Micronutrient Deficiencies in Indonesian Tropical Sites: Preliminary Evidence from Gua Harimau (South Sumatra) and Kolana (Alor Island)

Pratiwi Yuwono1*, Stuart Hawkins2, Truman Simanjuntak3, Sofwan Noerwidi4, Fayeza Sally5, Ruly Fauzi4, Marlin Tolla4, Mentari Halimun6, Chloe Boucher7, Nicola Czaplinski8, Sekar Kinanthi5, Gelora Mengalik9, Tampubolon Rifatolistia9, Mahirta5, Marlon Ririmase4, Hariyadi4, Rama Siswantara4, and Melandri Vlok10

This study presents preliminary findings on micronutrient deficiencies among non-adults from two contemporaneous Neolithic sites in Indonesia, an inland site of Gua Harimau (South Sumatra) and a coastal site of Kolana (Alor Island). Despite disparate environments, both assemblages exhibit remarkably high frequencies of skeletal lesions consistent with scurvy (vitamin C deficiency) and hypomineralisation disorders (rickets) in their non-adult cohorts. The presence of rickets is particularly striking given the tropical latitude and abundant sunlight available at both environments, suggesting dietary and cultural factors superseded environmental UV exposure in disease etiology. We propose that the convergence of reliance on vitamin C-poor cultivated foods during agricultural transition, high infectious disease burdens (malaria, treponematosis) increasing metabolic demands for micronutrients, and potential cultural practices limiting sunlight exposure, collectively drove these deficiencies. Using integrated paleopathology and osteobiographical approaches, we explore how the synergy between nutritional inadequacy and infectious disease amplified childhood morbidity, contributing to syndemic disease ecology in Neolithic Indonesia. These findings challenge assumptions about nutritional adequacy in tropical environments and underscore the importance of considering multi-micronutrient deficiencies, even where sunlight is abundant when reconstructing prehistoric health in the Asia-Pacific region.