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Reference topic 4: The Last Ice Age and the Birth of Agriculture

Agriculture and human health: what farming did to the body

ProbableEvidence grade: Probable. Good observational evidence with a plausible mechanism, or small or few trials.83 sources0 graded recommendationsTopic hub: Food

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On 19 September 1991, two German hikers, Erika and Helmut Simon, were walking near the Tisenjoch pass, 3,210 m up in Italy's Schnals Valley. In the ice lay a human body, only its upper half showing. Freeing him took days; he was finally cut loose with ice picks while a camera team filmed. The next day the prehistorian Konrad Spindler, of Innsbruck University, judged him at least four thousand years old. A survey later settled which country he belonged to: he had lain 92.56 m from the Austrian border, on the Italian side.1

Spindler's estimate was, if anything, cautious. The Iceman, now known as Ötzi, died about 5,300 years ago, in his mid-forties.23 His hips, shoulders, knees and spine showed heavy wear, his teeth were badly worn, his lungs were blackened with soot, and his skin carried dozens of tattoos, all lines or crosses.3 How he died stayed hidden for a decade, until the radiologist Paul Gostner found a flint arrowhead lodged in his left shoulder. It had pierced the artery beneath his collarbone, and he had bled to death. He also had a severe head injury.43

Mismatch card

The system

The agricultural body: a forager's physiology, partly retuned since farming began.

What it expects

A varied diet of wild plants and animals, daily walking and carrying, small mobile groups, seasonal variety.

What it gets

Cereals supplying 42% of the world's dietary energy, sedentary work, and dense settlements shared with animals and strangers.65

What happens in the gap

In early farmers, on average: shorter stature, more tooth decay and infection, heavy repetitive labor. Since then, immune genes have been retuned against new pathogens, possibly at the cost of more inflammatory and autoimmune risk.

The handrail

Build meals from many foods rather than one refined staple, move and carry through the day, and keep up the dental basics; Topics 12, 16 and 40 give the doses. (●●○)

Strength of evidence

●●○ Large skeletal and genetic datasets agree on the average costs of early farming, but regions differed and skeletons can mislead.

What this topic covers

  • ·The Last Time the Ice Won
  • ·Harvesting Before Farming
  • ·A Monument Before the Farm
  • ·The Worst Mistake
  • ·What the Bones Remember
  • ·The Grain Bargain
  • ·Written in the Genome

The practical version is in the book: Chapter 2, What Your Body Expects, and How to Trust This Book.

The skeptic's corner

The case against this topic, from the research itself.

The case against farming is strong on average and weak as a universal law, and skeletons are a biased record. Under the so-called osteological paradox, a person who dies quickly of an infection leaves no mark on the bone. A cemetery full of lesions can therefore mean a population strong enough to survive illness rather than a sicker one.76 Growing populations also fill cemeteries with children, and that skews estimates of how long people lived.7662

Nor was the decline universal. The southern Levant was the heartland of wheat and barley. There, a comparison of some 200 Natufian foragers with a similar number of Neolithic farmers found more infection after farming, less skull trauma in men and no change in joint disease: "a complex health profile."77 Life expectancy at birth barely moved, from 24.6 years among the foragers to 25.5 among the farmers. Those figures assume stable populations and are dominated by infant and child deaths (Topic 36). Women's ages at death suggest that deaths in childbirth rose along with fertility.78 Among prehistoric Southeast Asian rice farmers, farming and tooth decay do not go together as a rule; the classic link rests mainly on American maize farmers.79

Foragers were not a disease-free baseline either. At Taforalt, in Morocco, people who harvested acorns and pine nuts before the ice age ended had decay in more than half their adult teeth, a rate comparable to modern industrialized populations.80 At Con Co Ngua, a settled forager site in northern Vietnam, about one person in seven had bone lesions consistent with hydatid disease, a tapeworm infection usually tied to herding.81 Foragers' leisure was also less ample than once claimed, as critics have argued since the early 1980s,4744 although farming does seem to cost leisure. Among the Agta, hunter-gatherers in the Philippines, more time spent on non-foraging work, mostly farming, went with less leisure, an effect driven by women.82

Finally, the costs eased. Stature and body mass recovered over thousands of years.52 Grain is not a poison for most people: celiac disease affects about 0.7% to 1.4% of people worldwide, depending on whether cases are confirmed by biopsy or by blood test.83 Anyone who suspects it should talk to a clinician about testing before cutting out gluten.

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Sources cited above

  1. 1.South Tyrol Museum of Archaeology (n.d.). The discovery. https://www.iceman.it/en/oetzi/the-discovery (first recovery attempt on 20 September, when only his axe was brought down; cut loose on 23 September; Spindler called in on 24 September and estimated the body's age at "at least 4000 years old"; border survey on 2 October)
  2. 2.Wang, K., Prüfer, K., Krause-Kyora, B., Childebayeva, A., et al. (2023). "High-coverage genome of the Tyrolean Iceman reveals unusually high Anatolian farmer ancestry." Cell Genomics, 3(9), 100377. https://doi.org/10.1016/j.xgen.2023.100377 (directly dated to between 3350 and 3120 BCE; Anatolian farmer ancestry about 90%)
  3. 3.South Tyrol Museum of Archaeology (n.d.). The body. https://www.iceman.it/en/oetzi/the-body (died around 46 years old; about 1.60 m tall and about 50 kg; 61 tattoos)
  4. 4.South Tyrol Museum of Archaeology (n.d.). Milestones. https://www.iceman.it/en/the-research/milestones. First report of the arrowhead: Gostner, P., and Egarter Vigl, E. (2002). "INSIGHT: Report of radiological-forensic findings on the Iceman." Journal of Archaeological Science, 29(3), 323-326. https://doi.org/10.1006/jasc.2002.0824 (arrowhead found in 2001; arterial injury and death by bleeding confirmed by imaging in 2007)
  5. 5.Larson, G., Piperno, D.R., Allaby, R.G., Purugganan, M.D., et al. (2014). "Current perspectives and the future of domestication studies." PNAS, 111(17), 6139-6146. https://doi.org/10.1073/pnas.1323964111
  6. 76.Wood, J.W., Milner, G.R., Harpending, H.C., and Weiss, K.M. (1992). "The osteological paradox: problems of inferring prehistoric health from skeletal samples." Current Anthropology, 33(4), 343-370. https://doi.org/10.1086/204084
  7. 62.Bocquet-Appel, J.-P. (2011). "When the world's population took off: the springboard of the Neolithic Demographic Transition." Science, 333(6042), 560-561. https://doi.org/10.1126/science.1208880
  8. 77.Eshed, V., Gopher, A., Pinhasi, R., and Hershkovitz, I. (2010). "Paleopathology and the origin of agriculture in the Levant." American Journal of Physical Anthropology, 143(1), 121-133. https://doi.org/10.1002/ajpa.21301 (200 Natufian foragers and 205 Neolithic farmers)
  9. 78.Eshed, V., Gopher, A., Gage, T.B., and Hershkovitz, I. (2004). "Has the transition to agriculture reshaped the demographic structure of prehistoric populations? New evidence from the Levant." American Journal of Physical Anthropology, 124(4), 315-329. https://doi.org/10.1002/ajpa.10332
  10. 79.Tayles, N., Domett, K., and Nelsen, K. (2000). "Agriculture and dental caries? The case of rice in prehistoric Southeast Asia." World Archaeology, 32(1), 68-83. https://doi.org/10.1080/004382400409899
  11. 80.Humphrey, L.T., De Groote, I., Morales, J., Barton, N., et al. (2014). "Earliest evidence for caries and exploitation of starchy plant foods in Pleistocene hunter-gatherers from Morocco." PNAS, 111(3), 954-959. https://doi.org/10.1073/pnas.1318176111 (15,000 to 13,700 years ago; decay in 51.2% of adult teeth)
  12. 81.Vlok, M., Buckley, H.R., Domett, K., Willis, A., et al. (2022). "Hydatid disease (Echinococcosis granulosis) diagnosis from skeletal osteolytic lesions in an early seventh-millennium BP forager community from preagricultural northern Vietnam." American Journal of Biological Anthropology, 177(1), 100-115. https://doi.org/10.1002/ajpa.24435 (22 of 155 people)
  13. 47.Hawkes, K., and O'Connell, J.F. (1981). "Affluent hunters? Some comments in light of the Alyawara case." American Anthropologist, 83(3), 622-626. https://doi.org/10.1525/aa.1981.83.3.02a00130
  14. 44.Kaplan, D. (2000). "The darker side of the 'original affluent society'." Journal of Anthropological Research, 56(3), 301-324. https://doi.org/10.1086/jar.56.3.3631086
  15. 82.Dyble, M., Thorley, J., Page, A.E., Smith, D., et al. (2019). "Engagement in agricultural work is associated with reduced leisure time among Agta hunter-gatherers." Nature Human Behaviour, 3(8), 792-796. https://doi.org/10.1038/s41562-019-0614-6 (359 Agta in 10 camps)
  16. 52.Macintosh, A.A., Pinhasi, R., and Stock, J.T. (2016). "Early life conditions and physiological stress following the transition to farming in Central/Southeast Europe: skeletal growth impairment and 6000 years of gradual recovery." PLoS ONE, 11(2), e0148468. https://doi.org/10.1371/journal.pone.0148468 (407 adults)
  17. 83.Singh, P., Arora, A., Strand, T.A., Leffler, D.A., et al. (2018). "Global prevalence of celiac disease: systematic review and meta-analysis." Clinical Gastroenterology and Hepatology, 16(6), 823-836.e2. https://doi.org/10.1016/j.cgh.2017.06.037
  18. 65.FAO (2025). Food balance sheets 2010-2023: Global, regional and country trends. https://www.fao.org/statistics/highlights-archive/highlights-detail/food-balance-sheets-2010-2023/en

This topic carries 83 notes in the research manuscript; the 18 above are those behind the material on this page. Full source register.