Taxonomic Legacies and Biological Diversity: Reflections on Terminology in “Racial and Ethnic Differences in Bone Mass in Pediatric Populations”

I have read with great attention the systematic review titled “Racial and Ethnic Differences in Bone Mass in Pediatric Populations: A Systematic Review” by de Lima et al. (2026). This study, which carefully synthesizes findings from 26 studies on bone mass variation in children and adolescents, represents a substantial and methodologically rigorous contribution to the literature on pediatric bone health. I commend the authors for their rigorous standardization of complex DXA-based evidence. My intention in writing this letter is not to question the empirical findings of the review, nor the methodological diligence of the authors. Rather, as a biological anthropologist who teaches Human Biological Diversity at the university level, I would like to offer a theoretical and pedagogical reflection on the continued centrality of the concept of “race” within the analytical framing and title of the study. I acknowledge the structural constraints of systematic reviews; when synthesizing clinical literature, researchers often must adopt the classificatory terminology used in primary datasets, including Office of Management and Budget (OMB) racial categories (OMB 1997). In this regard, the authors' explicit acknowledgment in the discussion section that these categories represent social constructs rather than discrete biological entities is both appropriate and commendable. Nevertheless, the broader framing of the study, and especially the prominence of “racial differences” in the title, appears to stand in tension with this epistemological caution. Over the past several decades, biological anthropology has repeatedly emphasized that human biological variation is not structured into discrete, bounded racial groups but is instead characterized by continuous, clinal, and historically contingent patterns of variation (Templeton 1998). This position was articulated most clearly in the 2019 Statement on Race and Racism by the American Association of Biological Anthropologists (AAPA 2019), which reaffirmed that “race” lacks biological validity as an explanatory framework for human diversity. From this perspective, the differences in bone mass summarized by de Lima et al. (2026)—including well-documented population-level patterns such as variation in bone mineral density or calcium economy—are more coherently interpreted as outcomes of complex interactions among genetic ancestry, developmental environments, nutrition, and long-term geographic histories, rather than as properties of racial categories themselves (Relethford 2009). In this light, describing such differences as “racial” risks unintentionally perpetuating a typological legacy rooted in 18th- and 19th-century classificatory traditions, even when authors explicitly reject biological racialism in the body of the text. The issue here is not one of intent, but of conceptual inheritance: terminology carries theoretical weight, and titles in particular exert a disproportionate influence on how findings are interpreted, cited, and taught. From a conceptual standpoint, the simultaneous use of both “racial” and “ethnic” categories in the title also merits reflection. Despite long-standing efforts—dating back at least to Ashley Montagu's mid-20th-century interventions—to replace race-based thinking with more socially and historically grounded concepts, presenting these terms side by side may inadvertently suggest that “race” denotes a fixed biological reality while “ethnicity” captures social variation (Montagu 1942). Such framing can obscure the fundamentally biocultural and population-based nature of skeletal variation, especially in growing individuals. As an educator, I encounter the practical consequences of this tension directly. In the classroom, students are taught—correctly—that race has no biological foundation, while simultaneously being exposed to high-profile scientific titles emphasizing “racial differences” in biological traits. This disjunction creates a challenge of trust and conceptual consistency, particularly for students and clinicians attempting to reconcile contemporary anthropological theory with biomedical literature. In such cases, titles can overshadow the more nuanced and careful arguments presented within the text itself, reinforcing the mistaken impression that labels such as “Black” or “White” function as direct biological determinants. In this context, I would like to offer a constructive suggestion directed not at this study alone, but at the broader disciplinary conversation it reflects. Where possible, future work might benefit from prioritizing alternative framings—such as population-based variation, geographic ancestry–associated diversity, or human biological diversity—that more directly align with current anthropological understanding. For example, a title emphasizing “population or ancestry-related variation in pediatric bone mass” would more clearly signal the biocultural and non-typological framework that the authors themselves articulate in their discussion. I hope this commentary is received in the constructive spirit in which it is offered: as part of an ongoing effort to ensure that the language of human biology evolves alongside its empirical and theoretical advances. Careful attention to terminology is not merely a matter of semantics, but a reflection of our collective responsibility to describe human variation in ways that are scientifically accurate, conceptually coherent, and pedagogically responsible. The author declares no conflicts of interest. Data sharing not applicable to this article as no datasets were generated or analyzed during the current study.