ornamentation as purely public, advertising an assumed singular
identity, new perspectives are moving away from the strict dichotomy of surface/
interior and public/private to include to body itself as a field of experience and inte-
gral to identity-shaping (as opposed to identity-signaling, exclusively). Human
skeletal remains, as Joyce asserts, are an example of these blurry lines between
surface/interior and public/private: “[bioarchaeological] exploration of the ways in
which habitual practices and dispositions literally shape flesh and bones…further
questions the isolation of a public, inscriptional body surface covering an uninter-
preted physical interior because the biological person is both the medium and the
product of social action” (Joyce 2005:142).
Bioarchaeologists have begun to conceptualize human skeletal material as
embodied artifacts. Noteworthy contributions include cranial and body modification
(Geller 2006; Tiesler 2012, 2014; Torres-Rouff 2002, 2003, 2008, 2012), the tempo-
rality of bodies (Geller and Suri 2014), sex and gender (Agarwal and Wesp 2017),
social age (Nikitovic 2017; Sofaer 2011), and structural violence (de la Cova 2012;
Klaus 2012; Muller et al. 2017; Nystrom 2014; Nystrom et al. 2017). In addition to
these perspectives, I suggest that because skeletal remains are the product of a
broader social experience, they have the ability to speak to social structure and
agency and are thus viable sources of data for practice approaches. While agency
has been addressed using skeletal tissue (Crandall and Martin 2014; Glencross
2011; Velasco 2014), the dialectic between structure and agency has yet to be bioar-
chaeologically employed. Skeletal remains, as an integral part of the human body,
can be viewed as the site of lived experience. From this perspective, the analysis of
human skeletal tissues has the distinct capacity to produce direct evidence of lived
experience (Walker 2001).
In this book, I discuss skeletal embodiment of everyday practice. Specifically, I
use food consumption and physical activity as two examples of day-to-day practice
that can be examined osteologically. There are other ways in which bioarchaeolo-
gists can examine the materiality of everyday practice (discussed further in Chap.
6). However, given that much of this book focuses on foodways and physical activ-
ity, I will provide some theoretical grounding on these two topics. First, the anthro-
pology of food, which has a long history, will be summarized. The archaeology of
foodways, inspired by the theoretical movements described in Chap. 1, will also be
reviewed. I specifically address methodological approaches to the bioarchaeology
of food in Chap. 4; thus, for the present this chapter is limited to archaeology of
foodways. The anthropology of labor, an emerging discipline, is briefly examined,
which is followed by a more in-depth section on the archaeology of labor. While
physical activity certainly does not directly translate to labor, labor is certainly
included in physical activity.
nthropological and Archaeological Perspectives on Foodways

A
and Labor
Foodways
From a biological perspective, dietary consumption is an essential component to

life, providing necessary nourishment in the form of carbohydrates, proteins, fats,
vitamins, minerals, fiber, phytonutrients, and water (Armelagos 1987; Larsen 2000).
These nutrients facilitate growth, tissue repair, basal metabolic function, and physi-
cal activity. Beyond this, diet and its associated activities (i.e., food selection, prepa-
ration, presentation, consumption) play a very important social role (Caplan 1997;
Counihan and van Esterik 1997). Anthropological studies of foodways bridge these
perspectives and have greatly influenced our understanding of the multifaceted
nature of food.
Initial anthropological studies of food used ethnographic methods. In 1920,
Cushing published an article on Zuni breadstuffs (Cushing 1920). Soon thereafter,
Boas published a book on Kwakiutl salmon recipes, which is highly regarded as an
informative ethnographic resource (Boas 1921). This descriptive, ethnographic per-
spective soon developed into a functionalist approach as anthropologists began to
associate food with social relations. Radcliffe-Brown stressed the social function of
food, arguing that cuisine had the power to regulate social systems (Gumerman
1997; Radcliffe-Brown 1922). Despite the theoretical flaws of functionalism, this
was an important step in conceptualizing food as a significant social practice.
Levi-Strauss argued that food could be used to analyze the structure of a society
(Levi-Strauss 1963, 1966). From this, he developed a “culinary triangle,” which
described specific foods on various spectrums such as how cooked the food was
(i.e., raw to rotten), various ingredients (i.e., air, oil water) and techniques (i.e.,
broiling, boiling, roasting, and frying). According to Levi-Strauss, he was attempt-
ing “to discover for each specific case how the cooking of a society is a language in
which it unconsciously translates its structure” (Levi-Strauss 1966:595).
Bourdieu also wrote extensively on food and taste in relation to capital (Bourdieu
1984). Framing his research with French culture, he asserts that those individuals
with a high volume of cultural capital, within their own social context, effectively
define taste. Others, who have lower volumes of cultural capital, have no choice but
to accept this interpretation of taste. According to Bourdieu, this gets legitimized
and accepted as dichotomous forms of “high” and “low” culture. Individuals in the
low culture category do not have the cultural capital (e.g., education, lexicon, cri-
tique) enabling them to successfully engage with the high culture tastes. Using
1960s France as an example, he found the diets of the “working class” to be ample,
particularly for men, and often included a second helping. Items on the working
class menu included soups, pastas, and potatoes. The “bourgeoisie,” on the other
hand, had a very strict sequence of courses (i.e., fish, meat, cheese, dessert) that
were generally healthier and less fatty than the working class foods. Bourdieu por-
Anthropological and Archaeological Perspectives on Foodways and Labor 31
trayed this relationship in a diagram, entitled The Food Space (Fig. 2.1; Bourdieu
1984:186). This was recently updated by Gastronomica to fit a Western twenty-first
century context (Fig. 2.2; Watson 2012).
Bourdieu highlights how capital is embodied through consumption and, thus, is
highly informative.
“Taste, a class culture turned into nature, that is, embodied, helps to shape the class body. It
is an incorporated principle of classification which governs all forms of incorporation,
choosing and modifying everything that the body ingests and digests and assimilates, physi-
ologically and psychologically. It follows that the body is the most indisputable materializa-
tion of class taste, which it manifests in several ways” (Bourdieu 1984:190; emphasis
original)
Kamphuis and colleagues apply Bourdieu’s theory of cultural capital to modern

food choices (Kamphuis et al. 2015). Those who were found to possess a high vol-
ume of cultural capital were statistically significantly more likely to make healthy
food choices than those without cultural capital. In a special issue of Food, Culture
& Society, Smith Maguire draws attention to the nuances of diversity and cultural
creativity. While she argues that cultural capital plays a role in foodways, she aims
Fig. 2.1 The food space (Bourdieu 1984:186)

Fig. 2.2 The food space reinterpreted (Gastronomica: Watson 2012)
to “debunk the uncritical, uncultured low-income consumer” (Smith Maguire

2016:11).
In 1998 The Practice of Everyday Life II: Living and Cooking was published
posthumously (de Certeau et al. 1998). In this second volume, de Certeau and col-
leagues discuss the active nature of consumption. While production is often seen as
an agentive action, capable of encapsulating creative thought while manufacturing
something of value, consumption is often viewed as a passive, destructive act that
only destroys that which has been produced. De Certeau counters these assumptions
by asserting that consumption in its various forms is a constructive act, which facili-
tates expression. In Chap. 10, Giard discusses the productive act of cooking, “I
discovered bit by bit not the pleasure of eating good meals…but that of manipulat-
ing raw materials, of organizing, combining, modifying, and inventing…I had been
invested with the secret, tenacious pleasure of doing-cooking (Giard 1998:152;
emphasis added). Again, this interpretation presents an image that cooking and con-
sumption is constructive, powerful, and agentive.
Other scholars have examined the anthropology of food by analyzing diachronic
changes in subsistence as a product of population movement, environments, and
technologies. Foci of study include human origins (Binford 1968; Sobolik 1994),
agricultural adaptations (Boserup 1965; Christensen 1980; Cohen 1977; Earle 1980;
Morrison 1994), and climate change (King 1993). Another radical transformation in
the way anthropologists conceive of food occurred in the early 1980s with Goody’s
groundbreaking publication of Cooking, Cuisine and Class: A Study of Comparative
Sociology (Goody 1982). It was this book, in particular, that began to view food as
a marker of social identity and considered the agent-based process of food choice in
the selection, preparation, and consumption of cuisine.
In Food and Gender: Identity and Power, Counihan and Kaplan argue that the
association between gender, food, and power is multifaceted (Counihan and Kaplan
2013). The book is centered on two primary arguments, (1) control of production,
distribution and consumption can contribute to gender positions and (2) food can
symbolically communicate gender and established social status of both men and
women. Gender variations in consumption have also been studied in Melanesia
(Kahn 1986), Papua New Guinea (Munn 1986; Whitehead 2000), Sweden (Neuman
2016), Italy (Counihan 1999), the Andes (Weismantel 1988, 1989), and the Maasai
(Talle and Palsson 1990), just to name a few. Variation in food patterns can signal
gender identities, but can also entail gender-based social inequalities (Dong et al.
2017; Huber 2007; Miller 1997).
Foodways can also serve a social role within ritual practices and beliefs. In many
cultures, certain foods and dietary habits are considered sacred through their asso-
ciation with supernatural beings and processes (Bloch 1985; Khare 1992; Singer
1984; Toomey 1994). Many have hypothesized that the link between food and faith
is through social memory (Barthel et al. 2014; Feeley-Harnik 1994, 1995; Meah and
Jackson 2016; Mintz and Du Bois 2002; Sutton 2001). Weismantel has argued that
modern indigenous Andean practices of eating and drinking maize-based products
(chica) during religious feasts is an artifact of ancient Inca traditions (Weismantel
1991). The Inka are known to have held maize in high religious regard; it was
believed these offerings would nourish the dead. Brandes similarly studied the rela-
tionship between sugar and Mexican rituals for Dia de los Muertos (Brandes 1997).
Brandes suggests these religious foodways are based in traditional Aztec practices.
Eating in ritual contexts, such as major religious events and ritual performances, is
often a public act. Deliberate social statements such as these can reaffirm or trans-
form social relationships (Brown 1995; Buitelaar 1993; Murphy 1986). Within
smaller units, such as the individual, household, and kin group, “ritual and beliefs
surrounding food powerfully reinforce religious and ethnic boundaries” (Mintz and
du Bois 2002:107; see also Bahloul 1989; Fabre-Vassas 1997).
In studying the social nature of food, we must not overlook individual actors in
this process. Goody points out the importance of individual agency in food choice
(Goody 1982:29). While this can be extrapolated to societies, anthropologists must
be aware that basic food choices are often made at the level of the individual. Food
symbolism goes beyond simply reflecting society, rather dietary choice and con-
sumption can/should be viewed as a method of creating society through the actions
of individuals (Hodder 1986). Agent-based actions can serve to establish a common
membership into a broader group and, equally, identify those that are not a part of
the group. This phenomenon has been well documented in anthropological contexts
(Liburd 2003; Narayan 1995; Palmer 2002).
These topics are often difficult to detect in the archaeological contexts. With the
assistance of ethnohistoric evidence, White has researched gender identity through
foodways of the ancient Maya (White 2005). Hastorf has also been able to identify
gender differences in foodways in the ancient Sausa of the Andes (Hastorf 1996;
also see Hastorf 1991; Hyder et al. 2005; Sørensen 2000). Bioarchaeologically,
researchers have been able to speak to gendered foodways using stable isotope anal-
ysis (Ambrose et al. 2003; Somerville et al. 2015; Tung and Knudson 2018; dis-
cussed further in Chap. 3).
Many researchers are beginning to look at the effects of sociopolitical processes,
such as culture contact, on foodways (Hastorf 1996; Voss 2005). Scott contends that
in scenarios of culture contact, the culturally determined food preferences will
reflect the sociopolitically dominant culture (Scott 2008); however, this is not
always the case. Investigations into traditional foodways of peripheral territories
can not only elucidate the varieties of foods that were consumed, but also address
local agency by illustrating the process of food selection and preparation as popula-
tions juxtapose indigenous and foreign diets (Smith 1997, 2006). Smith has ana-
lyzed the interaction between Egyptian colonists and native Nubians through
ceramic artifacts at the archaeological site of Askut (Smith 2003). This study pres-
ents a clear dichotomy between Egyptian and Nubian vessels, which exemplifies
social identity enacted via foodways. While traditional Nubian serving vessels grad-
ually decrease in popularity diachronically, Nubian cookpots dramatically increase.
Evidence of both Egyptian and Nubian artifacts during this time period suggests the
coexistence of multiple identities and intermarriage as a result of culture contact.
Feasting is also a topic that has received a good deal of traction within archaeo-
logical research. The material remains of feasting, including large faunal deposits
and specialized ceramic vessel production, are oftentimes distinct and can be identi-
fied archaeologically (Bray 2003; Dietler 1996; Hayden 2001b, 2014; Kuusela in
press; O’Connor 2015). Feasts can signify celebration, such as weddings, work
feasts, and harvest festivals (Dietler 2001; Hastorf 2017). Celebratory feasts have the
least overt political agenda, according to Hastorf (Hastorf 2017). Potluck feasts, akin
to Dietler’s and Hayden’s concept of solidarity feast, can involve competition and
often have hidden motives involving community building and integration. Alliance
building feasts have “an overt political tinge and reflect asymmetrical positions”
(Hastorf 2017:200). Lastly, competitive feasts are designed to signal elevated socio-
economic status and means, either through rare ingredients, amount of food that is
present, or large number of people invited. Feasting as a form of gastropolitics, a
term that Hastorf has adopted, allows archaeologists to better understand the power
dynamics, the capital, and the social dimensions of ancient societies (Hastorf 2017).
VanDerwarker and Wilson examine the intersection between food and warfare in
the ancient past (VanDerwarker and Wilson 2016). Warfare is a large topic of
anthropological and archaeological research; VanDerwarker and Wilson uniquely
contribute case studies with explicit links between warfare and food insecurity.
They address the impact of warfare on food acquisition, warfare and nutritional
health, ritual foodways and violence, provisioning warriors and armies, changes to
status associated with warfare, food constraints on military campaigns, and compe-
tition over resources leading to violence during times of war (VanDerwarker and
Wilson 2016). Warfare impacted individuals, communities, and entire regions in
several ways. VanDerwarder and Wilson illustrate that food can and did impact
warfare, as did warfare impact food, in the ancient past.
Hastorf and Foxhall research the topic of surplus in the ancient world (Hastorf
and Foxhall 2017). According to Hastorf and Foxhall “surplus is not only an eco-
nomic reality, but a state of mind, created by and reflecting the social and political
relations of a group” (Hastorf and Foxhall 2017:26). In the past, scholars have
looked upon surplus as a defining point in the history of specific cultures. In theory,
with surplus, a society can provide for its members during times of need. However,
Hastorf and Foxhall point out that this only applies to some. We have to consider
who has access to the surplus? Who is in charge of the surplus material? Surplus is
not only about what is being stored, but how others see it. Using the Inka State and
ancient Athens as examples, the authors illustrate how surplus exists only within a
larger network of social and political actors and that all individuals in a given com-
munity with said surplus are not equal. Hastorf and Foxhall suggest we, as archae-
ologists, think about surplus as a culturally constructed state of mind, which directly
influences how societies conceptualize surplus and “enough.”
Archaeologically, diet can be analyzed at multiple levels. Many have taken a
very broad stance to understanding diet in past populations. The dietary regimes of
hunter-gatherers have been of interest for decades (Isaac 1971; Truswell 2008;
Yellen and Harpending 1972). These studies are often focused on prehistoric dietary
patterns within a particular region such as Australia (Head and Fullagar 1997;
O’Dea et al. 1991), Europe (Grayson 1998), Asia (Wright 1994), and South America
(Borrero and Barberena 2006; Scheinsohn 2003). Similarly, the dietary reconstruc-
tion of agriculturalist societies (Bar-Yosef and Belfer-Cohen 1989; Katz and Voigt
1986) as well as transitional groups (i.e., hunter-gatherer to sedentism; Bettinger
1980; Zvelebil and Rowley-Conwy 1984) has also been debated. These perspectives
provide valuable information on the diet of an entire population under study.
However, these approaches cannot detect subtle differences of social processes
between communities and individuals.
More nuanced levels of analyses exist, which can inform topics such as food
preparation, presentation, and dietary preferences. Goldstein has investigated the
link between the emergence of the Andean polity, Tiwanaku, and the increasing
frequency of a novel vessel form, which would have been used to consume chica, a
maize-based beer (discussed above; Goldstein 2003). By comparing culinary equip-
ment in several peripheral zones, Goldstein concludes that the expansion of the
Tiwanaku state was predicated on the introduction and acceptance of the new beer
vessels. These vessels defined and later unified the Tiwanaku state. This is an exam-
ple of both food preparation (i.e., chica) and food presentation (i.e., the vessels) as
forms of social identity converge. The widespread acceptance of this beverage and
this vessel either signals mass acceptance of the newly defined Tiwanaku state, or
coercive pressure to appear so.
Another archaeological example of food presentation is in the feasting scenario
of the ancient Aztecs. In an examination of Aztec populations, Michael Smith and
colleagues found that elites and commoners used the same types and quantities of
food-related ceramic vessels (Smith et al. 2003). However, through careful analysis,
Smith et al. found that elites possessed more serving vessels, which were often
important and painted fineware. The authors hypothesize that elites likely possessed
other markers of status that may have been organic and biodegradable in nature,
such as cotton clothing, feather art, and possibly restricted foods. However, based
on the market system mode of commercialized exchange, the painted fineware serv-
ing vessels must have been purchased in the public market setting. This act was not
only a display of wealth, but these fineware would later be utilized in important
public feasting events.
Food preference is very difficult to address through the archaeological record.
Monica Smith examines the interplay between the social and ritual significance of
India’s primary staple food, rice (Smith 2006). By the 1st millennium BCE rice is
found in the archaeological record throughout the Indian subcontinent. By the
1st century BCE text and archaeological evidence show the transition to social com-
plexity reflected in scenarios of urbanism, long-distance trade, ritual complexes,
and named political as well as ritual authorities. These authorities most likely coor-
dinated labor forces for the large scale maintenance and irrigation of rice fields to
both support the growing populace as well as to establish a food surplus. Smith
argues that initial leaders actively pursued rice as a staple crop, despite the labor-
intensive drawbacks, in exchange for the benefits of supporting the preferred food
of the nation. This implies a notion of food preference that would have predated the
emergence of leadership in the region, but also, one that would have continued for
millennia. Furthermore, by actively pursuing rice as the mainstay of the country, the
emerging authorities engaged in a shared identity with subordinate populations
through both production and consumption.
There are several methodologies in archaeology that can infer foodways of the
past (Bescherer Metheny and Beaudry 2015; Hastorf 2017; Wilkins and Nadeau
2015). While I will discuss bioarchaeological approaches to studying diet in Chap. 4,
I will briefly introduce a few archaeological techniques here. Each of these tech-
niques has advantages and disadvantages and are often chosen based on the unique
context of each archaeological site. On a large scale, dietary activities can leave
traces on the landscape as well as within both communal and private structures. And
on a more refined level of analysis, methods such as faunal and coprolite analysis
can speak to foodways of the past.
Activities associated with food cultivation and preparation can leave traces on
the landscape and in domestic living spaces. Entire landscapes can be altered, par-
ticularly in complex societies where agriculture is dramatically intensified.
Examples of agriculturally altered landscapes include terracing (Bayliss-Smith and
Hviding 2015; Dunning and Beach 1994; Ferro-Vázquez et al. 2017; Gadot et al.
2016; Gallet and Butterlin 2015; Healy et al. 1983; Londoño et al. 2017), plot agri-
culture (Cowgill 2009; Denham 2018; Lentz et al. 2014; Spriggs 1985; Stavi et al.
2017), and raised fields (Binford et al. 1997; Groenman-van Waateringe and van
Geel 2016; Martín et al. 2015; Rodrigues et al. 2016; Whitney et al. 2014). Plant
microremains and macroremains can also be used to infer environmental change
(anthropogenic or otherwise) as well as dietary patterns (Arranz-Otaegui et al. 2017;

Fuller et al. 2014; Henry et al. 2014; Mercuri et al. 2015; Pearsall 2018).
On a community scale, the presence and size of structures can provide significant
information on the society as well as sociopolitical and socioeconomic change. In
the scenario of ancient Egypt, the appearance of storage pits in the Buto-Ma’adi
culture (Lower Egypt) and the Naqada culture (Upper Egypt) reflects the emergence
of sedentary life (Bard 2007). These storage pits grow in size through time with
population growth and increasing social complexity. Furthermore, with the advent
of the Egyptian Empire in the Old Kingdom (2649-2150 BCE), specialized facilities
such as bakeries and breweries begin to appear (Butzer 1976). Rooms within a
structure can also elucidate interpretations of the society and the role that food
played. For example, Dunbabin analyzed the architecture of Greek and Roman din-
ing rooms (Dunbabin 1998). Based on this research, Dunbabin concluded that
Roman dining was used as a way to express rank and hierarchy, while Greek dining
was used to express egalitarianism. These are just a few of the examples that the
archaeology of structural units can speak to the foodways and lifeways of communi-
ties and populations.
Within households there are several lines of evidence that can be used to under-
stand food preparation, presentation, and consumption. The location of hearths and
ash pit deposits within or near a structure can speak to cooking techniques, particu-
larly when in association with a midden (Düring and Marciniak 2005; Stanish 1989;
Wandsnider 1997). Ceramic artifacts associated with serving and cooking, as dis-
cussed above, can be used in this context to identify ancient foodways. Middens and
disposal associated with these contexts can also be valuable indicators of how much
(i.e., size of middens), and what types of foods communities were consuming.
Coprolite analysis is another method that can be used to analyze recent meals
from the time of deposition (Bryant 1974; Callen 1963; Martínez Tosto et al. 2016;
Minnis 1989; Teixeira-Santos et al. 2015). These data can be very specific, practi-
cally recreating entire meals or identifying parasitic infection (Camacho et al.
2018; Mitchell 2015; Morrow and Reinhard 2016; Rácz et al. 2015; Warinner et al.
2015). However, coprolites do not preserve well in most climates and are very dif-
ficult to find.
The type, quantity, and location of faunal remains within an archaeological site
can explicate what types of animal foods a population was exploiting and how they
were being prepared (Cardoso et al. 2016; Emery 2004; Grau-Sologestoa et al.
2016; Stahl and Zeidler 1990; Teeter and Chase 2004; Wang et al. 2016).
Furthermore, faunal remains have been used to interpret social issues in the past,
such as social class and the dynamics of power through the consumption of prized
and rare meats (Crabtree 2015; Gumerman 2002; Pohl 1985). Understanding faunal
remains diachronically, particularly within a domestic context, can be difficult if the
deposition location was used for a long period of time. However, on a broader scale,
counting ratios of faunal remains can do a great deal to recreate the diet over
extended periods of time.
The analysis of organic residues within ceramic vessels is a growing technique
in analyzing ancient culinary traditions (Anderson et al. 2017; Colonese et al. 2017;
DeNiro and Schoeninger 1983; Evershed 2008; McGovern and Hall 2017;
Musaubach and Berón 2017; Reber et al. 2015; Samuel 1996). This method, when
feasible, has the ability to produce refined details on the contents of vessels.
However, archaeologists must also consider the context in which samples are taken.
For example, organic residue from a funerary vessel does not necessarily reflect
foods consumed, but may instead reflect religious and ethnic identities.
And last, but not least, archaeologists can also draw from art of the past and
interpret ancient depictions of food related activities. In Egypt, tomb paintings
include paintings of harvesting and feasting on tomb walls (James 1984; Romer
1984). In Sumer, cylinder seals and plaques represent domestication and produce
(Collon 1987; Schmandt-Besserat 2001). And in Nazca, Moche pottery often depicts
images of maize and the ritual and religious significance it played in daily life
(Towle 1961).
Labor
The anthropology and archaeology of physical activity is harder to define and less
researched than food. This is partially due to the fact that physical activity is such a
broad topic and essentially includes all bodily motion. Nevertheless, as practice
theory illustrates, even the smallest, most mundane of actions are important. In this
section, I will briefly describe the emerging field of anthropology of labor, and then
move on to archaeological interpretations of physical activity, labor, and
production.
The anthropology of labor is a field that is relatively new area of research. For the
most part, it focuses on how modern, Marxist-inspired, conceptions of labor are
influencing social inequality and dispossession in the 21st Century. Kasmir and
Carbonella discuss how the mutability of class relations has set the scene for the
several recent social movements (e.g., Arab Spring, Occupy, European revolts, dem-
onstrations in Turkey and Brazil; Kasmir and Carbonella 2008, 2018). They view
the emerging anthropology of labor as a potential resource for decolonizing anthro-
pology (Kasmir and Carbonella 2008:20–22). In their book, Blood and Fire: Toward
a Global Anthropology of Labor, Kasmir and Carbonella discuss the more than
40 years of neoliberal hegemony and its impact on modern labor systems (Kasmir
and Carbonella 2018). Recent protests and unionization have promoted clear
demands for emancipation, human rights, and social equality from the work force,
which has promise for a more ethical and sustainable modern workforce. While this
anthropology of labor perspective is interesting, it is difficult to apply Marxists
notions of capital, labor unions, and neoliberalism to the ancient world. I turn to a
discussion of the various ways in which archaeologists address physical activity and
labor.
Archaeological approaches to labor have often focused on the material correlates
of economic processes such as production and exchange; as Silliman states “labor
involves objects of production and production of objects” (Silliman 2001:384).
Topics such as elite control of labor, craft specialization, production, and exchange
have been approached archaeologically (Arnold 1993, 1996; Bauer and Agbe-
Davies 2010; Brumfiel 1987, 1991, 1996, 2006; Costin and Hagstrum 1995; Costin
and Wright 1998; D’Altroy and Hastorf 2001; Earle and Brumfiel 1987; Earle and
Ericson 2014; Murakami 2016; Schortman and Urban 1998). Silliman has devel-
oped a theoretical framework, labor as practice, which conceptualizes labor as a
social, rather than simply an economic, phenomenon (Silliman 2001); “labor must
be studied as a practice, as something people do” (Ortner 1984:149), and not just as
an institutional form or economic arrangement” (Silliman 2001:382). Silliman dis-
tinguishes work from labor; labor being “social and material relations surrounding
any activities that are designed to produce, distribute, or manipulate material items
for personal use or for anyone else or any activities whether material or not that are
required or appropriated for use by someone else” (Silliman 2001:381; emphasis
original). This is a broad definition, but one that speaks to the extensive scope of
labor. Silliman uses practice theory to highlight how labor (1) involves actions car-
ried out on a daily basis, (2) is highly routinized, and (3) is experienced bodily and
socially. These elements are pillars of practice theory and are discussed by both
Bourdieu (1977, 1990) and Giddens (1979, 1984). This approach draws direct atten-
tion to the lived experience of labor as an element of daily life.
Silliman applies his labor as practice approach to colonial scenarios, specifically
drawing on data and interpretation of the 18th 19th century California missions,
including Mission San Antonio de Padua in southern California. Within a colonial
setting, labor as practice has a palpable element of power and social inequality. In
some cases, indigenous people found opportunities in colonial labor markets; how-
ever, “in many cases, indigenous people were conscripted or coerced to work for
colonial settlements” (Silliman 2001:380). In colonial scenarios, an archaeology of
labor much be approached from both a top-down and a bottom-up approach. A top-
down perspective is necessary because those in power in a colonial scenario, the
administrators, are attempting to control the bodily movements and the productive
value of the colonized. However, a bottom-up approach is also needed because the
colonized are not powerless in these scenarios; the same daily actions that are being
controlled can be sites of resistance, autonomy, and self-expression. Silliman makes
clear that the inclusion of top-down and bottom-up approaches do not imply “oppo-
site poles,” rather they “refer to the different levels of social power, ones that articu-
late with gender, status, age, identity, and personal strategies to produce a complex
mosaic” (Silliman 2001:382). Silliman draws on historical documentation of labor,
which suggest that the Spanish contexts of colonization (e.g., missions, ranchos,
presidios, forts, trading posts, mines, pueblos) were organized around exploiting
Native American labor. Using material data from Mission San Antonio de Padua, he
presents artifacts that reflect both a colonial system as well as indigenous identity
(e.g., glass, metal knives, lithics, local ceramics, manos, mutates). He discusses how
labor can be viewed as both as an outcome of colonial oppression and as a form of
resistance and autonomy—“although colonial labor schedules and burdens may
require particular activities or may prevent individuals from enacting desired or
precontact cultural practices, the labor regime and its implements also provide
opportunities for native individuals to maintain social continuity or to build and

express new practices or identities” (Silliman 2001:383).
Dobres also addresses labor, centered upon the topic of technology, from an
interdisciplinary and phenomenological perspective (Dobres 2000). She argues that
technology produces more than things, it has the ability to produce social relations.
Agents, through labor, produce materials, but equally create value associated with
the object(s) they produce. In this light, technology is not void of culture. Dobres
makes the case that technology is an embodied process, an argument grounded in
practice theory. Thus, bodies produce objects, but objects and technology equally
produce bodies. This perspective mirrors Silliman’s view of labor and is particularly
interesting in a bioarchaeological context.
Voss, like Silliman, addresses the theoretical aspects of labor in colonial La
Florida (Voss 2008). Voss critiques the St. Augustine pattern, the hypothesis that
indigenous, African, and syncretic cultural elements were transferred via domestic
activities associated with women, while Spanish cultural elements were maintained
via male activities. She argues that concepts of race and gender are not as binary or
straightforward as the St. Augustine pattern suggests. New research suggests the
presence of a complex web of interaction, including macroscale economic, trade,
and labor relationships (Voss 2008:861). Analysis of labor, according to Voss, is one
approach to resolving three methodological issues associated with archaeology of
empires: tensions between generalization and particularity, attributing artifacts/fea-
tures to dualistic categories, and scales of analysis. According to Voss,
“Consideration of labor relations provides an entry point into the internal variability of
empires, for labor practices differed considerably across regions and over time, including
tribute requirements, conscription, wage labor, enslavement, and market-oriented agricul-
tural and craft production. Labor relations articulate with other colonial institutions, includ-
ing military, religious, mercantile, and bureaucratic institutions. Labor operates
simultaneously along multiple scales” (Voss 2008:874)
For these reasons, archaeology of labor can avoid oversimplification of colonial

power relations into an indigenous/colonial dichotomy. Voss indicates that neigh-
borhoods may be one of the most productive scales of analysis to better understand-
ing colonial labor and residential practice. At the sites of Santa Elena, St. Augustine,
and Santa María de Galve variations in locally produced ceramics and imported
ceramics were found between fort spaces versus civilian residences. The archaeol-
ogy of labor within households, a microscale approach, remains important particu-
larly as they relate to meso- and macro-labor practices. According to Voss, this
remains a “cornerstone of colonization” (Voss 2008:874). With regard to the St.
Augustine pattern, Voss maintains that even if local goods arrived in Spanish homes
as a result of macroscale labor distribution rather than intermarriage, as was origi-
nally assumed, this does not alter the “profound cultural effects that daily use of
non-Iberian material culture and consumption of local foods may have had on colo-
nial populations” (Voss 2008:875). Voss promotes a multiscalar archaeology of
labor as a way to directly address previously overlooked aspects of gender and race
politics in colonial settings.
References 41
Summary
In this chapter, I have presented the theoretical underpinnings that will frame the
following chapters. The importance of everyday life cannot be understated—it is the
foundation of lived experience. Scholars, such as Lefebvre, writing about the day-
to-day life in the early 20th century, inspired later practice theorists. To summarize,
I draw on Robin’s six framing points everyday life:
1 . Everyday life is central to human existence.
2. The practices of everyday life are not simply mundane but encompass a com-
plexity of actions and interactions that are both shaped by and allow people to
shape their world.
3. Ordinary objects and spatial arrangements formalize how people learn about
themselves and their world.
4. Social changes (and stasis) happen across everyday life.
5. A focus on everyday life draws attention to the role that all people—regardless
of their wealth, status, gender, or ethnicity—play in the development of human
societies.
6. A critical analysis of everyday life implies a willingness to consider the ethical,
moral, and political dimensions of studying people’s daily life (Robin 2013:44).
Practice theory, which focuses on the dialectic between social structure and indi-
vidual agency, was discussed in greater detail. Bourdieu, Giddens, and de Certeau
each bring their own brand of practice to the table. Despite interpretive differences,
each of these scholars agrees that the social structure is, to some degree constrain-
ing, but individuals, through daily practice, can challenge the status quo. Embodiment
is central to linking practice theory and human skeletal remains. The argument that
bones change and adapt to daily practice, for example geochemically absorbing
isotopic signatures of foods consumed or biomechanically adapting to the physical
demands of labor, enables bioarchaeologists to engage with this literature on every-
day practice and practice theory. Because the consumption of food as well as labor
practices are conducted every day they are ideal loci for examining social structure
and agency. Furthermore, because we, as bioarchaeologists, can observe the skeletal
changes associated with these embodied experiences, we are able to examine food-
ways and physical activity through the lens of practice theory. We are able to study
how foodways and labor are experienced bodily and interpret what this may have
meant for the individuals in various social, political, and economic settings.
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Chapter 3
Bioarchaeological Approaches to Activity
Reconstruction
The reconstruction of physical activity, using methods such as osteoarthritis and

muscle attachment sites, has been coined “the Holy Grail” of bioarchaeology
(Jurmain et al. 2012). This phrase encapsulates multiple valid points: the ubiquity of
these methods in bioarchaeology; the methodological challenges involved with this
type of research; and, perhaps most importantly, the potential contribution and sig-
nificance of activity reconstruction. Indeed, bioarchaeologists have been employ-
ing, testing, and critiquing these methods for decades. While many questions
regarding activity reconstruction remain, two things are certain—they are highly
complex and they hold an enduring position in the future of bioarchaeological
research.
The complexity of activity-related alterations to the skeleton stems from (1) the
compound biomechanical forces placed upon bone, which are highly variable
depending upon the type, intensity, and duration of activity; and (2) contributing
biological factors that influence these forces. In life, the skeletal frame is a mallea-
ble living system that can adapt and change in response to stress, including patho-
logical conditions, broken bones, as well as strenuous and repetitive physical
motion. In theory, these adaptations make an individual better suited to their envi-
ronment. The scientific examination of this plasticity—in other words, the mechani-
cal principles that describe musculoskeletal movement, structure, and change—has
contributed to the rise of an entire discipline: biomechanics. Complicating this
already vast and difficult subject, factors such as age, sex, metabolic function,
genetic influences, weight, and body size, all play varying roles in the presence,
absence, growth, and degeneration of osteological indicators of activity.
Despite these challenges, recent research suggests that there is a relationship
between activity and skeletal remodeling. Variation in muscle type, high-resolution
scanning technologies, and cross-disciplinary research have all contributed to a bet-
ter understanding of the relationship between activity and the musculoskeletal and
synovial systems. As anthropologists, we can take these methodological advance-
ments a step further and interpret mechanical adaptations within a holistic biosocial
framework. Of course, the activities that contributed to these skeletal changes are

https://doi.org/10.1007/978-3-030-02544-1_3
56 3 Bioarchaeological Approaches to Activity Reconstruction
the product of a once animated, social being. Activity reconstruction data can be
used, with caution, to infer many social contexts in the ancient past, including socio-
economic status, inequality, and everyday practice. This chapter discusses current
osteoarthritis and muscle attachment site research and explores how these data can
infer day-to-day lifeways in a bioarchaeological setting.
Osteoarthritis
Osteoarthritis, the deterioration of joints and associated soft tissue, is the most com-
mon post-cranial condition of the skeletal frame (Bridges 1992; Rogers 2000;
Waldron 2012). The World Health Organization estimates that osteoarthritis affects
10% of men and 18% of women (over the age of 60), worldwide (Woolf and Pfleger
2003). It is a condition that was present in the ancient world, just as it is today.
Despite the frequency of osteoarthritis, many aspects of this condition (e.g., etiol-
ogy, treatment) are still debated in both clinical and academic arenas (Felson et al.
2000; Ortner 2003; Resnick 2002). Differing definitions of the condition make
reporting and interpreting osteoarthritis data challenging. Several studies, however,
have found positive links between repetitive and strenuous joint use and joint dete-
rioration (Larsen 2015; Lieverse et al. 2016; Waldron 2009). Furthermore, the pres-
ence of this condition speaks broadly to the daily life activities that contributed to
the degeneration observed as well as the lived experience of the individual—often-
times characterized by pain, discomfort, and limited mobility.
Characteristics of Osteoarthritis
Osteoarthritis can be divided into two broad categories: primary and secondary.
Primary osteoarthritis occurs when there is an absence of an underlying condition
that has contributed to joint deterioration; this most common type of osteoarthritis,
associated with the aging process, is the primary focus of bioarchaeological research
(Rogers and Waldron 1995). Secondary osteoarthritis occurs when there is a preex-
isting pathological condition (e.g., rheumatoid arthritis, scoliosis) or traumatic
event (e.g., bone fracture, joint dislocation) that contributes to the development of
osteoarthritis (see Brandt et al. 2009 and Burt et al. 2013 for more information).
Since this chapter focuses on ways in which bioarchaeologists reconstruct activity
in the past, the following discussion is referencing primary osteoarthritis.
The initial indicators of osteoarthritis typically materialize in the soft tissue sys-
tem of a joint. If the fragile cartilage, tendons, ligaments, and various joint struc-
tures (e.g., bursa, synovium, joint capsule) begin to fail, joint space narrowing can
occur. Medical diagnoses of osteoarthritis frequently include joint space narrowing,
assessed via radiograph (Bijlsma et al. 2011; Gossec et al. 2008, 2009; Hayes et al.
2005; Kellgren and Lawrence 1963). Since bioarchaeologists do not have the ability
Osteoarthritis 57
Fig. 3.1 Osteoarthritic
lipping (distal humerus)
to observe soft tissue components of the joints, alterations to subchondral bone are
used as positive indicators of joint space narrowing (Fig. 3.1). Otherwise known
as lipping or osteophytes, this proliferative bone remodeling is thought reflect an
adaptive, physiological response to strain and degeneration—the body’s attempt to
stabilize a joint and prevent further damage (Felson 2000; Jurmain and Kilgore
1995; Waldron 2009, 2012). Osteophytes, which are particularly common in skele-
tal remains, can vary widely in size (from minute growths to marked spicules) and
increase dramatically with age (both in frequency and severity; Ortner 2003; Weiss
and Jurmain 2007).
Another skeletal manifestation of osteoarthritis is joint erosion, otherwise
referred to as porosity (Fig. 3.2). Porosity affects the joint surface and is initially
characterized by small pitting. If the condition progresses, porosity can become
more severe and widespread. The small pits can coalesce and cover a larger portion
of the joint surface. Further still, joint porosity can also manifest both coalesced and
pinpoint pits (Buikstra and Ubelaker 1994). Recent research has questioned the
relevance of porosity in osteoarthritis, suggesting that joint porosity may actually be
a by-product of increased vascular activity to aid in the maintenance of cartilage
tissue (Rothschild 1997; Weiss and Jurmain 2007; Woods 1995). Further research,
particularly in medical and biomechanical fields, can help to address this point.
Bioarchaeologists should be aware of this discussion and use these data with
caution.
porosity (proximal ulna
note the dual presence of
lipping and porosity)
eburnation (distal femur)
Perhaps one of the most characteristic and pathognomonic conditions of osteoar-

thritis is eburnation (Rogers and Waldron 1995; Fig. 3.3). Eburnation occurs when
little to no cartilage remains on the bones of a joint and, thus, bone-on-bone contact
Osteoarthritis 59
occurs with movement. Skeletally, this results in a polished appearance of the joint
surface and can progress to form striations on the bone surface parallel to the line of
motion. Eburnation is generally considered to be the most quintessential diagnostic
characteristic of osteoarthritis (Aufderheide and Rodríguez-Martín 1998; Ortner
2003; Rogers and Waldron 1995).
By definition, osteoarthritis only applies to synovial joint systems. Even though
vertebral degeneration is markedly similar to osteoarthritis, intervertebral joints are
cartilaginous and, therefore, the term osteoarthritis does not apply (Ortner 2003;
Roberts and Manchester 2007). When referring to degeneration on the centrum of a
vertebra, bioarchaeologists have adopted the terms osteophytosis and spondylosis
from clinical literature (Jurmain 1999; Jurmain et al. 2012; Sarzi-Puttini et al. 2005).
Osteophytic bone growths, particularly around the marginal surfaces of the verte-
bral bodies, can range from barely discernable spicules to ankylosis, or the fusion of
one or more vertebral bodies. An ankylosed spine results in a reduction in interver-
tebral disk space and inevitably limited mobility (Larsen 2015). Typically, the area
most affected by vertebral osteophytosis is the lumbar region, followed by the cervi-
cal vertebrae, while the thoracic vertebrae are usually the least affected (Jurmain
1999; Middleton and Fish 2009). This universal patterning has been attributed to a
bipedal gait stemming from the change in the distribution of force through human
evolutionary history (Bridges 1994; Jurmain and Kilgore 1995). It should be noted
that the superior and inferior articular facets of the vertebrae are synovial joints and,
thus, osteoarthritis would indeed apply.
Schmorl’s nodes, while not directly related to osteoarthritis, have been associ-
ated with physical activity and strenuous labor. They are typically small, shallow,
circular, or semicircular depressions that can be found on vertebral bodies (Kelley
1982; Plomp et al. 2012; Üstündag 2009). They have been interpreted as cartilagi-
nous nodes, possibly reflecting vertebral disc herniation (Resnick and Niwayama
1978; Schmorl and Junghanns 1971). Some studies have tied vertebral disc hernia-
tion with lifting heavy loads during spinal rotation (Cholewicki and McGill 1996).
In addition to physically straining activity, there do appear to be factors that increase
an individual’s susceptibility to Schmorl’s nodes, including acute trauma, genetic
predisposition, developmental conditions, and increased body mass (Burke 2012;
Dar et al. 2010; Mok et al. 2010; Plomp et al. 2015a, b; Plomp 2017; Williams et al.
2007; Zhang et al. 2010).
In addition to Schmorl’s nodes, other vertebral conditions that are partially
caused by physical activity include spondylolysis and spondylolisthesis.
Spondylolysis, a fracture of the pars interarticularis resulting in the detachment1 of
the vertebral arch, is also associated with activity and is indicative of a fatigue frac-
ture (Hu et al. 2008; Iwamoto et al. 2004; Mays 2007; Standaert and Herring 2000).
There is some evidence to suggest that extension and rotation, sports, and intense
activity in childhood may contribute to spondylolysis (Chosa et al. 2004; Morita
1
Spondylolysis typically occurs bilaterally causing complete detachment of the vertebral arch;
however, it can, on occasion, occur unilaterally, thereby causing only a partial detachment of the
vertebral arch (Porter and Park 1982).
et al. 1995; see Pilloud and Conzonieri 2014 for further discussion). Spondylolysis
can lead to spondylolisthesis, the anterior slippage of the vertebral body onto the
inferior vertebral/sacral body (Merbs 1996; Ortner 2003). While Schmorl’s nodes,
spondylolysis, and spondylolisthesis are not osteoarthritic processes, they are
thought to be the product, in addition to various contributing factors, of activity and
can be used to address ancient lifeways.
There remains a disparity between medical and bioarchaeological definitions and
interpretations of osteoarthritis and vertebral degeneration (Rogers and Waldron
1995). Research has shown that radiographs do not necessarily reveal marginal
bone growths, porosity, or eburnation (Brandt et al. 1991; Spector et al. 1993).
While medical diagnoses of osteoarthritis vary on a case-by-case basis, common
factors frequently include pain as well as joint space narrowing. How can bioar-
chaeologists reconcile the various skeletal indicators of osteoarthritis and the con-
flicting clinical data to form a cohesive and sound methodology that can inform
ancient lifeways? The answer is not simple. This discussion quickly turns to inqui-
ries about the causal factors of osteoarthritis, which are equally fraught with ques-
tions. The consideration of contributing influences, particularly age, have made the
examination of osteoarthritis as representative of activity more reliable.
Etiology of Osteoarthritis
Both the clinical and bioarchaeological fields continue to grapple with the etiology
of osteoarthritis. For decades, physically strenuous labor was thought to be the
cause of osteoarthritis (Jurmain 1977; Larsen 2015; Ortner and Putschar 1985).
Clinical, occupational health, and sports medicine research generally support this
hypothesis. Felson noted, for example, that there is a general lack of osteoarthritis
in amputees and paralytics, while there were elevated frequencies in populations
that were particularly active (Felson 1994). Many studies examined the frequency
of osteoarthritis in certain occupations, including farmers (Croft et al. 1992; Thelin
1990), textile workers (Waldron and Cox 1989), miners (Anderson et al. 1962;
Kellgren and Lawrence 1952; Lawrence 1955; Schlomka et al. 1955) and construc-
tion workers (Stenlund et al. 1993; see Weiss and Jurmain 2007 and Larsen 2015 for
thorough review). Individuals whose occupations involve repetitive squatting and
lifting are twice likely to develop knee osteoarthritis than individuals whose jobs do
not require physical activity (Messier et al. 2009; see also Felson et al. 1991). Hip
osteoarthritis has been clinically associated with occupations that require long peri-
ods of standing and lifting (Croft et al. 1992). Similarly, osteoarthritis of the hand
has been positively correlated with occupations that require increased manual dex-
terity, such as textile workers (Hadler et al. 1978). Further, it was reported that
individuals who are right handed are more likely to have osteoarthritis expression
on their right arm, wrist, and hand, versus their left (Hadler et al. 1978). Multiple
sports studies have also been linked with osteoarthritis, including those focused on
baseball pitchers (Hansen 1982; Woods et al. 1973), football players (Brodelius
Osteoarthritis 61
1961; Chantraine 1985; Moretz et al. 1984; Rall et al. 1964; Solonen 1966; Vincelette
et al. 1972), ballet dancers (Brodelius 1961), weightlifters (Aggrawal et al. 1979),
and swimmers (Stulberg et al. 1980; see also DiFiori et al. 2014; Gouttebarge et al.
2015). While mechanical loading continues to be a known risk factor for osteoar-
thritis (Block and Shakoor 2010; Hunter et al. 2002; Messier et al. 2009; Silverwood
et al. 2015; Vignon et al. 2006), other factors, including age, sex, and body weight,
put an individual at greater risk of osteoarthritis.
The fact that so many studies have found a positive correlation between occupa-
tions/sports and osteoarthritis suggests there is a relationship between activity and
joint degeneration; however, more recently, multiple contributing factors have
shown to also be correlated with the condition. The foremost of these—age—sig-
nificantly impacts the presence and severity of osteoarthritis (Blagojevic et al. 2010;
Felson et al. 2000; Jurmain et al. 2012; Lieverse et al. 2007; Weiss and Jurmain
2007). This is not particularly surprising; as an individual becomes older, they are
more likely to experience joint degeneration (Felson et al. 2000; Johnson and Hunter
2014; Mannoni et al. 2003; Oliveria et al. 1995). Busija and colleagues report that
osteoarthritis is “uncommon in people under the age of 45 years,” however, “nearly
60% of people over the age of 75 are affected by it” (Busija et al. 2010:762). The
age-progressive nature of osteoarthritis may be linked with cumulative wear-and-
tear (i.e., the repetitive use of a joint over one’s life course), sarcopenia, decreased
bone turn over, as well as a reduced capacity for soft tissue repair (Busija et al.
2010; Felson and Zhang 1998; Johnson and Hunter 2014). Given the strong clinical
link between age and osteoarthritis, as well as the clear archaeological evidence that
osteoarthritis is positively correlated with age across millennia in a plethora of con-
texts, it is crucial that bioarchaeologists control, in some way shape or form, for age
in their research design (discussed further below).
Biological sex is another contributing factor to osteoarthritis. In general, females
are at higher risk of developing osteoarthritis (Busija et al. 2010; Hame and
Alexander 2013). Some sources suggest that females over the age of 50 are 50%
more likely to have osteoarthritis than males (Buckwalter and Lappin 2000; Jones
et al. 2000). This may be influenced by a reduction in estrogen levels post-menopause
(Srikanth et al. 2005). However, clinical tests have found no consistent association
between osteoarthritis and levels of estrogen (Hanna et al. 2004; Hochberg 2001;
Nevitt et al. 2001; Wluka et al. 2000). Lessened bone mineral density, a frequent
by-product of menopause, increases the risk of osteoarthritis, but does not necessary
influence disease progression (Nevitt et al. 2010). Other potential reasons why
women have a higher prevalence of osteoarthritis than men include: bone composi-
tion, ligament laxity, lower cartilage volume, pregnancy, and neuromuscular
strength (Johnson and Hunter 2014).
Another important contributing factor of osteoarthritis to consider is body
weight. Multiple clinical studies have shown direct correlations between obesity
and the presence of osteoarthritis (Anderson and Felson 1988; Grotle et al. 2008;
Hart et al. 1999; King et al. 2013; Lawrence et al. 2008; Lementowski and Zelicof
2008; Rai et al. 2014). This is particularly true for weight-bearing joint systems,
such as the hip and knee (Felson et al. 1988; Felson and Zhang, 1998; Jiang et al.
2012). Obesity is said to increase the risk of knee osteoarthritis by more than three
times (Blagojevic et al. 2010; Silverwood et al. 2015). Some have argued that obe-
sity was not frequent in ancient populations (Booth et al. 2002; Eaton et al. 1988);
however, this interpretation is highly dependent upon archaeological context. In
Weiss’ examination of Californian Amerinds she found no significant correlation
between osteoarthritis and body mass (with the exception of a negative correlation
between body mass and hip osteoarthritis; Weiss 2006). Currently, the most com-
mon method of assessing body mass index via skeletal remains femoral head breadth
(Auerbach and Ruff 2004). Future research into estimates of body mass via human
skeletal remains may aid bioarchaeologists in (1) assessing whether individuals in
the population under study have elevated body mass indices, and (2) controlling for
this variable.
Lastly, genetic factors have been shown to be a predisposing component to osteo-
arthritis (Abramson and Attur 2009; Gonzales 2013; Rodriguez-Fontenla et al.
2014; Sambrook et al. 1999; Spector and MacGregor 2004; Waldron 1994).
Generalized nodal osteoarthritis, mainly impacting the distal and proximal interpha-
langeal joints of the hand, has a very strong hereditary component (Cicuttini and
Spector 1997). Disruptions in the normal function of genes, including COL2A1,
COX-2, and DIO2, as well as chromosomal linkages (2q, 11q, 7q22), have also been
associated with osteoarthritis (Bomer et al. 2015; Chapman 1999; Kerkhof et al.
2010; Uitterlinden et al. 2000; Valdes et al. 2008; Wright 1996). Further, inflamma-
tory responses associated with osteoarthritis have also been linked to a genetic com-
ponent (Malemud 2015; Valdes and Spector 2008). As biomedical researchers
continue to investigate the connection between osteoarthritis and heritability, osteo-
archaeologists are left in a difficult position. We know that genetic factors are likely
contributing to the presence of osteoarthritis, but genetic sequencing is oftentimes
not accessible either due to methodological or financial limitations. Going forward,
with technological advancements, it will be very interesting to assess the connec-
tions between osteoarthritis in skeletal remains and genetic analysis.
Biomechanical stress, age, sex, weight, and genetics are not an all-encompassing
list if risk factors for osteoarthritis. Other possible contributing factors include diet,
ancestry, and joint alignment (Busija et al. 2010; Johnson and Hunter 2014). Broadly
speaking, these factors either (1) expose the joint to risk (i.e., local risk factors), or
(2) expose the individual to risk (i.e., systemic risk factors). As detailed in Fig. 3.4,
local risk factors are, for the most part, modifiable with the aid of modern medicine.
Systemic factors can either be modifiable, as is the case with weight, or non-
modifiable (e.g., sex, age). If an individual is predisposed to osteoarthritis, either
due to modifiable or non-modifiable systemic risk factors, and also has a susceptible
joint system (local risk factors), they are at high risk of developing osteoarthritis. As
Glyn-Jones and colleagues note “osteoarthritis develops through the action of hos-
tile biomechanics on a susceptible joint” (Glyn-Jones et al. 2015:376).
With the knowledge that osteoarthritis is multifactorial, several bioarchaeolo-
gists have put forward recommendations and considerations for future osteological
examinations. Weiss and Jurmain have suggested that (1) samples should be sepa-
rated by both age and sex, (2) unique scoring methods should be applied to joint
Osteoarthritis 63
Fig. 3.4 Potential risk factors for susceptibility and predisposition to osteoarthritis (Johnson and
Hunter 2014)
margin changes and surface alterations (e.g., lipping, pitting, eburnation), and (3)
new technologies should be applied to the examination of osteoarthritis (e.g., con-
trolled animal experiments; Weiss and Jurmain 2007). Similarly, Jurmain and col-
leagues also propose further collaborative projects as well as additional genetic
research (Jurmain et al. 2012). An open discussion between bioarchaeologists, med-
ical professionals, biomechanical researchers, and individuals diagnosed with
osteoarthritis, would also be beneficial. The use of advanced imaging technologies
(magnetic resonance imaging in clinical samples and computed tomography in skel-
etal samples) may also help to close the gap between the medical and bioarchaeo-
logical interpretations of osteoarthritis (see Eckstein et al. 2006; Runhaar et al.
2014; Taljanovic et al. 2008; Yusuf et al. 2011).
Previous Bioarchaeological Approaches to Osteoarthritis
The bioarchaeological analysis of osteoarthritis has been used to address numerous

anthropological and archaeological questions. While skeletal changes associated
with osteoarthritic degeneration were recognized centuries ago, it was not until
Angel’s examination of skeletal remains from the Native American site, Tranquility
(California), that osteoarthritis was systematically studied to address past lifeways
(Angel 1966). He noted marked osteoarthritic changes in the elbow joint and sug-
gested this could be a result of spear throwing (otherwise known as “atlatl elbow”).
Since Angel’s examination of the Tranquility sample, bioarchaeologists have con-
tinued to interpret ancient lifeways using osteoarthritis. Subsistence patterns
(Bridges 1991; Hemphill 2010; Jurmain 1990; Larsen 1995; Larsen et al. 1995;
Lieverse et al. 2007, 2016; Machicek and Beach 2013; Merbs 1983; Molleson 2000;
Pickering 1979; Suzuki et al. 2016), food preparation (Merbs and Euler 1985;
Molleson 1989), mobility (Hemphill 1999), health and socioeconomic status
(Watkins 2012; Woo and Sciulli 2013), economic intensification (Klaus et al. 2009),
occupation (Austin 2017; Coggon et al. 1998), sexual division of labor (Bridges
1992; Hollimon 1988; Holliman 1992; Larsen et al. 2008; Sofaer 2000; Walker and
Holliman 1989), weaponry (Bridges 1990) and marginalized groups (Angel et al.
1987; Davidson et al. 2002; Parrington and Roberts 1990) have all been addressed
in previous bioarchaeological studies (see also Jurmain et al. 2012 and Larsen 2015
for thorough review).
In a recent publication, Zhang and colleagues examine the effects of early urban-
ization and intensifying social stratification in the Yinxu region, China (the last capi-
tal of the Late Shang Dynasty; c. 1250–1046 BCE; Zhang et al. 2017). Of particular
relevance to this book, Zhang and colleagues frame osteoarthritis as a product of
daily habitual activities. Other contributing factors to osteoarthritis (e.g., age, sex,
genetics) are also discussed, but the argument that an element of joint degeneration
is due to repetitive motion that comprises everyday life is clear. Based on their
analysis of osteoarthritis (n = 167), Zhang et al. suggest there was a gendered divi-
sion of labor in this cultural context, with males generally having higher rates of
osteoarthritis than females, particularly in the upper body. There were also inter-site
differences between Xiaomintun and Xin’anzhuang, the former having more fre-
quent and severe forms of osteoarthritis than the latter. Zhang and colleagues sug-
gest that these findings support the hypothesis that there were differing occupation
specializations between these communities. Xiaomintun individuals may have been
involved in bronze-casting and were eventually interred with bronze-casting arti-
facts. In addition to men having higher rates of osteoarthritis, women at Xiaomintun
have higher rates of osteoarthritis than women at Xin’anzhunag, which may suggest
that bronze-casting might have involved the whole family (Zhang et al. 2017).
Cheverko and Bartelink use osteoarthritis to assess a subsistence transition in
Californian Native American populations during the Late Holocene (4500-200 BP;
Sacramento-San Joaquin Delta region of Central California, specifically; Cheverko
and Bartelink 2017). It is hypothesized that Native Americans transitioned from
lower cost, high-ranked resources (e.g., large game) to a higher-cost, low-ranked
resource (e.g., acorns and small seeds) as availability of food resources changed.
They found a significant increase in osteoarthritis for both males and females
through time (n = 256). Late Period (1200-200 BP) males and females exhibited
significantly higher rates of hip osteoarthritis, which the authors suggest may be
attributed to walking long distances and/or transporting heavy loads. This would be
necessary if higher-cost, low-ranked resources were depleted in the local region and
Native Americans had to resort to acquiring food resources from farther afield.
Lastly, there were no significant differences between males and females, suggesting
that males and females performed similar levels of activity (Cheverko and Bartelink
2017). This article illustrates how osteoarthritis data can be used to examine how
humans adapt to changing environments and fluctuating resource availability by
altering their mobility patterns and activity levels.
Osteoarthritis 65
Eng has also examined the correlation between subsistence strategies and osteo-
arthritis during the Bronze Age–Iron Age transition in China and Mongolia (Eng
2016). She analyzed four Bronze Age sites (1800–600 BCE) and two Iron Age sites
(209 BCE–220 CE), and compared rates of osteoarthritis by joint, sex, age, time
period, and site (n = 305). Males had higher rates of osteoarthritis at the elbow and
women had higher rates of osteoarthritis at the hip (Eng 2016:178). Age and osteo-
arthritis were positively correlated, particularly at the spine, elbow, and knee (Eng
2016:178). Interestingly, she found that the Bronze Age sample had a higher preva-
lence of osteoarthritis in the lower limb joints and the Iron Age sample had higher
rates of osteoarthritis in the vertebrae and upper limb joints. Eng suggests that these
findings indicate a transition from a mixed economy, characterized by mobile (by
foot) herding, hunting, gathering, fishing, and small-scale agriculture, during the
Bronze Age, to a mounted nomadic pastoral subsistence strategy, coupled with
mounted warfare, during the Iron Age. Furthermore, there was no distinct osteoar-
thritis pattern between the sites; this counters the traditional narrative of cultural
uniformity in Inner Asian steppe pastoral communities and indicates that these com-
munities may have varied both in economic practices as well as physical activities
(Eng 2016).
Lieverse and colleagues recently revisited the topic of osteoarthritis at Cis-
Baikal, Siberia (Lieverse et al. 2007, 2016). Originally examined in 2007, Lieverse
et al. questioned whether mobility and activity differed between the late Mesolithic/
early Neolithic Kitoi culture (6800-4900 BCE; pre-hiatus) and the middle Neolithic/
Early Bronze Age Serovo-Glaskovo culture (4200–1000 BCE; post-hiatus2). They
found that overall prevalence of osteoarthritis was similar between the pre-hiatus
Kitoi sites and the post-hiatus Serovo-Glaskovo sites and suggest that osteoarthritis
prevalence remained relatively constant throughout the mid-Holocene (Lieverse
et al. 2007:11). However, when assessing osteoarthritis distribution (by joint region:
vertebral, shoulder, elbow, wrist/hand, hip, knee, ankle/foot), they found higher
rates of knee osteoarthritis in pre-hiatus males than pre-hiatus females and post-
hiatus males; the authors suggest this may have been due to increased travel over
steep and uneven terrain. Additionally, vertebral osteoarthritis among pre-hiatus
females was significantly lower than pre-hiatus males and post-hiatus females, indi-
cating that pre-hiatus females may not have had as much load bearing stress on the
back and neck and also supports higher logistic mobility among the Kitoi peoples.
In short, the authors suggest that broad levels of activity remained similar between
the pre- and post-hiatus groups, however, the mobility and activities differed. In
2016, Lieverse et al. revisited this topic and further refined their definition of joint
region (Temporomandibular joint or TMJ, cervical vertebral osteophytosis or VOP,
cervical,3 thoracic VOP, thoracic, lumbar VOP, lumbar, shoulder, elbow, wrist, hip,
2
Hiatus here refers to a 700-year gap in cultural continuity in the Cis-Baikal region (4900–
4200 BCE), during which time there was an interruption in mortuary tradition coupled with the
absence of human skeletal remains (Lieverse et al. 2007).
3
Vertebral osteophytosis (VOP) concerns degeneration to the centra of the vertebra, a cartilaginous
joint between intervertebral disks; vertebral osteoarthritis refers to the synovial joint systems of the
knee, ankle, and first metatarsal phalangeal joint or first MTP). Through an inter-site
comparison, they were able to establish that pre-hiatus Lokomotiv, located in the
Angara River microregion, had significantly higher frequencies of vertebral osteo-
phytosis and osteoarthritis than the contemporary pre-Hiatus Shamank II, located in
the south Baikal microregion. Rates of osteoarthritis at post-hiatus Ust’-Ida I were
in between that of Lokomotiv and Shamank II. This may be due to higher activity
levels possibly due to more intensive resource acquisition and/or higher population
densities and lower residential mobility within the Angara River microregion. Intra-
site comparisons suggest that there is more osteoarthritis in males than females; the
authors hypothesize that this may be due to male-dominated logistical foraging in
both pre-hiatus as well as post-hiatus groups. Lastly, intra-joint comparison of the
elbow and knee (elbow: humeral–ulnar and humeral–radial, knee: medial, lateral,
anterior) were examined to better understand composite joint degeneration. Notably,
osteoarthritis of the humeral-ulnar junction suggests that the contribution of supina-
tion and pronation is similar to that of flexion and extension, contrary to similar
studies on other hunter-gatherers populations. The Lieverse et al. (2016) publication
is an excellent example of why it is important to readdress research questions and
data sets; the intra-site, inter-site, and intra-joint analyses revealed nuances about
the Cis-Baikal group that were initially masked in the Lieverse et al. (2007)
publication.
Another innovative publication recently published by Becker and Goldstein
examines osteoarthritis in a Tiwanaku colony (near Moquegua, Peru; 900-1500 CE;
Becker and Goldstein 2018). Using a robust sample size (n = 1389), Becker and
Goldstein compare individuals from Chen Chen-style cemeteries (associated with
agrarian subsistence) versus Omo-style cemeteries (associated with pastoral subsis-
tence). Interestingly, Becker and Goldstein found no differences in osteoarthritis
between the Chen Chen and Omo groups—rather, osteoarthritis differed between
age-at-death and sex. Specifically, Omo middle adult females had pronounced
osteoarthritis at the shoulder, hip, and sacroiliac joints, Chen Chen middle adult
females exhibited increased osteoarthritis at the wrist, and subadults had elevated
frequencies of arthropathic changes at the elbow and ankle joints. Omo middle adult
females (pastoralists) may have been carrying heavy loads, putting burden on their
shoulders, backs, and hips, long distances. Chen Chen middle adult females (agri-
culturalists) may have been engaged in food preparation and weaving. What is par-
ticularly interesting about this publication is the high frequency of osteoarthritis in
children. Becker and Goldstein estimate that high-impact repeated tasks may have
begun as early as 5 years old and heavy labor around 8 years old for Andean chil-
dren, which also conforms to ethnohistorical accounts of child labor in the region
(Becker and Goldstein 2018:58). They contend, “intense and repetitive work from a
younger age may positively influence skeletal evidence of activity indicators”
(Becker and Goldstein 2018:62). This is important because up until now the major-
ity of osteoarthritis research has focused on adults, probably because (1) subadults
do not typically show osteoarthritic changes (although Becker and Goldstein’s pub-
superior and inferior articular facets (Lieverse et al. 2016).

Osteoarthritis 67
lication provides an excellent example of why this assumption should be chal-

lenged) and, (2) if subadults do not show osteoarthritis changes and they are included
in group-level statistics (e.g., mean scores for a population), this could grossly
underestimate osteoarthritis in a given population. These findings are significant not
only because they illustrate that arthropathic changes can occur in non-adults but
also because these data suggest that osteoarthritis present in young, middle, and old
adults may have begun at a much earlier age (i.e., childhood) and have implications
for the progression of the disease. Perhaps bioarchaeologists should begin analyz-
ing subadults for osteoarthritis to assess whether child labor was present in a given
social/temporal context and if so, interpret adult data with this in mind. Thus, osteo-
arthritis in young, middle, and old adults, may have begun at much earlier age (e.g.,
childhood), and become worse with time.
Lived Experience and Care
In line with osteobiographical approaches, bioarchaeologists have begun to address

how osteoarthritis was experienced in the past. Clinical literature and patient sur-
veys suggests that osteoarthritis is frequently accompanied by joint stiffness,
impaired movement, swelling, and, mostly commonly, joint pain (Bijlsma et al.
2011; Dieppe and Lohmander 2005; Jurmain et al. 2012; Ortner 2003; Rogers and
Waldron 1995). The intense pain associated with the condition may be related to the
fact that subchondral bone is highly innervated and thus particularly sensitive
(Glyn-Jones et al. 2015). If we use this insight when examining osteoarchaeological
case studies, we may be able to speak to lived experience and care of individuals.
Martin and Harrod discuss ways in which bioarchaeologists can speak to pain and
suffering in the ancient past. They note that advanced osteoarthritis, as well as cra-
nial depression fractures, long bone fractures, severe localized infections, moderate
to severe systemic bacterial infections, caries, abscesses, tooth loss, scurvy rickets,
anemia, ear infections, polio, tuberculosis, trepanematosis, and leprosy, are skeletal
and dental conditions that can be interpreted as having been painful and caused suf-
fering and disability (Martin and Harrod 2016:170).
Tilley’s bioarchaeology of care approach and index of care web-based applica-
tion can also be used here (Tilley 2015; Tilley and Cameron 2014; Tilley and
Oxenham 2011; Tilley and Schrenk 2017). In cases of severe osteoarthritis, particu-
larly those than exhibit eburnation or ankylosis, bioarchaeologists can argue that not
only was the condition likely extremely painful and limited mobility but also that
the individual may have required assistance and support from family, friends, and/
or a broader community. Tilley provides several examples of care requirements for
individuals with osteoarthritis in her book, “Theory and Practice in the
Bioarchaeology of Care” (Tilley 2015). In the case of Man Bac Burial 9, a 10 year
old who lived in what is now Vietnam during the Neolithic Period (c. 2000 BCE),
Tilley argues that this individual, who had significant lower limb atrophy suggesting
paralysis as well as moderate to severe osteoarthritis on both mandibular condyles
and on the left mandibular fossa, had Klippel–Feil syndrome and temporomandibu-
lar joint osteoarthritis (Tilley 2015). Care for this individual would have included
provisioning of food and water, assistance in eating and drinking, aid in maintaining
body temperature, protection from the elements, ensuring physical safety, help with
personal hygiene, and likely nursing with hands-on care. The temporomandibular
arthritis, in addition to restrictions of head and neck movement from Klippel–Feil
syndrome, would have made mastication difficult and painful; this may have led to
a diet of soft foods that did not require much chewing (Tilley 2015:204).
In another example from the Neanderthal site La Chapell-aux-Saints 1 (40,000–
60,000 BCE), Tilley discusses the implications of moderate to severe osteoarthritis
in the lower cervical vertebrae, thoracic vertebrae, and left hip, in addition to mild
to moderate osteoarthritis in the right temporomandibular joint, both shoulder joints,
and the right interphalangeal joint of the fifth foot phalanx (Tilley 2015). She sug-
gests that, given the atypical distribution of vertebral osteoarthritis (lumbar degen-
eration is more common), pathological changes to the vertebrae may be secondary
osteoarthritis from an initial traumatic injury; further, the bilateral shoulder osteoar-
thritis present on this individual could be a by product of the vertebral osteoarthritis.
Together, these conditions likely limited neck and shoulder mobility. More signifi-
cantly, hip eburnation in this individual was associated with an osteomyelitic infec-
tion, which may be indicative of septic arthritis. Tilly indicates that an altered gait
due to the severe hip osteoarthritis and infection may have caused the phalangeal
osteoarthritis. The temporomandibular joint osteoarthritis would have caused mas-
ticatory pain and limited jaw movement. Tilley contextualizes the widespread
osteoarthritis in this individual with a discussion of Neanderthal lifeways. The
severity of osteoarthritis in this case may have directly contributed to limited mobil-
ity and, thus, dependence upon other Neanderthals for food acquisition and care,
particularly during high fevers that were associated with the osteomyelitic infection.
According to Tilley, these instances of osteoarthritis chronic discomfort, if not
actual pain and that based on the pathological conditions of this individual, he
“needed and received health-related care provision to achieve survival to age at
death” (Tilley 2015:235).
Impairment and Disability
It is important to remember the lived experience of people who had or have osteo-
arthritis (Domett et al. 2017). The pain and loss of function associated with the
condition can be debilitating. For example, in modern developed countries the
socioeconomic burden as a direct result of osteoarthritis is significant. It is esti-
mated that osteoarthritis costs between 1.0 and 2.5% of the gross domestic product
of these countries, and may impact developing countries even more (Glyn-Jones
et al. 2015). Roush breaks down impairment and disability as they relate to osteoar-
thritis (Roush 2017). Using the example of hip osteoarthritis, Roush describes the
impairment of this condition as pain as well as loss of motion and strength (Roush
2017:40). Functional limitation, as a product of these impairments, restricts ones
participation in everyday activities. The functional limitation of hip osteoarthritis,
Osteoarthritis 69
for example includes the inability to walk up and down stairs. Disability describes
the inability of an individual with functional impairments to participate in a societal
role. Using the same example of hip osteoarthritis, the disability in this case would
be the inability to continue ones job if said job requires one use stairs frequently
(Roush 2017). Roush’s example provides a model for how we can begin to address,
not only the pain associated with osteoarthritis (i.e., impairment) but also the
broader implications for lived experience (i.e., functional limitations, disability),
which can impact not only the individual but also the community.
Plomp interprets back pain (i.e., vertebral osteoarthritis, spondylosis, vertebral
disc herniation, spondylolysis), in light of impairment and disability (Plomp 2017).
She describes the conflicting information between vertebral degeneration and
impairment that clinical resources report. Some research has found no relationship
between vertebral pathological conditions and pain (Raastad et al. 2015), while
other sources report it may be a common, even debilitating, source of pain
(Borenstein 2004; Gellhorn et al. 2013; Manchikanti et al. 2002; van Schoor et al.
2005). In 2008, Faccia and Williams conducted a study that examined Schmorl’s
nodes and pain in modern patients (Faccia and Williams 2008). They found that
Schmorl’s nodes that occur at the center most point of the vertebral body were the
most painful and hypothesize that this is due to the density of innervation at this
location (Faccia and Williams 2008). Faccia and Williams report that 92% of
patients included in their study said that pain they attribute to Schmorl’s nodes lim-
ited their activity (Faccia and Williams 2008:39). Further, 75% of patients missed
work due to back pain that they associated with Schmorl’s nodes (Faccia and
Williams 2008:39). Clearly, back pain can have a significant effect on daily life,
impairment, and disability. Even though Faccia and Williams’ findings suggest a
strong correlation between skeletal lesions and pain, Plomp, in examining multiple
vertebral pathological conditions, conveys that it is not clear-cut (Plomp 2017).
Additional studies, similar to Faccia and Williams, that explore the relationship
between skeletal lesions and pain/disability from a clinical perspective will be par-
ticularly useful to interpreting the lived experience of skeletons in the past (Faccia
and Williams 2008).
Most bioarchaeological discussions of care, impairment, and disability are cen-
tered upon the experience of the individual. Stodder addresses the potential of the
Global Burden of Disease (GBD) model in making population-level interpretations
in bioarchaeological research (Stodder 2017). The GBD is used to quantify health
status and measure the burden of specific and chronic diseases in a regional and
global setting (Murray et al. 2012; Murray and Lopez 1996). It takes into consider-
ation disability weights for particular conditions (DW), years lived with said dis-
ability (YLD), and years of life lost (YLL). Stodder uses the GBD model in her
examination of two Puebloan skeletal samples, San Cristobal and Ridges Basin
(1300-1680 CE and 710-825 CE, respectively). In examining 18 conditions, includ-
ing tuberculosis, eburnation, and various locations of fractures (e.g., face, clavicle,
femur), she found that the highest morbidity for both men and women were:
impaired mobility of the lower limb, skull fractures, and dental caries (Stodder
2017:189). At San Cristobal, women had a higher disease burden from elbow and
hip eburnation, tuberculosis, and clavicular as well as humeral fractures (Stodder

2017:190). Considering the context (terrain, subsistence strategy, division of labor,
and built environment) of these populations, Stodder argues that impaired mobility
of the lower limb would have notably impacted the lives of these individuals and
groups; for example, there would have been a clear functional impact on an indi-
vidual who lived in a cliff dwelling that was accessed by a series of ladders (Stodder
2017:195). While the GBD has drawbacks, it presents an opportunity to (1) quantify
morbidity, (2) compare burdens of health states between age categories, sexes,
groups, and populations, and (3) analyze pathological conditions on a
population-level.
Employing care, disability, and impairment models in bioarchaeological studies
of osteoarthritis can be problematic in that skeletal manifestations of the disease do
not always align with pain. Weiss has examined the intersection between pain and
radiographic evidence of joint space narrowing through a detailed analysis of the
National Institutes of Health’s Osteoarthritis Initiative public-use data set (Weiss
2014). She concludes that these medical indicators of osteoarthritis do not necessar-
ily coincide; severe pain can occur in patients with little to no joint space narrowing,
while minimal pain can occur in patients with significant joint space narrowing.
Other clinical studies have shown that there is little correlation between radiological
indicators of the disease and pain (Bijlsma et al. 2011; Glyn-Jones et al. 2015;
Johnson and Hunter 2014; Rogers and Waldron 1995). The one exception to this is
eburnation. In clinical contexts, eburnation is most reliably associated with pain
(Waldron 2012). As noted above, bioarchaeologists can continue to engage with
clinical research, bridging the gap between skeletal manifestations of osteoarthritis
and individual experience (see Faccia and Williams 2008). In the meantime, per-
haps bioarchaeologists should engage in discussions of pain, impairment, and dis-
ability using eburnation data, as opposed to lipping, porosity, or generalized
osteoarthritis data.
ngoing Bioarchaeological Debates: Definitions, Data,

O
and Statistics
Notably, there remains no uniform definition of osteoarthritis or scoring methodol-

ogy within bioarchaeology; likely stemming from the ongoing etiology discussion
as well as the disparity between clinical and skeletal interpretations, osteoarthritis
data are presented in a plethora of formats throughout bioarchaeological publica-
tions. Early skeletal analyses of osteoarthritis (e.g., Angel 1966; Armelagos 1969;
Ortner 1968) typically present the condition in a presence/absence format and
oftentimes failed to specifically define what osteological traits (i.e., lipping, poros-
ity, eburnation) they considered in this assessment. Later, Buikstra and Ubleaker
developed a scoring system designed for widespread use, which considers lipping,
porosity, and eburnation independently of one another (Buikstra and Ubelaker
Osteoarthritis 71
1994:115). More recently, in developing the data collection codebook for the Global
History of Health Project, Steckel and colleagues put forward another scoring
method that posits a rank system, which considers lipping, porosity, and eburnation
to be positively correlated and continuous (Steckel et al. 2006:31–33).
These forms of data scoring become even more complicated in light of how these
data are presented; the predominant forms of data presentation include: (1) defining
a presence/absence classification or (2) presenting lipping, porosity, and eburnation
values, often summarized as mean scores. Unfortunately, both of these methods
have their respective pitfalls. The former involves skeletally defining osteoarthritis.
For example, Larsen et al. suggest that osteoarthritis is present if discernable lipping
(as defined by Buikstra and Ubelaker 1994), porosity, and/or eburnation are evident
(Larsen et al. 1995; see also Klaus et al. 2009; Lieverse et al. 2007). Rogers and
Waldron, on the other hand, propose that either eburnation or two of the following:
osteophytes, pitting, and/or alteration to the joint surface, constitute evidence of
osteoarthritis (Rogers and Waldron 1995; see also Cheverko and Bartelink 2017;
Larsen et al. 1995; Zhang et al. 2017). Considering the previous discussion regard-
ing the complex etiology of osteoarthritis, as well as the contrast between clinical
and bioarchaeological perspectives, defining this condition as either present or
absent based on an individual researcher’s interpretation or definition is problem-
atic. Alternatively, a standardized scoring system that considers lipping, porosity,
and eburnation separately would allow researchers to return to their original datas-
ets and reconsider previous definitions of osteoarthritis. It is of utmost importance
that authors clearly specify what scoring system and definitions of presence/absence
were applied in all applicable publications.
The latter form of osteoarthritis data organization (i.e., raw scores and/or means)
produces a vast amount of data; as discussed above, it is recommended that side,
sex, and age categories (if possible) should be separated—creating three times more
data than would otherwise be presented. For example, if we wanted to compare
mean scores for upper body osteoarthritis between two skeletal populations, a seem-
ingly straightforward task, we would need to present 504 data points (seven skeletal
elements per side: glenoid fossa, proximal humerus, distal humerus, proximal ulna,
proximal radius, distal ulna, distal radius—each of which would need an indepen-
dent mean lipping, porosity, and eburnation value; further broken down into the
following categories: male/female; young/middle/old adult; skeletal population 1/
skeletal population 2). Further, to be mathematically thorough, we would want to
include an n value (sample size), presenting the number of individuals that were
examined; because bioarchaeological research rarely occurs exclusively with com-
plete skeletons (either due to post-mortem damage, erroneous curation, or com-
mingled remains) each data point would need its own n value. To illustrate the data
dispersal, we would also want to present standard deviation values for each point.
This of course triples our previous estimate, for a grand total of 1512 data points,
which only includes the upper body and does not present data on individuals whose
sex and/or age could not be determined. Clearly, this type of data set is difficult to
organize, present, mentally digest, and publish.
Some authors have opted for grouping indicators of osteoarthritis into joint sys-
tems (Becker and Goldstein 2018; Cheverko and Bartelink 2017; Klaus et al. 2009;
Larsen et al. 1995; Lieverse et al. 2007; Zhang et al. 2017). Conceptually, this makes
sense, given that muscles and joints work together to achieve a bodily motion.
Furthermore, the data become more manageable if they are grouped into composite
groups. Jurmain and Kilgore advocate for assessing multiple indicators of osteoar-
thritis per joint (Jurmain and Kilgore 1995). For example, for the distal humerus
alone, they analyze: the medial margin of the trochlea, the trochlear ridge, the lateral
margin of the capitulum, the olecranon fossa, coronoid fossa, the articular surface
of the trochlea, and the articular surface of the capitulum. They employ an ordinal
scaling method unique to each indicator, ranging from 0–1 and 0–4.
The statistical implications for having such a complex data set are also problem-
atic. Authors who present their data in present/absent formats have typically
employed chi-squared test or Fisher’s exact test (see Austin 2017; Domett et al.
2017; Eng 2007; Lieverse et al. 2007). When ordinal scaling methods are used,
researchers either use Analyses of Covariance (ANCOVA; Cheverko and Bartelink
2017; Cheverko and Hubbe 2017) or nonparametric tests, including the Wilcoxon
pairs test (nonparametric equivalent to the paired t-test), Mann–Whitney U (non-
parametric equivalent to unpaired t-test), Spearman’s r rank correlation coefficient
(nonparametric equivalent to Pearson’s r), and Kruskal–Wallis H (nonparametric
equivalent to one-way ANOVA; see Lieverse et al. 2016; Schrader 2012, 2015;
Zampetti et al. 2016). Recently, alternative statistical methods have been introduced
to the bioarchaeologists toolkit. Klaus et al. present multivariate odds ratios as a
way to control for comparisons being made between two populations with non-
identical age structures (Klaus et al. 2009; also see Zhang et al. 2017). This provides
a prevalence difference between two populations as an age-related proportion
(Klaus et al. 2009:209). More recently, generalized estimating equation (GEE), a
population-averaged method that takes multiple factors into consideration, has been
applied to osteoarthritis data (Becker and Goldstein 2018; see also Nikita 2014).
According to Becker and Goldstein, “GEE works well for this type of data because
it models estimates of population parameters that are calculated using each recorded
data point within each individual’s joint, allowing for the largest possible sample
size while still remaining linked to an individual…it preserves individual-level
information but does not permit one heavily effected individual to skew the data”
(Becker and Goldstein 2018:57–58). Calce et al. argue apply principal component
analysis, a nonparametric method, to osteoarthritis data (Calce et al. 2016). In doing
so, they were able to produce aggregate scores, identify variables that encompassed
the most osteoarthritic variation, conduct intra- and inter-sample comparisons, and
create predictive models based on these data. New statistical approaches, such as
generalized estimation equations and principal component analysis, are allowing
researchers to extract more information from their data, such as predictive modeling
and multi-factor analyses. Considering the various methods of data collection and
statistical analysis currently in use by bioarchaeologists, it is easy to see why
osteoarthritis data is difficult—if not impossible—to compare between publica-
tions. While there is not yet a consensus within the bioarchaeology community on
Entheseal Changes 73
the best way to handle osteoarthritis data, researchers continue to discuss the poten-
tial as well as the limitations of various methods.
Data from the Global Burden of Disease project (conducted in 2010) identified
osteoarthritis, particularly hip and knee osteoarthritis, as the most common joint
disease (Cross et al. 2014; Storheim and Zwart 2014). Furthermore, it is estimated
that osteoarthritis diagnoses will double by 2020 (Johnson and Hunter 2014:5;
Lawrence et al. 2008). Considering the high prevalence of osteoarthritis in modern
societies, the strong history of osteoarthritis research in bioarchaeology as well as
the potential outcomes of better understanding patterns of ancient activity, there
remains a strong incentive to continue this line of research. In doing so, it is impor-
tant to (1) clearly state the methods that are being employed, including scoring
system and definition of presence/absence; (2) understand that the definitions of
osteoarthritis are constantly changing; and (3) remain open to new ideas, methods,
and interpretations.
Entheseal Changes
Entheseal changes, or alterations to the bone at the point of muscle/ligament attach-

ment, represent another avenue for bioarchaeologists to address day-to-day life.
Like osteoarthritis, the examination of entheses on bone is not without obstacles.
However, if we consider contributing factors, such as age, we can begin to mitigate
these complications. Additionally, entheses are biological components that, while
influenced by physical activity, are not directly involved in synovial degeneration.
While osteoarthritis and entheseal changes do have common causation factors, they
are separate biological systems. This is of great value to the examination of every-
day practice because they provide yet another perspective on interpretations of
ancient activity.
The Physiological Structure of Entheses
Often referred to as musculoskeletal stress markers in bioarchaeological literature,

entheses are complex systems that enable physical motion, while simultaneously dis-
sipating stress (Benjamin et al. 2002). The study of entheses has drawn substantial
attention from medical researchers because of the direct application to common sport-
ing injuries. In fact, frequent injuries such as “tennis elbow” “golfer’s elbow,” and
“jumper’s knee” are now known to be entheseal damage (Benjamin et al. 2006).
However, despite decades of research, there is still much to be learned about how mus-
cles and ligaments attach to bone and how bone responds to overuse of these tissues.
There are two main categories of entheses: fibrous and fibrocartilaginous
(Benjamin and McGonagle 2001, 2009; Benjamin and Ralphs 1998; Shaw and
Benjamin 2007). Both fibrous and fibrocartilaginous entheses serve to attach and
maintain the intersection of muscle and bone. However, these categories differ in
how the connection is made. In a fibrous enthesis, the muscle or ligament affixes to
a dense connective tissue, which then attaches directly to the bone or periosteum. In
a fibrocartilaginous enthesis, however, the muscle/bone connection is more compli-
cated and has undergone chondrogenesis. Through this process, four distinct soft/
hard tissue zones are created: (1) fibrous connective tissue, (2) uncalcified fibrocar-
tilage, (3) calcified fibrocartilage, and (4) bone (Benjamin et al. 1986; Benjamin
et al. 2002). Of the two categories of entheses, fibrocartilaginous attachments have
been more thoroughly examined, primarily due to their vulnerability to injury and,
therefore, priority within medical research. Several clinicians have found a strong
link between enthesis and spondylarthropathies, for example (Benjamin et al. 2004;
Benjamin and McGonagle 2009; de Miguel et al. 2011).
Benjamin and colleagues have put forward the “enthesis organ” concept, which
suggests that inflammatory changes associated with enthesis use and overuse are not
localized to the enthesis itself (Benjamin et al. 2004). Rather, diffuse changes
involving the bone and associated soft tissue also occur. Benjamin et al. promote
“viewing insertion sites not merely as focal attachments, but as parts of an ‘enthesis
organ complex’ that may dissipate stress concentration at the bony interface away
from the attachment site itself” (Benjamin et al. 2004:3306; emphasis original).
This has previously been illustrated in the Achilles tendon attachment (posterior
calcaneus; Benjamin and McGonagle 2001; Canoso 1998; Rufai et al. 1995). At the
Achilles, stress is dissipated away from the point of attachment and focused on the
adjacent areas of the tendon, bone, bursa, and fat-pad. Benjamin and colleagues
argue that the enthesis organ concept can broadly be applied to enthesis and test this
hypothesis at 26 fibrocartilaginous enthesis, including the triceps, biceps, quadri-
ceps, and patellar attachments (Benjamin et al. 2004). If entheses are viewed as a
complex soft and hard tissue system, pathological changes associated near the point
of attachment, such as synovitis, bursitis, and various spondylarthropathies, can be
better understood and partially explained.
Of particular interest to bioarchaeologists, skeletal changes at the point of mus-
cle/ligament attachment can vary considerably. When an entheseal change is visible
and/or palpable, in its simplest form, it is characterized by a smooth, well-defined
mark on bone that is free of vascular foramina (Villotte and Knüsel 2013; Fig. 3.5).
More impacted entheses can increase in robusticity, but also begin to resorb—what
Hawkey and Merbs refer to as stress lesions (Hawkey and Merbs 1995). Entheses
can be characterized by varying degrees of marginal irregularity, erosion, calcifica-
tion/ossification of soft tissues, vascularization, and cavitation (Figs. 3.6 and 3.7).
Villotte, and others, have suggested that fibrocartilaginous entheses are easier to
detect due to a well-defined margin (Villotte 2006); additionally, more is known
about their growth, maintenance, and degeneration due to an extensive clinical lit-
erature. Through the use of identified skeletal collections, where age, sex, and occu-
pation are known, Villotte has repeatedly found strong correlations between activity
and fibrocartilaginous entheses (Villotte et al. 2010). There have been numerous
publications in the last few years that have supported Villotte’s findings and further
encourage the differentiation of fibrous and fibrocartilaginous entheses in bioar-
Fig. 3.5 Attachment of M.

subscapularis to the
proximal humerus
(observable, but healthy
enthesis)

subscapularis to the
proximal humerus
(marginal irregularity,
vascularization, and
erosion present

biceps brachii to the
proximal radius (marked
vascularization and erosion
present)
chaeological research (Havelková et al. 2011; Henderson et al. 2010, 2013). Results
of fibrous attachment sites are not as clear-cut (Alves Cardoso and Henderson 2010;
Villotte and Knüsel 2013). Henderson has proposed that pathological conditions,
such as periostitis and osteitis, may influence fibrous entheses owing to their mode
of attachment (i.e., collagen fibers attaching tendon to bone or tendon to perios-
teum; Henderson 2013). Using a PubMed search, Henderson found no papers,
which associated entheseal changes and pathological processes. She suggests this
may be due to the lack of symptoms in living individuals (i.e., patients do not com-
plain of pain when fibrous inflammation occurs and thus clinicians are less likely to
research them), as well as the relatively large footprint of fibrous entheses, which
helps prevent rupture. Henderson suggests bioarchaeologists assess pathological
conditions concurrently with entheseal changes, so that we can begin to assess
whether or not a relationship between the two exists. Once fibrous entheses are bet-
ter understood in both clinical and bioarchaeological research, a separate scoring
method will likely be required to associate these entheses with activity (Henderson
et al. 2013). Villotte did include fibrous entheses in his scoring method and did find
an association between entheseal changes and activity in various known skeletal
collections (Villotte 2006; Villotte et al. 2010). More research into the differences
between fibrous and fibrocartilaginous entheses needs to be conducted to determine

if they need to be examined separately in bioarchaeological contexts.
Etiology of Entheseal Change
The etiology of entheseal change has not been researched as extensively as osteoar-
thritis. There are several reasons for this. First, not as many clinical complaints are
made relative to osteoarthritis. Most clinical entheses reports of pain are due to
overuse (e.g., sports injury) or autoimmune disease (Benjamin et al. 2002;
Claudepierre and Voisin 2005; McGonagle 2009; McGonagle et al. 2007; Shaw and
Benjamin 2007). Individuals are less likely to go to the doctor with enthesitis (also
referred to as enthesopathy in both clinical and bioarchaeological literature), or
inflammation of the entheses, as opposed to osteoarthritis, which as was discussed
above effects approximately 60% of people over 75. Second, not as much medical
research has been done on entheses, again relative to osteoarthritis, given that it
does not affect as many people. Clinical research of enthesis has looked to the struc-
ture–function relationship between entheseal inflammation and mechanical load
and exercise (Benjamin et al. 2006; Shaw and Benjamin 2007). The Achilles ten-
don, in particular, has been well researched and, of those who complain of enthesi-
tis, is a common source of pain (McGonagle et al. 2002, 2008; Shaw et al. 2008).
The rotator cuff, a group of muscles and tendons that surround the shoulder, is
another common area of injury affecting 23% of one sample (Reilly et al. 2006; see
also Minagawa et al. 2013; Uhthoff et al. 2003). Another study found a prevalence
rate of 36% in individuals who experienced pain and 17% of individuals without
symptoms (Yamamoto et al. 2010). As discussed below, entheseal damage does
appear to be age progressive. In a study of asymptomatic individuals, Milgrom et al.
report 33% of individuals in their fourth decade had rotator cuff injury while 55%
of individuals in their fifth decade had rotator cuff injury (Milgrom et al. 1995; see
also Giai Via et al. 2013). A connection between enthesitis and spondyloarthropa-
thies, chronic inflammatory joint diseases, has also been established (Claudepierre
and Voisin 2005). This is particularly interesting for bioarchaeologists as some
spondyloarthropathies, such as, ankylosing spondylitis, can be identified skeletally.
Lastly, before the advent of ultrasonography and magnetic resonance imaging, it
was difficult to observe entheses in living patients. These advancements in imaging
technologies have allowed researchers to examine entheses in vivo and investigate
causation factors as well as possible treatments.
Initial skeletal studies of entheseal change assumed the osteological response to
activity was straightforward (i.e., the muscle is used, it puts stress on the bone, the
bone reacts by creating ridges along the line of muscle attachment). However, recent
studies have shown that this process is far from simple or straightforward. Of
particular note, physical activity is not the only (or even primary) causation factor
in the presence of marked entheses. Even though the following contributing factors
to entheses are not thoroughly discussed in medical literature, we know from bioar-
chaeological research that age, sex, and body size as well as other factors may lead
to the development of entheses.
Researchers have found that entheseal markers have multifactorial causation fac-
tors. Perhaps most notably, age has been positively correlated with entheseal
changes across multiple populations (Acosta et al. 2017; Al-Oumaoui et al. 2004;
Alves Cardoso and Henderson 2010; Churchill and Morris 1998; Jurmain 1999;
Jurmain and Roberts 2008; Kennedy 1989; Mariotti et al. 2004, 2007; Milella et al.
2012; Molnar 2006, 2010; Niinimaki 2011; Niinimäki and Baiges Sotos 2013; Robb
1998; Rogers et al. 1997; Villotte 2009; Villotte et al. 2010; Wilczak 1998; Yonemoto
2016). Villotte and Knüsel unite clinical and osteological perspectives in their
assessment of the relationship between aging and entheses; they note that excessive
mechanical stress, including high frequency, speed, and intensity, can cause micro-
traumatic insults to fibrocartilaginous entheses, and, in young adults, lead to
activity-related enthesopathy (Villotte and Knüsel 2013). However, as the body
ages, particularly during and after the sixth decade of life, the physical properties of
the entheseal organ begin to deteriorate. The reduction in tendon vascularity con-
tributes to microtears, enthesophytes, calcification, and erosion (see Milella et al.
2012 and Villotte and Knüsel 2013). Furthermore, it becomes less likely that dam-
age to an enthesis can be repaired later in life. In short, increasing age contributes to
the likelihood that factors other than physical activity are the source of entheseal
change. In many respects, non-old-adults (i.e., <60; here termed young adults and
middle adults) are more reliable subjects with regard to activity and addressing an
everyday experience. It is still not clear why entheses increase in frequency and
severity with age and many questions remain; are entheseal changes accrued over
one’s life? Or, as an individual gets older, are their bones more susceptible to enthe-
seal remodeling? Does a decrease in cortical bone, associated with advanced age,
impact bone responsiveness to stress? Does sarcopenia, or the loss of muscle mass
with age, impact entheseal physiology? How does “occupational mobility” or the
ability to change occupations throughout one’s life effect entheseal changes
(Henderson et al. 2013)? Regardless, it is now generally accepted that they are
highly correlated. With further clinical research and future bioarchaeological stud-
ies, as well as collaboration between the two, we might be able to better understand
activity-related changes in older individuals; however, for now, data from these indi-
viduals should be used with caution.
Weiss suggests the relationship between entheseal remodeling in males versus
females is not straightforward (Weiss 2003a, 2004, 2007, 2009; Weiss et al. 2012).
She points out that males are typically larger and have more muscle mass, which
could have a dramatic effect on their respective attachment sites. In theory, males
would be predisposed to larger and more severe entheseal changes. This issue can
be addressed through the examination of body size; by statistically controlling for
body size, differences in entheseal remodeling scores between the sexes can be
attributed to sexual division of labor (if statistical significance is maintained after
controlling for body size), or size variation (if statistical significance is no longer
present after controlling for body size). Thus, both sex and body size may impact
entheseal changes.
Milella et al. examined entheseal changes in the well-documented Fressetto col-

lection (early twentieth century Sassari, Sardina; Milella et al. 2012). This collec-
tion has records of age, sex, and occupation for many of the skeletons. Milella and
colleagues wanted to see if there was a relationship between entheseal changes and
age, sex, and/or activity (i.e., occupation). They authors found a strong correlation
between entheseal changes and age and sex. However, the correlation between
entheseal changes and activity was moderate, at best. The authors do suggest further
research on additional entheses as well as similar projects on various known skeletal
collections to confirm these findings. If entheseal change are as strongly linked with
age as Milella et al. found, they could be used “not only for biocultural reconstruc-
tion but also for inferences regarding demography and life history” (Milella et al.
2012:386).
Recently, Simon Mays reintroduced the topic of “bone-formers” and “bone-
losers” to bioarchaeological literature (Mays 2016; see also Rogers et al. 1997;
Rogers and Waldron 1995). In short, the theory suggests that not all individuals (or
populations) are equal in their ability to produce or resorb bone. This has massive
implications for osteoarchaeology and paleopathology. Using the Eighteenth to
Nineteenth Century London Spitalfields collection, Mays compares the anterior
longitudinal ligament (ALL) and osteoporosis or cortical index (CI) of the metacar-
pal (assessed via radiogrammetry). Controlling for age, sex, skeletal completeness,
occupation, and parity, Mays found a positive association between ALL and CI. This
suggests that, in this population, some individuals appear more likely to produce
bone. Mays does note that bone formation and resorption occurs in two primary
areas: the periosteal and the endosteal envelope. These surfaces may differ in their
remodeling responses to hormonal, mechanical, age-related, and other influences
(Gosman et al. 2011; Szulc and Seeman 2009). If additional research suggests that
some individuals and populations are predisposed to forming or losing bone, this
could have profound impacts on bioarchaeological studies of entheseal changes.
The co-occurrence of entheseal changes and diffuse idiopathic skeletal hyperos-
tosis as well as seronegative spondyloarthropathies have been studied by bioarchae-
ologists and clinicians (Faccia et al. 2016; Jankauskas 2003; Kyriakou 2009; Rogers
et al. 1997; Villotte and Knüsel 2013; see clinical citations above). Bioarchaeologists
have typically excluded individuals with diffuse idiopathic skeletal hyperostosis
and seronegative spondyloarthropathies from their samples if the primary goal of
the study is to examine physical activity (Foster et al. 2013; Havelková et al. 2013;
Milella et al. 2012; Niinimäki and Baiges Sotos 2013; Rogers and Waldron 1995).
However it is worth noting that some research has found an association between
enthesophytes and osteophytes in the appendicular skeleton (Hardcastle et al. 2014,
2015; Kalichman et al. 2007). This may link back to the bone formers debate
described above (i.e., if an individual is predisposed to proliferative bone growth
this may manifest in both entheseal changes as well as osteophytes). This could also
speak to similar causation factors (e.g., activity, age, genetics). Multi-method
approaches, such as osteoarthritis and entheseal changes, have been used to assess
the causation of these co-occurring conditions (see below).
The etiology of entheseal changes remains complicated and a bit murky. Several
bioarchaeologists have done excellent work bridging the gap between osteology and
medical research (Henderson; Jurmain; Villotte; just to name a few). The continua-
tion of this combined research (bioarchaeology and medicine) will help us better
understand (1) who is vulnerable to entheseal changes, (2) what the contributing
factors of entheseal changes are, and (3) the lived experience of people with enthe-
seal changes (e.g., pain, limited mobility, treatments, care requirements). At this
point it seems prudent to distinguish between fibrous and fibrocartilaginous enthe-
ses. While some researchers have been successful at linking fibrous entheses with
activity (Villotte 2006; Villotte et al. 2010), others have suggested that due to the
lack of clinical data on fibrous entheses, fibrous and fibrocartilaginous entheses
should be analyzed separately (Henderson et al. 2013). Further research, both medi-
cal and bioarchaeological, is necessary to gain a better understanding of the simi-
larities and differences between these two types of entheses. One venue of research
that is particularly promising is investigations of fibrous entheses in identified skel-
etal collections (discussed further below). At very least, we can say that entheseal
changes should be analyzed with caution. Much research has suggested a link
between entheseal changes and physical activity, but it is not straightforward.
Contributing factors, most notably age, are problematic and need to be taken into
consideration. Other contributing factors likely include sex, body size, bone formers
versus bone losers, and pathological conditions (specifically, diffuse idiopathic
skeletal hyperostosis, and seronegative spondyloarthropathies).
Previous Bioarchaeological Approaches to Entheseal Change
Over the past three decades, the analysis and interpretations of entheseal remodel-
ing have undergone dramatic changes within the discipline of bioarchaeology. One
of the first publications on entheseal changes to the skeleton was Dutour’s article on
Neolithic Saharan populations (Dutour 1986). Dutour concluded due to increased
entheseal changes in the elbow and ankle that Neolithic Saharan populations were
engaging in activities such as javelin throwing, wood-cutting, archery, and walking/
running. In a similar vein, Lai and Lovell combined multiple indicators of activity
(vertebral osteophytosis, Schmorl’s nodes, osteoarthritis, entheseal changes) to
examine the Hudson’s Bay Company Fur Trade. From these analyses, they sug-
gested this population was participating in carrying, lifting, as well as paddling/
rowing (Lai and Lovell 1992). It was not until 1995, however, that a systematic
method of scoring entheses was published. Hawkey and Merbs examined Hudson
Bay Eskimo samples and clearly defined (both in text and photos) their proposed
scoring system, which ranked entheseal robusticity, stress lesions, and ossification
(Hawkey and Merbs 1995). This soon became a standard method of measuring
entheseal severity within bioarchaeological studies.
Munson Chapman examined an indigenous Pecos Pueblo (New Mexico) sample
and found that Spanish contact had little to no effect on Native activity patterns
(Munson Chapman 1997). However, entheseal markers were found to increase in
severity with age. Hawkey examined entheseal changes, what she referred to as
musculoskeletal stress markers, in a likely disabled individual (Burial 391) from
Gran Quivira Pueblo, New Mexico (Late Period AD 1550-1672; Hawkey 1998).
From studying the skeleton, Hawkey determined that only a limited range of move-
ments would have been possible: there would have been no mobility in the hip,
elbows, and wrists; minor mobility of the lumbar and shoulders; by the time the
individual was a young adult they would have lost all function in their knees, ankles,
head, and neck. Hawkey diagnoses this individual with juvenile rheumatoid arthritis
who likely died during middle adulthood. From this, Hawkey suggests that this
individual would have been completely dependent on others and at least one mem-
ber of the community would have taken care of this individual, providing evidence
for compassion.
Lieverse and colleagues examine entheseal changes in two populations from Cis-
Baikal (the same skeletal sample discussed above (Previous Bioarchaeological
Approaches to Osteoarthritis); Lieverse et al. 2009). By comparing the Early Neolithic
Kioti sample (6000–4800 BCE, pre-hiatus) to the Late Neolithic/Bronze Age Isakovo-
Serovo-Glaskovo sample (4000–2000 BCE, post-hiatus), they questioned whether or
not lifeways differed between these two different periods. They examined 24 upper
body entheses and found that the Kioti males had higher entheseal mean scores than
either Kioti females or Isakovo-Serovo-Glaskovo males. The supinator enthesis was
significantly higher in the Isakovo-Serovo-Glaskovo sample. These findings suggest
different lifeways between the Kioti and Isakovo-Serovo-Glaskovo associated both
with differing subsistence regimes. Both the Kioti and Isakovo-Serovo-Glaskovo
were found to have elevated costoclavicular ligament and deltoid entheseal changes,
which the authors attribute to the extensive use of watercraft.
Drapeau uses a comparative approach to examine activity and bilateral asymmetry
via entheseal changes in modern humans and African apes (Drapeau 2008). Humans
generally have more developed entheses in the lower limbs and apes in the forelimb,
owing to locomotion (i.e., bipedalism versus quadrupedalism). Drapeau found more
asymmetrical entheseal expression in humans, for both forelimbs and hind limbs,
than apes. A moderate degree of handedness could be detected in apes. Drapeau con-
cludes that entheseal changes do provide information about muscle activity levels and
that the more habitual or strenuous muscle use, a more dramatic entheseal change
will occur at the point of attachment. The implications of this study, of course, are
particularly interesting for assessing activity and handedness in the Plio-Pleistocene.
Using this approach it may be possible to assess fossil data and make interpretations
about extinct hominid and hominin species (see also Feuerriegel 2016; Mariotti and
Belcastro 2011; Petermann and Sander 2013; Sanchez et al. 2013).
Entheseal Changes and Sexual Division of Labor
In addition to the reconstruction of activity, many scholars have attempted to iden-

tify a sexual division of labor in past populations through the examination of enthe-
seal markers. Many studies have found males to have higher rates of entheseal
changes than females and have attributed these results are correlated to differences
in physical activity. Wilczak studied skeletal remains from seven samples that
included Native Americans as well as American blacks and whites. Entheses were
found to increase significantly with age in males, but not females (Wilczak 1998;
also see Gresky et al. 2016; Munson Chapman 1997; Nagy 1999; Peterson 1998).
Conversely, some studies found females to have higher rates of entheseal remodel-
ing than males (al-Oumaoui et al. 2004; Nagy and Hawkey 1995).
Eshed et al. compared entheseal changes between Natufian hunter-gatherer pop-
ulations and Neolithic agricultural populations and doing so also assessed whether
there was a sexual division of labor during this time (Eshed et al. 2004). The transi-
tion from the hunter-gatherer to predominantly agricultural way of life occurred in
the Levant during the Pre-Pottery Neolithic period (8000–6000 BCE). During this
time, archaeological evidence suggests the Levant experienced changes in settle-
ment patterns, social structure, social organization, as well as ritual behavior. To test
whether activity differed between these two periods Eshed and colleagues com-
bined skeletal data from four sites dating to the Natufian period and four sites dating
to the Neolithic period. They examined 21 entheses from the upper body and found
considerable variation both between time periods but also between males and
females. The Neolithic sample had significantly higher entheseal changes scores
than their predecessors, the Natufian sample. Eshed et al. attribute this to harsh
working conditions associated with a life dependent upon agriculture. Some of the
activities would have been altogether new for the Neolithic peoples, such as tree
felling, mud-brick construction, quarrying flint, and large-scale limestone block
quarrying. Whereas other activities, including harvesting, food processing, and
stone construction, would have been present during the Natufian period, just not to
the same extent or intensity as the Neolithic period. Females show pronounced
entheses associated with lower forearms movement (brachioradialis, extensor carpi
radialis longus); Eshed et al. suggest that women may have been conducting skilled
work with their hands such as basketry, spinning, and weaving. Furthermore, activi-
ties that were divided between the sexes also changed between the Natufian and
Neolithic. For example, women in the Natufian period likely used mortar and pestle,
which are archaeologically prolific during the Natufian, whereas women during the
Neolithic likely adopted the saddle quern. Eshed et al. attribute higher scores of the
deltoideus in the Natufian sample to using a mortar and pestle; the saddle quern
would have put less force on the deltoideus, limiting entheseal changes in the
Neolithic sample (Eshed et al. 2004).
Havelková et al. also examined sexual division of labor via entheseal changes in
a Ninth Century early Medieval population from Mikulčice castle (Moravia) and
surrounding hinterlands (Havelková et al. 2011). Their aim was twofold: to assess
any differences in habitual activities between castle versus hinterland, and to address
sexual division of labor in these populations. They hypothesized that the castle sam-
ple would reflect the rich, who would be relatively less physically strained, whereas
the hinterland population, likely reflecting farmers, would have undergone more
intensive and repetitive manual labor. They examined nine fibrocartilaginous enthe-
ses from both the upper and lower body. They found significant differences between
entheseal changes with the hinterland males exhibiting the highest entheses scores,
while castle males exhibited the lowest entheses scores. Sexual dimorphism was
greatest in the hinterland sample, particularly for upper limb entheses. This suggests
that females in the castle and females in the hinterland were performing similar
tasks, and may suggest that castle females may not have held the same social status
that castle males did. Based on archaeological evidence and the entheseal changes
data, Havelková and colleagues suggest females may have been grinding grain, car-
rying water, spinning, weaving, manufacturing pottery, and tanning skins. The high
mean scores at the elbow in both the castle female and hinterland female samples
suggest these activities may have been similar in both groups (for females).
Hinterland males, on the other hand, may have been making shoes, plowing, black-
smithing, building, and fishing. This is supported by elevated shoulder entheseal
changes (Havelkova et al. 2011).
More recently, Santana-Cabrera et al. combined ethnohistoric, archaeological,
and skeletal data to infer activity in Pre-Hispanic Canaria Island (Eleventh to
Fifteenth Century CE; Santana-Cabrera et al. 2015). They analyzed 41 fibrous and
fibrocartilaginous entheses from the upper body with the aim of better understand-
ing indigenous lifeways prior to European arrival. They found significant variation
in entheseal robustness between males and females. Overall, males had higher mean
entheseal scores than females. Using principal component analysis, Santana-
Cabrera et al. were also able to test the interaction between certain entheses and
their physiological functions, and correlate them to the various physical activities
described in the ethnohistoric accounts. They found that entheses involved in rota-
tion and abduction/adduction of the shoulders, flexion and extension of the elbows,
and pronation and supination of the forearm, likely explained the main patterns of
activity in males. In females, however, the main patterns of activity were visible in
the entheses related to pronation and supination of the forearm, stabilization of the
wrist, and flexion and extension of the fingers. While males displayed a higher
degree of entheseal robustness, the product of more intense activities, females dis-
played more variation in entheseal expression, suggesting that females were engaged
in a more diverse range of activities than males (Santana-Cabrera et al. 2015).
Entheseal Changes and Identified Skeletal Collections
The bioarchaeological examination of entheses, particularly in identified skeletal

collections (i.e., known sex, age at death, and/or occupation), is one area of research
that can shed light on this complicated biological process. For example, Campanacho
and Santos examined entheseal changes of the os coxae and documented occupation
in the Coimbra identified skeletal collection (Campanacho and Santos 2013). First,
they split the sample into manual (e.g., farmer, carpenter) and non-manual (e.g.,
priest, student) laborers. Then they determined a femur robusticity index, parsing
robust individuals from gracile ones. The authors presumed that individuals who
fell in the manual labor and robust groups likely had physically demanding occupa-
tions, whereas individuals who were in the non-manual category and were gracile
likely had less demanding physical activities. Unfortunately, sample sizes were
quite small once they created these categories and logistic regression was not possible
on the majority of entheses examined. However, exostoses on the iliac crest could
be compared to physical activity categories. Campanacho and Santos found that
physical activity did not influence the development of iliac crest exostoses.
Additional studies on various identified collections similar to this would prove
very informative about possible links between activity and entheseal changes
(Campanacho and Santos 2013).
In a study by Alves Cardoso and Henderson, entheses from the humerus were
compared to known age-at-death and occupation in the Nineteenth to Twentieth
Century Coimbra skeletal collection (Portugal; Alves Cardoso and Henderson
2010). They found no relationship between any of the entheses examined and occu-
pation (divided into manual labor and non-manual labor categories). However, age
was “the single most significant factor in enthesopathy formation” (Alves Cardoso
and Henderson 2010:550). In their review of entheseal definitions and life course
changes, Villotte and Knüsel state that, “in studies of entheseal changes in skeletal
samples with known age-at-death, age is the main aetiological factor identified”
(Villotte and Knüsel 2013:139; see also Alves Cardoso and Henderson, 2010; Cunha
and Umbelino 1995; Mariotti et al. 2004, 2007; Milella et al. 2012; Niinimaki 2011;
Shaibani et al. 1993; Villotte 2009; Villotte et al. 2010).
While this all sounds rather discouraging, Lopreno and colleagues bring up sev-
eral points of constructive critique for the analyses of identified skeletal collections
(Lopreno et al. 2013). Lopreno et al. draw attention to the ambiguous nature of the
historical documentation of occupation; oftentimes the descriptions are vague and
the bioarchaeologists is left to categorize an unfamiliar occupation into, for exam-
ple, manual labor or non-manual labor categories. Furthermore, as mentioned
above, occupational mobility, or the changing of one’s career, is rarely if ever
addressed (Henderson et al. 2013). Lopreno and colleagues also found variability in
the entheseal changes selected for observation—this is a point that is true for most
studies of entheseal changes, not just in identified skeletal collections. They encour-
age the standardization of occupations and their associated biomechanical and
sociocultural categories. To facilitate this, they provide a table that provides a sug-
gested standardized classification of occupations, their relative biomechanical stress
loads, and occupational groupings (Lopreno et al. 2013:182). They also have pub-
lished a helpful map of identified skeletal collections within Europe, an excellent
resource for young researchers attempting to locate these collections (Lopreno et al.
2013:177).
Karakostis and colleagues report more encouraging findings in a study of hand
entheseal changes in a documented skeletal collection from Nineteenth Century
Basel, Switzerland (Karakostis et al. 2017). Importantly, the collection that
Karakostis et al. examined is associated with records that document occupation
throughout the active working life of the individuals in the collection. This differs
other skeletal collections, which typically document occupation only at the time of
death. Karakostis et al. used a 3D scanner (Breuckmann SmartScan structured-light
scanner) to assess the entheses involved labor for two groups: occupations involving
sustained high-grip force (e.g., bricklayer, carpenter, day laborer, mill builder) and
less strenuous and/or mechanized occupations (e.g., baker, bookbinder, butler, door-
man). Results showed congruency with the Karakostis and Lorenzo study, which
identified two synergistic muscle groups in the hand, one that contracts during hand
movement and is associated with sustained high grip force, and another that posi-
tions the thumb relative to the palm and fingers (Karakostis and Lorenzo 2016).
Individuals in the heavy labor group had entheseal changes that were consistent
with high-grip force and individuals in the non-heavy labor group had entheseal
changes that were akin to the other synergistic muscle group (thumb relative to palm
and fingers).
Entheseal Changes and Bone Structure
Another area of research that has proven quite interesting is a multi-method

approach, combining the study of entheses and bone structure. Djukic et al. have
compared the microarchitecture of trabecular bone to entheseal changes (Djukic
et al. 2015). Based on the premise that bone structure remodels and adapts in
response to mechanical load, microarchitecture studies have examined structural
remodeling at the microscopic level (Ding et al. 2002; Djuric et al. 2010; Hert 1994;
Ruff et al. 2006; Turunen et al. 2013). In addition to those studies that have found a
correlation between trabecular microstructure organization and activity, other
researchers have found a lack of activity can lead to cortical thinning, cortical poros-
ity, decreased trabecular number and thickness, increased trabecular separation, and
increased rod-like trabeculae (Bouvard et al. 2012; Britz, et al. 2012). Djukic and
colleagues set out to test whether mechanical loading influenced both entheses and
microarchitecture at the site of the enthesis. Using 24 adult male skeletons from
Medieval Serbian cemeteries, Djukic et al. scored four enthesis according to
Villotte’s three-tiered methodology (Villotte 2006) and used microcomputed tomog-
raphy (μCT) to assess microarchitecture. They found no consistent correlation
between the four entheseal stages and microscopic organization of trabecular bone.
Cortical thickness did significantly differ between the entheseal changes scores,
which is not particularly surprising. There was also a correlation between entheseal
changes (Score C, or the most severe according to Villotte’s method) and trabecular
architecture, suggesting Djukic et al.’s hypothesis may hold true (i.e., structural
adaptations to trabecular bone are present at the site of entheseal attachments), but
only in cases of severe entheseal change. This may indicate that in severe entheseal
changes, both the microstructure of trabecular bone as well as the entheseal attach-
ment follow the same adaptation pattern (Djukic et al. 2015).
Similarly, Niinimäki and colleagues have examined the relationship between
entheseal changes and cross-sectional geometry of long bones (Niinimäki et al.
2013). Like microarchitecture studies, bone-cross sectional geometry research is
based on the premise that bone shape and thickness adapts based on physical activ-
ity (Holt 2003; Macintosh et al. 2017; Maggiano et al. 2008; Rodríguez et al. 2018;
Ruff 2008; Shaw and Stock 2009; Stock and Shaw 2007; Weiss 2003b). Using an
early Twentieth Century skeletal sample from Finland (Helsinki) and two Medieval
English collections (Newcastle, Blackgate and York, Barbican), Niinimäki and col-
leagues used pQCT scanning to assess site-specific cross-sectional cortical bone
area (CA) and cortical bone thickness. They then compared these data to areas of
entheseal attachment versus areas of non-attachment. In line with Djukic et al.’s
findings described above, Niinimäki et al. found that cortical bone was significantly
thicker at points of muscle attachment versus areas of non-attachment. The authors
suggest that mechanical loading is applied to the overall bone shaft, but that attach-
ment sites experience greater loading, thus increasing the cortical thickness. Cortical
thickness and cortical bone area at non-attachment sites was found to decrease with
age. However, cortical thickness was found to increase with age at points of attach-
ment. Niinimäki and coauthors suggest that these findings suggest the possibility of
maintaining cortical thickness despite age-related bone loss. Of particular interest to
activity-related studies, the greatest variation in orientation loading was found at
50% of the length of the humerus and variation was found between populations,
sides, and sexes. Niinimäki et al. posit that because the entheses at 50% of the length
of the humerus are responsible for both shoulder and elbow movement that this area
has the most potential for inferring activity patterns. Additionally, because variation
was found between skeletal collections, the left and the ride side, and males and
females, this could reflect activity differences as opposed to anatomical unifor-
mity (Niinimäki et al. 2013).
Entheseal Changes and Animal Models
Some researchers have pursued the examination of entheses by controlling for body
size, diet, sex, and activity via animal experimentation. For example, both hard and
soft tissues of rabbits, dogs, mice, turkeys, reindeer, and sheep, have been analyzed
for entheseal reaction to muscle use (Gao et al. 1996; Niinimaki and Salmi 2014;
Thomopoulos et al. 2008, 2010; Wallace et al. 2017; Zumwalt 2005). In an experi-
mental study by Zumwalt, entheseal changes were examined in sheep who had been
exposed to various amounts and intensity of physical activity (Zumwalt 2006).
Experimental sheep were placed on a weighted treadmill and ran for 1 h per day for
90 days. Sedentary control sheep did not engage in this activity. Zumwalt found no
differences in entheseal attachments between the experimental and the control
group. She suggests three possible explanations: (1) the mature age of the sheep, (2)
inappropriate stimulus to produce morphological change, and (3) failure to surpass
the threshold for inducing morphological change (Zumwalt 2006). Equally, these
data could suggest that entheseal changes do not reflect activity as has previously
been assumed. Further research testing Zumwalt’s three possible explanations for
her findings should be explored to better understand entheseal function. For obvious
reasons, it would quite difficult to conduct a similar experiment on human
specimens.
While this certainly is not a comprehensive review of bioarchaeological research
into entheseal changes, it does summarize some of the major trends. There has
been a general movement from recreating specific activities (e.g., atlatl throwing,
rowing) towards more generalized interpretations of lifeways. As more and more

studies are finding strong evidence for multiple contributing factors to entheseal
changes (e.g., age), researchers are looking for new ways to examine these contrib-
uting factors (e.g., identified skeletal collections, bone structure, animal models), as
well as control for them (e.g., statistics—see discussion below). Many bioarchae-
ologists are turning to clinical research to better understand the physiology of enthe-
ses (e.g., fibrous versus fibrocartilaginous) and what that might mean for skeletal
manifestations of entheseal change. Lastly, some scholars have brought bioarchaeo-
logical theory to entheseal changes data (e.g., osteobiography, care), illustrate the
deeper interpretations of lived experience that can be made using theoretical
models.
ngoing Bioarchaeological Debates: Terminology, Scoring,

O
and Statistics
With such a complicated topic, it is not surprising there remain topics of ongoing
debate within bioarchaeology. Terminology, scoring method, and statistics continue
to central points of discussion within the field. Entheseal changes have a long his-
tory of terminological discussion in bioarchaeology. In previous research they have
been referred to as markers of occupational stress (Hawkey and Merbs 1995;
Kennedy 1989, 1998), activity induced stress markers (Hawkey and Street 1992),
musculoskeletal stress markers (Cashmore and Zakrzewski 2013; Eshed et al. 2004;
Hawkey 1998; Hawkey and Merbs 1995; Lieverse et al. 2009; Molnar 2006; Molnar
et al. 2010; Molnar et al. 2011; Peterson 1998), muscle markers (Weiss 2007);
entheses (or enthesopathy in its pathological form; Alves Cardoso and Henderson
2010; Dutour 1986; Hawkey 1998; Steen and Lane 1998; Villotte et al. 2010),
entheseal remodeling (Hagihara et al. 2015; Schrader 2012), and entheseal changes
(Henderson et al. 2013; Jurmain et al. 2012; Jurmain and Villotte 2010; Lieverse
et al. 2013; Milella et al. 2012; Schrader 2015). The more recent trend toward the
use of the word entheses, a term used in clinical literature, illustrates the link
between medical and bioarchaeological fields. Furthermore, as Jurmain et al. point
out, the use of the term entheseal avoids specifying any etiology (as opposed to
markers of occupational stress, for example), which is particularly important given
the multifactorial nature of entheseal changes (Jurmain et al. 2012; see also Jurmain
and Villotte 2010). Villotte and colleagues have formalized this terminology in a
recent publication, arguing that a consensus on the terminology will “reduce misun-
derstandings between researchers, improve the reliability of comparisons between
studies, and eliminate unwarranted etiological assumptions inherent in some of the
descriptive terms presently used in the literature” (Villotte et al. 2016:49).
In association with the fibrous/fibrocartilaginous studies, many researchers have
suggested new macroscopic ordinal scaling methods be employed to score enthe-
seal changes. There are several proposed methods that look beyond Hawkey and
Merbs’ basic assumption that entheses linearly progress from bone growths, to bone
destruction at the point of overuse, to ossified exostoses (Hawkey and Merbs 1995;
Table 3.1). Villotte and colleagues define an “enthesopathy,” or pathological enthe-
sis, as (1) irregularity at the attachment margin, and/or (2) irregularity, with a mini-
mum of three foramina, cystic changes, calcification deposit, bony production or
osseous defect in the interior enthesis (Villotte 2006, 2009; Villotte et al. 2010; see
also Benjamin et al. 2002; Table 3.2). Mariotti and colleagues, on the other hand,
have argued that entheses vary widely between attachment sites and suggest an
independent scale be used for each entheses (Mariotti et al. 2004, 2007; Table 3.3).
Henderson and colleagues have defined zones of an attachment site to bone (Alves
Table 3.1 Hawkey and Merbs Muscle attachment site scoring method (Hawkey and Merbs
1995:327–329)
Score Description
R0 No signs of robusticity are present
R1 The cortex is only slightly rounded, and often not visible without viewing under a strong
light. There is a slight indentation at the site of attachment, but no well-defined
surrounding margin of bone
R2 The cortical surface is uneven, with a mound-shaped elevation that is easily observable.
No sharp ridges or crests have formed. Roughening of the attachment site occurs, most
often with well-defined surrounding margin of bone.
R3 Distinct sharp crests or ridges have formed. Often there may be a slight depression
between the two crests, but the depression does not extend into the cortex. Deep
indentation occurs with a clearly defined margin of bone. Usually the roughed area has
developed crests of bone.
S1 There is a shallow “furrow,” a pitting into the cortex that has a lytic-like appearance. It is
less than 1 mm in depth.
S2 The pitting is deeper and covers more surface area. It is greater than 1 mm, but less than
3 mm in depth. It may vary in length, but not longer than 5 mm.
S3 The pitting is marked, and greater than 3 mm in depth, or more than 5 mm in length.
Note that Hawkey and Merbs originally proposed three scoring categories: robusticity, stress
lesion, and ossification exostoses. In the original publication, they state that robusticity and stress
lesion categories are thought to occur on a continuum, suggesting that there is a threshold of activ-
ity that any given entheses has; if crossed, the muscle attachment begins to degrade and it loses the
ability to absorb stress (i.e., stress lesion). Ossification exostoses, on the other hand, are thought to
reflect acute trauma.
Table 3.2 Villotte’s entheseal scoring method (Villotte et al. 2010:226)

Score Description
Enthesopathy Well-defined imprint on the bone, without vascular foramina and with a
Absent regular margin
Enthesopathy Irregularity or enthesophyte(s) are located at the outer part and/or irregularity,
Present foramina (at least three), cystic changes, calcification deposit, bony
production, or osseous defect are found at the inner part
Three scoring stages (A, B, C) were defined in Villotte’s original publication of the method
(Villotte 2006). However, in a more recent publication (Villotte et al. 2010), the authors simplified
this method by combining stages B and C to reflect the pathological stage of enthesopathy.
Table 3.3 Mariotti et al.’s scoring method for enthesopathy (Mariotti et al. 2004, 2007)
Score Description
EF-0 Absence of exostotic formations
EF-1 Minimal exostoses (<1 mm)
EF-2 Clear exostoses (1–4 mm)
EF-3 Substantial exostoses (>4 mm)
OL-0 Absence
OL-1 Presence of fine porosity (holes <1 mm in diameter)
OL-2 Diffuse porosity, with holes ca. 1 mm in diameter, or presence of a small area of erosion
(ca. 4 mm in length or diameter)
OL- Presence of several small areas of erosion (ca. 4 mm in length or diameter
3a
OL- At least one extensive and deep osteolytic area (>4 mm in length or diameter)
3b
OL- Trait not recordable: when the enthesis is missing or in a poor state of preservation
nr (more than 50% of the area is illegible) or when alterations are so weak their effective
presence is in doubt
EF enthesophytic formation, OL osteolytic formation; the scoring method for enthesopathy,
reflecting the presence of enthesophytes or osteolytic areas, was presented in Mariotti et al. (2004).
Later, Mariotti and colleagues developed a method for robusticity, indicating what they refer to as
a normal osseous marking (Mariotti et al. 2007). It is here that they describe a scoring methodology
unique to each entheseal change. Please refer to Mariotti et al. (2007) for a description and images
of each of the robusticity scores. A consensus on which scoring method is best to use has yet to be
reached.
Cardoso and Henderson 2010; Henderson et al. 2010, 2012, 2013; Wilczak et al.
2017; Table 3.4). Zone 1 consists of the entheseal margin opposite the acute angle
of attachment, whereas zone 2 is the remaining surface and margin. In zone 1 there
is a three-point scoring system for both bone formation and erosion and in zone 2
there is a two to three point scoring system for bone formation, erosion, fine poros-
ity, and cavitation.
In a recent study, Michopoulou and colleagues tested to see if there was a cor-
relation between scoring method (Hawkey and Merbs 1995; Mariotti et al. 2004;
Villotte et al. 2010) and activity in a documented skeletal collection from Athens
(Michopoulou et al. 2015). Activity was assessed via recorded profession and cross-
sectional geometry. Employing generalized linear modeling, Michopoulou et al.
found that age was the primary factor in the presence of entheseal change and body
mass was the second most important factor. Unfortunately, activity (defined either
by documented profession or cross sectional geometry), rarely influenced entheseal
change expression—this was true for all scoring methods tested. The authors did
find that age and body size varied between the right and left sides and suggest that
because other factors that could potentially impact entheseal changes, such as hor-
mones, would impact both sides and not just one. Michopoulou et al. propose further
research into underlying causes of entheseal changes as the scoring methods cur-
rently in use are not fully assessing this (Michopoulou et al. 2015).
Table 3.4 Henderson et al.’s scoring method for enthesopathya (Henderson et al. 2013:155)
Zone Feature Abbreviation Definition Degrees of expression
Zone Bone BF (Z1) 1 = small, nodular or
1 formation slightly raised margin
<1 mm
2 = distinctive sharp
crests or other
enthesophytes ≥1 mm
but <50% of margin
3 = distinctive sharp
crests or other
enthesophytes ≥50% of
the margin
Erosion ER (Z1) Depressions or excavations of any 1 = <25% of margin
shape and involving discontinuity 2 = 25–50% of margin
of the cortex generally greater in 3 = >50% of margin
width than depth with irregular
margins. Only erosions >2 mm
were recorded
Zone Bone BF 1 = “roughness”/
2 Formation rugosity, change is
diffuse not a distinct
structure
2 = distinct structure
measuring >1 mm,
affecting <50% of
surface
3 = distinct structure
measuring >1 mm,
affecting ≥50% of
surface
Erosion ER Depressions or excavations of any 1 = <25% of surface
shape and involving discontinuity 2 = 25–50% of surface
of the cortex generally greater in 3 = >50% of surface
width than depth with irregular
margins. Only erosions >2 mm
were recorded
Fine FPO Small, round to oval perforations 1 = <50%
Porosity with smooth, rounded margins 2 = ≥50% of surface
≤1 mm
Macro- MPO Small, round to oval perforations 1 = one or two pores
porosity with smooth, rounded margins 2 = >2 pores
>1 mm
Cavitation CA Subcortical cavity with an external 1 = 1 cavitation
opening smaller than the maximum 2 = >1 cavitation
diameter of the cavity
Similarly Palmer et al. compared the Mariotti (Mariotti et al. 2004, 2007) and
Coimbra (Henderson et al. 2013) methods in a post-medieval skeletal collection from
Aalst, Belgium (Palmer et al. in press). The authors found that entheseal scores were
broadly similar between the two scoring methods. However, statistical differences
between the upper and lower limb as well as between males and females (lower
limb), were only found using the Mariotti method. These findings draw into question
the distinction between various proposed methods. Could it be that these methods are
all variations on a theme? Are they simply finding new ways of describing similar
morphological features? Future studies like Palmer et al.’s analysis of Mariotti and
Coimbra methods are needed to better understand the similarities and differences of
the various scoring methods that are currently in use (Palmer et al. in press).
There have also been notable technological advancements in scoring methods,
including the use of three-dimensional scanners (Henderson 2018; Karakostis et al.
2018; Noldner and Edgar 2013; Nolte and Wilczak 2010, 2013; Pany et al. 2009;
Weiss 2015; Zumwalt 2005). However, several methodological issues have been
encountered. Authors report difficulty in delineating the borders of entheses on
skeletal as well as high error rates (Henderson 2018; Nolte and Wilczak 2010; Weiss
2015). Pany and colleagues found promising results using a Breuckmann optotopo-
metric scanner (Breuckmann TriTOS Sensor L39/060 (Pany et al. 2009). Unlike
other studies that had used a NextEngine scanner (e.g., Henderson 2018; Nolte and
Wilczak 2010), Pany and colleagues report a scanned 3D surface area that correlates
with their composite enthesopathy score. While the Breuckmann scanner is more
expensive and produces a relatively large dataset, Pany et al. argue that it makes
delimitation of insertions easier.
Lastly, the manner in which statistical analyses are applied to entheseal changes
data is as variable as osteoarthritis data. Robb succinctly summarizes some inherent
problems with entheseal data;
“Specimens are typically assigned scores according to ordinals graded categories…which
partially dictates an analytical strategy. Ordinal data cannot be analyzed using numerical
methods, which presume fixed, measurable intervals between recording points. On the
other hand, if muscle marking data are analyzed as simple nominal categories, information
about the relative sequence or degree of marking categories is lost. Additional factors to
consider are the pattern of variation muscle scores typically display … and the fact that
missing data are common, so that methods which require a complete data matrix can be
applied to only a fraction of most datasets. In these aspects, muscle marking data are very
similar to osteoarthritis data” (Robb 1998:366)
This ordinal/nominal debate is something that could be altogether avoided if con-

tinuous data, such as is acquired in 3D scanning, could be used. However, as dis-
cussed above, this method for assessing entheseal changes needs further research.
Most frequently, entheseal changes data are presented in the form of mean or
median values for a given population. However, this presents problems as well.
Mean scores tend “to obscure rather than reveal differences between individuals and
groups” (Robb 1998:368). Mean scores are often paired with standard deviation
values, in an attempt to assess the range of entheseal values that is lost in mean or
median score. However, Robb points out that this is mathematically inappropriate
“…since these measures presuppose numerical rather than categorical data” (Robb
1998:368). Weiss supports aggregating entheseal scores into what she refers to as
aggregate groups. In other words, muscles that functionally work together in the
same joint motion (e.g., arm flexion, supination, leg adduction), can be grouped
together. Weiss argues “aggregation reduces error variance and increases reliability
and predictive validity” (Weiss 2003b:296) and has presented this approach in mul-
tiple publications (see Weiss 2003a, b, 2004, 2007; also see Stirland 1998). It is also
important to acknowledge that aggregate data are much easier to present in publica-
tion and presentation (as opposed to listing out dozens of entheses and their respec-
tive mean scores and standard deviations). Several scholars have employed the
aggregate entheseal approach (see Lieverse et al. 2009; Mountrakis and Manolis
2015; Schrader 2012).
In the scenario where entheseal changes are scored as present or absent, such as
Villotte’s scoring method (see above), Fishers exact test can be used to address sta-
tistical differences between two samples (see Villotte et al. 2010). Entheseal data are
often analyzed using nonparametric rank-order statistics (e.g., Spearman’s r, Mann–
Whitney U, Kruskal–Wallis H; see Eshed et al. 2004; Lieverse et al. 2009; Molnar
2006; Molnar et al. 2011; Palmer et al. 2016; Weiss 2007). More recently multivari-
ate analyses (e.g., principal components analysis, multidimensional scaling, dis-
criminant functions, cluster analysis) have been applied to entheseal changes data
(see Havelková et al. 2013; Milella et al. 2015; Santana-Cabrera et al. 2015). Nikita
has proposed generalized linear models and generalized estimating equations
(Nikita 2014; see also Henderson and Nikita 2016; Karakostis et al. 2017;
Michopoulou et al. 2015). Nikita illustrates that generalized linear models and gen-
eralized estimating equations facilitate the same sample comparisons as the non-
parametric tests described above, but additionally, allows for the examination of the
impact of multiple predictors variables (Nikita 2014). Cheverko and Hubbe’s pro-
posal of the use of ANCOVA for age-related markers, discussed above in Ongoing
Bioarchaeological Debates: Definitions, Data, and Statistics, is also applicable to
entheseal changes (Cheverko and Hubbe 2017). ANCOVA allows for a covariate to
be statistically controlled for; in this case, age is recommended as the covariate
given the high correlation between entheseal changes and age in previous bioar-
chaeological studies.
While many hurdles remain for the bioarchaeological analysis of entheseal
changes, there have been major advancements in this area of research in the past
decade. International workshops and organized sessions have facilitated discussion,
collaboration, and inquiry among researchers and speak to the continued interest of
entheseal changes in bioarchaeology. Recently, a workshop on musculoskeletal
stress markers at the University of Coimbra (2009); an organized session at the
American Association of Physical Anthropologist’s 81st (2012) annual meeting,
entitled “Working Nine to Five: The Future of Activity-Related Stress;” an
International Journal of Osteoarchaeology Special Issue (2013), entitled “Entheseal
Changes and Occupation: Technical and Theoretical Advances and Their

Applications;” as well as a conference, entitled “Working Your Fingers to the Bone”
(University of Coimbra, July 2016), are just a few examples that illustrate the
renewed interest in this methodology.
Combination Studies
Assuming that osteoarthritis and entheseal changes are both to some extent caused
by physical activity, several researchers have combined these methods in an attempt
to speak broadly to activity in the past. Molnar et al. examine osteoarthritis and
entheseal changes in two Middle Neolithic samples from Gotland, Sweden (3400–
2300 BCE; Molnar et al. 2011). Two contemporary populations from Ajvide and
Västerbjers, hunter-gatherer-fishers on the island of Gotland, were compared.
Owing to the complicated nature of diagnosing osteoarthritis, particularly in skele-
tal remains (see discussion above), Molnar and colleagues conservatively define
osteoarthritis as eburnation. The relationship between eburnation and entheseal
changes was examined in relation to age, sex, body side, and site. They found ebur-
nation and entheseal changes to be positively correlated with age. Significantly
higher entheseal scores were also found in individuals with eburnation. Males had
higher frequencies of entheseal changes and eburnation at Ajvide, whereas eburna-
tion was more common in females at Västerbjers; these findings may be influenced
by differing age distributions between the two sites. The differences in eburnation
and entheseal changes between the sexes, age groups, and sites, lead the authors to
conclude that other factors, other than activity, may be influencing these
results (Molnar et al. 2011).
Palmer and colleagues examined osteoarthritis and entheseal changes at the post-
medieval Dutch cemetery, Middenbeemster (Palmer et al. 2016). They questioned
(1) whether activity as indicated by osteoarthritis and entheseal changes differed by
socioeconomic status and/or gender, and (2) whether or not osteoarthritis and enthe-
seal changes were correlated. They found high rates of osteoarthritis in the shoulder.
Entheseal changes suggested that men were performing tasks that required heavy
lifting (biceps brachii) and that women were engaging in activities that involved
pushing or pulling objects with a flexed elbow (triceps brachii). The authors hypoth-
esized that individuals of known “elite” status would have fewer and less severe
instances of osteoarthritis and entheseal changes; however, this was not the case.
There were no apparent activity-related differences in socioeconomic status. Palmer
et al. suggest this may be due to (1) the low number of “elite” individuals in the
sample, (2) diverse occupations in this dairy farming community, and (3) the pos-
sibility that there was little social differentiation between socioeconomic groups in
this study. Lastly, Palmer and colleagues also found a low correlation between
osteoarthritis and entheseal changes, which they suggest may be due to differing
etiologies between the two conditions (Palmer et al. 2016).
Woo and Pak examined osteoarthritis and entheseal changes in the shoulder,
elbow, wrist, hip, knee, and ankle in a Korean skeletal sample (Joseon Dynasty;
Woo and Pak 2013). Their primary objectives were to assess activity during this
period and also test whether osteoarthritis and entheseal changes were correlated.
They found that both osteoarthritis and entheseal changes were limited in this popu-
lation, suggesting that these individuals were not habitually physically stressed. The
authors indicate that this may be due to the middle class socioeconomic status that
the people who were buried in this cemetery likely belonged to. Also, the ceme-
tery’s location in the capital city, Seoul, may have inferred a certain social status on
this population. Additional sampling, which includes individuals from various
social strata as well as the inclusion of multiple cemetery samples would further test
this hypothesis. Osteoarthritis and entheseal changes were positively correlated at
the elbow. Furthermore, age was found to correlate with some of the joints exam-
ined for osteoarthritis and some of the entheseal attachment sites. The authors cau-
tion against the assumption that osteoarthritis and entheseal changes are caused by
the same factors and support further research to better understand the complexities
of this topic (Woo and Pak 2013).
In a 2016 publication, Becker takes a life history approach to entheseal changes
and osteoarthritis at the site of Ch’iji Jawira, which belonged to the Tiwanaku
culture of the Bolivian highlands (Becker 2016). She examines the skeletal remains
from a female individual (age 30–39) who displayed evidence of osteoarthritic
degeneration to her arms, wrists, hands, fingers, lumbar spine, sacroiliac joint,
hips, and feet. Marked entheseal changes were also observed on her wrists, hands,
fingers, and feet, suggesting extensive musculature use in these areas. The archae-
ological site that these remains originated from, Ch’iji Jawira, is thought to have
been a pottery manufacturing center and even had a small residential area to the
community that was dedicated to ceramic manufacturers. Becker argues that indi-
vidual CJ-35250, the female discussed above, may have been one of the first
ceramic specialists at Ch’iji Jawira. Crafting, including pottery manufacturing,
includes a significant amount repetitive joint movement, as well as heavy use of
hand and foot musculature. Previous research also suggests that entheseal changes
and osteoarthritis was more pronounced at Ch’iji Jawira compared to other neigh-
borhoods and the capital city of Tiwanaku, giving further credence to the argu-
ment that Ch’iji Jawira may have specialized in pottery production (Becker 2012,
2013, 2017).
In short, research from studies that have combined entheseal changes and osteo-
arthritis are ambiguous. Some suggest that similar causation factors between osteo-
arthritis and entheseal changes underlie the skeletal markers that bioarchaeologists
observe (Becker 2016). While others have found contradictory interpretations and
suggest further research into the etiologies of these conditions is necessary (Molnar
et al. 2011; Palmer et al. 2016; Woo and Pak 2013). Some researchers have also
investigated other morphological changes to the skeletal that may be influenced by
activity and have put forward promising results (see Ibáñez-Gimeno et al. 2013;
Villotte and Knüsel 2014).
Osteoarthritis, Entheseal Changes, and Everyday Life 95
Osteoarthritis, Entheseal Changes, and Everyday Life
Bioarchaeologists can further build upon previous studies by considering osteoar-

thritis and entheseal changes from a theoretically informed perspective. If we con-
tend that these conditions are related to repetitive and strenuous physical activity
(while taking into consideration the confounding factors discussed above), skeletal
indicators can be used as evidence of daily life. As discussed in Chap. 2, addressing
day-to-day life in the ancient past is highly meaningful—providing a deeper under-
standing of how people actually lived, not in terms of dramatic or enthralling events,
but rather on a more mundane level. This includes consideration for what types of
activities people did on a repetitive basis. As bioarchaeologists, we typically cannot
speak to what exact activities were practiced; however, if we compare two individu-
als of the same sex and age cohort, and one individual has marked osteoarthritis/
entheseal changes while the other has virtually none—one possible conclusion is
that the first individual’s day-to-day life was considerably different from the second.
These findings can speak to broader topics in social archaeology, such as the variety
of social identities and/or the social, economic, and political organization of past
populations.
There are important caveats to viewing osteological indicators of activity through
the lens of everyday practice. For osteoarthritis, lipping, porosity, and eburnation
should be conceptualized as the sum, so to speak, of a lifetime of movements,
actions, and events. Others have addressed the fact that osteoarthritis is cumulative
(Denko 1993; Ortner and Theobald 1993); once the soft tissue system begins to
deteriorate, continued use of the joint will only worsen the condition. There is no
possibility of a joint repairing lipping or eburnation, for example. Thus, the skeletal
indicators of osteoarthritis observed by bioarchaeologists are the unidirectional, end
result of this gradual process. With this in mind, it becomes clear why comparisons
between individuals/groups should always be made with age in mind.
Entheseal changes offer a different perspective on the everyday lives of the indi-
vidual or population being examined. To begin, in young individuals, excessive
mechanical stress, either in terms of frequency, speed, and/or intensity, can contrib-
ute to microtraumatic entheseal damage (Villotte and Knüsel 2013). However,
whether or not and to what degree this trauma can be remodeled is unknown. With
age, “the amount of denatured collagen and proteolytic cleavage of matrix compo-
nents increase…these changes lead to deterioration in the physical properties of the
tendon, which in turn, may favour the occurrence of mechanically induced altera-
tions in the enthesis” (Villotte and Knüsel 2013:139). Villotte and Knüsel identify
the sixth decade of life as a point in which fibrocartilaginous entheses become the
target of degenerative processes and are prone to (1) microtears or microdamage,
(2) formation of enthesophytes, (3) disturbance of collagen fibers and the organiza-
tion of cell columns, (4) calcific deposits, (5) increase in the thickness of the calci-
fied fibrocartilage layer, (6) vascularization of the calcified and uncalcified
fibrocartilage layers, and (7) erosion of the surface and bone resorption under the
entheses (Villotte and Knüsel 2013:139–140). This should be kept in mind when
Table 3.5 Osteoarthritis at Kerma: Burials 425.D and IC

Left Right
425.D IC 425.D IC
L P E L P E L P E L P E
Shoulder Glenoid fossa 0 0 0 1 3 0 0 0 0 – – –
Prox. humerus 0 0 0 1 1 0 0 0 0 1 1 0
Elbow Dist. humerus 0 0 0 0 0 0 0 0 0 0 0 0
Prox. ulna 0 0 0 1 1 0 0 0 0 1 1 0
Prox. radius 0 0 0 0 0 0 0 0 0 0 0 0
Wrist Dist. ulna 0 0 0 0 0 0 0 0 0 0 0 0
Dist. radius 0 0 0 1 1 0 0 0 0 1 1 0
Hip Acetabulum 0 0 0 – – – 0 0 0 1 1 0
Prox. femur 0 0 0 1 1 0 – – – 1 1 0
Knee Dist. femur 0 0 0 1 3 0 0 0 0 2 3 0
Prox. tibia 0 0 0 0 0 0 0 0 0 1 3 0
Ankle Dist. tibia 0 0 0 0 0 0 0 0 0 0 0 0
L lipping, P porosity, E eburnation
using entheseal changes to assess patterns of everyday life. In young and middle
adults we could be viewing skeletal changes associated with manual labor and
repetitive actions. However, this becomes less likely with increasing age.
The resolution on these methods is not refined enough to, for example, determine
when exactly an individual started/stopped frequent and strenuous activities. With
the age-progressive nature of osteoarthritis and entheseal changes, perhaps bioar-
chaeologists can turn to the young and middle adult individuals in their samples to
better understand ancient lifeways. As of yet, this discussion is applicable to those
specimens who are not aged as 60+; due to the degenerative processes that target
entheses during and beyond the sixth decade of life, their relationship becomes
much less clear. This is not to discourage bioarchaeologists from collecting or ana-
lyzing these data, but rather to examine them with a degree of caution.
To illustrate these points, I draw on data from an Ancient Nubian example. The
data presented in Tables 3.5 and 3.6 are from two young adult (18–29) males from
the Kerma cemetery, which is located ~10 km south of the Third Cataract of the Nile
(Fig. 3.8). Kerma was a Bronze Age culture that flourished in the Middle Nile region
from the Third-Second Millennia BCE (c. 3200–1500 BCE).4 The capital city of
Kerma, typesite of the Kerma culture, is located 4 km east of the cemetery. The
cemetery includes massive burial tumuli (the largest of which is 90 m in diameter),
minor tumuli (10–50 m), and subsidiary burials (built into the tumuli after their
closure). Excavated in 1913–1916 by George Reisner, the cemetery was originally
thought to have contained 20,000–40,000 burials (Edwards 2004). The size and
wealth of the burial tumuli suggest that this was a royal and/or elite cemetery
(termed “chiefs,” by Reisner). However, in addition to the royal/elite burials, Reisner
4
It should be noted, that all burials discussed in this chapter are from the same time period, the
Classic Kerma Period (1650–1500 BCE; Bonnet 1990).
Table 3.6 Entheseal changes at Kerma: Burials 425.D and IC

Left Right
425.D IC 425.D IC
Shoulder M. supraspinatus/ 3 2 3 2
M. infraspinatus
M. subscapularis 2 2 – 3
M. teres minor 2 2 3 1
Elbow M. triceps brachii 1 1 1 2
M. brachialis 1 4 2 4
M. biceps brachii 2 3 2 3
M. brachioradialis – – – 3
Wrist Common extensors 2 3 2 3
Common flexors 1 2 2 2
Hip M. semimembranosus/ – 3 – –
M. semitendinosus/
M. biceps femoris
M. gluteus medius 3 4 – –
M. gluteus minimus 3 4 – –
M. iliopsoas 2 3 – 3
M. quadratus femoris 1 3 – 3
Knee M. gastrocnemius 3 5 2 6
Patellar ligament 1 4 1 4
M. popliteus 3 3 2 1
also noted the presence of what he interpreted to be “sacrificial” burials (Reisner

1923a, 1923b). These individuals had fewer grave goods and were typically placed
in non-focal areas (e.g., on the ground, in a central corridor), whereas the chiefs
were always buried on traditional Nubian burial beds in prominent locations (e.g.,
on a burial bed). Furthermore, the sacrificial burials were thought to have forfeit
their lives to follow their leaders into the afterlife (Reisner 1923a). The most sub-
stantial example of these sacrificial burials is in the central corridor of Tumulus X,
where 322 (estimated to be originally ~400) people were seemingly buried in a
single inhumation event (Reisner 1923a, 1923b). Whether or not these individuals
were actually sacrificed is debated–there are no osteological indicators of homicide
(e.g., perimortem trauma; Judd and Irish 2009); of course, these individuals could
have been put to death by other means that did not involve skeletal damage, includ-
ing artery severing or poisoning. Buzon and Judd examined physiological stress
indicators in sacrificial and non-sacrificial burials from Kerma (Buzon and Judd
2008). No statistically significant differences in physiological stress indicators were
found between these two groups; however, the authors do discuss the possibility of
differential risk of death between these two groups.
Osteoarthritis data were recorded according to Buikstra and Ubelaker and the
Hawkey and Merbs method was used to assess entheseal changes (Buikstra and
Ubelaker 1994; Hawkey and Merbs 1995). While Hawkey and Merbs’ scoring sys-
tem has been critiqued for low interobserver error rates (see Davis et al. 2013), I
Fig. 3.8 Map of Kerma
collected all data presented in this publication and thus, interobserver error does not
apply. While the Hawkey and Merbs method does not possess the same detail and
refined description as recently proposed methods, it does broadly encapsulate the
buildup and gradual breakdown of entheseal changes in an easy to use and straight-
forward ordinal scale. Lastly, age and sex estimation were based on accepted bioar-
chaeological methods (pubic symphysis and auricular surface degeneration and
pelvic and cranial morphology, respectively; Buikstra and Ubelaker 1994).
Subadults were not included in the sample.
While this is certainly an interesting burial context, what can be said about the
everyday lives of these individuals? If we look at rates of osteoarthritis and enthe-
seal changes between two individuals, 425.D and IC, differing life stories appear.
Despite being of the same sex and age group, individual IC has more osteoarthritic
lipping and porosity than burial 425.D, which can be characterized by an absence of
skeletal indicators of osteoarthritis. The fact that porosity is occurring in association

with marginal lipping lends credence to a common causal factor, as opposed to
increased vascular activity alone. Furthermore, drawing on the example by Becker
and Goldstein discussed above (Previous Bioarchaeological Approaches to
Osteoarthritis), synovial degeneration at such a young age may indicate intensive
and repetitive work starting in young adulthood or even childhood (Becker and
Goldstein 2018).
The entheseal changes data provide another perspective on the broadly defined
physical activities these individuals may have engaged in. For many of the entheses
listed, individual IC has more severe entheseal changes, some of which were so
severe they were beginning to erode (e.g., M. brachialis, M. gastrocnemius). In
combining osteoarthritis and entheses data from these two examples, we can begin
to address a facet of their everyday experience. Individual 425.D may have been
somewhat physically active, reflected by low to moderate entheseal scores, this
activity may not have been prolonged or intense enough to cause significant enthe-
seal remodeling (i.e., scores 4–6) or synovial joint degeneration. Individual IC,
however, may have been regularly engaging in strenuous actions that not only
caused muscle growth leading to moderate to severe entheseal change but also put a
greater amount of stress on their synovial structures, leading to joint space narrow-
ing, cartilage thinning, and an eventual skeletal response to this process. From this,
we can infer that over years of routine strenuous labor, individual IC’s musculoskel-
etal system began to erode, while individual 425.D was likely not as physically
active; this assessment is particularly interesting when one considers the young age
of these individuals. The broader archaeological context at Kerma makes these find-
ings even more compelling.
Burial IC and 425.D were inhumed in disparate contexts, which may be reflec-
tive of the social significance these individuals maintained in life—burial 425.D
was a part of a subsidiary tomb cut into the larger structure of Tumulus IV (Fig. 3.9),
while burial IC was found in a mass grave associated with Tumulus X. Within sub-
sidiary pit 425, seven bodies were buried (three males, three females, and one sub-
adult), four of which were placed on traditional Nubian-style funerary beds
(Fig. 3.10; Reisner, 1923a, b); the other three individuals were buried on the ground,
below two of the burial beds. The burial of note here (Burial D) was interred on the
largest of the three beds with a bronze dagger; this, in addition to the fact that the
skeleton was male, led Reisner to argue that individual D was the primary burial or
chief. He also interpreted the other six burials to be sacrifices, with the adult burial
nearest the chief (Burial B) to be the “favorite wife” (Reisner, 1923a:215). Again, it
is unclear if these burials were sacrificial or what relationship they may have had
with the primary inhumation. What is particularly interesting is the contrast in
funerary tradition between the chiefs, such as 425.D, and mass grave corridor sacri-
fice burials, such as IC.
In each of the large tumuli at Kerma, massive central corridors bisected the struc-
tures (Fig. 3.11). These served as architectural supports and mass graves. Within
each of the corridors, between 12 and 322 individuals were found. Many are buried
in a tradition Kerma-style burial position (flexed, on right side, hands near/on/under
Fig. 3.9 Plan view of Tumulus IV at Kerma Cemetery (subsidiary tomb #425 in circle; adapted
from Reisner 1923a:193)
face, with the head towards the east and feet towards the west; Kendall 1996).
However, Reisner argues that if these people had been killed prior to being placed
in the corridors, they would all be buried in the same uniform position (described
above). However, because a minority of burials were found with extremities in vari-
ous positions, as well as the head in the hands or between the elbows, he concludes
that “…many of these bodies are in attitudes which could only be the result of fear,
resolution under pain or its anticipation, or the other movements which would natu-
rally arise in the body of perfectly well persons suffering a conscious death by suf-
focation” (Reisner 1923a:70). As discussed above, this has yet to be determined.
However, the mortuary context of these corridor burials was certainly much differ-
ent than the subsidiary burials.
Individual IC, as an example, was one of 322 individuals that were excavated
from the main hallway in Tumulus X (Fig. 3.12). The burial was in a flexed position,
with the hands over the face, but was facing south instead of north. There were no
Fig. 3.10 Subsidiary Tomb #425 (individual D highlighted; adapted from Reisner 1923a:214)
grave goods found in association with this individual—some of the corridor burials
were interred with leather caps/skirts, daggers, beaded necklaces/bracelets, and
other jewelry. However, the quality and quantity of grave goods was much greater
in the subsidiary tombs than the corridor. With this mortuary context in mind, we
can analyze the osteoarthritis data within a biocultural framework. While we cannot
speak to specific social rank or activity, we can put forward the hypothesis that indi-
vidual IC was part of a lower socioeconomic status and may have been engaging in
physically strenuous activities. Conversely, individual 425.D, with the wealthy
grave goods and multi-person burial, may have been of a higher socioeconomic and/
or sociopolitical status resulting in limited entheseal changes and osteoarthritis.
It is difficult to make these hypotheses of individuals hold up to scrutiny–perhaps
IC was genetically prone to osteoarthritis? There may have been a significant weight
difference between the two individuals, contributing to the progression of osteoar-
thritis in one and not the other. One way to further test our hypothesis is to look at
the population level and see if similar differences between burial types hold. Tables
3.7, 3.8, 3.9, 3.10, 3.11, and 3.12 present the osteoarthritis and entheseal data for
Fig. 3.11 Plan view of Tumulus X at Kerma Cemetery (Central corridor highlighted; adapted
from Reisner 1923a:Plan XXI)
Fig. 3.12 Central corridor of Tumulus X (Burial IC highlighted; adapted from Reisner 1923a:
Plan XXIII, XXIV)
chiefs (such as 425.D), subsidiary burials (such as those buried alongside 425.D),
and sacrificial corridor burials (such as IC). Unfortunately, sample sizes for these
categories are limited, particularly for chiefs and corridor burials; this is likely a
product of (1) a small number of chiefs compared to the rest of the population, and
Table 3.7 Osteoarthritis at Kerma in young adults

Left Right
Chief Subsidiary Corridor Chief Subsidiary Corridor
% n N % n N % n N % n N % n N % n N
Glenoid Fossa 0% 0 1 0% 0 19 0% 0 3 0% 0 2 8% 1 13 20% 1 5
Prox. Humerus 100%a 1 1 7% 1 15 40% 2 5 0% 0 2 0% 0 16 33%a 2 6
Dist. Humerus 0% 0 1 0% 0 17 0% 0 5 0% 0 1 0% 0 21 0% 0 6
Prox. Ulna 0% 0 2 0% 0 17 33%a 2 6 0% 0 2 12% 2 17 40% 2 5
Prox. Radius 0% 0 1 0% 0 17 0% 0 6 0% 0 2 0% 0 19 0% 0 5
Dist. Ulna 0% 0 2 0% 0 12 0% 0 3 0% 0 2 0% 0 14 0% 0 3
Dist. Radius 0% 0 1 0% 0 15 17% 1 6 50%a 1 2 0% 0 17 0% 0 3
Acetabulum 0% 0 1 0% 0 19 20%a 1 5 – – – 0% 0 18 0% 0 3
Prox. Femur 0% 0 2 5% 1 19 33% 2 6 0% 0 2 6% 1 17 25% 1 4
Dist. Femur 0% 0 2 0% 0 18 33%a 2 6 0% 0 2 5% 1 19 40%a 2 5
Prox. Tibia 0% 0 2 0% 0 19 20%a 1 5 0% 0 2 0% 0 21 0% 0 5
Dist. Tibia 0% 0 2 0% 0 17 0% 0 5 0% 0 2 0% 0 19 0% 0 4
Data organized into presence/absence (Larsen 2015); present = discernible lipping/porosity and/or
eburnation
a
Significantly higher (p ≤ 0.05) than comparable subsidiary burial category (Chi-square applied
when sample sizes ≥10; Fisher’s exact applied when sample sizes <10)
Table 3.8 Osteoarthritis at Kerma in middle adults

Left Right
% n N % n N % n N % n N % n N % n N
Glenoid 0% 0 3 21% 9 43 29% 2 7 40% 2 5 30% 13 44 38% 5 13
Fossa
Prox. 20% 1 5 19% 9 48 53%a 10 19 33% 2 6 30% 16 53 33% 9 27
Humerus
Dist. 0% 0 5 2% 1 52 10% 2 21 17% 1 6 5% 3 64 10% 3 29
Humerus
Prox. Ulna 0% 0 4 17% 7 42 10% 2 20 20% 1 5 16% 8 51 32% 8 25
Prox. Radius 0% 0 3 2% 1 41 0% 0 17 0% 0 6 2% 1 45 0% 0 22
Dist. Ulna 0% 0 4 0% 0 29 14%a 2 14 0% 0 4 10% 4 39 13% 2 15
Dist. Radius 0% 0 3 10% 4 41 5% 1 19 0% 0 6 5% 2 43 14% 3 21
Acetabulum 29% 2 7 31% 16 52 40% 6 15 40% 2 5 29% 15 51 31% 5 16
Prox. Femur 14% 1 7 11% 6 55 20% 4 20 14% 1 7 15% 8 54 20% 5 25
Dist. Femur 0% 0 7 16% 8 49 22% 4 18 17% 1 6 21% 11 52 20% 5 25
Prox. Tibia 0% 0 6 12% 6 51 16% 3 19 0% 0 7 11% 6 54 19% 4 21
Dist. Tibia 0% 0 5 0% 0 44 0% 0 17 0% 0 6 0% 0 44 5% 1 19
eburnation
a
Significantly higher (p ≤ 0.05) than comparable subsidiary category; (Chi-square applied when
sample ≥10; Fisher’s exact applied when sample <10
Table 3.9 Osteoarthritis at Kerma in old adults

Left Right
% n N % n N % n N % n N % n N % n N
Glenoid Fossa 100% 3 3 50% 5 10 33% 1 3 0% 0 2 60% 6 10 78% 7 9
Prox. Humerus 25% 1 4 31% 4 13 56% 5 9 0% 0 2 29% 4 14 57% 8 14
Dist. Humerus 0% 0 4 0% 0 14 0% 0 8 25% 1 4 6% 1 17 13% 2 15
Prox. Ulna – – – 17% 2 12 10% 1 10 0% 0 2 31% 4 13 33% 3 9
Prox. Radius 0% 0 2 8% 1 12 14% 1 7 0% 0 1 0% 0 11 10% 1 10
Dist. Ulna 100% 1 1 10% 1 10 0% 0 5 0% 0 1 11% 1 9 9% 1 11
Dist. Radius 0% 0 2 18% 2 11 13% 1 8 0% 0 1 15% 2 13 13% 1 8
Acetabulum 67% 2 3 55% 6 11 67% 6 9 67% 2 3 50% 6 12 71% 5 7
Prox. Femur 20% 1 5 22% 2 9 69%a 9 13 25% 1 4 20% 2 10 38% 5 13
Dist. Femur 0% 0 4 38% 3 8 23% 3 13 0% 0 4 18% 2 11 8% 1 12
Prox. Tibia 33% 1 3 27% 3 11 56% 5 9 25% 1 4 10% 1 10 33% 4 12
Dist. Tibia 0% 0 3 0% 0 8 10% 1 10 0% 0 3 0% 0 9 0% 0 9
eburnation
a
Significantly higher (p ≤ 0.05) than comparable subsidiary category; (Chi-square applied when
sample ≥10; Fisher’s exact applied when sample <10
(2) post-excavation treatment of skeletal remains.5 The limited sample sizes

contributed to the decision to combine male and female data. While this is not ideal,
it does provide a generalized overview of some of the osteoarthritis/entheseal differ-
ences between these burial categories. Sacrificial corridor burials regularly had
more osteoarthritis and higher entheseal scores than either chiefs or subsidiary buri-
als. Overall, these data support the findings of individuals 425.D and IC.
Those individuals who were interred in the central corridors frequently had
higher rates of osteoarthritis and entheseal changes than either the chief or subsid-
iary burials. Many of these comparisons were statistically significant. These data
suggest that physical activity, broadly interpreted, was intensive and frequent for
individuals that were buried in the tumuli corridors. Their day-to-day lives may
have been characterized by strenuous manual labor that directly impacted their mus-
cles/ligaments as well as joint systems. This may have started at a young age seeing
as how degenerative changes to the joint systems as well as entheseal changes are
already present among the young adult sample. Drawing on the broader archaeo-
logical context of the Kerma city and habitation sites, these activities may have
included agropastoralism, construction efforts, loading/unloading boats, and defen-
sive efforts (Bonnet 1992; Bonnet and Valbelle 2007; Trigger 1976). The chiefly and
subsidiary burials had lower frequencies and mean scores for osteoarthritis and
entheseal changes and, thus, may have been engaging in less strenuous and frequent
5
Many of the skeletal remains excavated by Reisner were not curated; there are approximately 200
individuals now housed at the Duckworth Museum at Cambridge University—the location of the
remaining thousands of skeletons that Reisner excavated are unknown.
Table 3.10 Entheseal changes at Kerma in young adults
Left Right
x n SD x n SD x n SD x n SD x n SD x n SD
M. supraspinatus/ 3.0 1 – 1.7 12 0.78 2.4 5 1.14 2.5 2 0.71 1.7 14 1.07 2.3 6 1.37
M. infraspinatus
M. subscapularis 1.0 1 – 0.7 11 0.79 1.3 4 0.50 1.0 2 0.00 0.8 11 1.17 2.2a 6 2.04
M. teres minor 3.0 1 – 0.8 12 0.94 1.8 5 1.48 2.5 2 2.12 1.2 13 1.17 1.5 6 1.76
M. triceps brachii 0.5 2 0.71 0.7 17 0.92 1.8a 4 0.96 0.5 2 0.71 0.9 14 0.92 2.7a 3 0.58
M. brachialis 2.0 2 0.00 1.9 17 0.99 2.4 5 1.14 2.0 2 0.00 1.6 17 1.12 2.4 5 1.67
M. biceps brachii 2.0 1 – 1.6 17 1.06 2.6 5 0.89 3.0 2 1.41 2.2 19 1.21 2.8 5 0.84
M. brachioradialis 1.0 1 – 1.3 13 0.85 1.3 6 0.82 2.0 2 1.41 1.0 13 0.71 2.0 1 –
Common extensors 3.0 1 – 2.2 15 0.94 3.0 5 1.22 3.0 1 – 2.0 16 1.15 3.4a 5 1.14
Common flexors 2.0 1 – 1.4 16 0.96 1.8 5 0.84 2.0 1 – 1.1 17 0.93 2.0 5 1.22
M. semimembranosus/ – – – 1.5 16 1.03 2.3 4 1.50 – – – 1.7 15 1.29 1.7 3 1.15
M. semitendinosus/
M. biceps femoris
M. gluteus medius 3.0 2 0.00 2.0 15 1.00 2.5 4 1.29 3.0 2 1.41 2.2 14 1.48 3.3 4 1.89
M. gluteus minimus 3.5 2 0.71 2.4 16 1.26 3.3 4 0.50 3.0 2 0.00 2.3 13 1.25 3.3 4 1.89
M. iliopsoas 2.0 2 1.41 1.9 16 1.34 1.8 5 1.30 2.0 2 1.41 2.0 16 1.21 2.0 3 1.00
M. quadratus femoris 2.0 2 0.00 1.7 18 0.89 1.8 5 1.30 2.0 2 1.41 1.6 18 1.46 2.3 3 0.58
M. gastrocnemius 2.0 2 1.41 1.5 17 0.94 2.4 5 1.95 2.0 2 1.41 1.6 17 0.86 2.5 4 1.00
Patellar ligament 0.0 1 – 1.4 18 1.54 2.5 4 1.00 0.0 1 – 1.0 18 1.14 3.0a 3 1.00
M. popliteus 0.5 2 0.71 0.9 16 1.20 2.0 4 1.83 0.5 2 0.71 0.8 19 1.01 0.3 3 0.58
a
Significantly higher (Mann–Whitney U; p ≤ 0.05) than comparable subsidiary burial category
105
Table 3.11 Entheseal changes at Kerma in middle adults
106
Left Right
M. supraspinatus/ 2.6 5 1.82 2.7 38 1.28 3.3 16 1.13 2.8 6 1.83 3.1 49 1.19 3.2 25 0.96
M. infraspinatus
M. subscapularis 2.0 5 2.12 1.7 33 1.24 2.9a 12 1.62 2.3 6 1.75 2.2 45 1.48 3.0a 23 1.55
M. teres minor 1.8 5 1.30 1.8 33 1.18 2.6 11 0.92 2.0 6 1.41 2.0 46 1.28 2.7a 22 1.43
M. triceps brachii 1.8 4 1.71 1.6 39 1.35 2.3 18 1.78 1.6 5 1.52 1.7 46 1.37 1.8 24 1.06
M. brachialis 1.8 4 0.50 2.2 41 1.44 2.9 18 1.55 2.0 5 1.22 2.8 51 4.62 2.9 24 1.12
M. biceps brachii 2.0 4 0.82 2.6 47 1.19 3.1 18 1.11 2.0 6 0.63 2.6 43 1.28 3.0c 22 1.25
M. brachioradialis 1.3 3 0.58 1.7 34 1.04 2.0 18 1.14 1.6 5 1.14 1.5 34 0.86 3.6 20 1.10
Common extensors 3.6 5 1.67 3.2 47 1.11 3.6 20 1.10 3.8 6 1.47 3.1 56 1.16 3.4 28 0.99
Common flexors 1.8 5 1.30 1.8 49 1.06 2.2 20 1.06 2.3 6 1.63 2.0 54 1.08 2.1 28 1.01
M. semimembranosus/ 4.4a,b 5 0.55 3.1 40 1.22 3.5 15 0.74 3.6 5 0.55 3.3 43 1.37 3.5 13 0.78
M. semitendinosus/
M. biceps femoris
M. gluteus medius 3.8 6 0.75 3.4 41 1.37 3.6 17 1.54 3.7 7 0.49 3.4 46 1.24 4.0a 22 1.20
M. gluteus minimus 3.8 6 0.98 3.3 41 1.29 3.8 17 1.48 3.7 7 1.25 3.3 49 1.12 4.0a 22 0.90
M. iliopsoas 2.9 7 1.57 2.6 49 1.34 3.5a 16 1.37 2.7 6 1.03 2.6 47 1.12 3.3a 18 1.32
M. gastrocnemius 2.4 7 0.98 2.2 41 0.95 3.0a 17 0.79 2.2 6 0.98 2.7 42 2.88 2.6 21 1.07
Patellar ligament 2.3 6 1.03 2.0 46 1.33 2.6a 17 1.23 2.6 7 1.27 2.0 49 1.31 2.4a 22 1.56
M. popliteus 2.4 5 1.14 1.6 42 0.97 1.9 12 1.16 1.8 5 0.45 1.6 43 1.30 1.8 19 1.08
a
Significantly higher (Mann–Whitney U; p ≤ 0.05) than comparable subsidiary burial category
b
Significantly higher (Mann–Whitney U; p ≤ 0.05) than comparable corridor burial category
c
Significantly higher (Mann–Whitney U; p ≤ 0.05) than comparable chief burial category
3 Bioarchaeological Approaches to Activity Reconstruction
Table 3.12 Entheseal changes at Kerma in old adults
Left Right
M. supraspinatus/ 3.8 4 2.06 3.6 13 1.33 3.3 9 1.32 4.0 1 – 3.4 13 1.33 3.9 14 1.33
M. infraspinatus
M. subscapularis 2.5 2 2.12 3.3 8 1.28 2.8 4 0.50 4.5 2 0.71 2.8 12 1.80 3.1 11 1.22
M. teres minor 2.0 2 2.83 3.3 9 1.58 3.6 7 0.98 3.0 1 – 2.7 11 1.27 3.7 10 0.82
M. triceps brachii – – – 2.7 10 1.64 1.7 10 1.25 1.0 1 – 2.1 11 1.30 2.2 10 1.23
M. brachialis – – – 2.4 10 1.07 2.8 10 1.32 3.0 2 1.41 2.6 11 1.03 2.9 10 1.10
M. biceps brachii 3.0 2 0.00 3.6 11 1.57 2.8 8 1.04 3.0 2 0.00 2.9 12 1.24 3.5 11 1.21
M. brachioradialis – – – 2.8 9 0.67 2.3 4 1.50 3.0 1 – 2.7 9 0.71 2.2 5 0.84
Common extensors 4.0 4 1.41 3.5 11 0.82 3.4 7 0.53 5.0 2 1.41 3.9 16 1.15 4.2 12 1.03
Common flexors 2.7 3 0.58 1.7 10 0.48 2.8 8 1.16 3.5 2 0.71 2.1 15 0.92 2.8 14 1.37
M. semimembranosus/ 4.5 2 0.71 4.3 7 1.38 5.0 8 0.76 4.0 2 1.41 3.9 9 1.17 4.9 7 1.46
M. semitendinosus/
M. biceps femoris
M. gluteus medius 3.0 1 – 4.0 7 1.63 3.8 9 1.20 4.0 4 1.15 4.3 7 1.38 4.2 12 1.03
M. gluteus minimus 3.5 2 0.71 3.6 8 1.30 4.0 9 1.41 3.5 4 1.73 3.9 7 1.21 3.8 12 1.19
M. iliopsoas 3.6 5 1.14 3.6 9 1.13 3.7 9 1.50 3.8 4 1.26 3.1 9 1.83 3.7 10 1.77
M. gastrocnemius 2.0 2 0.00 2.3 8 1.16 2.5 12 1.09 2.3 4 0.96 2.6 8 1.77 1.7 11 0.90
Patellar ligament 1.7 3 0.58 3.0 8 1.69 3.0 11 1.18 2.5 4 1.29 3.0 10 1.33 3.0 12 0.95
M. popliteus 1.5 4 0.58 1.9 7 1.07 2.3 10 1.16 1.3 3 0.58 2.0 7 0.82 2.9 7 1.35
Note: Statistical analysis was not performed on the old adult sample given the problematic nature of entheseal changes in older individuals
107
actions. Their everyday experience may have involved activities such as bureau-
cratic meetings, scribal duties, recreational sports, and/or hunting (Bianchi 2004).
Moreover, it is particularly interesting that osteoarthritis and entheseal changes
between the chiefly and subsidiary burials were markedly similar; this is a point I
have made elsewhere (see Schrader 2015). Perhaps the everyday lives of those
deemed subsidiary sacrifices and chiefs by Reisner were not all that different from
one another. The skeletal embodiment of social disparities in the form of osteoar-
thritis and entheseal changes have been documented elsewhere (see Havelková et al.
2013; Yonemoto 2016; Zhang et al. 2017)
This assessment of physical activity and everyday experience can further eluci-
date Ancient Kerma society. Given that Kerma was a state level society, complete
with monumental architecture, international trade, and expansive political power, it
would not be surprising if social inequalities existed. I propose that the burial con-
text, grave goods (quantity and quality), as well as the activity reconstruction data
presented here, all serve as evidence to suggest that the individuals interred in the
corridors were of a lower social stratum than those interred in the subsidiary tombs
(including chiefly burials). If this was the case, it is not surprising that their day-to-
day lives differed. Whether or not the corridor population was able to assert agency
via the quotidian physical activities discussed in this chapter is unclear. These indi-
viduals certainly were agentive in some form, whether or not they could express that
agency through manual labor is unknown. The next chapter will explore dietary
reconstruction as a possible venue for agentive expression, particularly in popula-
tions that may be under some degree of social, political, or economic control.
Summary
In this chapter I have discussed the current state of osteoarthritis and entheseal
research within bioarchaeological studies. With the aim of reconstructing physical
activity in the past, these areas of research remain promising and fruitful. Villotte
and Knüsel identify three factors for the continued interest in activity reconstruction
in bioarchaeology:
1. The areas of tendon or ligament attachment are usually easily visible on dry
bones
2. Entheses exhibit a number of morphological variations, with more or less pro-
nounced changes, such as irregularity and porosity, so changes can be scored
3. As entheses are regularly under heavy strain during physical activity, changes
can, hypothetically, be used to reconstruct past physical activities (Jurmain and
Knüsel 2013:135)
As with many methodological approaches, there are complicating factors to
these techniques. However, when causal factors, such as age, are taken into consid-
eration, broad interpretations of activity can be productive. More specifically, this
chapter has drawn attention to how osteoarthritis and entheseal changes can be
References 109
interpreted not only in terms of patterns of physical activity but also everyday life.
Using burials from the Ancient Nubian cemetery at Kerma as examples, I have pre-
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cultural milieu. These differences are manifest not only in the mortuary context but
also on the skeleton. Rates of osteoarthritis and entheseal changes varied between
those individuals who were buried in the central corridors of the tumuli versus those
individuals who were buried in subsidiary tombs. Physical activity is one complex
facet of everyday experience; there are other methods in a bioarchaeologist’s tool-
kit, such as dietary reconstruction, that can further address the quotidian.
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Chapter 4
Examining Diet and Foodways via Human
Remains
The function of food, both in terms of bodily sustenance as well as social signifi-
cance, is both complex and diverse. Most basically, dietary consumption serves as a
source of necessary nourishment. Caloric matter is masticated and saliva begins the
breakdown process via digestive enzymes (amylase, lipase; Pedersen et al. 2002).
After being swallowed, ingested material continues through the esophagus and is
further broken down by the gastric acids of the stomach. In the small intestine, pro-
teins, lipids, and the majority of carbohydrates are absorbed into the blood vessels
lining the wall of the intestine and then further metabolized. The large intestine
absorbs water, vitamins K, B12, thiamine and riboflavin, and a small proportion
(approximately 10% in humans) of undigested carbohydrates and is host to a thriv-
ing microbiome (Eckburg et al. 2005; McNeil 1984). After nutrient and water
extraction is complete and the consumable has passed through the entire digestive
tract it is excreted as fecal matter. Within anthropological literature, this process has
been and continues to be scrutinized particularly as it relates to nonhuman primates
and human evolution (Aiello and Wheeler 1995; Breslin 2013; Carmody and
Wrangham 2009; Dufour et al. 2013; Hladik et al. 1999; Milton 1999; Ulijaszek
et al. 2012; Wrangham et al. 1999).
Importantly, in humans, food encompasses much more than the biological pro-
cesses of digestion. Humans select certain foods based on multiple factors including
access, taste, medicinal treatments, taboos, socioeconomic status, religious prac-
tices, social identity, etc. (Bourdieu 1984; Falk 1991; Messer 1984; Mintz and Du
Bois 2002; Rozin 1996; Sobal et al. 2014). Humans prepare foods in varied ways,
from cooking food to adding seasonings and mixing ingredients to create more
complex meals (Counihan and Kaplan 2013; Gumerman 1997; Lévi-Strauss 1966).
This preparation element is not only a cultural process, as people draw on familial
recipes/techniques and social memory, but also can have biological consequences
(e.g., sanitization benefits of using fire when cooking meat; Wrangham 2009).
Humans present foods for special occasions and guests (e.g., feasts, weddings, reli-
gious ceremony; Goody 1982). Lastly, humans bioculturally consume food as is
described above; however, unlike nonhuman primates, we are also cognizant of the

https://doi.org/10.1007/978-3-030-02544-1_4
128 4 Examining Diet and Foodways via Human Remains
intimate nature of consumption as our bodies break down and absorb food and
incorporate it into our corporeal selves (Fischler 1988). An excellent example of
cognitive consumption is funerary cannibalism observed in the Indians of the west-
ern Amazonian rainforest; the Wari’ are said to have practiced the consumption of
the dead as a way of grieving and acknowledging the connection between life and
the afterlife (Conklin 2001).
But how exactly can food be addressed in the ancient past? Archaeologists typi-
cally address dietary patterns in several ways, including paleobotanical, faunal,
midden, coprolite, iconography, and residue analyses (Bescherer Metheny and
Beaudry 2015; Hastorf 2017; Wilkins and Nadeau 2015; see further discussion in
Chap. 2). While each of these techniques has merit, they frequently address the
dietary patterns of a group or community (Twiss 2012). For example, a midden (a
refuse heap) is typically used by a family or, in some cases, an entire community. It
is difficult, if not impossible, to parse out dietary patterns of individuals using these
methods. Additionally, archaeological remains do not necessarily reflect foods con-
sumed. For example, if residue analysis was performed on a ceramic vessel—there
is no direct evidence to suggest that the food was actually consumed. There are
several cultural contexts in which food is placed in vessels, but not eaten (Grinsell
2015; Méry and Tengberg 2009; Smith 1992). Bioarchaeological methods can pro-
vide more nuanced interpretations of dietary patterns in the ancient past and com-
plement traditional archaeological approaches to dietary reconstruction.
One of the most common methods bioarchaeologists employ is carbon and
nitrogen stable isotope analysis. By assessing the ratio between isotopes of car-
bon and nitrogen, bioarchaeologists are able to speak to the foods that an indi-
vidual consumed. These interpretations can then be expanded to look at a group,
community, or population. Further, these isotope techniques have also been used
to address weaning and periods of nutritional stress (Fuller et al. 2005; Mekota
et al. 2006; Schurr 1998; Waters-Rist et al. 2011; Williams et al. 2005). Other
methods, including compound specific analyses, dental wear, and dental calculus
studies, have also proven successful and have the potential to complement stable
isotope data providing a more complete picture of ancient diet (Evershed 2008;
Fogel and Tuross 2003; Schmidt 2010; Ungar et al. 2006; Warinner et al. 2015;
Watson 2008). Bioarchaeological methods, which can direclty assess foods con-
sumed, can therefore address facets of ancient diet that archaeology typically
cannot. As I have discussed in Chap. 2, these bioarchaeological contributions
facilitate social interpretations and theoretical framing. Owing to the fact that
bioarchaeology can address individuals, we can also speak to the agency involved
in selecting, preparing, and consuming foods. Further, because we are discussing
foods that were consumed, we can also interpret our data using an embodiment
framework.
In this chapter I will focus on the current state of dietary reconstruction in bioar-
chaeology. As in Chap. 3, I will incorporate data from my own research on ancient
Nubian populations to examine the skeletal archive of foodways and further how
these data can shed light on cultural entanglement, identity, and agency.
Stable Isotope Analysis 129
Stable Isotope Analysis
Since the mid-1970s stable isotope analysis has been used to address questions
about ancient human populations (see Chisholm et al. 1982; DeNiro and Epstein
1981; DeNiro and Schoeninger 1983; Schoeninger and Peebles 1981; Vogel and van
der Merwe 1977). Stable isotope analysis is based on the principle that isotopes are
atoms of the same element with an equal number of protons, but differing numbers
of neutrons. For example, the element carbon is composed of 14 isotopes (8C-22C),
all of which have six protons, but vary in their number of neutrons (i.e., 2–16,
respectively). However, only two of these isotopes are stable (12C and 13C), meaning
they are not subject to radioactive decay, or possess half-lives so extensive they are
virtually immeasurable (Dawson et al. 2002). While radioactive isotopes (e.g., 14C)
are useful in other contexts, such as dating organic material from archaeological
contexts, stable isotopes are conducive to other types of analysis because of their
enduring and unchanging form. Common stable isotopes studied include oxygen,
carbon, nitrogen, hydrogen, and sulfur, although 255 stable isotopes form 80 ele-
ments are known to exist (Fry 2006).
Carbon isotope analysis is particularly useful in assessing plant consumption and
is based on variation in plant physiology. When the relative abundances of 13C and
12
C (expressed as δ13C) are evaluated, bioarchaeologists can determine if an indi-
vidual’s diet was based on C3, C4, or CAM (crassulacean acid metabolism) foods
(Schoeninger 2011). In C3 plants stomata remain open at all times, allowing gas
exchange, resulting in the transpiration (loss of water vapor) of the lighter isotope
(12C), while the heavier isotope (13C) is retained within the plant because it is not
subject to transpiration. Therefore, an isotope signature with depleted levels of 13C
relative to 12C (δ13C −35 to −20‰) would reflect the consumption of C3 plants
(Deines 1980; Smith and Epstein 1971; van der Merwe and Vogel 1978). C3 plants
are characterized by more temperate species such as wheat, barley, rice, beans,
tubers, as well as most fruits and vegetables. C4 plants, on the other hand, are
adapted to hot and arid climates by being able to minimize the amount of time that
stomata are open, and thereby minimizing water loss. This results in less 13C-depleted
tissues relative to C3 plants (δ13C −14 to −9‰; Katzenberg 2000; Schwarcz et al.
1985). C4 plants are characterized by tropical grasses such as corn, sorghum, millet,
and sugarcane. CAM plants have a unique photosynthetic process, opening their
stomata only at night and closing them during the day. CAM plants include most
succulent species; like C4 plants, this is an adaptation to hot and arid environments.
Isotopically, this results in wide ranging effects δ13C −12 to −27‰) depending on
the environmental conditions and the plant. The primary source of terrestrial carbon
is atmospheric CO2 (~ −7.5‰) and the primary source of marine carbon is dis-
solved CO2 and bicarbonate ions (HCO3−; ~1.5‰; Fahy et al. 2017; Lee-Thorp et al.
1989; van Klinken 1991; see overviews in Price and Burton 2012; Schoeninger and
Moore 1992).
Nitrogen isotopes, 15N/14N expressed as δ15N, can speak to ancient dietary pro-
tein sources (e.g., legume vs. non-legume; level in the food chain; Ambrose and
DeNiro 1986; DeNiro and Epstein 1981; Schoeninger 1985). Nitrogen can be incor-
porated into plants through direct nitrogen fixation, ammonium/nitrate in soil water,
or soil nitrogen (Lee-Thorp 2008). For example, legumes have δ15N values closer to
that of atmospheric nitrogen (N2 = 0‰) because they are able to more effectively
absorb nitrogen via the bacteria rhizobium. Non-leguminous plants, however, do
not have this symbiotic relationship with rhizobium, which results in higher δ15N
values (Brill 1977). Furthermore, nitrogen is transferred from food sources to con-
sumers and accrues through the food chain (also known as trophic level; Bocherens
and Drucker 2003; DeNiro and Epstein 1981; Hedges and Reynard 2007; O’Connell
et al. 2012). Studies have shown that δ15N values increase ~3–5‰ between trophic
levels (Bocherens and Drucker 2003; Schoeninger and DeNiro 1984). Accordingly,
carnivores will have the higher δ15N ratios and plants as well as herbivores have the
lower δ15N ratios. Nitrogen analysis can also suggest the consumption of freshwater
fish, as fish have an elevated δ15N compared to land mammals (Richards and Hedges
1999).
Bone is approximately 70% inorganic, otherwise known as hydroxyapatite or
carbonate,1 and 30% organic, or collagen.2 Through controlled feeding experiments
Ambrose and Norr and Tieszen and Fagre illustrated that collagen carbon primarily
originates from ingested protein in the diet, whereas the carbon in carbonate reflects
the whole diet (Ambrose and Norr 1993; Tieszen and Fagre 1993). This research has
been further substantiated by numerous scholars (Krueger and Sullivan 1984;
Lee-Thorp et al. 1989; Schoeninger et al. 1997, 1998; Schroeder et al. 2009).
Katzenberg argues that there are two important reasons to pursue the analysis of
carbonate (Katzenberg 2000). First, stable isotope studies can be applied to much
older materials (e.g., fossils), where collagen can no longer be isolated and exam-
ined (Lee-Thorp et al. 1989; Lee-Thorp and Sponheimer 2006). Second, it provides
another perspective (i.e., whole diet) on dietary patterns (Ambrose and Norr 1993;
Ambrose et al. 2003; Bocherens and Drucker 2003; Jim et al. 2004; Kellner and
Schoeninger 2007).
How do the complexities of δ13C and δ15N relate to daily life in the ancient past?
To address this question, we need to take a closer look at rates of bone and soft tis-
sue turnover. Bone is in a constant state of osteoblast destruction and osteoclast
construction; this allows for repair and adaptation as the skeletal frame adjusts to
mechanical loads and physical stressors (Larsen 2015; Mays 2010). It is estimated
that it takes anywhere between 10 and 25 years to completely remodel bone colla-
gen (Hedges et al. 2007; Shin et al. 2004; Stenhouse and Baxter 1976, 1979).
However, different bones remodel at different rates (Hobson and Clark 1992;
Katsimbri 2017; Pfeiffer et al. 2006). The ribs, for example, are under constant
1
The mineral portion of bone is primarily hydroxyapatite, however, several ions can substitute for
hydroxyapatite (e.g., strontium or lead for calcium, and carbonate for phosphate; Burton and
Katzenberg 2000; Katzenberg 2000; LeGeros et al. 1967).
2
The vast majority (85–90%) of the organic portion is collagen; the remaining 10–15% consists of
noncollagenous proteins, proteoglycans, and lipids (Katzenberg 2000; Triffit 1980).
Stable Isotope Analysis 131
pressure due to respiration and, thus, are continually undergoing a process of corti-
cal renewal (Skedros et al. 2013). Fahy and colleagues report, “with a greater sur-
face area to volume ratio ribs have a relatively fast cortical turnover rate, which is
approximately 4% a year after age 50” (Fahy et al. 2017; see also Frost 1969; Hill
and Orth 1998). The femora, on the other hand, are comparably dense and have a
much slower turnover rate (Fahy et al. 2017; Hill and Orth 1998; Hedges et al. 2007;
Skedros et al. 2013). For this reason, Fahy et al. encourage standardization of bones
sampled, so that similar periods of the life course are being examined. Because
multiple skeletal tissues remodel at different rates, we can examine how dietary pat-
terns changed throughout the life course (Chenery et al. 2012; Cox and Sealy 1997;
Lamb et al. 2014; Pollard et al. 2012; Sealy et al. 1995; Schroeder et al. 2009). It
should be noted that this process is altered throughout the life course, differs
between bone collagen and appetite, and can be impacted by bone disease, sex,
mechanical loading, and dietary deficiencies (Agarwal 2016; Agarwal and Glencross
2010; Brickley and Ives 2008; Burr 2002; Hedges et al. 2007; Parfitt et al. 2000;
Pfeiffer et al. 2006; Pollard et al. 2012; Robling et al. 2001; Sealy et al. 1995).
The turnover rate of soft tissue is much more rapid. Like bone, muscle and skin
are constantly being remodeled. In muscle, this process takes 40–60 days, depend-
ing on the frequency and intensity of exercise (Guillet et al. 2004; Moore et al.
2005). The human epidermis is completely renewed every 2–4 months (Babraj et al.
2005; el Harake et al. 1998). Hair and nails grow incrementally; hair grows ~0.35–
0.44 mm per day (Ferriman 1971; Saitoh et al. 1967) and nails take 4–6 months to
fully grow (Bergtresser and Taylor 1977; Halprin 1972; Samman and Fenton 1986).
Since these tissues are remodeling at varying rates, they reflect different periods of
the life course. This has allowed bioarchaeologists use isotopic analyses to address
seasonality, mobility, and multi-tissue turnover comparisons (Basha et al. 2018;
Eriksson and Liden 2013; Finucane 2007; Knudson et al. 2007; Lyon and Baxter
1978; O’Connell and Hedges 1999; O’Connell et al. 2001; Turner et al. 2013; White
et al. 2009; White and Schwarcz 1994; Williams and Katzenberg 2012).
In a recent publication, entitled “A stable relationship: Isotopes and bioarchaeol-
ogy are in it for the long haul,” Britton discusses the history, contribution, and per-
sistence of stable isotopes in bioarchaeology (Britton 2017). The popularity of
isotope analysis as well as the continued use of this method in bioarchaeological
research is noteworthy. The field is too vast to describe, or even summarize, here.
However, there have been a few applications of isotopic analyses that have been
particularly interesting and will be briefly discussed. The recent application of den-
tal microsampling has allowed researchers to assess diachronic variation within
individuals (Beaumont and Montgomery 2015; Burt and Garvie-Lok 2013; Eerkens
et al. 2011; Willmes et al. 2016). Using microsampling as well as analysis of mul-
tiple teeth, scholars have been able to infer time of weaning and associated health
outcomes (Beaumont et al. 2015; Britton et al. 2017; Burt 2013; Haydock et al.
2013; Tsutaya and Yoneda 2015; Xia et al. 2018). Life history and selective mortal-
ity have been broached using stable isotopes (Holder et al. 2017; Marsteller et al.
2017; Pearson et al. 2015; Sandberg et al. 2014). Researchers employing isotopic
analyses have addressed human-animal relationships as well as subsistence prac-

tices using zooarchaeological perspectives (Aguilera et al. in press; Britton et al.
2011; Chen et al. 2016; Guiry et al. 2016; Makarewicz 2016; Makarewicz and Sealy
2015; McManus-Fry et al. 2018; Price et al. 2017; Sandias and Müldner 2015;
Szpak et al. 2014; Tomczyk et al. in press; Towers et al. 2014). Importantly, inter-lab
reliability has also been discussed (Pestle et al. 2014).
Using carbon and nitrogen isotopic data we can better understand diet, as a
socially significant quotidian practice, in the ancient past. Isotope data from bone
reflects an individual’s diet over a period of years before death (depending on
which bone is sampled). We can view these data, like osteoarthritis and entheseal
changes, as the accrual of daily practices. While this method does not possess the
precision and refinement to reconstruct specific daily meals, we can nevertheless
use these data to better understand how individuals’ dietary habits broadly differed.
I will illustrate this point below with an example from ancient Nubia. Furthermore,
carbon and nitrogen data from various soft tissues can further provide dietary evi-
dence of daily life from shorter spans of times (weeks to months). In and of itself,
this data can be used to speak to daily consumptive practices in a more temporally
nuanced way, but also, it can be compared to bone to see how foodways may have
differed between the decades before death (bone) to near death (soft tissue). Lastly,
other bioarchaeological methods of dietary reconstruction can be used indepen-
dently or in conjunction with carbon and nitrogen isotopic analyses to reconstruct
ancient diet.
Other Bioarchaeological Methods of Dietary Reconstruction
Below, I briefly review methods alternatives to bulk carbon and nitrogen isotope
analysis that bioarchaeologists employ to address diet via human remains. These
methods can also be particularly useful when carbon and nitrogen analysis is unsuc-
cessful or not possible.
Compound Specific Isotope Analysis
While bulk stable isotope analysis of collagen and apatite can distinguish plants
with differing photosynthetic pathways, including C3 and C4, compound specific
analyses have the potential to identify specific components of foods (e.g., amino
acids, lipids; Colonese et al. 2015, 2017; Evershed et al. 1995, 2002; Jim et al.
2004; Stott and Evershed 1996; Tripp et al. 2006). For example, Naito and col-
leagues used amino acid analysis to differentiate consumed terrestrial and freshwa-
ter animals, which often have ambiguous results when tested with conventional
Other Bioarchaeological Methods of Dietary Reconstruction 133
bulk carbon and nitrogen analyses (Naito et al. 2013a). They found trophic distinc-
tions between terrestrial and freshwater animals, specifically in glutamic acid and
phenylalanine, thus allowing for a more price reconstructing of ancient dietary pat-
terns. While this field of study is still developing, researchers have made great
strides in comparing amino acid and lipid profiles to bulk bone collagen and have
applied these methods to various bioarchaeological contexts (Corr et al. 2008, 2009;
Evershed 2007; Howland et al. 2003; Mora et al. 2017; Naito et al. 2013b; O’Connell
and Hedges 2001).
Dental Calculus
Another relatively recent addition to the bioarchaeologist’s toolkit is the study of the
fossilized material in ancient dental calculus (Barton and Torrence 2015; Cristiani
et al. 2018; Fuller et al. 2014; Gismondi et al. 2018; Leonard et al. 2015; Mariotti
Lippi et al. 2017; Power et al. 2014, 2015a, b, 2018; Radini et al. 2017). Dental
calculus is formed by the crystallization of plaque and it is made up of a combina-
tion of proteins and minerals deposited from the saliva, and mineralized bacteria.
The crystal structure of dental calculus essentially works as a trap for dietary
remains such as starch grains, phytoliths, and various dietary biomarkers, and pre-
serves them for long periods of time (Adler et al. 2013; Arensburg 1996; Buckley
et al. 2014; Lieverse 1999; Power et al. 2014; Warinner et al. 2014; Warinner et al.
2015). Gagnon et al. found that coca use, as indicated by poor oral health and micro-
plant remains in calculus, increased with the emergence of the Southern Moche
state and concluded that it may have played a role in emergent social inequality
(Gagnon et al. 2013). Henry and colleagues examined plant microremains (starch
grains and phytoliths) from both Neanderthal and early modern human contexts and
found that both species consumed a wide array of plant foods, including low-rank
underground storage organs and grass seeds (Henry et al. 2014). This suggests that
Neanderthal dietary ecology was complex and warrants further investigation (Henry
et al. 2014:52). However, calculus inclusions have also been critiqued as being a
depositional environment, which does not necessarily imply consumption, and there
is limited knowledge about the mechanisms in which dietary remains are deposited
into calculus (Lieverse 1999; Radini et al. 2017). Calculus can also provide a win-
dow into the oral microbiome of past populations; Warriner et al. have studied the
taxonomic and protein functional characterization of dental calculus and have iden-
tified pathogens, antibiotic resistance genes, and DNA sequences that match dietary
sources down to the species level (Warinner et al. 2014). Future microbiome
research will certainly incorporate further phytolith analysis and genetic sequencing
of both food and bacteria, multi-tissue assessment of calculus, bone, and soft tissue,
and further discussion of calculus formation.
Dental Wear
Dental wear occurs both macroscopically, as occlusal enamel is subject to abrasion,

attrition, and erosion, as well as microscopically (Schmidt 2010). Macroscopic
changes to dental enamel occur when abrasive foods are chewed (abrasion); when
teeth come into contact with one another (attrition), or if teeth are used as tools
(extramasticatory wear; and when teeth are exposed to acidic substances (erosion),
including extrinsic substances, such as acidic foods, and intrinsic conditions, such
as oral pH (Bax and Ungar 1999; Erdal 2008; Larsen et al. 1998; Lukacs and Pastor
1988; Molnar 2008, 2011; Shellis et al. 2006). Older individuals typically have a
greater degree of wear due to the accumulation of abrasion, attrition, and erosion.
Macroscopic wear has been used to infer changes in subsistence strategies (Larsen
2015; Watson et al. 2013). For example, human populations in a variety of contexts
have shown dramatic declines in macroscopic occlusal wear with the adoption of
farming (Formicola 1987; Larsen 1995; Meng et al. 2011). It is hypothesized that
because agriculturalists eat softer and less abrasive foods, coupled with the fact they
process and cook foods, they do not exhibit as much dental wear (Larsen 1995).
Conversely, Watson found an increase in macroscopic wear when comparing food-
foraging to agricultural populations in northwest Mexico; he suggests this may be
due changes in food processing techniques (Watson 2008). Limited research has
been conducted on deciduous dental wear in the past but has recently gained increas-
ing attention, providing valuable complementary insights on the onset of weaning
as well as dietary differences across social strata (Dawson and Robson Brown 2013;
Mays 2016; Prowse et al. 2008).
In addition to looking at the macroscopic changes to the surface of teeth, bioar-
chaeologists have examined how microscopic alterations to enamel correlate with
food. Microscopic changes are characterized by minute scratches and pits etched on
the tooth’s surface. Different types of foods leave distinct marks; for example, hard
and brittle foods, such as fruit, bark, and seeds, leave large pits in the enamel,
whereas foods that are tougher, such as leaves and stems, create striations and
smaller pits (Krueger et al. 2017; Scott et al. 2005, 2006; Ungar et al. 2008). The
size, depth, and frequency of these microwear patterns can also speak to the general
types of foods consumed (e.g., pastoralist versus agriculturalist; Schmidt 2001;
Schmidt et al. 2016). Recent research has also suggested that microwear analysis of
deciduous teeth can be used to infer when in an individual’s life weaning occurred
and the physical properties of complementary foods, as well as early childhood
changes in dietary consistency in relation to socioeconomic conditions (Mahoney
et al. 2016; Nystrom 2016; Scott and Halcrow 2017). Microwear analysis stands
apart from macrowear, microbiome, and skeletal isotopic analyses in that it captures
the last days to weeks of an individual’s diet before death (Teaford and Oyen 1989).
This could be meaningful in interpreting how diet, an important aspect of everyday
life, differed between the long term (i.e., macrowear, micriobiome, skeletal isotopic
analyses), and shortly before their death.
An Example of Daily Life Foodways 135
Dental Decay
Dental decay (e.g., carious lesions, periodontitis, and dental abscess) has also been
associated with dietary shifts. A dependence upon carbohydrate-rich foods is often-
times associated with carious lesions and dental decay (Aufderheide and Rodríguez-
Martín 1998; Cohen and Armelagos 1984; Cucina et al. 2011; Larsen 1995, 2015).
Growing dependence upon maize agriculture in North America has been linked
with an increase in carious lesions and an overall decline in oral health (Larsen
2006, 2015; Temple and Larsen 2007; Turner 1979). However, in a study of
Southeast Asian skeletal remains, Tayles and colleagues found that rice did not
impact the frequency of caries (Tayles et al. 2000). Diets that are high in protein
tend to have lower carious lesion frequencies, owing to the fact that proteins increase
the pH level of the dental plaque limiting bacterial growth (Hillson 1996; Littleton
and Frohlich 1993). It is important to acknowledge, however, that dental decay is a
complex multifactorial, pathological process, which does not necessarily correlate
with carbohydrate consumption (Cucina et al. 2011; Lingström et al. 2000; Lukacs
and Largaespada 2006; Tayles et al. 2000, 2009).
Several scholars have used a multi-method approach to interpreting diet from
dental disease (Lillie and Richards 2000; Lubell et al. 1994; Somerville et al. 2017;
Wang et al. 2016). Questions regarding social, economic, and political transitions
(Buzon and Bombak 2010; Eshed et al. 2006; Klaus and Tam 2010; Listi 2011;
Mickleburgh 2016; Vodanović et al. 2012), social status (Cucina and Tiesler 2003;
Hubbe et al. 2012; Valentin et al. 2006), as well as sex and gender (Keenleyside
2008; Lukacs 2017a, b) have been addressed using a combination of dental decay
and stable isotopic methods in conjunction with the archaeological record. Like
dental macrowear, dental decay is age-progressive; older adults are more likely to
experience dental disease, which is exacerbated by and contributes to abrasion,
attrition, and erosion. Analysis of dental decay provides yet another perspective,
which can elucidate broad dietary changes between different populations.
Collectively, stable isotope analysis, compound specific analyses, dental wear and
dental decay approaches encompass the spectrum of traditional to cutting-edge bio-
archaeological research of diet. Next, I provide a case study that explores the dietary
daily life of ancient Nubians using stable isotope analysis.
An Example of Daily Life Foodways
Building on the example provided in Chap. 3, I present another Nubian case study
that will incorporate agency, identity maintenance, and resistance through daily
practice. Concurrent with the Kerma population (Chap. 3), the C-Group was also an
indigenous Nubian population that inhabited the Second Cataract region of Lower
Nubia) during the Third-Second millennia BCE (2400–1500 BCE; Fig. 4.1; Hafsaas
2007; O’Connor 1993). The C-Group were cattle pastoralists and agriculturalists
(Hafsaas 2007); their villages were likely relatively small in terms of population
Fig. 4.1 Map of Ancient Egypt and Nubia (C-Group and Pharaonic Samples)
size and were sparse amongst the harsh terrain of the rocky Second Cataract region
(Trigger 1976). Egypt, likely threatened by the growing power of Kerma to the
south, conquered and colonized Lower Nubia in 1943 BCE (Edwards 2004; Trigger
1976). A total of 17 heavily fortified fortresses were built between the First and
Second Cataracts. Soldiers from Egypt were brought to Nubia to inhabit the for-
tresses and serve as a standing army (Adams 1977). The fortresses housed the occu-
pying Egyptian army, while local C-Group populations lived outside the fortress
walls (Edwards 2004; Smith 1995, 2003). This episode of colonization presents an
opportunity to examine how C-Group Nubians responded to these sociopolitical
events through everyday practice.
Using stable isotope analysis, I examine the diets of contemporary C-Group

Nubians and Egyptianized Egyptonubians (also known as the Pharaonic skeletal
sample). When compared to historic, archaeological, and previously published food
web data, dietary patterns of C-Group Nubians and Egyptianized Egyptonubians
become apparent. When contextualized in a quotidian perspective, we can view the
carbon and nitrogen isotope ratios of bone collagen to be the products of repetitive
and agentive consumption.
How Do We Know What Ancient Egyptians and Nubians Ate?
While ancient Egyptian and Nubian diets were in many respects similar due to spa-
tial proximity, closer examination enables elements of these two diets to be differ-
entiated. Funerary offerings, artistic depictions, written documents as well as
archaeological, archaeozoological, and archaeobotanical remains have suggested
foods such as bread, palm date, pomegranate, melon, fig, cucumber, leek, cabbage,
onion, beans, lentils, honey, goat, pig, cattle, and fish were available to Nile Valley
inhabitants (Darby et al. 1977; James 1984; Saffirio 1972; Wilson 2001).
Egyptians are known to have depended heavily upon bread and beer, particularly
those made from emmer wheat and barley (Alcock 2006; Samuel 1996a, 1996b,
2000). Bread and beer were often used as a form of income as well as tax, which is
evidenced by large-scale bakeries and breweries (in operation by the Old Kingdom
2600–2150 BCE) and state records (Breasted 1906; Butzer 1976; Murray 2000).
There is also evidence to suggest that the tetracycline component of beer may have
served an antibiotic purpose (Armelagos et al. 2001; Bassett et al. 1980). The major-
ity of Egyptians did not have access to meat, particularly beef (Ikram 1995; Romer
1984). Beef in Egypt was considered to be a status food that was only consumed by
the most elite and/or royal. Most Egyptians relied upon pig, sheep, goat, and other
riverine species (e.g., turtle, crocodile) as a source of protein (Ikram 2000).
Nubians, on the other hand, may have depended more upon sorghum, millet, and
cattle as mainstays of their diet. The domestication of sorghum (Sorghum bicolor)
in the Nile Valley has been thoroughly debated (de Wet and Huckabay 1967;
Haaland 1992, 1995; Munson 1976; Young and Thompson 1999). Currently, there
is no direct evidence of sorghum domestication until c. 500 BCE (Fuller 2004).
Many have suggested that sorghum was likely domesticated, and certainly wild
varieties were consumed, before this date (see Haaland 1995, 1999).3 Sorghum was
often prepared into porridge, similar to many other African cultures, and continued
3
Excavations at Um Direiwa, a Neolithic site approximately 100 km northeast of modern
Khartoum, (c. 4800 BCE) have uncovered grindstones with traces of wild sorghum and millet
(Haaland 1987). Additionally, evidence of earlier sorghum domestication has been found outside
the Nile Valley. At Mehel Teglinos, in the Kassala region of Sudan (eastern Sudan, bordering with
modern Eritrea), recent excavations have found domesticated sorghum dating to c. 3950 BCE
(Beldados and Constantini 2011; Haaland 2012).
to play an important role in Nubian culture through the Meroitic Period (300 BCE–
400 CE; Dirar 1993; Edwards 1996, 2004). Beer was also popular in Nubia, but was
of another variety than Egyptian beers. Bouza, a traditional Nubian beer, is made
from millet, rather than wheat or barley (Burckhardt 1819; Hornsey 2003). As
Haaland describes “Nubia was on the crossroad between the bread-eating cuisine to
its north and the porridge/beer-consuming world to the South” (Haaland 2012: 336).
Archaeological evidence suggests cattle held an important place in Nubian cul-
ture since the Predynastic era (c. 3100 BCE; Wengrow 2001). Marshall and
Hildebrand highlight the importance of cattle and pastoralism in arid environments,
such as Egypt and Nubia, and suggest that the domestication of African cattle may
have taken place as early as the Tenth Millennium BCE (Marshall and Hildebrand
2002). Cattle were frequently depicted in works of art, particularly rock art, through-
out Nubia (often in association with the Neolithic A-Group culture; Brandt and
Carder 1987; Davis 1984). Cattle hides were often included in funerary contexts
(Williams 1991). At Kerma’s eastern cemetery, thousands of cattle crania (bucrania)
outline the burial tumuli. The largest tumulus is estimated to have had up to 4000
bucrania (Chaix 2001, 2004). As Haaland points out, this would have provided tens
of thousands of kilograms of meat for consumption (Haaland 2012). Chaix’s analy-
sis of the zooarchaeological remains of Kerma further support the concept that these
cattle were being eaten; cattle were a “significant proportion of the animals con-
sumed” within Nubia (Chaix and Grant 1992:61). Additionally, many of the bucra-
nia funerary offerings at Kerma exhibited horn deformation, a practice that is likely
reinforced with religious significance (Chaix 1996; Chaix et al. 2012). When these
multiple facets of cattle culture are incorporated and seen throughout Nubian and in
various Nubian cultures (e.g., A-Group, C-Group, Kerma), many have suggested
this evidence indicates the presence of a widespread cattle cult in Nubia (Brass
2003; Williams 1986).
Previous examinations of carbon and nitrogen stable isotope ratios in Egyptian
populations support the hypothesis that Egyptian diets are characteristically C3-
dominant (Table 4.1; Iacumin et al. 1996; Macko et al. 1999; Thompson et al. 2005).
Analysis of Nubian diets suggests a more mixed C3/C4 dietary regimen (Iacumin
et al. 1998; Thompson et al. 2008). While there has been a considerable amount of
isotopic research conducted on Egyptian and Nubian human remains, much of it has
focused on the much later Meroitic, X-Group, and Christian time periods (350 BCE–
350 CE, 350–550 CE, 500–1400 CE, respectively; see Dupras and Schwarcz 2001;
Schwarcz et al. 1999; White 1993; White et al. 1999; White and Armelagos 1997;
White and Schwarcz 1994). Since humans are distinctly biocultural beings—our
diet depends what is available and what will biologically sustain us, but also what
our cultural framework dictates—it is possible that the foods consumed in the
Meroitic, X-Group, and Christian Periods, were grounded in a different biocultural
context. For this reason, previous isotopic research that focused on Meroitic or Post-
Meroitic Periods were not included in the following comparisons.
We can also juxtapose the isotopic results of human remains with δ13C and δ15N
data from Nile Valley animals and plants (Tables 4.2 and 4.3; Fig. 4.2). As with
comparative human remains, some faunal data were excluded due to temporal and/
Table 4.1 Carbon and nitrogen stable isotope results from comparative Nile Valley human
remains
Mean Mean
Culture Publication Site Perioda n Tissue δ13C SD δ15N SD
Nubian Iacumin Kerma Ancient Kerma 5 Bone −16.4 1.3 12.2 0.7
et al. (1998) collagen
Middle Kerma 4 Bone −19.7 0.8 13.1 0.9
collagen
Classic Kerma 2 Bone −20.3 – 12.1 –
collagen
Thompson Kerma Classic Kerma 48 Bone −17.7 1.7 13.9 0.7
Egyptian Iacumin Gebelein First 6 Bone −19.4 0.3 12.9 0.9
et al. (1996) Intermediate collagen
Asyut First 8 Bone −19.8 0.4 13.0 1.0
Intermediate collagen
Macko et al. Unknown Late Middle 9 Hair −21.5 1.1 14.0 1.1
(1999) Kingdom
Thompson Abydos Twelfth Dynasty 2 Bone −18.5 0.1 13.0 0.9
a
Ancient Kerma = 2500–2050 BCE; Middle Kerma = 2050-1750 BCE; Classic Kerma = 1750–
1500 BCE; First Intermediate: 2120–1990 BCE; Late Middle Kingdom: c. 2000 BCE; Twelfth
Dynasty: 1991–1786 BCE
Table 4.2 Carbon and nitrogen stable isotope results from comparative Nile Valley faunal remains
Culture Publication Site Perioda Animal δ13C δ15N
Egypt Iacumin et al. (1996) Unknown Eighteenth Dynasty Ox −23.2 9.4
Thompson et al. (2005) el-Badari Late Old Kingdom Sheep −18.9 6.8
Pig −17.6 9.7
Cow −15.4 10.9
Nubia Iacumin et al. (1998) Kerma Middle Kerma Goat −22.7 6.7
Turtle −15.3 8.6
Classic Kerma Goat −11.0 11.2
Thompson et al. (2008) Kerma Middle-Classic Kerma Sheep −15.0 9.0
Goat −16.8 8.3
Cow −7.0 12.7
Dog −13.6 11.6
a
Eighteenth Dynasty = 1500–1300 BCE; Late Old Kingdom = c. 2000 BCE; Middle Kerma = 2050–
1750 BCE; Classic Kerma = 1750–1500 BCE
or spatial distance (see Dupras and Schwarcz 2001; Iacumin et al. 1998; Thompson
et al. 2005, 2008). To the best of my knowledge, all ancient Nile Valley δ13C and
δ15N plant comparisons are presented here; while several of the samples are
chronologically distant from the C-Group population, they are included due to a
dearth of comparative plant remains.
Table 4.3 Carbon and nitrogen stable isotope results from comparative Nile Valley plant remains
Culture Publication Site Perioda Sample δ13C δ15N
Nubian Iacumin et al. (1998) Kerma Ancient Kerma- Acacia −24.6 1.7
Classic Kerma beans
Barley seeds −23.1 9.1
Doum Palm −23.8 8.9
Egyptian Iacumin et al. (1996) Thebes New Kingdom Egg yolk −22.1 13.8
Bread −22.7 12.5
Wheat seed −22.6 8.3
Pomegranate −24.2 3.4
Leaf −25.7 17.0
Schwarcz et al. Kellis Late Ptolemaic-Early Wheat – 16.1
(1999) Roman Period Broad bean – 12.1
Barley – 14.4
Grape – 16.7
Olive – 18.8
Date – 14.9
Fig – 17.8
Doum nut – 11.7
Dupras and Kellis Romano-Christian Wheat −22.9 –
Schwarcz (2001) Barley −23.3 –
Fava bean −23.1 –
Grape −22.1 –
Olive −21.9 –
Date −22.2 –
Doum nut −26.3 –
Fig −23.8 –
Millet −9.9 –
New Kingdom 1550–712 BCE; Late Ptolemaic-Early Roman: 60 BCE–100 CE; Ancient Kerma-
a
Classic Kerma: 2450–1450 BCE; Romano-Christian: c. 250 CE
The comparative carbon and nitrogen data from plants and animals indicate that
both C3 and C4 plants were available in the Nile Valley. The faunal data that origi-
nated from Egypt tend to have lower δ13C than the Nubian faunal remains. This
could indicate differing foddering practices, particularly for provisioned animals
(e.g., cattle, caprids, and pigs). Alternatively, these data could suggest a difference
in bioavailability of C3 versus C4 between Egypt and Nubia. However, the Nubian
caprids, turtle, and dog indicate a mixed C3/C4 intake; similarly the Egyptian pig
and cow also suggest a mixed C3/C4 diet. Combined with the human data from
Table 4.1, it would appear that both C3 and C4 were available in Egypt and Nubia.
The nitrogen data are complicated by environmental factors. For example, we
would not expect an herbivorous cow to result in δ15N 12.7. This could be the result
of 15N-depleted urea in draught-adapted species, which causes 15N-enriched tissues
(Ambrose and DeNiro 1986; Thompson et al. 2008). Alternatively, 15N-enrichment
can be caused by nitrogen recycling in gut flora (Sealy et al. 1987; Thompson et al.
2008). As shown in Table 4.1 and 4.2, other scholars have also found enriched δ15N
Fig. 4.2 Carbon and nitrogen stable isotope results for comparative Nile Valley faunal remains
in Nile Valley populations. Thompson suggests this could be the result of arid envi-
ronment (Thompson et al. 2008:384). Additional data, particularly from untested
faunal specimens,4 is needed to better understand food resources of ancient Nile
Valley peoples, but also to assess nitrogen enrichment in the area.
Who Were the C-Group Nubians?
As described above the C-Group was a population of indigenous Nubians living in

Lower Nubia from c. 2400 to 1500 BCE (Table 4.4). They thrived in the rocky ter-
rain and harsh climate that is known as the Batn al Hajar, or “Belly of the Rock.”
Concurrent with the C-Group, the indigenous Nubian Kerma culture, centered at the
city of Kerma (~220 km south), was becoming increasingly complex. By the Middle
Kerma Period (2050–1650 BCE) Kerma functioned as a state, controlling other
Nubian population centers, such as Sai and Bugdumbush, between the Second and
Fourth Cataracts (Bonnet 1986; O’Connor 1993; Smith 1998). Likely threatened by
this growing centralized power, Egypt conquered and colonized Lower Nubia dur-
ing the Middle Kingdom.
4
Carbon and nitrogen analysis of fish needs to be explored; this is likely food resource of ancient
Nile Valley populations. Note that Thompson et al. did analyze a Nile Perch (δ13C −14.9, δ15N 5.0),
however, it was from an unknown context and unknown time period (Thompson et al. 2005).
Table 4.4 Chronology for Egypt and Nubia (adapted from Smith 2003)
Date BCE Egypt Lower Nubia Upper Nubia
2050–1650 Middle Kingdom C-Group Middle
Twelfth Dynasty: 1995–1780 BCE Kerma
Thirteenth Dynasty: 1780–1650 BCE
1650–1550 Second Intermediate Period Classic
Fourteenth/Fiftheenth/Sixteenth Dynasties: Kerma
concurrent 1650–1550
1550–1050 New Kingdom Egyptian Colony
Eighteenth Dynasty: 1550–1300
Nineteenth Dynasty 1300–1190
Twentieth Dynasty: 1190–1050
By the end of the campaign (1943–1843 BCE, Egypt built 17 fortresses between

the First and Second Cataracts (Trigger 1976). These fortresses are an important
component to understanding the relationship between Egypt and Nubia during the
Middle Kingdom (Smith 1995, 1998). Not only would these structures have had the
obvious ideological message of advertising Egypt’s authority, but they also served
the very practical function of protection and control of the Nile River (e.g., trade
goods, communication, and population movement). Further, these forts clearly
defined Egyptian control from the Second Cataract to the Mediterranean. These
forts would have been very costly in terms of construction and maintenance; the fact
that Egypt ultimately built 17 forts suggests that there was a strong motivating fac-
tor and a distinct purpose to these outposts (Emery 1965; Trigger 1976).
The archaeological record suggests there was limited interaction between the
Egyptian forces and C-Group peoples (O’Connor 1993; Smith 2003). The C-Group
maintained traditional Nubian burial practices, characterized by subterranean pits
(often lined and/or capped with stone slabs), a flexed burial position, and the inclu-
sion of C-Group-style ceramic vessels (Säve-Söderbergh 1989). Moreover, few
Egyptian artifacts are found in C-Group habitation or funerary contexts and vice
versa (Smith 1995, 1998). Scholars have suggested that the C-Group peoples main-
tained independence and “no fundamental restructuring of C-Group society can be
correlated with the Twelfth Dynasty occupation of Lower Nubia” (Trigger 1976:79);
however, the daily lives of the C-Group Nubians living in this colonial context have
yet to be fully explored.
Throughout the Twelfth Dynasty (1995–1780 BCE), Egyptian soldiers were
brought from Egypt to inhabit and defend the fortresses. By the end of the
Twelfth Dynasty, Egypt changed its imperial strategy and, instead of sending rotat-
ing garrisons to the fortresses, they encouraged permanent settlement and relocation
to this frontier zone (Smith 1997). During this time, there is an increase in elite
Egyptian burials (who would previously have been returned to Egypt for burial), and
older individuals, women, and children, appear in Egyptian burial contexts5 (Smith
1995). There are also changes to the use (or lack thereof) in the habitation space of
5
The human skeletal remains referenced here originate from the Buhen fortress and were not
retained after excavation (S.T. Smith, pers. comm.)
the fortresses; barracks were abandoned and space was instead divided into private
living quarters, which was more suitable for the long-term occupancy of families
(Smith 1997). There is also a rise in C-Group and Kerma ceramic vessels within
fortress walls, suggesting a trade relationship with local Nubian communities.
The Egyptian Empire became increasingly decentralized through the
Thirteenth Dynasty. By 1650 BCE, the unified empire had deteriorated into the
Second Intermediate Period, which was characterized by foreign rule. Scholars had
assumed that the Second Cataract fortresses were abandoned or destroyed during
this time. However, Smith has found that there is a dramatic increase, as much as
20% of the total assemblage, in Nubian-style ceramic vessels at the fortress of
Buhen (Smith 1995, 1997). This counters the assumption that the fortresses were
deserted; rather, it presents a very interesting scenario of cohabitation between
Egyptians and Nubians despite political upheaval (Smith 2013). In this light, Smith
argues that many of the Egyptian settlers actively chose to stay in Lower Nubia with
the decline of the Middle Kingdom. As Egyptian colonizers then expatriates, this
group had lived in the Second Cataract region for more than 200 years (approxi-
mately six generations) and had developed strong social, economic, and political
ties with local Nubians. There is also written evidence of this relationship; a stela
found at Buhen proclaims that the Egyptian inhabitants of the fortresses formally
pledged their allegiance to Kerma (Edwards 2004; Säve-Söderbergh 1949;
Smith 1995).
When Egypt regained power during the New Kingdom, immediate efforts were
made by Pharaoh Ahmose (1550–1525 BCE) to retake the Second Cataract
fortresses. Thutmoses I (1504–1492 BCE) and Thutmosis III (1479–1425 BCE)
continued this endeavor by expanding the southern border into Upper Nubia. During
these campaigns, Egypt virtually annihilated the city of Kerma and a new southern
boundary was established at the Fifth Cataract (O’Connor 1993). Rather than send-
ing rotating garrisons as was done in the Twelfth Dynasty of the Middle Kingdom,
Egypt sent colonizers into Nubia with the direct aim of consolidating the empire,
collecting taxes, and keeping the peace (Smith 2003). During the New Kingdom, a
large portion of the graves in the Second Cataract region culturally conformed to
Egyptian burial practices (e.g., supine burial, coffin, rectilinear subterranean pit,
Egyptian-style pottery). Although elements of C-Group burial practices persist into
the mid-to late Eighteenth Dynasty they become increasingly infrequent (Edwards
2004). By the end of the Eighteenth Dynasty, nearly all cemeteries in Lower Nubia
show a total shift towards Egyptian burial practices, which has been referred to as
acculturation of the local population (Williams 1991). The burials that conform to
the Egyptian burial style and date to c. 1500–1400 BCE were deemed “Pharaonic”
by the Scandinavian Joint Expedition, who conducted salvage excavations in the
region between 1961 and 1964 (prior to immanent flooding due to the construction
of the Aswan High Dam; Säve-Söderbergh 1984). Whether these individuals were
biologically Nubian, Egyptian, or a combination thereof has yet to be determined.
Buzon has illustrated the complexities of biological, versus ethnic identity as well
as cultural entanglements in colonial scenarios (Buzon 2006, 2011; Buzon et al.
2016; discussed further in Chap. 5). Here, I refer to the Pharaonic sample as
Egyptonubian, with the understanding that their biological and cultural identity is
not altogether clear.
There is evidence to suggest that ancient Nubian’s used foodways as means to
define as well as advertise their self-defined identities. Stuart Tyson Smith has
investigated the ceramic assemblage at the archaeological site of Askut (near the
Second Cataract of the Nile), during the Middle Kingdom (2040–1650 BCE) and
Second Intermediate Period (1650–1550 BCE; Smith 1995, 2003). This study pres-
ents a clear dichotomy between Egyptian and Nubian vessels (cooking, serving, and
storage vessels), which exemplify social identity enacted via foodways. Nubian
serving vessels increase in number during the Second Immediate Period (when
Kerma controlled the Second Cataract region, including Askut), then decrease dur-
ing the New Kingdom Period when Egypt regained this territory. Interestingly,
Nubian cookpots are abundant and increase through time. Smith contends that both
gendered and ethnic elements contributed to the distribution of these assemblages.
Specifically, he proposes that women (historically known for their role preparing
food in both Egypt and Nubia) were more closely associated with the cookpots and
the gradual and prolonged increase in these vessels suggests intermarriage between
Egyptian men and Nubian women. Men, who were culturally responsible for enter-
taining (e.g., banquets, feasts), are linked with the serving ware. This interpretation
explains the rise in Nubian serving ware during the Second Intermediate Period
(when Nubia was in power at Askut) and its gradual decline during the New
Kingdom (when Egypt was in power). Furthermore, a residue analysis pilot study
indicates that the Egyptian and Nubian vessels held distinctly different foods (Smith
2003). Thus, Stuart Tyson Smith’s examination of the material record at Askut sup-
ports the notion that Egyptians and Nubians associated food with multiple identities
(i.e., gender, ethnic).
What Were the C-Group and Pharaonic Samples Eating?
In order to examine carbon and nitrogen isotope ratios, rib fragments were taken
from 25 C-Group individuals and 25 Pharaonic individuals. The bone was soaked in
HCl for 1–2 days until gelatinized (according to Longin 1971). After rinsing, NaOH
solution was added to remove contaminants (Katzenberg and Weber 1999). Bone
collagen was analyzed at the Biogeochemical Analytical Service Laboratory at the
University of Alberta using an EuroEA Elemental Analyzer (EuroVector) coupled
with an Isoprime Mass Spectrometer (GV Instruments). The degree of collagen
preservation was assessed using the atomic ratio of carbon to nitrogen and the total
collagen yield (Ambrose 1990; DeNiro 1985). Many of the samples that were ana-
lyzed for bone collagen were not viable, owing to low yields and high carbon to
nitrogen ratios. As suggested by DeNiro, the ratio between carbon and nitrogen
should be 2.9–3.6 (DeNiro 1985). Values higher or lower than this could indicate
diagenesis, contamination, degradation, or methodological complications.
Unfortunately, this is a common issue in arid climates (Baker 1992). Of the 50
Table 4.5 Carbon and nitrogen results of C-Group and Pharaonic Samples
Sample Time Perioda Sexb Agec Culture δ13C δ15N C:N %C %N
95:171 1600–1500 BCE F MA C-Group −17.8 13.5 3.3 28.5 9.9
201:8 1550–1500 BCE F YA C-Group −16.9 12.8 3.5 32.1 10.7
266:81 2100–1600 BCE M OA C-Group −17.9 13.2 3.5 36.7 12.1
266:101 2100–1600 BCE M OA C-Group −18.5 13.7 3.5 33.2 11.0
270:17 1650–1600 BCE F A C-Group −17.3 12.7 3.4 32.3 11.0
183:31 1475–1400 BCE M MA Pharaonic −20.2 11.2 3.4 43.2 15.0
183:114 1475–1400 BCE F MA Pharaonic −20.1 12.2 3.5 32.9 11.0
400:11B 1475–1425 BCE F MA Pharaonic −20.6 12.0 3.4 41.4 14.4
400:15 1475–1425 BCE M OA Pharaonic −20.2 12.7 3.1 34.3 13.0
400:18A 1475–1425 BCE F MA Pharaonic −20.1 10.7 3.5 32.0 10.7
a
Time period based off of ceramic seriation (see Bietak 1968; Säve-Söderbergh 1989; Säve-
Söderbergh and Troy 1991)
b
F female, M male (scored according to pelvic traits in Buikstra and Ubelaker 1994)
c
YA young adult (20–34), MA middle adult (35–49), OA old adult (+50), A indeterminate adult
(scored according to cranial and pelvic traits in Buikstra and Ubelaker 1994)
samples tested, only 10 were viable. This only provides a small glimpse into the
dietary patterns of the C-Group and Pharaonic samples of Lower Nubia during the
colonial Middle Kingdom. When coupled with the archaeological record and com-
parative isotopic data, these results become more robust.
The mean δ13C value for the C-Group is −17.7‰, suggesting a mixed C3/C4 diet
(Table 4.5). The mean δ15N value for the C-Group is 13.2‰, which is an ~3–5‰
increase compared to the Nubian caprids and turtle, as well as the Egyptian pig and
ox (Fig. 4.2). The mean δ13C value for the Pharaonic sample is −20.2‰, which
points toward a predominately C3 diet. The mean δ15N value for the Pharaonic
sample is 11.7‰, which is ~3–5‰ higher than the Egyptian caprids and ox, as well
as the Nubian caprid and turtle (Fig. 4.2). The nitrogen data should be interpreted
with caution, given the confounding factor of nitrogen enrichment in the region.
Collectively, these data suggest the C-Group sample was eating different grains than
the Pharaonic sample. Owing to the small sample size, a nonparametric Mann–
Whitney U was used to test for significant differences between these two groups.
Both δ13C values (U = 0.500, p = 0.008) and δ15N values (U = 2.000, p = 0.017) were
found to significantly differ between the C-Group and Pharaonic samples.
Thompson et al.’s previous study of a contemporary Nubian population, Kerma
(Classic Kerma Period = 1650–1550 BCE), can be compared to the C-Group/
Pharaonic data (Fig. 4.3; Thompson et al. 2008). Thompson and colleagues report a
mean δ13C value of −17.7‰ and a mean δ15N value of 13.9‰ (Thompson et al.
2008:382). These findings are markedly similar to the C-Group data presented here.
Iacumin et al. also assessed carbon and nitrogen ratios from the Kerma skeletal
material; their data spans the Ancient Kerma to Classic Kerma Periods (2500–
1550 BCE; Iacumin et al. 1998). Iacumin reports a mean δ13C value of −18.3‰ and
a mean δ15N value of 12.5‰. Directly comparable Egyptian human samples include:
15
14 C-Group
Pharaonic
Kerma (1)
d15N
13
Kerma (2)
Egypt (3)
12 Abydos, Egypt (4)
Egypt (5)
11
-23 -22 -21 -20 -19 -18 -17 -16
d13C
Fig. 4.3 Carbon and nitrogen isotope results for C-Group, Pharaonic, and comparative Nile Valley
human samples. 1 = Thompson et al. (2008); 2 = Iacumin et al. (1998); 3 = Macko et al. (1999);
4 = Thompson et al. (2005); 5 = Iacumin et al. (1996); Error bars = ±1σ
Iacumin et al. (1996)6 (mean δ13C value −19.65, mean δ15N value 12.94), Macko
et al. (1999)7 (mean δ13C value −21.5, mean δ15N value 14.0), and Thompson et al.
(2005)8 (mean δ13C value −19.05, mean δ15N value 13.1).
Egyptians were likely heavily dependent upon C3 grains, such as wheat and bar-
ley. Based on the mean δ13C values (>−20‰), Nubians may have had a mixed C3/
C4 diet. These enriched δ13C values may also be the product of consuming animals
that were foddered on a mixed C3/C4 diet. As discussed above, the nitrogen data are
particularly difficult to assess given the fractionation effects of the hot and arid
environment. It is possible that these populations were consuming caprid and/or
freshwater fish resources; however, with so few faunal data points originating from
a similar spatial and temporal context as the skeletal samples, in addition to the
dearth of freshwater fish data (with the exception of Thompson et al. 2005), more
detailed assessment of the nitrogen data is not possible at this time.
What is most interesting about the C-Group and Pharaonic data is how removed
they are from one another. There are several comparative samples that have δ13C and
δ15N values in between the C-Group and Pharaonic samples (i.e., Iacumin et al.
1996, 1998; Thompson et al. 2005). It appears as though the C-Group and Pharaonic
individuals were eating foods, or consuming animals that were being foddered off
of differing foods, that were distinct. It is unlikely that environmental factors are
contributing to these findings given that the C-Group and Pharaonic populations
6
Excludes the Predynastic sample reported by Iacumin et al. due to temporal distance from the
C-Group/Pharaonic samples (Iacumin et al. 1996).
7
Note that this data is not from bone collagen, but rather from hair.
8
Excludes the Predynastic and Twenty-sixth–Thirtieth Dynasty samples reported by Thompson
et al. due to temporal distance (Thompson et al. 2005).
were living in the same area at similar times. If these findings cannot be explained
by environmental factors, we must consider the possibility that cultural factors may
be playing a role in food choice practices.
If we frame the isotopic results with the archaeological context discussed above,
these data can be interpreted in light of resistance, social identity, agency, and daily
practice. The C-Group maintained an indigenous diet, markedly similar to that of
Kerma (Iacumin et al. 1998; Thompson et al. 2008), despite colonization. This
C-Group dietary pattern may reflect a culturally mediated social identity in which
the daily consumption of a mixed C3/C4 diet, or the consumption of animals that
were foddered on a mixed C3/C4 diet, reinforced group cohesion and differentiated
local (i.e., C-Group Nubian) from “the other” (i.e., Egyptian). As described above
there was minimal interaction between the C-Group Nubians and the Egyptian sol-
diers during the Twelfth Dynasty.
There are two individuals examined here (266:81, 266:101) who lived during
this period of cultural separation. In a period of military colonization, the daily
action of eating food that differed from the occupying force may have been an act
of resistance. From the archaeological record, we know that C-Group Nubians were
not trading with the Egyptian forces. It is impossible to say whether this lack of
material interaction was due to the C-Group Nubians or the Egyptian soldiers (or
both). Eating a traditional Nubian diet could have been one way in which the mar-
ginalized C-Group could have expressed agency in consuming these meaningful
food items and in doing so reasserted their independence and resistance to Egyptian
imperialism. Several archaeologists have argued that the lack of acculturation dur-
ing this period was due to a reaction by the C-Group against the Egyptian military
occupation of their homeland (Smith 1995, 1998; Säve-Söderbergh 1989:9;
Säve-Söderbergh and Troy 1991:8, 12; Williams 1991).
The other C-Group individuals in this case study (95:171, 201:8, 270:17) date to
the Thirteenth Dynasty, Second Intermediate Period, or New Kingdom, when there
was more interaction between the Egyptians and C-Group Nubians. Despite archae-
ological evidence of material interaction, these C-Group individuals maintained a
similar diet to earlier C-Group Nubians (i.e., 266:81, 266:101). It is important to
reiterate that these individuals were also buried in a C-Group burial style, as opposed
to other Egyptonubians who began to be buried in an Egyptian burial style (Pharaonic
sample) around this same time. These C-Group Nubians may have been expressing
and maintaining a Nubian identity that was deeply entrenched, both temporally (i.e.,
with previous C-Group Nubians) but also spatially (i.e., shared customs with Kerma
to the south). Consuming a mixed C3/C4 diet, or certain animals that were foddered
on a mixed C3/C4 diet, on a daily basis would have been a way in which C-Group
Nubians could communicate and reinforce their identity and independence.
The later Pharaonic sample, a group that were likely biologically Egyptonubian
who had adopted Egyptian burial traditions, consumed foods that were more closely
associated with Egypt (i.e., C3-dominant; Smith 1998). A predominantly C3 diet
may reflect one aspect of the cultural entanglements that were no doubt present dur-
ing this time. As the Egyptonubians of the Second Cataract adopted aspects of
Egyptian culture (e.g., burial practices), they may also have adopted the recipes,
ingredients, and culinary practices of the Egyptians. We can theorize that it was
advantageous for Nubians to adopt Egyptian cultural practices in a colonial milieu—
individuals who assimilated to Egyptian social norms may have been more likely to
get better jobs, own land, be allowed temple access, etc. (O’Connor 1993; Smith
2003; Smith and Buzon 2014; Török 2009). We may never know the motivating fac-
tor behind Nubians adopting Egyptian cultural practices. From the data presented
here, it appears as though along with Egyptian burial practices, the Pharaonic popu-
lation also likely adopted Egyptian C3 foods, which may have included C3 foddered
animals.
An agent-centered practice perspective can also inform the Pharaonic isotopic
data. The consumption of an Egyptian diet may have served as an everyday rein-
forcement for the Egyptian identity that these Egyptonubians were expressing. For
example, if a biological Nubian chose to adopt certain aspects of Egyptian social
identity (e.g., burial practices), it may have been important to also consume, perhaps
conspicuously, Egyptian foods. Similarly, if an Egyptonubian (either the progeny of
Egyptian expatriates, or Egyptians and local Nubians) was trying to gain status, an
elite position, and/or respect, in a New Kingdom Egyptian colonial system, it may
have been advantageous to highlight one’s “Egyptianness” through identity mark-
ers, such as food.
Summary
In this chapter I have highlighted how food is distinctly biocultural in humans.

Bioarchaeology can provide new perspectives on diet in the ancient past through
stable isotope, compound specific, dental calculus, dental wear, and dental decay
analyses. These data can be used to (1) elucidate foods consumed, and (2) produce
multiscalar interpretations. I have presented isotopic data for Nile Valley humans,
animals, and plants and contextualized these findings with a case study of Second
Cataract Egyptians and Nubians. From these data, we can hypothesize that Egyptians
ate a C3-based diet (e.g., wheat, barley) and Nubians ate a mixed C3/C4 diet (e.g.,
sorghum, millet). C-Group Nubian samples suggest that the C-Group culture may
have maintained a Nubian diet, which was markedly similar to Kerma. This can be
interpreted as a possible act of resistance against Egyptian forces in the Middle
Kingdom and the maintenance of an indigenous identity throughout the Second
Intermediate Period. The later Pharaonic group may have similarly been expressing
an Egyptian identity via the consumption of C3 foods. This may have been a way to
further “Egyptianize” themselves and could have benefitted them within the impe-
rial system.
These ideas will be explored further in Chap. 5 where I will present activity
patterns and dietary data from the Nubian site of Tombos. These methods will be
integrated into interpretations of practice and everyday life in the ancient past.
References 149
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Chapter 5
Day-to-Day Life in Ancient Nubia
Building on the methodological approaches to everyday practice proposed in

Chaps. 3 and 4, this chapter focuses on how osteological data, framed with practice
theory, can shed light on day-to-day life in the ancient past. I present entheseal,
osteoarthritis, and stable isotope data from the Ancient Nubian town, Tombos. As
discussed in prior chapters, Tombos served as an Egyptian colonial outpost in the
New Kingdom Period and continued to thrive as a postcolonial Nubian–Egyptian
community during the Third Intermediate and Napatan Periods (Table 5.1).
Interpreting these osteological data through the lens of practice theory enables us to
address the nuance of both agency and social structure in this ancient context.
Situating Tombos in a Transitional Sociopolitical Landscape
The New Kingdom Period, also known as Egypt’s Golden Age, is considered to be
the pinnacle of Ancient Egyptian civilization. Some of the most iconic Pharaohs of
Egypt’s past, including Tutankhamun, Hatshepsut, and Ramesses II, reigned during
the New Kingdom. However, this great period of Egyptian prosperity hinged upon
territorial expansion and economic exploitation of both Nubia and Syro-Palestine.
Pharaoh Ahmose (1550–1525 BCE) began his reign by reclaiming control of the
Lower Nubian forts, discussed in Chap. 4, and reestablishing the border with Nubia
at the Second Cataract (Emery 1965; Smith 1991a; Fig. 5.1). Thutmosis I (1504–
1492 BCE) and Thutmosis III (1479–1425 BCE) continued these efforts by expand-
ing the southern border of Egypt even farther. Armed with chariots, introduced via
trade and immigration from the Near East, Egypt virtually annihilated the Nubian
city of Kerma and the southern political boundary of Egypt was established at the
Fourth Cataract of the Nile River (Breasted 1962; O’Connor 1993). Stelae and
Egyptian monuments were built throughout Nubia, including those at Tombos, pro-
claiming this victory over “Wretched Kush” (see Fig. 5.2; Smith 2003). By

https://doi.org/10.1007/978-3-030-02544-1_5
166 5 Day-to-Day Life in Ancient Nubia
Table 5.1 Chronology of 1550–1050 BCE New Kingdom Colonial Rule

Ancient Nubia
1050–750 BCE Third Intermediate Period
750–332 BCE Napatan Period
Fig. 5.1 Map of Tombos and other archaeological sites in Nubia
1400 BCE the much of Nubia was under the direct control of Egypt with an imposed
administrative center at Napata (Shaw 2000).
With this territorial expansion, Egypt was faced with another problem; how
would the Empire consolidate these foreign lands into the imperial regime to avoid
Situating Tombos in a Transitional Sociopolitical Landscape 167
Fig. 5.2 Thutmosis I

Conquest Stela at Tombos
(Photo: S. Schrader)
foreign invasion, such as a resurgence of Kerma power? Egypt addressed this issue
using various economic, political, social, and ideological methods (Kemp 2006;
Smith 1992). New towns centered on Egyptian temples were constructed through-
out Nubia (Gebel Barkal near Napata, Soleb, Amara, Sesibi, Sai; Figure 5.1; Bard
1999). These towns not only promoted Egyptian religion and facilitated Nubian–
Egyptian coexistence but also served as economic centers of redistribution (Trigger
1976).
Egyptian civil officials, priests, artisans, and more generally, colonizers are
known to have moved from Egypt to Nubia (Kemp 1978, 2006). New political
offices such as the “King’s Son of Kush,” “Viceroy of Kush,” “Overseer of Foreign
Lands,” and “Deputy of Wawat” were introduced and are referred to in the bureau-
cratic texts of Ancient Egypt (Emery 1965; O’Connor 1983). Egyptian colonial
policy encouraged the cultural assimilation of Nubians (particularly in Lower
Nubia) as Egyptian-style artifacts increasingly dominate the material record
(Morkot 1995; Save-Soderbergh 1968). In the past, Egyptologists and archaeolo-
gists have assumed that this reflects acculturation of local Nubians (Breasted 1909;
Emery 1965). However, recent research suggests this process was much more com-
plex and situational. Stuart Tyson Smith’s research at Tombos, discussed further
below, suggests that transculturation and complex cultural entanglement, as opposed

to outright acculturation, occurred in Upper Nubia (Smith 2003).
Egypt rule persisted in Nubia until, due to foreign invasion, environmental stress-
ors, and the increasingly powerful priesthood of Amun at Thebes, the New Kingdom
became politically fragmented, initiating the Third Intermediate Period. This period
in Nubian history remains somewhat unclear. Ancient Egyptian texts provide an
interesting account of the Viceroy of Kush, Panehsy, which is particularly telling of
Nubian–Egyptian relations during this time. Egypt was experiencing what was
coined “the year of the hyena”; drought, famine, ransacking Libyans, and the dis-
unity of the Priesthood/Pharaoh led to a period of chaos and disorder (Wilkinson
2007). Concerned by these increasing problems, the last Pharaoh of the New
Kingdom, Ramesses XI (1107–1078 BCE), requested the military and leadership
services of Panehsy. As the Pharaoh’s primary representative in Nubia, Panehsy
accepted this mission and, with his army, restored order in Thebes. However,
Panehsy saw this period of governmental weakness as an opportunity and waged
war against Egypt. Ramesses XI responded with military force; under the Egyptian
general Paiankh, Panehsy’s army was pushed back and he retreated to Nubia (Thijs
2003). Panehsy would live a long and relatively prosperous life in Nubia and was
later buried at Aniba (Lower Nubia). This anecdote not only describes the tone of
political relations between Egypt and Nubia at the end of the New Kingdom Period
but also suggests that Nubia was relatively unified and possessed strong local lead-
ers. By 850 BCE Nubia had undergone the process of state formation, and was uni-
fied as the Second Kingdom of Kush, centered at Napata; Kush would go on to
conquer and rule Egypt as the Twenty-Fifth Dynasty (760–656 BCE).
The Twenty-Fifth Dynasty of Egypt (760–656 BCE), characterized by Kushite
rule, was the last dynasty of the Third Intermediate Period (1069–664 BCE). The
rulers of the Twenty-Fifth Dynasty legitimized their power by portraying them-
selves as “saviors” of the Egyptian civilization (Joffe 2002; Morkot 1999; Smith
1998, 2007b). Pharaohs, including Kashta, Shabaka, and Taharqo, emulated many
aspects of Ancient Egyptian culture (e.g., clothing, art, and architecture; Morkot
2000). The restoration of the Egyptian tradition was not an exact imitation; instead,
many Nubian cultural elements and symbolism were entwined with Egyptian ele-
ments, creating an entangled material culture (Smith 2013, 2014). Despite a fairly
prosperous dynasty, Kush was ousted from Egyptian rule by the Assyrians, which
ushered in the Late Period (664–332 BCE; Dynasties 26–31; Taylor 2000). However,
this did not reduce Kush’s power within Nubia. Major cities of Kush, including
Kawa, Napata, el Kurru, and Meroë would continue to thrive during the Napatan
Period. In fact, the Napatan state continued as a centralized power in Nubia until ca.
CE 400 centered at Meroë (Smith 1998).
It was once thought that after the Egyptian Empire withdrew from Nubia, local
Nubians either completely abandoned their territories, or they reverted to tribal and
seminomadic lifestyles (Kendall 1982; O’Connor 1983). These lifeways allegedly
persisted until 850 BCE with the appearance of, what was considered to be, a
Napatan “Chiefdom” (Griffith 1916, 1917, 1929; Reisner 1920). If this were the
case, rapid sociopolitical and economic expansion would have had to occur to (1)
establish the Kushite royal lineage (burials begin at el-Kurru and Nuri; near Napata),
(2) develop a unified religious ideology (manifest at Gebel Barkal (near Napata),
and (3) extend territorial control from the Second to Sixth Cataracts—all of which
were developed by the emergence of the Twenty-Fifth Dynasty (760–656 BCE;
Adams 1964; Dixon 1964).
After the Twenty-Fifth Dynasty, Adams claims Nubians “… became progres-
sively less Egyptian and more barbarous in character” (Adams 1964:109). This per-
spective is rooted in the ethnocentric and, oftentimes, racist tendencies of 19 and
early 20th Century archaeologists. Further, these arguments do not acknowledge
local Nubians as being economically independent, politically strong, and militarily
savvy; rather, this stance instead passively deems Nubians as members of a back-
ward periphery (Morkot 2001).
With continued excavation efforts, the depopulation argument is becoming less
plausible (Williams 1990). Excavations at Tombos and other contemporary sites,
such as Amara West (~130 km north of Tombos), show continued occupation from
the New Kingdom, through the Third Intermediate Period, and into the Napatan
Period (Smith 2006, 2007b, 2008; Smith and Buzon 2014; Spencer 2014). In line
with recent Nubian-centered perspectives (Morkot 2000; Smith 2008; Smith and
Buzon 2014; Török 1995), it is plausible that Nubia was organized into a series of
polities or was even operating as a successor state during the questionable period of
1069–850 BCE. The tale of Panehsy further supports this argument; Panehsy’s abil-
ity to (1) produce a Nubian army that was both willing and able to attack Egyptian
forces, and (2) retreat to Nubia unharmed, where he was presumably protected,
suggests Nubia was not completely devastated by Egyptian withdrawal and may
have been, at least to some degree, unified (see Schrader et al. 2018 for further
discussion).
Archaeological evidence from the Napatan Period is limited; however, this can
be primarily attributed to the need for further excavation. Edwards supports this idea
“…there is no reason to suspect that the mysteries surrounding the origins of the
Napatan state are anything other than a reflection of inadequate fieldwork” (Edwards
2004:116). Tombos is one of few excavated sites that was occupied during this tran-
sition and, thus, is vitally important to the archaeological understanding of the New
Kingdom/Napatan quotidian.
Tombos in Context
The town of Tombos was established at the start of the New Kingdom. Archaeological
and bioarchaeological evidence suggests this community was inhabited by Egyptians
and Nubians and likely served as an imperial administrative center (Buzon 2006;
Smith 2003, 2007b). Located on the rocky Third Cataract of the Nile River, Tombos
would have made an ideal location for a riverine point of control. Here, trade, com-
munication, and population movement could have all been monitored. This region
is also considered to be a border between contrasting direct and indirect Egyptian
colonial strategies (Smith 2003). To the north, many Egyptian colonies were built
(e.g., Amara, Sesebi, Sai, Soleb), bringing about direct interaction and coexistence
between Egyptians and Nubians (i.e., direct control). These sites are characterized
by being strongly culturally Egyptian. However, south of Tombos, the Egyptian
Empire took a more hegemonic, or indirect, approach and was primarily concerned
with using the preexisting infrastructure to encourage economic productivity with
minimal imperial intervention (Doyle 1986). The Egyptian Empire enforced a simi-
lar indirect approach in Syro-Palestine (Higginbotham 2000; Redford 1992; Smith
1997). Thus, it is not surprising that sites south of Tombos are more culturally
Nubian. This may be a consequence of the hegemonic imperial approach; alterna-
tively, this strong Upper Nubian culture could explain why a territorial imperial
strategy would not have been effective in this region (Smith 1998, 2003).
The ethnic and biological identity of the inhabitants of Tombos has been
addressed through archaeological and bioarchaeological methods. Burial traditions
at Tombos vary diachronically and fluidly blend both Nubian and Egyptian ele-
ments. The traditional Egyptian burial style dictated that the body of the deceased
lies in the supine position (head in the west, facing the east), mummified, within a
coffin1 (Baines and Lacovara 2002). This is contrasted to the traditional Nubian
burial style, which is characterized by the body being placed in a flexed position
(head towards the east, facing north) on a burial bed (Save-Soderbergh 1989).
During the New Kingdom Period, most of burials at Tombos are in the Egyptian
style and were interred either in a multi-interment pyramid or a chamber tomb.
However, there are a few inhumations (n = 6), all of which are female, that are bur-
ied in the traditional Nubian flexed position (Buzon et al. 2016; Smith 2003, 2007a,
b; Smith 2014). Similarly, the majority of ceramic vessels, which would have been
filled with oils, wine, and food to aid the deceased in the afterlife, were Egyptian-
style; however, a few Nubian-style pots (black-topped Kerma ware) have also been
found (Smith 2003, 2008). These findings are particularly interesting when viewed
in light of social identity, culture contact, memory, and resistance. According to
Smith:
“…funerals provide an opportunity for the negotiation of social identities, allowing for the
reinterpretation of relationships between individuals in a redefinition of the role of the dead
constructed through funerary rites…The wealth and cultural cues embodied in funerary
monuments and grave goods did not simply reflect the position of the deceased, but had a
prospective value, in this case projecting the picture of Egyptian identity and power that the
colonists wanted to portray…Yet at the same time Nubian women at Tombos subverted that
message by insisting on a burial that asserted their Kerman ethnic identities within this
otherwise strongly marked Egyptian cemetery. The Nubian pottery found in association
with the pyramid might in this context represent native resistance rather than acceptance of
women living at Tombos, or even a cultural and ethnic counterpoint during the funerals
employing Egyptian burial practice.” (Smith 2003:197)
1
However, it should be noted that the degree to which this funerary protocol was ascribed to as well
as the quality of the burial practices (i.e., embalming, presence of a coffin) was very much associ-
ated with socioeconomic status (Baines and Lacovara 2002; Smith 1991b, 2010). Those of a higher
class were more likely to be able to ensure the finest bodily and tomb preparations for the
afterlife.
With time, particularly during the Third Intermediate and Napatan Periods, there is
an increasing fusion of Egyptian and Nubian burial traditions. For example, the
appearance of burials in coffins on beds emerges (Smith 2003). During the Napatan
Period, the traditional Nubian single (or double) inhumation tumuli burials were
used. The pyramid tradition, both the construction of new pyramids as well as the
reuse of New Kingdom pyramids, also continues into the Napatan Period as well
(Smith 2006, 2007b). Again, when viewed in light of social identity and memory
these findings suggest that precolonial burial practices, dating from centuries prior,
were reestablished during the independent postcolonial period (Smith and Buzon
2014). Similar patterns are also present at Amara West (Spencer 2014). Furthermore,
a complex blend of burial traditions, combining aspects of both Egyptian and
Nubian mortuary practices, existed in this space.
“This demonstrates that key elements of Nubian burial practice were revived, like tumuli
and bed burials, if indeed they ever truly disappeared… We can reach a greater understand-
ing of the eventual rise of the Napatan 25th Dynasty by placing it in the context of this
complex cultural mosaic consisting of different degrees of Nubian-Egyptian blending. We
need no longer look directly to Egypt for Egyptian influence, such as the construction of
royal pyramids, which are better seen as an innovation modeled on the New Kingdom—or
alternatively, a continuing tradition of elite pyramid construction.” (Smith 2007b:12–13)
Using craniometric and strontium isotope analyses, Buzon has shown that the bio-
logical and geographic origins of people at Tombos were both local (i.e., Nubian)
and foreign (i.e., Egyptian; Buzon 2006; Buzon et al. 2007; Buzon and Simonetti
2013). During the Third Intermediate and Napatan periods the cranial metrics
become more blended and the strontium data indicate the inhabitants of Tombos
were of local origin (Buzon et al. 2016). Collectively, these data indicate that
Egyptians were migrating from Egypt to Nubia and that indigenous Nubians were
also occupying this colonial town. These data also suggest that these two groups
intermarried and created successive generations of local Nubian-Egyptians.
Archaeological evidence from the cemetery at Tombos indicates prosperous
administrators occupied this town during the New Kingdom period of colonization.
In 2000, the pyramid tomb of Siamun, a high-ranking administrator, was excavated.
Funerary cones, which would have lined the façade of the pyramid entrance, were
inscribed with his title: “Honored by Osiris and Anubis, Master of the Divine
Pavilion, the Scribe of the Treasury, Scribe-Reckoner of the Gold of Kush, Siamun,
and his [mother] the Mistress of the House Weren” (Buzon et al. 2016; Smith
2003:141). Siamun’s title, in addition to the general size and grandeur of the tomb,
indicate he was appointed by the Egyptian Empire and represented an elite socio-
economic status. Furthermore, multiple pyramid tombs, similar to Siamun’s pyra-
mid, have been identified at Tombos. Future excavation of these tombs will certainly
elucidate additional administrative roles and broaden our understanding of this
community.
In addition to these elite tombs, there is also a significant middle-class/non-elite
component to Tombos. Several chamber tombs, excavated in 2000 and 2002, were
found to contain multiple inhumations (Smith 2007b). The tombs themselves were
larger and more elaborate than similar tombs from this period, suggesting an
e levated socioeconomic status. Furthermore, grave goods, such as scarabs, amulets,

jewelry, coffins, imported ceramic vessels, and ushabtis were also included with the
deceased. These burial contexts suggest these individuals were not as high ranking
as Siamun, but also were not markedly poor. This middle-class population of
Tombos may have engaged in activities such as scribes, prosperous servants, and
artisans (Buzon and Richman 2007).
The bioarchaeological examination of skeletal remains from New Kingdom
Tombos further supports the idea that this community was composed of middle to
upper socioeconomic status individuals who were administering the Third Cataract
and Upper Nubia. When skeletal remains were analyzed for osteoarthritis and
entheseal changes, both indicators of physically stressful manual labor, the Tombos
sample had particularly low frequencies of each condition (Schrader 2010, 2012).
These data were then compared with various Nile Valley populations. The Tombos
sample consistently had the lowest levels of both osteoarthritis and entheseal mark-
ers than any comparative sample. Thus, this bioarchaeological investigation of
activity supports the archaeological material record.
While we know a great deal about the burial practices and biosocial identities of
Tombos, there remain many questions about the everyday lives of people inhabiting
in this colonial town. Through the analysis of entheseal changes, osteoarthritis, and
carbon and nitrogen isotope analysis, physical activities and dietary patterns can be
examined. Additionally, using a diachronic approach, we can begin to address how
the transition from colonial to postcolonial impacted this population, but also how
the people of Tombos remained agentive during this period of change.
Osteology, Structure, and Agency
If we situate this archaeological narrative within a broader discussion of practice

and agency, we can use osteological data to interpret everyday life at Ancient
Tombos. As discussed in Chap. 2, practice theory argues that there is a dialectical
relationship between social structure, a preexisting and all-encompassing societal
framework, and human agency, an individual’s ability to act. Stable isotope, enthe-
seal changes, and osteoarthritis data from the New Kingdom sample are presented
to infer what the everyday experience was for a Nubian–Egyptian living in a colo-
nial town. Asymmetric power relations inherent to this scenario of Egyptian colo-
nization no doubt influenced the applicable social structure; however,
Nubian-Egyptians in this milieu would have maintained some degree of agency.
Osteological data from the Third Intermediate/Napatan Period will also be pre-
sented. The inhabitants of Tombos during this postcolonial period may have had a
very different everyday experience than their New Kingdom ancestors. A varying
social structure and relative agentive response would have applied to this postcolo-
nial community as well.
Osteology, Structure, and Agency 173
Osteology
The methods described in Chaps. 3 (entheseal changes, osteoarthritis) and 4 (stable

isotope analysis) were applied to the Tombos skeletal collection. The Hawkey and
Merbs method for entheseal changes was applied (Hawkey and Merbs 1995). Even
though alternative methods have been proposed, I argue that Hawkey and
Merbs’ scoring system remains valid for a straightforward, macroscopic method of
assessing entheseal changes. Furthermore, all data were collected by myself and,
thus, critiques of interobserver error are not applicable. Osteoarthritis data were col-
lected according to Buikstra and Ubelaker (Buikstra and Ubelaker 1994). Sex and
age were estimated based on cranial and pelvic morphology and degeneration
(Buikstra and Ubelaker 1994). The Tombos skeletal collection, now housed at
Purdue University, consists of a New Kingdom sample and a Third Intermediate
Period/Napatan sample (Table 5.2). The Third Intermediate and Napatan periods
were combined here because (1) this created an increased sample size and (2) there
is no inherent separation, or distinct beginning or end, of the Third Intermediate
(sometimes referred to as the Pre-Napatan Period in Nubia) and Napatan Periods
(Schrader and Buzon 2017). ANCOVA was used to both control for the contributing
factors of age and body size as well as compare samples. This is a departure from
Chap. 3, which compared osteoarthritis and entheseal changes within age cohorts.
Using ANCOVA here is intentional, as a way to illustrate another way to analyze
and present activity data. Similarly, osteoarthritis data here are presented in mean
score per element, whereas in Chap. 3 Larsen’s presence/absence method was
employed (Larsen 2015).
Entheseal changes are significantly higher in the Third Intermediate Period/
Napatan sample than the New Kingdom sample (Table 5.3). This pattern is present
both in the upper body as well as the lower body; however, every lower body enthe-
ses, on both the left and the right side, have a significantly higher mean score in the
Third Intermediate Period/Napatan sample than the New Kingdom sample. This sug-
gests that the population of Third Intermediate Period/Napatan Tombos was engag-
ing in more strenuous physical activity on a regular basis than New Kingdom Tombos.
In the New Kingdom sample, the right common extensors attachment is significantly
higher than the left. In the Third Intermediate Period/Napatan sample, the right com-
mon flexors attachment is significantly higher than the left. The fact that arm/hand
entheses are more pronounced on the right hand side is not surprising given right-
handed predominance in humans (Annett 1992; Falk 1987); these data support the
argument that entheseal changes are indeed influenced by physical (over)use.
Table 5.2 Demographic distribution of Tombos skeletal sample

New Kingdom Third Intermediate Period/Napatan
Female Male Female Male
YA MA OA ? YA MA OA ? YA MA OA ? YA MA OA ?
12 19 15 9 6 17 9 10 10 11 7 1 8 8 5 0
Table 5.3 New Kingdom versus Third Intermediate Period/Napatan (controlling for age)
Left Right
New
Kingdom 3IP/Napatan New Kingdom 3IP/Napatan
x n SD x n SD x n SD x n SD
M. supraspinatus/M. 0.70 27 1.14 1.95 19 1.58 0.75 20 1.07 2.35 23 1.85
infraspinatus
M. subscapularis 0.64 25 0.95 1.89 18 1.57 1.47 19 1.22 2.17 24 1.81
M. teres minor 0.78 27 1.19 1.26 19 1.63 1.47 17 1.59 1.43 23 1.65
M. triceps brachii 1.36 22 1.40 1.38 24 1.10 1.46 26 1.14 1.52 21 1.12
M. brachialis 1.27 22 0.94 1.83 23 1.27 1.26 27 1.10 1.76 21 1.09
M. biceps brachii 2.18 22 1.44 2.13 23 1.52 1.91 22 1.54 2.10 20 1.41
M. brachioradialis 1.26 19 1.10 1.95 20 1.15 1.13 16 0.81 2.24 21 1.30
Common extensors 1.58 31 1.23 2.73 22 1.70 2.15a 27 1.46 2.79 24 1.77
Common flexors 0.94 33 1.69 1.34 23 1.37 0.96 26 1.04 1.67a 24 1.55
M. semimembranosus/M. 1.75 48 1.58 2.94 35 1.94 2.60 35 1.61 3.37 35 1.63
semitendinosus/M. biceps
femoris
M. gluteus medius 1.48 23 1.31 2.41 22 1.44 1.17 24 1.17 2.75 20 1.41
M. gluteus minimus 1.43 23 1.38 2.23 22 1.63 1.13 23 1.14 1.90 20 1.45
M. iliopsoas 1.32 22 1.36 2.04 24 1.30 1.00 26 1.23 1.91 23 1.78
M. quadratus femoris 1.00 25 1.19 1.96 24 1.12 0.93 28 1.02 1.96 24 1.27
M. gastrocnemius 1.32 22 1.17 2.13 23 1.36 0.90 20 1.29 2.09 22 1.23
Patellar ligament 1.18 17 1.29 2.39 18 1.24 1.17 23 1.56 2.10 21 1.26
M. popliteus 0.50 14 0.85 1.12 17 0.93 0.30 20 0.47 1.29 21 1.27
Bold = significantly higher (p ≤ 0.05) than New Kingdom skeletal sample (ANCOVA, covari-
ate = age) (left compared to left, right compared to right)
a
Significantly higher (p ≤ 0.05) than left side (within the same sample; i.e., New Kingdom left
versus New Kingdom right, Napatan left versus Napatan right)
There are a few entheseal changes that significantly differ between males and
females. In the New Kingdom sample, five entheses are significantly higher in
males than females, even when body size was statistically controlled for. These
attachments include: left M. triceps brachii, left and right M. biceps brachii, left M.
brachioradialis, and left M. semimembranosus/M. semitendinosus/M. biceps femo-
ris. Collectively, these muscles are responsible for elbow flexion and extension,
forearm pronation and supination, and knee flexion. There is one entheseal attach-
ment, common flexors, that was found to be higher in females than males. The com-
mon flexors, which are a group of entheses including M. pronator teres, M. flexor
carpi radialis, M. palmaris longus, M. flexor digitorum superficialis, and M. flexor
carpi ulnaris, are responsible for hand and finger movement, including abduction
and adduction of the hand. These data suggest that during the New Kingdom there
may have been a sexual division of labor, where men were using their elbows and
knees more than women. Similarly, women may have been involved in a repetitive
activity that relied upon the hand(s).
The Third Intermediate Period/Napatan sample was also analyzed for a potential
sexual division of labor. There is only one enthesis that was found to significantly
differ between males and females: right M. popliteus (higher in males). This muscle
is located at the back of the knee and is responsible for knee flexion and extension
as well as bipedal locomotion. These data suggest that during the Third Intermediate/
Napatan Period there may not have been a sexual division of labor. Males may
have been using their right knee more than females, but this is the only location
throughout the body that suggests differential activities between males and females
(Tables 5.4 and 5.5).
Comparisons of entheseal changes within the sexes (i.e., females versus females,
males versus males) were also calculated to tease apart the broad trends presented
in Table 5.3. When New Kingdom females are compared to Third Intermediate
Period/Napatan females (Table 5.6), we see that the Third Intermediate Period/
Napatan population frequently has significantly higher entheseal mean scores. Like
Table 5.4 New Kingdom females versus males (controlling for age and body size)
Left Right
Females Males Females Males
infraspinatus
M. subscapularis 0.31 13 0.63 0.71 7 0.95 0.80 10 1.03 2.25 8 1.04
M. teres minor 0.86 14 1.23 0.88 8 1.46 1.25 8 1.91 1.75 8 1.39
M. brachialis 1.00 11 1.00 1.75 8 0.89 0.93 14 0.92 2.00 7 1.41
M. biceps brachii 1.27 11 1.19 3.38 8 0.74 1.08 13 1.04 2.83 6 1.47
Common extensors 1.40 15 1.35 2.00 11 1.00 1.71 14 1.68 2.40 10 0.97
Common flexors 1.12 17 2.15 0.82 11 1.17 0.92 13 1.19 0.70 10 0.67
femoris
M. gluteus medius 1.29 14 1.33 1.33 6 1.03 1.00 14 1.30 1.38 8 1.06
M. iliopsoas 0.83 12 1.27 1.60 5 1.14 0.94 16 1.39 1.22 9 0.97
M. gastrocnemius 1.07 14 1.07 1.80 5 1.30 0.83 12 1.53 1.00 7 1.00
M. popliteus 0.25 8 0.71 1.00 4 1.15 0.17 12 0.39 0.33 6 0.52
Bold = significantly higher (p ≤ 0.05) than comparative male/female sample (ANCOVA, covari-
ate = age, body size) (left compared to left, right compared to right)
Body size for the upper body was calculated by averaging the z-scores of: the humeral head,
humeral length, and maximum epicondylar breadth. Similarly, body size for the lower body was
calculated by averaging the z-scores of: the femoral head, femoral length, and maximum epicon-
dylar breadth.
Table 5.5 Third Intermediate Period/Napatan females versus males (controlling for age and body
size)
Left Right
Females Males Females Males
infraspinatus
M. subscapularis 1.85 13 1.52 2.00 5 1.87 2.12 17 1.62 2.67 6 2.34
M. teres minor 1.23 13 1.59 1.33 6 1.86 1.44 16 1.67 1.50 6 1.87
M. brachialis 1.93 14 1.54 1.60 5 0.89 1.87 15 1.25 1.40 5 0.55
M. biceps brachii 1.58 12 1.24 2.67 6 1.75 1.86 14 1.23 2.20 5 1.48
Common flexors 1.36 14 1.39 1.71 7 1.50 1.88 17 1.50 1.33 6 1.75
semitendinosus/M. biceps femoris
M. gluteus medius 2.21 14 1.37 2.75 8 1.58 2.38 13 1.26 3.43 7 1.51
M. iliopsoas 1.73 15 1.28 2.63 8 1.30 1.60 15 1.68 2.86 7 1.77
M. gastrocnemius 1.73 15 1.33 2.88 8 1.13 1.92 12 1.24 2.38 8 1.30
M. popliteus 0.91 11 0.83 1.50 6 1.05 0.67 12 0.65 2.43 7 1.51
Bold = significantly higher (p ≤ 0.05) than comparative male/female sample (ANCOVA, covari-
ate = age, body size) (left compared to left, right compared to right)
Body size for the upper body was calculated by averaging the z-scores of: the humeral head,
humeral length, and maximum epicondylar breadth. Similarly, body size for the lower body was
calculated by averaging the z-scores of: the femoral head, femoral length, and maximum epicon-
dylar breadth.
Table 5.3, much of the upper body and all of the lower body entheses are higher in
the Third Intermediate Period/Napatan female sample than the New Kingdom
female sample. These data suggest that Third Intermediate Period/Napatan females
were more physically active than New Kingdom females.
Third Intermediate Period/Napatan males also have higher entheseal scores than
New Kingdom males, but to a lesser extent than females (Table 5.7). Of the 18
entheseal changes analyzed for the upper body (nine left, nine right), only four are
higher in Third Intermediate Period/Napatan males than New Kingdom males. The
majority of lower body entheses, however, are higher in Third Intermediate Period/
Napatan males than New Kingdom males (10 out of the 16 that were analyzed).
Like the female example above, Third Intermediate Period/Napatan males were
probably engaging in more physically strenuous activities than New Kingdom
males, particularly those that involved the lower body.
Skeletal indicators of osteoarthritis support the entheseal data with the Third
Intermediate Period/Napatan sample showing significantly higher lipping and
porosity than the New Kingdom sample (Table 5.8). However, there are only a few
Table 5.6 New Kingdom females versus Third Intermediate Period/Napatan females (controlling
for age)
Left Right
New New
Kingdom 3IP/Napatan Kingdom 3IP/Napatan
infraspinatus
M. subscapularis 0.31 13 0.63 1.85 13 1.52 0.80 10 1.03 2.12 17 1.62
M. teres minor 0.86 14 1.23 1.23 13 1.59 1.25 8 1.91 1.44 16 1.67
M. brachialis 1.00 12 0.95 1.88 17 1.41 0.93 15 0.88 1.87 15 1.25
M. biceps brachii 1.50 12 1.38 1.75 16 1.24 1.36 14 1.45 1.86 14 1.23
Common flexors 1.12 17 2.15 1.25 16 1.34 1.00 14 1.18 1.88 17 1.50
femoris
M. gluteus medius 1.29 14 1.33 2.21 14 1.37 1.00 15 1.25 2.38 13 1.26
M. iliopsoas 0.77 13 1.24 1.75 16 1.24 0.88 17 1.36 1.60 15 1.68
M. gastrocnemius 1.07 14 1.07 1.73 15 1.33 0.83 12 1.53 2.00 13 1.22
M. popliteus 0.25 8 0.71 0.91 11 0.83 0.17 12 0.39 0.71 14 0.61
significant differences between the two samples, whereas the majority of entheses
are significantly higher in the Third Intermediate Period/Napatan sample. The Third
Intermediate Period/Napatan sample exhibits higher rates of osteoarthritis in the left
and right shoulder (left glenoid fossa lipping, right glenoid fossa lipping, left proxi-
mal humerus porosity), and the left knee (left proximal tibia lipping). Eburnation is
uncommon in both samples, with only four joints impacted by the painful condition
(left distal humerus, left acetabulum, right distal femur, and right proximal tibia).
Unfortunately, sample size of the stable isotope component of this project is lim-
ited because many of the specimens that were tested did not have an appropriate
C:N ratio or the collagen yield was not adequate. This is a common problem in
Ancient Nubia and is thought to be the product of the extreme hot and arid climate
(Baker 1992). However, several samples did meet the necessary criteria to be con-
sidered viable and were tested in triplicate to assure their reliability. The dietary
patterns of New Kingdom and Third Intermediate Period/Napatan Tombos, as
assessed by carbon and nitrogen isotope analysis, are markedly similar (Table 5.9;
Fig. 5.3). The mean δ13C value for New Kingdom Tombos is −19.21‰ ± 1.27 and
the mean δ15N value is 12.79‰ ± 0.68. The mean δ13C value for Third Intermediate
Table 5.7 New Kingdom males versus Third Intermediate Period/Napatan males (controlling for
age)
Left Right
New New
Kingdom 3IP/Napatan Kingdom 3IP/Napatan
infraspinatus
M. subscapularis 0.71 7 0.95 2.00 5 1.87 2.25 8 1.04 2.67 6 2.34
M. teres minor 0.88 8 1.46 1.33 6 1.86 1.75 8 1.39 1.50 6 1.87
M. brachialis 1.67 9 0.87 1.67 6 0.82 1.70 10 1.34 1.50 6 0.55
M. biceps brachii 3.22 9 0.83 3.00 7 1.83 2.88 8 1.25 2.67 6 1.75
Common flexors 0.82 11 1.17 1.71 7 1.50 0.70 10 0.67 1.33 6 1.75
femoris
M. gluteus medius 1.50 8 1.07 2.75 8 1.58 1.44 9 1.01 3.43 7 1.51
M. iliopsoas 1.88 8 0.99 2.63 8 1.30 1.22 9 0.97 2.86 7 1.77
M. gastrocnemius 1.57 7 1.27 2.88 8 1.13 1.00 7 1.00 2.38 8 1.30
M. popliteus 1.00 4 1.15 1.50 6 1.05 0.33 6 0.52 2.43 7 1.51
Period/Napatan Tombos is −19.41‰ ± 0.27 and the mean δ15N value is

12.94‰ ± 0.38. For both samples, this is suggestive of a mixed C3/C4 diet, with a
terrestrial mammal and possibly riverine fish component. These results are particu-
larly interesting when they are juxtaposed with the C-Group (δ13C −17.7 ± 0.61,
δ15N 13.2 ± 0.43) and Pharaonic (δ13C −20.2 ± 0.21, δ15N 11.7 ± 0.80) isotopic data
presented in Chap. 4 (discussed further below).
Structure and Agency
The data presented in this chapter suggest that levels of physical activity differed
between the New Kingdom and Third Intermediate/Napatan Period, however,
dietary patterns did not change between the two periods. How do these data trans-
late into an understanding of day-to-day life? How can we reconcile these osteologi-
cal interpretations of everyday activity with structure and agency? The answer lies
Table 5.8 New Kingdom versus Napatan osteoarthritic lipping, porosity, and eburnation (controlling for age)
Left Right
New Kingdom 3IP/Napatan New Kingdom 3IP/Napatan
L P E L P E L P E L P E
x x x n x x x n x x x n x x x n
Glenoid 0.54 0.15 0.00 13 0.86 0.43 0.00 21 0.65 0.18 0.00 17 0.80 0.45 0.00 20
Proximal 0.36 0.14 0.00 28 0.37 0.16 0.00 19 0.45 0.14 0.00 22 0.44 0.44 0.00 25
Humerus
Distal 0.38 0.16 0.00 32 0.30 0.09 0.44 23 0.42 0.04 0.00 26 0.30 0.09 0.00 23
Humerus
Osteology, Structure, and Agency
Proximal 0.68 0.09 0.00 22 0.61 0.26 0.00 23 0.84 0.12 0.00 25 0.75 0.25 0.00 20
Ulna
Proximal 0.24 0.05 0.00 21 0.08 0.00 0.00 24 0.29 0.10 0.00 21 0.24 0.10 0.00 21
Radius
Distal Ulna 0.75 0.19 0.00 16 0.48 0.19 0.00 21 0.74 0.11 0.00 19 0.70 0.20 0.00 20
Distal 0.47 0.05 0.00 19 0.58 0.13 0.00 24 0.53 0.21 0.00 19 0.55 0.14 0.00 22
Radius
Acetabulum 0.69 0.22 0.02 51 0.78 0.24 0.00 37 0.88 0.47 0.00 43 0.74 0.29 0.00 38
Proximal 0.60 0.12 0.00 25 0.52 0.24 0.00 25 0.48 0.11 0.00 27 0.58 0.21 0.00 24
Femur
Distal 0.54 0.23 0.00 26 0.35 0.13 0.00 23 0.68 0.44 0.04 25 0.46 0.38 0.04 24
Femur
Proximal 0.24 0.12 0.00 17 0.63 0.26 0.00 19 0.41 0.23 0.09 22 0.57 0.29 0.00 21
Tibia
Distal Tibia 0.20 0.00 0.00 20 0.33 0.19 0.00 21 0.23 0.00 0.00 22 0.25 0.05 0.00 20
L lipping, P porosity, E eburnation
Bold = significantly higher (p ≤ 0.05) than New Kingdom skeletal sample (ANCOVA, covariate = age) (left compared to left, right compared to right)
179
Table 5.9 Carbon and nitrogen isotope results: Tombos individuals

Sample Time period δ13C δ15N C:N %C %N
Unit 5 Pit B New Kingdom −19.66 12.12 3.67 36.82 11.63
Unit 5 Pit D New Kingdom −18.83 12.61 3.31 40.06 13.98
Unit 6 Locus 47 Pit G New Kingdom −20.14 13.54 3.46 35.42 12.01
Unit 6 Locus 47 Burial 1 New Kingdom −17.89 12.33 3.33 37.17 13.01
Unit 6 Pit H Burial 2 New Kingdom −16.85 12.11 3.54 45.54 15.01
Unit 6 Locus 40 Pit G New Kingdom −20.06 12.40 3.57 38.63 12.57
Unit 6 Locus 27 New Kingdom −20.62 13.71 3.81 41.16 12.59
Unit 7 Locus 4 New Kingdom −19.62 13.48 3.53 43.59 14.76
Unit 3 Burial 1 3IP/Napatan −19.25 13.05 3.58 33.11 10.49
Unit 15 3IP/Napatan −19.73 12.52 3.39 34.67 11.81
Unit 20 Shaft 1 3IP/Napatan −19.26 13.26 3.30 43.73 15.47
in an interpretative model, grounded in archaeological context. The colonial and

postcolonial setting of the New Kingdom and Third Intermediate/Napatan Period,
respectively, has been thoroughly examined at Tombos by Drs. Stuart Tyson Smith
and Michele Buzon with more than 20 years of excavation. Additionally, other sites
contemporary to Tombos have been excavated and, together, bolster a practice the-
ory interpretation. Because of this robust research we are able to elucidate the extant
social structure and suggest possible venues of agentive action that occurred in this
complex colonial and postcolonial community.
Here, I will employ Bourdieu’s concepts of habitus. As discussed in Chap. 2,
Bourdieu conceived of habitus as unconscious and engrained dispositions that were
the product of both past and present circumstances (Bourdieu 1977). These disposi-
tions are based on one’s experiences, beliefs, interactions, perceptions, feelings, etc.
and are intrinsically linked with one’s capitals (economic, social, and symbolic).
Although Bourdieu was not a self-proclaimed Marxist, he emphasizes the influence
of capital on daily practice throughout his writings. Capital refers not only to one’s
income, assets, and property but also more nuanced forms of status such as accent/
dialect, tastes/cuisine, posture/mannerisms, clothing, skills, and diplomas/degrees/
credentials. These various forms of capital are crucial to one’s position in the field.
Field, according to Bourdieu, is the context, or the social space, in which the indi-
vidual exists. This is the milieu where people can change their habitus and poten-
tially their capital. The field can be described as a struggle in which actors vie for
transformation and only through this can they change their habitus. Thus, according
to Bourdieu, everyday practice is the product of habitus, capital, and field.
New Kingdom Everyday Life and Habitus
The social structure of New Kingdom Tombos was grounded in a colonial and mul-
ticultural setting. As discussed above, New Kingdom Tombos was an Egyptian-
controlled administrative center where Egyptians (individuals who came to Nubia
Fig. 5.3 Carbon and nitrogen isotope results: Tombos compared to C-Group and Pharaonic
samples
from Egypt, likely in a bureaucratic role) and Nubian-Egyptians (the biological

descendants of Nubians and Egyptians, who enacted Egyptian, and to a lesser
extent, Nubian cultural practices) coexisted (Smith 2003, 2005; Smith and Buzon
2017). This is evident from the skeletal and archaeological data from the Tombos
cemetery. The ancient town and fortress of Tombos is located directly below the
modern town, making excavation difficult. This endeavor is underway, however,
much of our current knowledge of this ancient community is derived from the cem-
etery context (Smith and Buzon 2018).
The fact that both Egyptians and Nubians coexisted in this colonial administra-
tive town and that they intermarried is meaningful. These individuals were living
side-by-side, having children, and blending cultural practices. Stuart Tyson Smith
describes this as direct control, where Egyptian administrators, such as Siamun,
were put in place to monitor the surrounding area (Smith 1997, 1998, 2003). This is
contrasted with an indirect control, or hegemonic, approach which was put in place
south of the Tombos (Morkot 2001). In the territories where indirect control was
enacted, it is possible that indigenous Nubian leaders were coopted and put in posi-
tions of power (Edwards 2004). Tribute and taxes were likely paid by this peripheral
territory to the empire; however, colonial towns, like Tombos, were not constructed
south of the Third Cataract and there is no evidence to suggest that Egyptian colo-
nists were sent farther south than Tombos.
Smith also discusses the concept of buffer zones, which are spaces on the bound-
ary of direct- and indirect-controlled territories, such as Tombos (Smith 2003). The
Egyptian Empire may have modified their tactics in instances of buffer zones in
order to (1) maintain control in a border region and (2) encounter less indigenous
resistance (Smith 2003). In the case of revolt or rebellion, the nearest Egyptian
town, Sesibi, was approximately 50 km north of Tombos (Fig. 5.1). In Smith’s
words, “Tombos was isolated from Egyptian power, outnumbered and perhaps sur-
rounded by a foreign culture” (Smith 2003:195). Archaeological evidence north of
Tombos supports this argument. There are more imperial towns and religious cen-
ters, both of which are built in accordance with Egyptian design. In Lower Nubia
acculturation took place during the New Kingdom—the presence of Nubian-style
artifacts and funerary assemblage virtually disappears from the archaeological
record and is replaced by Egyptian-style material remains. If we compare the find-
ings of Lower Nubia to Tombos, we see a very different pattern. The inclusion of
Nubian-style ceramics, burial beds, flexed burial position, etc. all suggest that
Tombos may have been strategically lenient when it came to enforcing Egyptian
ideals (Smith 2003). If this were the case, then we can theorize that Tombos may
have had a unique, more flexible, multicultural habitus whereas Egyptianized Lower
Nubia may have reproduced a habitus that was in line with Egypt.
The multicultural, buffer zone-influenced, habitus would certainly have impacted
daily-life at New Kingdom Tombos. While osteological approaches cannot speak to
the refined activities that Bourdieu suggests (e.g., posture, mannerisms, taste), we
can use the entheseal and osteoarthritis data to interpret what types of activities the
people of Tombos were engaged in and we can draw on the isotope data to investi-
gate what types of foods were being consumed. The entheseal changes and osteoar-
thritis data suggest that these Nubian-Egyptians were participating in limited
physically strenuous daily activities. I have previously argued that this may be due
to the specialized imperial function of Tombos (i.e., administrative center; Schrader
2012). Furthermore, in relation to osteoarthritis data from other skeletal collections,
the presence of degenerative joint disease at New Kingdom Tombos is very limited
(see Austin 2017; Zabecki 2009). In addition to formal Egyptian bureaucrats, such
as Scribe-Reckoner of the Gold of Kush, residing at Tombos, other occupants would
have been: scribes, prosperous servants, artisans, and musicians. The day-to-day
activities of these individuals would not have been particularly strenuous or demand-
ing. Males did have slightly higher entheseal scores, with body size taken into con-
sideration, possibly indicating a sexual division of labor; however, this pattern was
not visible in the osteoarthritis data. These interpretations present an image of colo-
nialism that differs from what we might expect. Bioarchaeologists investigating
other instances of colonization have provided evidence for an increase in disease,
workload, and violence, as well as a decrease in overall health in local populations
as empires enforced policies such as tribute demands and surplus extraction
(Andrushko et al. 2006; Eng and Zhang 2013; Klaus and Tam 2009; Larsen et al.
2001; Tung 2012).
Interpretations of the carbon and nitrogen data provide additional support for the
coexistence model at New Kingdom Tombos. The isotope ratios presented here sug-
gest a mixed C3/C4 diet with a terrestrial mammal and/or fish contribution. These
data are not at all surprising, given that both C3 and C4 foods are available in the
region. However, when these interpretations are coupled with the Lower Nubia data,
presented in Chap. 4, we see that the Tombos C/N data fall directly between the
Pharaonic and C-Group samples. If we conceptualize the Pharaonic sample as
hyper-Egyptian and the C-Group sample as hyper-Nubian, as is argued in Chap. 4,
we can then deduce that the Tombos New Kingdom sample is neither altogether
Egyptian nor Nubian. In line with the previous discussion, Tombos was likely a
colonial town where a coexistence and multicultural approach served to (1) create a
close-knit and stable colonial town and (2) solidify the potentially vulnerable buffer
zone. Just as the people of Tombos embraced parts of Egyptian and Nubian culture,
they may also have embraced one another’s dietary practices.
According to Bourdieu, the field in this scenario can also be viewed as a space
where individuals may gain social and economic capital by adopting certain man-
ners, tastes, skills, etc. that pair within the contextual habitus. It is only when one’s
habitus and field are suited to one another that an individual can gain capital
(Bourdieu 1990). Stuart Tyson Smith and others have suggested that it may have
been advantageous for Nubians in an Egyptian colonial milieu to adopt certain
Egyptian practices in order to fit in and prosper (O’Connor 1993; Smith 2003; Török
2009). If this were the case, the act of selectively adopting certain Egyptian prac-
tices can be viewed as agency—these individual decided to (1) coexist with
Egyptians at Tombos (as opposed to moving farther south to an area of indirect
control) and (2) adopt Egyptian practices to varying degrees. The majority of buri-
als, including Egyptians, Nubians, and Nubian-Egyptians (according to Buzon’s
cranial metric data), were interred in an Egyptian style (supine position, mummi-
fied, coffin, pyramid/chamber tomb; Buzon 2006; Buzon et al. 2016; Smith 2003;
Smith and Buzon 2014, 2017). There are also select individuals who were buried in
a Nubian-style (flexed, burial bed, Nubian-style pottery). These lines of evidence
suggest Nubian-Egyptians could express their social identities via burial practices at
Tombos (Smith and Buzon 2017).
New Kingdom Tombos habitus certainly included much more than what we can
assess in the material and osteological record; however, using Bourdieu’s model, we
can begin to theorize the social structure that was in place during this colonial period
and the agency that individuals in this environment maintained. The daily practices
that resulted from the interaction of habitus and capital in the field(s) of this colonial
town were not particularly physically strenuous and reflect a blend of both Egyptian
and Nubian lifeways (both mortuary and dietary practices). Social structure was
likely heavily influenced by Egyptian norms, however, Nubian-Egyptians living in
Tombos maintained agency, which is evident in their (1) cultural presence in this
Egyptian colony, (2) multicultural cuisine, and (3) mortuary practices. As Smith
argues, “contradicting Egyptianization models that posited the complete disappear-
ance of Nubian culture throughout the empire, the persistence of Nubian style burial
practices, cuisine/ceramic traditions, and other aspects of material culture demon-
strates the complexities of entanglements and the resilience of Nubian culture even
in the face of colonization and the widespread adoption of Egyptian cultural fea-
tures” (Smith 2014:3). It should be noted that Tombos might not reflect the broader
Nubian experience during the New Kingdom. In this specialized administrative,
buffer zone, multicultural colony, it was advantageous for both Egyptians and
Nubians to coexist. However, in other New Kingdom contexts, this may not have
held true. The balance between Egyptian and Nubian would be skewed and the
habitus, capital, and practice of individuals in these spaces.
Third Intermediate Period/Napatan Everyday Life and Habitus
As the unity of the Egyptian Empire began to fade, Egypt’s Golden Age crumbled
into the Third Intermediate Period. Some have suggested that Nubia’s growing inde-
pendence and power may have contributed to the decline of the New Kingdom
(Edwards 2004; O’Connor 1993; Török 1995). As stated above, ongoing excava-
tions, including those at Tombos, have illustrated thriving communities in Nubia
during the Third Intermediate and Napatan Periods (Smith 2008, 2013, 2014;
Spencer 2014). These were postcolonial communities that were reworking their
economic, political, and social spheres as they gained independence (Morkot 2013;
Schrader et al. 2018; Schrader and Buzon 2017). At Tombos, this population would
have been the product of over 500 years of Nubian–Egyptian coexistence.
Third Intermediate Period/Napatan Tombos would have been very different from
New Kingdom Tombos. Rather than being defined as a colonial Egyptian town in
Nubia, tasked with coexistence and maintaining the southern border of direct con-
trol, Third Intermediate Period/Napatan Tombos would have been independent of
Egyptian rule and beginning to define itself economically, politically, and socially
in this new role (Smith 2013). It is unclear at this time how unified Nubia was at the
dawn of the Third Intermediate Period. It is possible that towns such as Tombos
were operating independently, or they could have already banded together, using the
extant colonial structure, to form the beginnings of a successor state (i.e., the
Napatan State; Smith 2013). As Edwards points out, the need for further excavation
of sites during this obscure Third Intermediate/Napatan period is essential (Edwards
2004). “Coming out of the shadow of Egypt,” as Stuart Tyson Smith puts it, would
have been an opportunity for the community of Tombos to gain capital and change
their habitus (Smith 2014).
Burial practices at Tombos during the Third Intermediate/Napatan Period reflect
long-term coexistence between Egyptians and Nubians and are more multicultural
than ever (Smith 2014; Smith and Buzon 2014). Many burials continue to be in the
Egyptian supine position; however, several females are buried in the flexed position
(Smith 2003). Some individuals in the cemetery complexly weave Nubian and
Egyptian funerary practices together by being buried in a coffin (Egyptian-tradition)
that was then placed on a burial bed (Nubian-tradition). Burial tumuli, which were
common in the precolonial Kerma Period (2500–1500 BCE), become popular again.
Pyramids, both newly constructed as well as reused from the New Kingdom, con-
tinued to be places of burial (Smith 2006). These multicultural burial practices and
dietary patterns at Tombos reflect the long-standing Nubian–Egyptian cultural heri-
tage that was present in this now postcolonial community, but also speak to an
altered habitus (Smith 2013; Smith and Buzon 2014).
Strontium data indicates that these individuals were of local origin and cranial
metric data suggests this population was the offspring of both Egyptians and
Nubians (Buzon et al. 2016). There is an increase in femora size between the New
Kingdom and Napatan periods, which may reflect migration from farther South or
might suggest a more resilient population (Gibbon and Buzon 2016). Accidental
trauma was limited and comparable to the New Kingdom Tombos sample (Schrader
and Buzon 2017). Entheseal changes from Third Intermediate Period/Napatan
Tombos are significantly higher than the New Kingdom sample; this may have been
associated with an increase in quarrying, agropastoralism, and construction efforts
in a postcolonial landscape (Schrader and Buzon 2017). While these bioarchaeo-
logical studies greatly contribute to our understanding of the biocultural environ-
ment of Tombos during and after the transition from New Kingdom colony to
independent Third Intermediate Period/Napatan state, framing these data in practice
theory may shed light on the everyday lives of this population.
The osteological data presented here suggests that the Third Intermediate/
Napatan Period sample may have been engaging in more frequent and strenuous
physical activities than the New Kingdom sample, supporting previous interpreta-
tions (Schrader and Buzon 2017). This is particularly true for entheseal attachment
sites of the lower body, but there are also several correlations with entheses from the
upper body (Tables 5.3, 5.6, and 5.7). The osteoarthritis data also substantiate the
entheseal data, although the differences between the New Kingdom and Third
Intermediate/Napatan osteoarthritis data are less stark. Given the postcolonial envi-
ronment of the Third Intermediate/Napatan Period, the Tombos population may
have been increasingly independent: growing and harvesting plant foods, engaging
in animal pastoralism, as well as building structures. If the population of New
Kingdom Tombos was relying on imperial connections and trade networks for these
goods, which would have come to a halt with the disunity of the Third Intermediate
Period—the people of Third Intermediate Period/Napatan Tombos would have to
provide for themselves.
Another distinct possibility is that the people of Third Intermediate Period/
Napatan Tombos were participating in granite quarrying, carving, and transporta-
tion. The natural outcrop of granite, which defines the Third Cataract region, was an
excellent resource for large boulders that could be used to create larger-than-life
statuary. There is archaeological evidence of these activities from Third Intermediate
Period/Napatan Period Tombos. Some boulders show evidence of intentional
breakage (Fig. 5.4). To fracture a large boulder, shims would have been intention-
ally placed and then hammered, breaking the rock in the desired location. These
large granite blocks were further refined onsite via carving. Once the statue was
roughly carved it would be transported to the Nile. The Tombos statue, named
Okjunundi by the local Tombos community, currently rests between the granite
boulders and the Nile (Fig. 5.5). It is thought to be Taharqa, a pharaoh of the Twenty-
Fifth Dynasty (690–664 BCE). However, because the final carving, including the
cartouche of the statue’s namesake, was not completed, this is only a hypothesis.
There is also evidence to suggest that the 6-m tall statues found at Napata originated
Fig. 5.4 Evidence of

quarrying at Tombos
(Photo: S. Schrader)
from Tombos (Dunham 1947). Collectively, these data suggest that the people of
Tombos were quarrying during the Third Intermediate/Napatan Period.
Entheseal and osteoarthritis data indicate that both Third Intermediate/Napatan
Period males and females were participating in activities that were more strenuous
than the comparative New Kingdom sample. In the New Kingdom Tombos sample,
males had higher rates of entheseal changes than females (five entheses) and females
had a higher entheseal mean score than men (one enthesis), suggesting a possible
division of labor. Similar findings have been reported by other studies of entheseal
changes and osteoarthritis in Egyptian skeletal collections (Austin 2017; Zabecki
2009). During the Third Intermediate/Napatan Period at Tombos there was only one
entheses that was higher in males than females (no entheses were higher in females).
When Third Intermediate Period/Napatan males are compared to New Kingdom
males, again the Third Intermediate Period/Napatan sample has significantly higher
entheseal scores. This pattern is even more marked when Third Intermediate Period/
Napatan females are compared to New Kingdom females. These data indicate that
while there was a chronological change in entheseal changes for both men and
women—it is more marked in women. In other words, women of the New Kingdom
were not particularly physically strained, but women of the Third Intermediate/
Napatan Period were engaging in similar levels of physical activities as men.
Fig. 5.5 Okjunundi (possibly Taharqa) (Photo: S. Schrader
The utilization of Tombos’ natural granite resources as well as the changing pat-
terns in physical activity (i.e., increase in entheseal changes and osteoarthritis)
between the New Kingdom and the Third Intermediate/Napatan Period may point to
an altered source of capital. Bourdieu describes three types of capital: economic,
social, and symbolic (Bourdieu 1977; Browitt 2004). In a postcolonial and indepen-
dent landscape, quarrying could be a way for the people of Tombos to gain all three
types of capital. First, economic capital would be acquired by selling large granite
statues either north to Egypt or south to Napata (the capital city of the Napatan
State). Second, social capital, referring to networks of social influence, would also
be enhanced through the prestige and connections of trading these monumental
works of art. Lastly, symbolic capital (legitimated form of economic and social
capital, often drawing on concepts of honor and prestige) would also have been
secured as Tombos monopolized this niche market of granite quarrying. In this way,
the Third Intermediate/Napatan population of Tombos could have been manipulat-
ing a previously untapped resources (granite), modify it (breaking the stone), imbu-
ing it with meaning (carving the stone), and then capitalizing (economically,
socially, and symbolically) on these actions. With each step in this process, prac-
tice—as a product of habitus—was enacted.
The marked similarity between the carbon and nitrogen isotope values of the
New Kingdom and the Third Intermediate/Napatan Periods suggests diachronically
steady dietary practices. As discussed above, if this is another manifestation of

Nubian and Egyptian cultural practices, it continued through the Third Intermediate/
Napatan Periods. Given the Egyptian Empire’s promotion of coexistence and the
extended period of cohabitation, it is not altogether surprising that multiethnic food
traditions would continue from the New Kingdom to the Third Intermediate/Napatan
Periods. If this is the case, this is another example of the expression of multiple
identities, in addition to burial practices, in a postcolonial landscape. It should be
noted, as discussed in Chap. 4 and above, these carbon and nitrogen findings could
speak to foddering practices rather than foods consumed. Further isotopic sampling
of animal remains will be conducted to examine this.2
After more than 500 years of coexistence in a buffer zone colonial territory, the
habitus of the Third Intermediate Period/Napatan Tombos community would have
differed from that of the New Kingdom (Morkot 2001; Smith 2014). We can pre-
sume that coexistence, between Nubians and Egyptians, would have been so
engrained that the field had been modified to incorporate the postcolonial. The daily
activities of the people of Tombos became more physically strenuous. Females
seem to have been as physically active as men, which was different than the social
structure and sexual division of labor norms present in the New Kingdom. I have
proposed construction, animal husbandry, plant cultivation, and quarrying as pos-
sible activities this community could have been participating in. This may have been
due to independence after the colonial network had collapsed. Additionally, there
may have been the potential for the people of Tombos to gain capital as a leader in
trade. Dietary trends may have stayed constant from the New Kingdom to the Third
Intermediate/Napatan Period, suggesting the continuation of a multiethnic commu-
nity with overlapping social identities. The agentive opportunities in this new socio-
political and socioeconomic landscape were numerous.
Summary
While dietary and activity reconstruction of these samples is certainly interesting

and informs our understanding of the everyday lives of these groups, we can go
further in our interpretations of these data. If we consider the social structure as well
as concurrent agentive practices, we can conceptualize everyday action, including
physical activity and diet, as arenas for cultural production and change. In the words
of Ortner, “In enacting these routines, actors not only continue to be shaped by the
underlying organizational principles involved, but continually re-endorse those
principles in the world of public observation and discourse” (Ortner 1984:154).
Using the archaeological and bioarchaeological we can examine these routines and
mundane experiences spatially and diachronically, in order to elucidate how actors
2
Very few animal remains have been excavated from the Tombos cemetery; however, continued
excavation, including within the fortress walls and town of ancient Tombos, is providing more
faunal specimens (Smith and Buzon 2018).
References 189
are shaped by and agentively shape social systems in diverse settings. We can view
physical activity and diet as repeated practices that are performed within a predi-
cated structure that in turn, through agentive action, restructures structures (Dobres
and Robb 2000).
During the New Kingdom Period, physical activity was limited and may have
been the product of occupations such as: scribes, prosperous servants, artisans, and
musicians. Dietary patterns reflect a mixed Nubian–Egyptian diet. Coupled with
previous bioarchaeological research that suggests intermarriage, limited skeletal
indicators of stress, and few instances of trauma—this research suggests that every-
day life at New Kingdom Tombos was multicultural, peaceful, and contrasts with
what we might expect to find in a typical colonial scenario. Archaeological evidence
from the cemetery also points towards a multicultural environment, where individu-
als (or the members of the community that were responsible for their burial) could
express Nubian identities. From this we can infer that the habitus present at Tombos
during this time was grounded in coexistence, a multi-vocal social identity, and a
buffer-zone degree of flexibility. Agency can be seen in the continued presence of
Nubian burial traditions and foodways. Adopting Egyptian cultural practices and
accepting positions in the colonial bureaucracy may have been a way for Nubians to
gain capital (economic, social, and symbolic) in this colonial system.
In the Third Intermediate/Napatan Period, 500 years after initial colonization, I
argue that the field would have been considerably different than the field of the New
Kingdom. After multiple generations of Nubian–Egyptian intermarriage and con-
tinued coexistence, the “playing field,” as Bourdieu refers to it, would have been
situated within the context of a recently independent, postcolonial community that
had great potential. In this milieu, the inhabitants of Tombos may have been engag-
ing in more strenuous everyday activities—such as quarrying, construction, and
agropastoralism—than their New Kingdom predecessors. This was an excellent
opportunity for Nubia to “come out of the shadow of Egypt.” Everyday practice of
the Third Intermediate/Napatan Period Tombos community may have involved
more strenuous labor, but these actions can be viewed as agentive as these individu-
als navigated their way through the postcolonial period, creating a source of eco-
nomic capital and in doing so building social and symbolic capital as well.
The bioarchaeological methods employed here (activity and dietary reconstruc-
tion) bolster the material record and contribute a different perspective to structure
and agency. When skeletal tissue is theorized as embodied action and lived experi-
ence it becomes an ideal medium to examine practice.
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tion of archaeology and history. Journal of Egyptian History, 3(1), 159–189.
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entanglements and hybrid identity. In N. Spencer, A. Stevens, & M. Binder (Eds.), Nubia in
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Chapter 6
Conclusions and Future Directions
In an Ancient Egyptian text, known as the “Teaching of Khety,” a father encourages

his son to pursue a career as a scribe. He does so by describing alternative career
paths:
The Farmer
The farmer cries out more than the guinea fowl;
his voice is louder than a crow’s
His fingers are swollen
and stink greatly.
He is weary, having been sent to the Delta.
He is ruined.
He prospers, if one prospers among lions.
The hippos are grievous for him:
his labour is trebled by them.
He goes out,
and when he reaches his house in the evening,
the walk has finished him off.
The Gardener
The gardener carries a yoke;
his shoulders are bent as with age.
There is a lesion on his neck
and it festers.
He spends the morning watering vegetables
and the evening with the coriander,
while at noon he has done himself in in the orchard.
He works himself to death
more than all (other) jobs.

https://doi.org/10.1007/978-3-030-02544-1_6
196 6 Conclusions and Future Directions
The Carpenter
Every carpenter who wields an adze,
he is more tired than the corvée labourer.
His fields are the timber,
his hoe the adze.
There is no end to his labour.
He does more than his arms can manage,
yet at night he (has to) light (his own) fire.
The Smith
But I have seen the coppersmith at his labours,
at the mouth of his furnace.
His fingers are like a crocodile’s,
and he stinks more than fish roe. (Wilkinson 2016)
While some have referred to this text as the “Satire of Trades,” others consider
these descriptions to be a realistic account of everyday life for non-elites in Ancient
Egypt. While we can reference Ancient Egyptian written works, such as the Teaching
of Khety, tomb paintings that reflect everyday life, or models depicting manual
labor included in tombs—no such data exist for Ancient Nubia. There was no sys-
tem of writing for Ancient Nubia (prior to New Kingdom Egyptian occupation, and
even then the written material was authored by Egyptians), and the use of tomb
paintings or models was not practiced. Needless to say, this is also the case for many
ancient civilizations—no written or pictorial documentation of daily life exists.
Even in scenarios, such as Ancient Egypt, were written and pictorial documentation
survives—can we trust these sources to truly reflect patterns of everyday life? Or
did their author use creative and interpretive license (as the case may be with the
Teaching of Khety).
As Chap. 1 asserts, everyday life is important, both today as in the ancient past.
As archaeologists, we cannot truly understand the individuals, groups, and popula-
tions under study until we address their day-to-day lives. According to Robin,
“Understanding ancient everyday life matters because what people do on a daily
basis is central in the construction of their societies, and as researchers gain better
insights into everyday life in the past they may discern that some of what is truly
remarkable about human societies is situated in deep understandings of the ways of
daily lives” (Robin 2013:203). While archaeologists investigate everyday life
through various means, bioarchaeologists have the distinct opportunity to provide a
different, and hopefully complementary, perspective on everyday life. By grounding
our research in embodiment theory and incorporating multiscalar perspectives, bio-
archaeologists speak to the lived experience of daily action at the individual, group,
or population level.
Embodiment theory is key to Bioarchaeology of the Everyday. “In bioarchaeol-
ogy, embodiment is used to investigate the biological effects of social and cultural
actions, with an understanding that the body acts as an interface between lived expe-
riences and the environment, and preserves material evidence of individuals interac-
6 Conclusions and Future Directions 197
tion and negotiation with their world” (Zuckerman et al. 2014:515). If we contend
that the social and biological realities of individuals transform skeletal material, as
embodiment theory argues, then we can view the materiality of skeletal remains as
direct products of these processes. Bioarchaeologists can use various methodologi-
cal approaches to address anthropological questions all within the framework of
Bioarchaeology of the Everyday.
Chapter 2 contends that social structures have inherent limitations but also have
distinct opportunities for change. Practice theory articulates this argument and
stresses the importance that day-to-day actions have in this process. Practice theory
scholars, including Bourdieu, Giddens, and de Certeau, all highlight the paramount
significance of mundane practices. These authors differ in their views on whether
the actor is aware of limitations of said social structure and how resistance through
practice is a form of agentive action or if the actor is unconscious of these factors.
For archaeologists, practice theory provides an important foundation linking inquiry
to a deeper understanding of the past. Archaeologists study everyday life in ancient
cultures not only because it is important and interesting, but when framed with
practice theory, day-to-day life becomes crucial to interpreting social structure and
agency. Foodways and physical activity are two examples of practices that are per-
formed on a daily basis and are also topics that can be addressed bioarchaeologi-
cally. Previous research and the theoretical backing for anthropology and
archaeology foodways and labor1 are discussed.
In Chaps. 3 and 4 I present methodological discussions of ways in which bioar-
chaeologists can contribute to discussion of everyday life in the past. Osteoarthritis
and entheseal changes, while complicated by complex etiologies, offer an interest-
ing perspective on the physicality of everyday life. I present case studies from
Ancient Kerma and the Second Cataract illustrating these points. At the Kerma
necropolis, burial practices varied considerably; Reisner, who excavated the site in
the early Twentieth Century, argued that these varying burial practices were associ-
ated with socioeconomic status (Reisner 1923). Osteoarthritis and entheseal changes
analysis of individuals from differing burial contexts (corridor burial versus chiefly
burial), suggest markedly different lifeways. The individual in the corridor burial,
with higher rates of both osteoarthritis and entheseal changes, may have engaged in
more frequent and more strenuous physical activity throughout their life. They may
have been involved in agropastoralism, construction, defensive efforts, as well as
boat loading and unloading. Conversely, the chiefly individual had limited osteo-
logical indicators of osteoarthritis and entheseal changes and may have been
involved in bureaucratic meetings, scribal duties, recreational sports, and hunting.
The embodiment of the everyday lives of these individuals is present their skeletal
remains—osteoarthritis and entheseal changes speak to the types of activities these
individuals were conducting on a regular basis. These results are further supported
by a comparison of corridor, subsidiary, and chiefly burials at Kerma. A similar pat-
1
Although physical activity does not wholly translate to labor as it were, labor is a physical activity
that is conducted frequently, if not daily. The available literature on the archaeology of labor is
informative and provides background on issues of inequality, power, and resistance.
tern emerges; individuals who were provided a chiefly and subsidiary burial had
limited osteoarthritis and entheseal changes, whereas individuals who were buried
in corridors experienced higher frequencies and severities of osteoarthritis and
entheseal changes. It is not altogether surprising that people of differing socioeco-
nomic groups experience disparate physical activities, including manual labor.
What is novel is that bioarchaeologists can begin to think about how these data can
be used to interpret the everyday lives of past people and the interplay between the
social and biological manifested in skeletal remains.
The case study in Chap. 4 presents and interesting scenario of indigenous
Nubians (C-Group sample) and Egyptianized Nubians (Pharaonic sample) living in
an Egyptian colonized space. Using archaeological evidence and previously pub-
lished data from isotopic studies, I suggest that an Egyptian diet is characterized by
predominately C3 foods (e.g., wheat, barley), whereas a Nubian diet is more likely
to consist of a mix of C3 and C4 foods (e.g., sorghum, millet). Despite the small
sample size owing to poor collagen preservation, carbon and nitrogen values were
found to significantly differ between the C-Group and Pharaonic samples. The
C-Group value does align more with the proposed Nubian diet and is markedly
similar to Nubian dietary patterns at Kerma (Thompson et al. 2008). This may indi-
cate resistance to the colonial power and the Egyptian colonizers on the part of the
C-Group peoples. Eating traditional Nubian foods, despite a colonial presence,
could have served as a day-to-day act of resistance, while simultaneously support-
ing an indigenous Nubian identity. The Pharaonic sample had carbon isotope values
that were closer to Egyptian samples (Iacumin et al. 1996; Macko et al. 1999).
Because the Pharaonic sample likely reflects Egyptianized Nubians (i.e., Nubians
who were buried in an Egyptian style), these individuals may have been more
inclined to adopt Egyptian dietary practices. This act can also be viewed as an agen-
tive one, in that the Pharaonic individuals were not forced to consume Egyptian
foods. Further, in a colonial space, the act of dressing, eating, and being buried in
the same manner as the colonizers could benefit an individual or family in such a
colonial space. The juxtaposition between the C-Group and Pharaonic samples is an
excellent illustration of how the practice of everyday foodways plays an important
role in social structure, individual agency, and power relations between groups. As
many other scholars have argued, food is not simply a passive mundane task, but
rather an active meaningful performance that can imbue social identity, group mem-
bership, resistance, and agency.
Chapter 5 delves into the context of New Kingdom and Third Intermediate/
Napatan period Tombos. Entheseal changes, osteoarthritis, and stable isotope analy-
ses were used to better understand everyday life during this colonial and postcolo-
nial context. While activity patterns at New Kingdom Tombos were surprisingly
limited, considering that Tombos served as an Egyptian colony in Nubia at this time,
Tombos was not a typical colonial space. Similarly, the people of Tombos did not
blended foodways, creating a mix of Egyptian and Nubian foods. The excellent
research that has been produced over the past several decades from Drs. Stuart
6 Conclusions and Future Directions 199
Tyson Smith and Michele Buzon allow for a deeper understanding of this commu-
nity (Buzon 2006a, b, 2008, 2014; Buzon et al. 2007, 2016; Buzon and Bombak
2010; Buzon and Bowen 2010; Buzon and Richman 2007; Buzon and Simonetti
2013; Buzon and Smith 2017; Smith 2003, 2006a, b, 2007a, b, 2013, 2014; Smith
and Buzon 2014, 2017, 2018). Smith and Buzon have produced research that sug-
gests this was a peaceful, multiethnic space where expression of both an Egyptian
as well as a Nubian social identity was possible. This complements the entheseal
changes, osteoarthritis, and stable isotope data presented here—the everyday life of
people at New Kingdom Tombos involved minimally strenuous physical labor and
blended Egyptian and Nubian cuisines. Activity patterns from the Third Intermediate/
Napatan period show a dramatic increase in entheseal changes and osteoarthritis,
particularly for women. Rather than assuming this has negative connotations, I
instead posit that these data could indicate a recently independent community, that
had the ability to invest in their social, political, and economic future and thus may
have been actively engaged in agropastoralism, construction efforts, or granite quar-
rying (Schrader and Buzon 2017; Schrader et al. 2018). The dietary data indicate a
marked similarity between the New Kingdom and Third Intermediate/Napatan
period samples. This may be a product of an engrained multiethnic setting and a
continuation of the Nubian–Egyptian foodways that were already present during the
New Kingdom.
Returning to the example of the Teaching of Khety. The Bioarchaeology of the
Everyday Approach can be highly informative in those scenarios where archaeolo-
gists have no written or pictorial evidence of everyday life to assess, as is the case
with Ancient Nubia. In the absence of these lines of evidence, such as the Teaching
of Khety, bioarchaeological interpretations of everyday life can speak to the lived
experience of social inequality (as with the example of ancient Kerma elite burials
versus non-elite burials, Chap. 3), agency (illustrated with the C-Group’s rejection of
Egyptian dietary patterns, Chap. 4), and/or diachronic examination of habitus (New
Kingdom and Third Intermediate/Napatan period Tombos, Chap. 5).
Lastly, even in scenarios where written and/or pictorial evidence is present, a
Bioarchaeology of the Everyday perspective provides unbiased information—a
topic that is hotly debated in scenarios of historical documentation. As the titles to
many bioarchaeological monographs and blogs suggest, Written in Bones: How
Human Remains Unlock the Secrets of the Dead (Bahn 2003), Skeletons in Our
Closet: Revealing our Past through Bioarchaeology (Larsen 2000), Bones Don’t Lie
(Emery 2016), skeletal remains offer an unbiased source of data. Scholars continu-
ally contemplate whether the occupations described in the Teaching of Khety are
realistic, or rather do they reflect an elite scribe (1) haughtily looking down at other,
lower class occupations, or (2) being altogether satirical (Rollston 2001). This is a
question that will perhaps never be answered via interpretation of text. Using a
Bioarchaeology of the Everyday approach these types of hypotheses could be
empirically tested.
Future Directions
This book is not an all-encompassing discussion of Bioarchaeology of the Everyday,

but rather a springboard for further methodological and theoretical developments. I
view three areas of investigation, in particular, that could and should be expanded
upon: collaboration between archaeology and bioarchaeology, bioarchaeological
methods, and anthropologically oriented research.
As has been discussed throughout the book, one of the driving interests of
archaeological research has been everyday life. Whether in the form of landscape
modification, midden formation, or debitage studies, archaeologists have framed
their research questions, bolstered by theoretical perspectives of gender, power, and
interaction, around everyday life. This is highly informative and meaningful data—
a perspective that bioarchaeology can never replace. Instead, bioarchaeological
research into everyday life can be viewed as another complementary perspective.
These two data sets can be used together to bolster interpretations of everyday life
in the past.
For example, in an excavation of an associated cemetery and a habitation, par-
ticularly in a scenario with short use chronologies or excellent chronological con-
trol, both archaeological and bioarchaeological methods could be applied. The
domestic structures of the habitation could be assessed (Allison 1999; Hendon
2004, 2010; Wilk and Rathje 1982; Wilson 2008). The broader use of public versus
private space, and domestic versus work space could be examined (Canuto and
Yaeger 2000; Gillespie 2000; Hendon 1996, 1997; Joyce 2000; Love 1999; Robin
2002). Religious practice could be addressed via specialized artifacts (e.g., incense
burner, amulets, figurines, alters; Insoll 2004, 2011; Kyriakidis 2007; Renfrew
1994; Whitley and Hays-Gilpin 2008). Supplies and provisioning are archaeologi-
cally visible in storage facilities, domestic pottery assemblage, specialized struc-
tures, such as granaries, and equipment, such as beer making supplies (Arthur 2003;
Kohler-Schneider 2003; Kuijt and Finlayson 2009). Artifacts associated with craft
production, such as flint tools, iron ore slag, and potter’s wheels, can also speak to
everyday practice (Bachman 1982; Baldi and Roux 2016; Charlton and Humphris
in press; Gandon et al. 2018; Hart 2016; Mateva 2017). Midden and zooarchaeo-
logical analyses could shed light on what the community was eating (Albarella et al.
2017; Gifford-Gonzalez 2007; Grayson 1984; Rowley-Conwy et al. 2017; Russell
2012). Archaeobotanical data could identify foods prepared, environmental condi-
tions, routine activities, and labor organization (Bogaard 2016; Fuller et al. 2014;
Levin 2016; Mercuri et al. 2018). The examination of other artifacts could also
speak to everyday life (e.g., the presence of spindle whorls could indicate weaving;
jewelry could speak to personal adornment; tools and equipment could speak to
farming and animal husbandry). This list is obviously not comprehensive or exhaus-
tive; everyday life in this hypothetical scenario could be examined from any one of
multitude of archaeological methods. Importantly, each of these archaeological
approaches offers a perspective on day-to-day life that bioarchaeologist cannot
address.
Future Directions 201
Bioarchaeology can, however, also contribute perspectives on the everyday life

that archaeologists cannot obtain. As discussed in Chap. 1, owing to the nature of
the source of data (i.e., skeletons), bioarchaeologists are able to conduct multiscalar
analyses. Bioarchaeologists have the ability to study individuals, groups, or entire
populations (Stodder and Palkovich 2012). This compliments traditional archaeo-
logical approaches, which typically focus everyday life at the community scale.
Further, bioarchaeological data inherently examined the embodied lived experience
of the individual under examination (Krieger 2005; Sofaer 2006). In this way, bio-
archaeologists are examining the “production and experience of lived bodies in the
past by examining the juxtaposition of traces of body practices, idealized represen-
tations, and evidence of the effects of habitual gestures, postures, and consumption
practices on the physical body” (Hollimon 2011:150). Therefore, when we exam-
ine, for example activity or dietary patterns, bioarchaeologists are addressing the
lived experiences of these individuals. However, both the archaeological and bioar-
chaeological perspectives could be honed if they were paired together. Not only
would the collaboration provide a multi-method and multiscalar approach, but it
would result in several different perspectives of everyday life in the ancient past.
In addition to the methods employed in this book (osteoarthritis, entheseal
changes, carbon and nitrogen stable isotope analysis), there are various other
approaches to addressing the everyday life in the bioarchaeological record. In Chap.
3, I briefly discuss vertebral degeneration and Schmorl’s nodes (Faccia and Williams
2008; Novak and Slaus 2011; Plomp 2017; Plomp et al. 2012, 2015; Üstündag
2009). While these conditions are positively correlated with age, there is evidence
to suggest that they may be associated with heavy workload and therefore can
speak to an everyday experience. Cross-sectional geometry, histological studies,
external measurements of the long bones, and activity related non-metric traits are
other examples of bioarchaeological methods that addresses day-to-day life (Berry
1975; Lieberman et al. 2004; Lozanoff et al. 1985; Macintosh et al. 2017; Pomeroy
and Zakrzewski 2009; Ruff 2008; Ruff et al. 2015; Stewart et al. 2015; Stock and
Shaw 2007; Wilson and Humphrey 2015). In Chap. 4, I discuss dental decay, dental
wear, and dental calculus as examples of methods, in addition to stable isotope
analysis, that speak to ancient dietary patterns. Skeletal signs of nutritional defi-
ciencies, such as scurvy, can also speak to dietary patterns (Brickley and Ives 2008;
Larsen 2015).
Indicators of physiological stress during growth and development can help us
understand what life was like during the period of stress. These processes have bio-
cultural causation factors, meaning that both environmental and cultural stressors
that contribute to their development (see Fig. 2.1 in Larsen 2015:8; also Goodman
et al. 1988). A decrease in population-specific growth rates has been associated with
physiological and nutritional stress (Bogin 1999; Foster et al. 2005; Malina et al.
2010; Mays et al. 2009; Ruff et al. 2013). Stature, or terminal adult height, can also
reflect systemic physiological and nutritional stress during development (Arcini
et al. 2014; Bogin 1999; Mummert et al. 2011; Özer et al. 2011; Pfeiffer and
Harrington 2011; Steckel 1995, 2005; Vercellotti et al. 2014). Similarly, if an indi-
vidual is stressed during development, their vertebral arches and bodies may not
reach maximum growth potential and thus cause the neural canals to be relatively
small (Newman and Gowland 2015; Watts 2011, 2013). Linear enamel hypoplasia
and dental microdefects are deficiencies in dental enamel thickness that may be
caused by physiological stress (Goodman and Rose 1991; Hillson 1996, 2008).
While stress and “health” are complicated and debated topics within bioarchaeol-
ogy, if the conditions discussed above do in fact reflect a period of stress, then they
can be used to speak to everyday life for that individual during said period of stress
(see Temple and Goodman 2014 for discussion).
Some pathological conditions can also speak to an everyday lived experience,
particularly those that are persistent. For example, Veselka and colleagues have
examined the presence of Vitamin D deficiency in a post-medieval Dutch popula-
tion (Veselka et al. in press). They found that of the 29 cases of rickets found
(n = 100), 21 were in females. The authors suggest that a gender-based workload,
with boys working outside and girls primarily working inside in addition to conceal-
ing clothing, may have contributed to higher rates of Vitamin D deficiency in girls
versus boys. From this we can deduce that the everyday lives of girls, in this popula-
tion may have been spent indoors, laboring. While the boys also were likely work-
ing, they were doing so outside, such that they could absorb sufficient Vitamin D. In
a similar way, other chronic diseases, such as tuberculosis and leprosy, can also
speak to everyday life during the period of infection.
The osteobiographical as well as bioarchaeology of care approaches can also be
used to infer patterns of everyday life in scenarios of long-term pathological condi-
tions, trauma, or other debilitating condition (Martin and Harrod 2016; Stodder and
Palkovich 2012; Tilley 2015; Tilley and Cameron 2014; Tilley and Oxenham 2011;
Tilley and Schrenk 2017). For example, Neitzel details the burial of a Hopi-leader,
known as the “magician,” from an Ancestral Pueblo site (Neitzel 2012). Grave
goods, including copper, abalone shell, and turquoise objects, suggest this individ-
ual was of high socioeconomic status. Despite this high status, and middle age
(~35 years old), this individual suffered from various pathological conditions, such
as antemortem tooth loss, periodontal disease, antemortem forearm fracture,
moderate-to-severe osteoarthritis, and temporal-mandibular arthritis. With refer-
ence to this burial Martin and Harrod state, “despite his apparent status there is also
evidence of suffering, as he endured a litany of health problems that likely affected
his everyday activities” (Martin and Harrod 2016:166).
Lastly, another venue for possible research into the Bioarchaeology of the
Everyday is centered more upon anthropological questions than osteoarchaeologi-
cal methods. Structural violence, a topic that has only recently been explored bioar-
chaeology, entails the inequality and differential access to resources, systematically
imposed (Galtung 1969). Klaus and others have used a suite of skeletal conditions
that, when couched in a broader social context, can elucidate environments of sys-
tematically imposed inequality (Klaus 2012; see also de la Cova 2012; Martin et al.
2010; Martin and Harrod 2015; Nystrom 2014; Osterholtz 2012; Perez 2012;
Robbins Shug et al. 2012). Skeletal indicators of prolonged nutritional deficiency
and infectious disease (subadult growth velocity, terminal adult stature), acute
childhood metabolic stress (linear enamel hypoplasia), as well as demographic
References 203
p atterns (D30+–D5+ ratio) all speak to differential access to resources and social
inequalities. The presence of structural violence informs our understanding of an
everyday lived experience. In these scenarios, individuals are marginalized, physi-
cally beaten, mentally abused, and physiologically stressed on a daily basis for
extended periods of time. This inequality has very real physical, socioeconomic,
and mental implications for the individuals exposed to it.
Social identities are multiple and overlapping, encompassing various aspects of
daily life including gender, age, socioeconomic status, ethnic group, religion (Díaz-
Andreu et al. 2005; Knudson and Stojanowski 2008; Meskell 2001). In context, any
of these social identities could impact daily life. For example, bioarchaeologists
have addressed gendered differences and inequalities. Scholars have found gender
inequalities in frailty, violence, disease, and diet, just to name a few (DeWitte 2017;
Novak 2017; White 2005; Zuckerman 2017). Again if in a social system, gendered
groups are not being treated equitably, this can have implications for their day-to-
day lives.
Much of what bioarchaeologists already do could be considered part of the
Bioarchaeology of the Everyday perspective. If data and interpretations are framed
by quotidian questions, researchers could more substantively engage with day-to-
day practice in the ancient past. The goal of this book is to bring to light the impor-
tance of this everyday perspective, while illustrating its feasibility in bioarchaeological
research. Bioarchaeologists are ideally situated to discuss this topic and, together
with traditional archaeological approaches, can greatly inform our understanding of
everyday life. With continued efforts, I sincerely hope that bioarchaeologists employ
established methods, test new methods, and ask anthropological questions that elu-
cidate everyday life.
Summary
In this final chapter, I have summarized the previous chapters and discussed some
of the ways in which a Bioarchaeology of the Everyday might be pursued in the
future. Collaboration with archaeologists, alternative bioarchaeological methods,
and anthropological questions are identified as possible venues for pursuing a
Bioarchaeology of the Everyday. Future research will shed light on the lived experi-
ence of daily life for individuals, groups, and populations, in various temporal and
spatial contexts.
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Index
A agency, 147
Agency, 172, 183, 199 daily practice, 147
Anthropological questions, 202 fortresses, 142, 143
identities, 144, 147
resistance, 147
B Classic Kerma, 145
Beer, 137 Compound Specific Isotope Analysis, 132–133
Bioarchaeology of the Everyday, 1, 197, 199, Cooking, Cuisine and Class: A Study of
200, 202, 203 Comparative Sociology, 33
collaboration, 200
embodiment perspective, 7
D
multiscalar, 196
de Certeau, 25, 197
undefined, 7
Dental calculus, 133
Blood and Fire: Toward a Global
Dental decay, 135
Anthropology of Labor, 38
Dental wear, 134
Body as Material Culture: A Theoretical
Distinction: A Social Critique of the
Osteoarchaeology, 28
Judgement of Taste, 22
Bones Don't Lie, 199
Bourdieu, 21, 197
cultural capital, 22 E
doxa, 23 Embodiment, 7, 27, 196
fields, 23 body politic, 28
food space, 31 individual body, 28
habitus, 21 Entheseal changes, 73, 95, 98, 173–175,
social capital, 22 197, 198
symbolic capital, 23 animal experimentation, 86
Bouza, 138 body size, 78
Bugdumbush, 141 bone-cross sectional geometry research, 85
bone-formers, 79
clinical research, 77
C cluster analysis, 92
Cattle cult, 138 discriminant functions, 92
bucrania, 138 etiology, 77
rock art, 138 fibrocartilaginous, 73, 74
C-group, 135, 141–143, 145–147, 183, 198 fibrous, 73, 74, 76

https://doi.org/10.1007/978-3-030-02544-1
212 Index
Entheseal changes (cont.) N

generalized estimating equations, 92 Napatan Period, 168, 169
generalized linear models, 92 New Kingdom, 142, 143, 169, 171, 172, 198
multidimensional scaling, 92 Nitrogen isotopes, 129
multi-method, 85
muscle activity levels, 81
occupation, 79, 84 O
principal components analysis, 92 Osteoarthritis, 97, 197, 198
sex, 78 age, 61
sexual division of labor, 81 ancestry, 62
Enthesopathy, 90 biological sex, 61
Everyday Life Matters: Maya Farmers body weight, 61
at Chan, 4 care, 67
contributing factors, 61
daily habitual activities, 64
F data organization, 71
Food and Gender: Identity and Power, 33 definition, 70
Foodways, 30–38 diet, 62
ceramic artifacts, 37 disability, 68
coprolite analysis, 37 eburnation, 58
dietary preferences, 35 economic intensification, 64
faunal remains, 37 food preparation, 64
feasting, 34 generalized estimating equation, 72
food preference, 36 health and socioeconomic status, 64
food preparation, 35 impairment, 68
gender identity, 34 joint alignment, 62
landscapes, 36 joint space narrowing, 60
organic residues, 37 lived experience, 67
presentation, 35 local risk factors, 62
social identity, 34, 35 mobility, 64
Fourth Cataract, 165 multivariate odds ratios, 72
occupation, 64
osteophytosis, 59
G pain, 60, 67
Gender and Power in Prehispanic population-level interpretations, 69
Mesoamerica (2000), 5 porosity, 57
Giddens, 24, 197 primary, 56
duality of structure, 24 principal component analysis, 72
structuration, 24 scoring, 71
secondary, 56
septic arthritis, 68
K sexual division of labor, 64
Kerma, 96, 99, 135, 141–143, 145, 147, spondylosis, 59
165, 197 sports studies, 60
Kush, 168 subsistence patterns, 63
systemic risk factors, 62
L
Lefebvre, 19 P
Lower Nubia, 141–143 Pharaonic, 137, 143, 145–147, 183, 198
Postcolonial, 172
The Practice of Everyday Life, 25
M The Practice of Everyday Life II: Living
Middle Kingdom, 141, 143, 144 and Cooking, 32
Index 213
Practice theory, 172 Third Intermediate and Napatan Periods, 171

habitus, 21 Third Intermediate Period, 168, 169
Pyramid, 171 Tombos, 169, 172
administrative town, 165, 181
buffer zone, 181
S coexistence, 182
Sai, 141 cranial metrics, 171
Schmorl’s nodes, 59 culture contact, 170
Second cataract, 135, 143, 144, 165, 197 fortress, 181
Second Intermediate Period, 142–144 identity, 170, 171
Skeletons in Our Closet: Revealing our Past memory, 170, 171
through Bioarchaeology, 199 pyramid, 171
Social inequality, 199 resistance, 170
Stable isotope analysis sexual division of labor, 174, 182
barley, 137, 146 strontium data, 171
carbon, 128, 138, 140 Tumuli, 171
carbonate, 130
cattle, 138
collagen, 130 U
foddering practices, 140 Upper Nubia, 168, 172
freshwater fish, 146
millet, 137
nitrogen, 128, 138, 140 W
nitrogen recycling, 140 Who Studies the Everyday?, 2–3
radioactive isotopes, 129 anthropologists, 2
sorghum, 137 archaeologists, 3
undefined, 129–131 bioarchaeology, 6
wheat, 137, 146 historians, 2
sociologists, 2
Written in Bones: How Human
T Remains Unlock the Secrets
Third Cataract, 96, 169, 172, 181 of the Dead, 199

2019 Bioarchaeology and Social Schrader - Activity, Diet and Social

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2019 Bioarchaeology and Social Schrader - Activity, Diet and Social

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Bioarchaeology and Social Theory

Series Editor: Debra L. Martin

Activity, Diet and Social

ISSN 2567-6776 ISSN 2567-6814 (electronic)

Library of Congress Control Number: 2018959117

© Springer Nature Switzerland AG 2019

Sarah Schrader has produced a unique bioarchaeological study that integrates a

Bioarchaeology and Social Theory Debra L. Martin

1 The Anthropology and Bioarchaeology

Etiology of Entheseal Change������������������������������������������������������������������ 77

© Springer Nature Switzerland AG 2019 1

architecture, debitage, landscape modification, utilitarian ceramics, and evidence of

Who Studies the Everyday?

Several social science and humanities disciplines strive to examine, characterize,

Archaeology, a subdiscipline of anthropology, can contribute to this conversation by

perspectives were environmentally deterministic, lacked human agency, viewed

What Can Bioarchaeology Contribute?

osteological data is actually better suited for multiscalar analysis. Bioarchaeologists

Building upon this introduction to Bioarchaeology of the Everyday, I present theo-

Hodder, I. (1985). Postprocessual archaeology. Advances in Archaeological Method and Theory,

Tilley, C. (1999). Metaphor and material culture. Oxford, UK: Blackwell.

In Chap. 1, I illustrated why examining everyday life is important. I discussed what

Bringing Everyday Life to the Fore

© Springer Nature Switzerland AG 2019 19

momentous/memorable). Born in France in 1901, Lefebvre made the argument that

somewhat confined. Succinctly stated by Ortner, “modern practice theory seeks to

and harvesting fields, manufacturing goods, as well as processing and preparing

Like Bourdieu, Giddens attempts to mediate the subjectivist–objectivist divide by

De Certeau wrote The Practice of Everyday Life, drawing on anthropology, history,

Archaeologists play a key role in examining day-to-day life in ancient populations

The anthropological concept of embodiment addresses how physical bodies are

As discussed in Chap. 1, human bones, unlike artifacts are constantly in a state of

 nthropological and Archaeological Perspectives on Foodways

From a biological perspective, dietary consumption is an essential component to

Kamphuis and colleagues apply Bourdieu’s theory of cultural capital to modern

Fig. 2.1 The food space (Bourdieu 1984:186)

Fig. 2.2 The food space reinterpreted (Gastronomica: Watson 2012)

to “debunk the uncritical, uncultured low-income consumer” (Smith Maguire

(anthropogenic or otherwise) as well as dietary patterns (Arranz-Otaegui et al. 2017;

opportunities for native individuals to maintain social continuity or to build and

For these reasons, archaeology of labor can avoid oversimplification of colonial

Hayden, B. (2001b). Fabulous feasts: A prolegomenon to the importance of feasting. In M. Dietler

The reconstruction of physical activity, using methods such as osteoarthritis and

© Springer Nature Switzerland AG 2019 55

Perhaps one of the most characteristic and pathognomonic conditions of osteoar-

Previous Bioarchaeological Approaches to Osteoarthritis

The bioarchaeological analysis of osteoarthritis has been used to address numerous

superior and inferior articular facets (Lieverse et al. 2016).

lication provides an excellent example of why this assumption should be chal-

Lived Experience and Care

In line with osteobiographical approaches, bioarchaeologists have begun to address

hip eburnation, tuberculosis, and clavicular as well as humeral fractures (Stodder

 ngoing Bioarchaeological Debates: Definitions, Data,

Notably, there remains no uniform definition of osteoarthritis or scoring methodol-

Entheseal changes, or alterations to the bone at the point of muscle/ligament attach-

The Physiological Structure of Entheses

Often referred to as musculoskeletal stress markers in bioarchaeological literature,

Fig. 3.5 Attachment of M.

Fig. 3.6 Attachment of M.

Fig. 3.7 Attachment of M.

between fibrous and fibrocartilaginous entheses needs to be conducted to determine

Etiology of Entheseal Change

Milella et al. examined entheseal changes in the well-documented Fressetto col-

Bioarchaeology and Social Theory Debra L. Martin

1 The Anthropology and Bioarchaeology

Etiology of Entheseal Change�� 77

Who Studies the Everyday?

What Can Bioarchaeology Contribute?

Bringing Everyday Life to the Fore

nthropological and Archaeological Perspectives on Foodways

Previous Bioarchaeological Approaches to Osteoarthritis

Lived Experience and Care

ngoing Bioarchaeological Debates: Definitions, Data,

The Physiological Structure of Entheses

Etiology of Entheseal Change

Previous Bioarchaeological Approaches to Entheseal Change

Entheseal Changes and Sexual Division of Labor

Entheseal Changes and Identified Skeletal Collections

Entheseal Changes and Bone Structure

Entheseal Changes and Animal Models

ngoing Bioarchaeological Debates: Terminology, Scoring,

Osteoarthritis, Entheseal Changes, and Everyday Life

Stable Isotope Analysis

Other Bioarchaeological Methods of Dietary Reconstruction

Compound Specific Isotope Analysis

An Example of Daily Life Foodways

How Do We Know What Ancient Egyptians and Nubians Ate?

Who Were the C-Group Nubians?

What Were the C-Group and Pharaonic Samples Eating?

Situating Tombos in a Transitional Sociopolitical Landscape

e levated socioeconomic status. Furthermore, grave goods, such as scarabs, amulets,

Osteology, Structure, and Agency

New Kingdom Everyday Life and Habitus

Third Intermediate Period/Napatan Everyday Life and Habitus