Although malnutrition could not be excluded, the negative effect on bone mass was proposed to be mediated by elevated serum levels of proinflammatory cytokines such as tumor necrosis factor α (TNFα), interleukin 1 (IL1) and interleukin 6 (IL6) [42] known to stimulate bone resorption [43], as well as through hormones released in response to chronic psychological stress [44]. This evidence concerns the gene TNF and malnutrition.