The diachronic trend of female and male stature in Milan over 2000 years

Abstract

Stature is a biological trait directly determined by the interaction of genetic and environmental components. As such, it is often evaluated as an indicator for the reconstruction of skeletal biological profiles, past health, and social dynamics of human populations. Based on the analysis of 549 skeletons from the CAL (Collezione Antropologica LABANOF), a study of the diachronic trend of male and female adult stature in Milan (Italy) is being proposed here, covering a time span of about 2000 years, ranging from the Roman era to present-days. The skeletons, from necropolises dedicated to the less wealthy classes of Milanese society, were assigned to one of following five historical periods: Roman Era (first–fifth centuries AD), Early Middle Ages (sixth–tenth centuries AD), Late Middle Ages (eleventh–fifteenth centuries AD), Modern Era (sixteenth–eighteenth centuries AD) and Contemporary Era (nineteenth–twentieth centuries AD), and their stature was estimated according to the regression formulae of Trotter (1970). The collected data were then subjected to statistical analyses with ANOVA using R software. Although stature values showed an ample standard deviation in all periods, statistical analyses showed that stature did not significantly vary across historical periods in Milan for both sexes. This is one of the rare studies showing no diachronic changes in the trend of stature in Europe.

Full text

1
Vol.:(0123456789)
Scientic Reports | (2023) 13:1343 | https://doi.org/10.1038/s41598-023-28406-5
www.nature.com/scientificreports
The diachronic trend of female
and male stature in Milan
over 2000 years
Lucie Biehler‑Gomez 1, Beatrice del Bo 2, Daniele Petrosino 1, Paolo Morandini 1,
Mirko Mattia 1*, Luca Palazzolo 3, Uliano Guerrini 3 & Cristina Cattaneo 1
Stature is a biological trait directly determined by the interaction of genetic and environmental
components. As such, it is often evaluated as an indicator for the reconstruction of skeletal biological
proles, past health, and social dynamics of human populations. Based on the analysis of 549
skeletons from the CAL (Collezione Antropologica LABANOF), a study of the diachronic trend of
male and female adult stature in Milan (Italy) is being proposed here, covering a time span of about
2000 years, ranging from the Roman era to present‑days. The skeletons, from necropolises dedicated
to the less wealthy classes of Milanese society, were assigned to one of following ve historical
periods: Roman Era (rst–fth centuries AD), Early Middle Ages (sixth–tenth centuries AD), Late
Middle Ages (eleventh–fteenth centuries AD), Modern Era (sixteenth–eighteenth centuries AD) and
Contemporary Era (nineteenth–twentieth centuries AD), and their stature was estimated according
to the regression formulae of Trotter (1970). The collected data were then subjected to statistical
analyses with ANOVA using R software. Although stature values showed an ample standard deviation
in all periods, statistical analyses showed that stature did not signicantly vary across historical
periods in Milan for both sexes. This is one of the rare studies showing no diachronic changes in the
trend of stature in Europe.
Stature is a complex trait predominantly determined by genetic factors but with a large environmental compo-
nent. Although it is 75–90% hereditary determined1,2, it also depends on multifactorial causes including fetal and
childhood nutrition and health. Because of this interplay of genetic and environmental agents, stature has been
used in biological anthropology as a stress marker that can reect climate adaptation, nutritional conditions, and
health status. Indeed, changes in height over time have been related to climate change, socio-economic inequality,
demographic cycles, urbanization, and the spread of diseases3,4. ese environmental factors may alter growth
velocity and prevent the individual from reaching its genetic growth potential, making stature a sensitive tool
for reconstructing living conditions and microevolutionary trends1,2,5.
Diachronic studies on stature have been performed in various regions of the world6,7 (among others). In
Europe, studies have shown negative secular trends in adult stature related to climate change causing cold tem-
peratures, wars and religious conicts, the stress of industrialization, rapid urbanization, urban overcrowding,
increased population densities, poor hygiene, food shortages, unemployment, inequality of incomes, reduced
wages, spread of new diseases and epidemics, as well as height recoveries thanks to economic prosperity, climate
favorable to crops leading to higher yields in agriculture, increased productivity and the development of technol-
ogy, political stability, smallpox inoculation, and public health measures and monitoring3,5,8–16.
In a similar perspective, this paper presents the diachronic trend of female and male adult stature in a single
place, the metropolitan city of Milan (Italy) and over 2000years, spanning from the Roman era to Contemporary
times. To the best of our knowledge, this is the rst time that a study on the evolutionary trend of stature is under-
taken in such a conned geographical area and over a long period of time. is setting allows the observation of
the evolution of stature in a major European city throughout History and reduces geographical and social biases.
OPEN
1LABANOF, Laboratorio di Antropologia e Odontologia Forense, Sezione di Medicina Legale, Dipartimento
di Scienze Biomediche per la Salute, Università degli Studi di Milano, Via Mangiagalli 37, 20133 Milan,
Italy. 2Dipartimento di Studi Storici, Università degli Studi di Milano, Milan, Italy. 3Laboratorio di Biochimica e
Biosica Computazionale, Dipartimento di Scienze Farmacologiche e Biomolecolari, Università degli Studi di
Milano, Milan, Italy. *email: mirko.mattia@unimi.it
Content courtesy of Springer Nature, terms of use apply. Rights reserved

2
Vol:.(1234567890)
Scientic Reports | (2023) 13:1343 | https://doi.org/10.1038/s41598-023-28406-5
www.nature.com/scientificreports/
Materials and methods
e present paper is part of an ongoing project on the reconstruction of the life of the people of Milan through-
out History17–19, based on the skeletons of the CAL (Collezione Antropologica LABANOF—Anthropological
Collection of the LABANOF). e CAL is an osteological collection counting about 7000 individuals (about
5000 archaeological remains and 2000 contemporary remains from cemeteries), currently under study at the
Laboratory of Forensic Anthropology and Odontology (LABANOF) at the University of Milan.
For this paper, 549 skeletons of the CAL composed the study sample (Table1). e skeletons originated from
13 dierent sites in Milan (Fig.1): the excavation below the current Università Cattolica dated to the Roman era
(second–h century AD)20; that of the roman amphitheater of Sant’Eustorgio (fourth century AD); the scientic
excavation of the Ambrosian basilica of San Dionigi (h century AD)21; the emergency excavations of Palazzo
Litta (sixth–tenth century AD), Chiesa Rossa (sixth–tenth century AD), Piazza Sant’Ambrogio (divided in two
areas dated one to the sixth century and the other to the thirteenth–eenth century AD)22, and a cemetery
referable to the church of Sant’Andrea in Via Monte Napoleone (eenth century AD)23; the M4 underground
metropolitan line vertical excavations at the Sant’Ambrogio Basilica (with stratigraphic units spanning from
the Roman era—rst and second century AD, to the Late Middle Ages—eenth century AD) and San Vit-
tore (with phases of burials from the Roman era—third-fourth century AD, to the Modern age—sixteenth and
seventeenth century AD, including Tomb 20 from the second half of the eenth century which was a burial
chamber containing individuals in anatomical connection and commingled remains); the vertical excavation of
Via Necchi spanning from the Roman era to the Late Middle Ages; the mass grave burials probably due to the
Manzoni plague (middle of the seventeenth century AD) from Viale Sabotino24; the remains of the deceased
patients of the Ca’ Granda hospital (in partial or complete anatomical connection—seventeenth century AD)25;
and the CAL Milano Cemetery Skeletal Collection, a modern and documented osteological collection consti-
tuted of unclaimed cemetery individuals who died in the second half of the twentieth century26. Dating was
performed through stratigraphy, archaeological ndings, and radiocarbon analyses of bone samples. For the
purpose of this study, the skeletons were attributed to one of ve historical periods, divided as follows: Roman
era (rst–h century AD), Early Middle Ages (sixth–tenth century AD), Late Middle Ages (eleventh–eenth
century AD), Modern era (sixteenth–eighteenth century AD) and Contemporary era (nineteenth–twenty-rst
century AD). Archaeological data indicate that these sites were necropolises for the poor classes (rarely middle
classes) of the Milanese society. e entirety of the sample came from the same urban context, thus allowing a
diachronic analysis.
Table 1. Details on the study sample.
Period Site n individuals n females n males
Roman era
Università Cattolica 90 40 50
Sant’Eustorgio 3 0 3
San Dionigi 11 7 4
MM4 Sant’Ambrogio 2 2 0
Via Necchi 5 2 3
MM4 San Vittore 10 4 6
Tot a l 121 56 65
Early Middle Ages
Palazzo Litta 3 0 3
MM4 Sant’Ambrogio 37 19 18
Chiesa Rossa 6 2 4
Università Cattolica 3 1 2
Piazza Sant’Ambrogio 9 3 6
MM4 San Vittore 6 2 4
Via Necchi 42 23 19
Tot a l 106 50 56
Late Middle Ages
MM4 Sant’Ambrogio 48 22 26
Via Monte Napoleone 38 23 15
Via Necchi 14 5 9
Piazza Sant’Ambrogio 2 0 2
Tot a l 102 50 52
Modern era
Viale Sabotino 61 24 37
Crypt of the Ca’ Granda 28 17 11
MM4 San Vittore 11 9 2
Tot a l 100 50 50
Contemporary era CAL Milano Cemetery Skeletal Collection 120 60 60
Tot a l 549 266 283
Content courtesy of Springer Nature, terms of use apply. Rights reserved

3
Vol.:(0123456789)
Scientic Reports | (2023) 13:1343 | https://doi.org/10.1038/s41598-023-28406-5
www.nature.com/scientificreports/
e skeletons composing the study sample were selected based on two criteria: (1) the coxal bones should
be fused (about 16years of age) in order for sex estimation to be reliably performed using Phenice27, Klales
etal.28, Walker29,30 and Spradley and Jantz31; (2) stature estimation could be performed following Trotter32. In
this study, all stature estimations were undertaken following Trotter32, by applying regression formulae to long
bone measurements.
A forward stepwise regression was carried out to consider all interactions between sex, historical period, and
site, and nd the minimum predictive model by comparing each other using ANOVA (Faraway, 2005). Given that
some sites were not equally distributed from a statistical point of view (Table1), they were aggregated to reach
statistical homogeneity of population data. R soware was used to perform both linear models and ANOVA
statistical analyses, via lm() function and anova() functions, respectively. In detail, dierent multiple linear
regressions were carried out, computing the statistical signicance of each categorical variable, and growing the
complexity of the model, so as to also consider the interaction among variables. With this strategy, we veried
for each model statistical dierences among categorical data within each variable, as per previous study33. In
particular, the interaction between sex and period was tested in the model to verify the sexual dimorphism in
stature and the possible secular change in stature. e statistical signicance was set at a p value < 0.05. Mixed
models, via lmer() function in R, were also used setting sex as a xed variable to verify secondary random eects
of other variables on stature but no statistical dierences were found comparing models using ANOVA.
Ethical statements. Study of the archaeological remains was approved by virtue of a convention with the
Sopraintendenza Archeologia, Belle Arti e Paesaggio della Lombardia (i.e., the regional institution of the Italian
ministry of cultural heritage) and undertaken according to ethical and scientic principles per said convention.
Examination of the anonymized contemporary remains is consented and regulated by article 43 of the Presi-
dential Decree of the Italian Republic (DPR) n.285 of September 10th, 1990, of the National Police Mortuary
Regulation and in accordance with the Health Territorial Agency of the city of Milan. Informed consent was not
required. All methods were performed in accordance with the Italian law, institutional guidelines and regula-
tions.
Figure1. Map of Milan with the dierent archeological sites selected according to their historical period (red:
Roman era, blue: Early Middle Ages, green: Late Middle Ages, purple: Modern era; contemporary cemeteries
from the CAL Milano Cemetery Skeletal Collection are located further away from the city center).
Content courtesy of Springer Nature, terms of use apply. Rights reserved

4
Vol:.(1234567890)
Scientic Reports | (2023) 13:1343 | https://doi.org/10.1038/s41598-023-28406-5
www.nature.com/scientificreports/
Results
e descriptive statistics of the study sample are presented in Table2. e sample sizes varied between 50 and
65 individuals per sex and period(the entire dataset in available in the Supplementary Information). e data
provided in this paper represent all presently available skeletal individuals from the CAL and excavated from
sites in Milan that could be reliably sexed, accurately measured for stature estimation and attributed to a distinct
historical period as dened in the Materials and Methods section. As a result of the study, the stature of females
appears to vary from 143.5 to 177.6cm, with a mean of 157.8cm, whereas the values for males ranged from
152.0 to 195.4cm, with a mean of 168.5cm. As observable on Fig.2, the diachronic trend of mean stature in
both males and females remains stable over time. Indeed, statistical analyses showed that historical periods did
not signicantly inuence the variation of the data (p = 0.8738), as opposed to sex (p < 2e-16) (Table3). As per
the design of the study, bones were used for stature estimation in order of priority according to their standard
deviation. erefore, lower limbs were preferred to upper limbs, and femur and humerus were preferred to
tibia/bula and bones of the forearm, respectively. is preferential selection was dependent upon the state of
conservation and preservation of the skeletal remains. Table4 shows that the most commonly used bones for
stature estimation in the present study was the femur, in the overwhelming majority of cases (59.9%), and to a
lesser degree, the humerus (18%) and tibia (10.6%). On rare occasions, when state of preservation required it,
the bones of the forearm (5.3% each) and bula (0.9%) were used. erefore, this study shows that stature does
not appear to signicantly vary over 2000years in Milan, for both males and females.
Discussion
For the rst time, the diachronic trend of male and female adult stature was examined in Milan (Italy) spanning
2000years. Interestingly, statistical analyses showed that the simplest model to describe data was based solely
on sex and other variables (including historical period) were not able to ameliorate the statistical description,
if considered. Notably, no signicant changes in stature over time for both sexes were observed. is is, to the
best of our knowledge, the rst study to show no change in stature trend over time in Europe. Indeed, studies
have observed a U-shaped trend in adult stature, with tall individuals in Roman and Early Medieval times,
a negative secular trend in the Late Middle Ages and/or Modern era, and a height recovery in the twentieth
century3,8,9,11,13,14,34. is dierence between our study and the cited literature may be explained by several factors.
First, the present paper focused on a single place: although it considers individuals from various archaeological
Table 2. Descriptive statistics of the study sample.
Periods Females Males
nMean Median Minimum Maximum nMean Median Minimum Maximum
Roman era 56 157.06 156 146.7 177.6 65 168.71 168.5 154.7 184.7
Early Middle Ages 50 158.17 157.8 145 165.5 58 167.95 168 156.3 179.2
Late Middle Ages 50 157.73 157.1 147.4 172.2 52 169.75 169.9 157.6 179.5
Modern era 50 158.69 158.8 145.5 173 50 167.64 167.9 152 179.1
Contemporary era 60 157.46 157.1 143.5 171.1 60 168.67 168.2 156.6 195.4
TOTAL 266 157.79 162.1 143.5 177.6 283 168.55 164.7 152 195.4
Figure2. Boxplot visualization of the data according to sex and historical period.
Content courtesy of Springer Nature, terms of use apply. Rights reserved

5
Vol.:(0123456789)
Scientic Reports | (2023) 13:1343 | https://doi.org/10.1038/s41598-023-28406-5
www.nature.com/scientificreports/
sites, all necropolises are in the same geographical area, i.e., the city of Milan. e concentration of the study to
such a limited area prevents geographical biases, for instance, arising when considering individuals from both
rural and urban areas, or multiple areas with distinct topographies, microclimates, agricultural productions,
population densities and economic activities, which would represent dierent living conditions. In this paper,
the geographic and economic context of the study is homogenous and entirely restricted to the urban area of the
city of Milan, one of the most important and populous European cities throughout History. Second, in addition
to considering individuals from a single geographical context, social and economic disparities were similarly
limited. Based on archaeological data, we know that the skeletal remains from the various necropolises selected
belonged to individuals from poor social classes. People from middle classes were rare occurrences. Given that
socioeconomic factors may impact maximum growth, the fact that the individuals presented a similar socio-
economic background limited variation in the data and reduced biases for their interpretation. ird, the study
was performed with the systematic use of a unique methodology. Many methods for the estimation of stature
based on regression formulae have been published over the years, including Pearson35, Trotter and Gleser36,37,
Trotter32, and Olivier etal.38 (among others). Although each may be criticized for their reliability with varying
degree39, Trotter32 seems to present small method error, small variation and is still one of the most commonly
used methods for stature reconstruction today13. ese methods were developed from living individuals and as
such, the formulae may not be adequate for their application in past populations, as secular change may constitute
a bias in the estimation. Yet, regardless of the accuracy of the method in establishing living stature from long bone
measurements, all stature estimations were carried out following the same method in the present study, allowing
a reliable comparison of the data obtained and hence the analysis of its diachronic trend.
Nonetheless, performing the analysis based on reconstructed statures instead of bone lengths constitutes a
limitation of the study, by adding variability to the data sample. In addition, the study assumes a relative homo-
geneity of the sample, in particular regarding genetics and social status, mainly based on archaeological data,
which must be acknowledged.
Koepke and Baten14,15 examined a large sample of 2,974 individuals (both male and female) from 314 sites all
over Europe, spanning the last 2000years. Aer accounting for dierences in estimation techniques and separat-
ing Europe in various regions (i.e., Central/Western, Estern/Northern and Mediterranean) they observed several
trends: specically, a high stature in the Early Middle Ages followed by a decrease until the thirteenth century,
a height recovery in the fourteenth-eenth centuries and a second decrease in the seventeenth century, and
described an overall stagnant height over the last two millennia. is last result is consistent with our ndings,
although their sample had, as they acknowledged, low data on Mediterranean countries (which includes Italy),
females in general, and individuals aer the seventeenth century. e variation they noted over the centuries,
which they attributed to a low density of population and urbanization following invasions and plagues (in
particular the Justinian plague16), warm/cold climate and rapid urbanization, was not observed in our study.
Based on the surprising stability of the data, it can be hypothesized that living conditions in Milan, even for
the population belonging to the lower social and economic strata of society, were better than those of other urban
areas. Historians have long discussed the survival, but also the continuity and relevance of Milan city life aer
the Roman age, in spite of the political change and depopulation that followed the institutional end, or rather,
the transformation of the Western Roman Empire, and highlighted the presence of mercantile and cra activity,
well attested in the centuries of the Early Middle Ages and even more so since the eighth century40–42. e city of
Saint Ambrosius stood and still stands in a site that has always beneted from natural resources (e.g., water, land,
forests, including timber, game, edible fruits and branches to feed animals, and easy supply of metals), which is
Table 3. ANOVA results for the tested linear models.
ANOVA (Model 1 Vs Model 2) Pr(> F)
Linear model
Average ~ Sex Vs Average ~ Sex + Period 0.8738
Average ~ Sex Vs Average ~ Sex + Site_ag 0.8127
Average ~ Sex Vs Average ~ Sex + Period * Site_ag 0.5492
Mixed model Average ~ Sex Vs Average ~ Sex + (1|Period) 1
Average ~ Sex Vs Average ~ Sex + (1|Site_ag) 1
Table 4. Frequency of bone use for stature estimation in the sample.
SD (cm) Roman era
Early
Middle
Ages Late Middle
Ages Modern
era Contemporar y
era TOTAL
M F n%n%n%n%n%n%
Femur 3.27 3.72 79 65.3% 63 59.4% 41 40.2% 36 36% 110 91.7% 329 59.9%
Tibia 3.37 3.66 19 15.7% 12 11.3% 11 10.8% 7 7% 9 7.5% 58 10.6%
Fibula 3.29 3.57 2 1.6% 1 0.9% 0 0% 2 2% 0 0% 5 0.9%
Humerus 4.05 4.43 20 16.5% 16 15.1% 31 30.4% 31 31% 1 0.8% 99 18.0%
Radius 4.32 4.30 1 0.8% 11 10.3% 7 6.9% 10 10% 0 0% 29 5.3%
Ulna 4.32 4.30 0 0% 3 2.8% 12 11.8 14 14% 0 0% 29 5.3%
Content courtesy of Springer Nature, terms of use apply. Rights reserved

6
Vol:.(1234567890)
Scientic Reports | (2023) 13:1343 | https://doi.org/10.1038/s41598-023-28406-5
www.nature.com/scientificreports/
why since the Carolingian age, the great royal scal curtes41, that is, the assets of kings and queens, which was
the material basis and economic support of political power, arose precisely there. In addition to the possibility of
transporting and/or trading products, its position along the rivers guaranteed the availability of food resources,
thanks to the particular fertility of the land and the richness of the water, which also allowed the irrigation of the
lands, and encompassed vast and dense woodlands. In the praising eighth century poem, the Versum de Medi-
olano civitate, Milan is described as "famous for merchandise of all qualities and full of grains of all kinds; there
is an abundance of wine, and meat is in large quantities". e poem also tells how the poor received assistance
in the city: "the naked are abundantly clothed there; the poor and the Romans are satised"43,44. Indeed, at least
from the Early Middle Ages, Milan hosted various healthcare institutions, including the xenodochia, which later
became hospitals, dedicated to the assistance of the needy.
Milan in the Middle Ages, despite what has been written about it, clearly diers from the surrounding
countryside, even though it is no longer the glorious city of the Roman times, and is characterized by a diverse
population in terms of social articulation. A metropolis such as Milan oered chances of social armation.
e political centrality of the city over the centuries generated the presence of an almost continuous private
and public charity, which acted as a true rampart against poverty, and therefore guaranteed a better standard of
living for its inhabitants, including the poor43. is support oered by the city to the needy may have played a
relevant role on the trend of stature.
Centuries later, at the end of the thirteenth century, a text praising the city similar in typology to the above-
mentioned Versum, entitled De magnalibus Mediolani and written by a religious, Bonvesin da la Riva, exalted all
the riches of Milan: the abundance of waters, the mildness of the climate, the number of workers and artisans,
meadows, fruits, wheat and grains, vines, woods and forests, and the “abundance of foodstus”45. Among the
“greatnesses” of the city, ten urban hospitals can be counted (15 in the surrounding countryside) for the “poor
and sick”, which demonstrates how many were cared for in institutions as well as at home. All poor and sick,
and even children in need, were granted "with humanity and generosity" the comfort of a bed and food as well
as surgical care: "No indigent is rejected here"45.
Aer his conquest of the city in 1450, Francesco Sforza, then Duke of Milan, promoted a series of architectural
and infrastructural improvements for the city, including the foundation of a hospitale magnum. e Ospedale
Maggiore was conceived as a reform of the Milanese healthcare system, headquarters for the centralized manage-
ment of all city hospitals then in existence. Dedicated to the care of the poor, it became a model of healthcare
innovation and scientic activity across Europe in the sixteenth and seventeenth centuries. e hospital devel-
oped a model of care oriented toward “therapy”, aimed at the rehabilitation and recovery of a workforce that
needed to be reinserted into the labor market and its "removal" of the incurable25. e patients of the hospital,
all admitted based on a fede di povertà (“faith of poverty”) were given the comfort of a bed as well as complete
meals including bread legumes, wine and occasionally sh, meat, and dairy products17. In this sense, the hospital
became an actual “factory of health” as well as a large economic company, thanks to its substantial land holdings.
In the modern and contemporary age, the assistance and shelter provided by the Ospedale Maggiore proved
to be fundamental in warding o delinquency and revolts of the poorer population, since it provided precisely
the means of livelihood and care for the thousands of people who turned to it, including abandoned mothers
and children. ese numbered in the thousands, mostly females (called "Colombe" and taken in at St. Celsus
Hospital) and were guaranteed a more than decent standard of living. Despite various attempts at changing
welfare policy between the seventeenth and nineteenth centuries that led to problems of various kinds (i.e.,
runaways and revolts), the "Colombe" continued to enjoy a privileged status and to see the Ospedale Maggiore
as the institution that would protect them for life, as a true family46.
e city’s location in a land rich in natural resources, availability of food resources, political power, possibility
of defense of the population within the walls, and especially, and more and more as the centuries went by, care of
the poor may therefore explain, at least in part, the “stability” of the trend in stature over the centuries, as people
were known to leave the countryside and other areas to have a chance at a better life in Milan.
One might speculate, but not yet having conrmation of this due to the scarcity of studies that can be com-
pared, that the genetic input that arose from the mixing for centuries of men and women of dierent backgrounds
contributed to the "physical endurance" of the Milanese population. In theory, the various foreign invasions and
occupations of the city of Milan could have led to considerable gene ow, which may have helped maintain stable
stature trends despite social and political changes and prevented negative secular trends. However, it should be
kept in mind that barbarian migrations always involved a few thousand people, such as the Huns, the Ostro-
goths or the Lombards, who settled over vast territorial areas which may have been already densely populated,
such as Milan, and so their genetic input could have turned out to be scarce47. Furthermore, Wenskus48 already
argued that the protagonists of the migrations were groups of warriors who did not share specic biological
characteristics.
e analysis of other stress markers (such as cribriotic lesions, porotic hyperostosis, enamel hypoplasia and
Harris lines) on a sample 200 individuals (50 per historical period, including Roman era, Middle Ages, Modern
and Contemporary eras), equally divided between males and females, shows that frequencies of non-mechanical
stress were more or less stable in Milan until the Contemporary era, when they dropped notably (from 67 to
26% of individuals)49. ese results strengthen those of the present study, showing a concordant trend between
stature and other stress markers, until the nineteenth century, when they diverge. is divergence may be due
to the sensitivity of stature to non-mechanical stressors, which may be dierent from the other stress markers
previously mentioned.
To further our understanding of health and stature variation in the past, one perspective would be to perform
paleogenomic analyses on the skeletal remains of the study sample in order to confront the “potential” stature
of the individuals, genetically determined and obtained from paleogenomic data, to that actually reached and
osteologically calculated from the skeletal remains2. is way, we may be able to distinguish between individuals
Content courtesy of Springer Nature, terms of use apply. Rights reserved

7
Vol.:(0123456789)
Scientic Reports | (2023) 13:1343 | https://doi.org/10.1038/s41598-023-28406-5
www.nature.com/scientificreports/
who reached their full genetic growth potential and those who did not, and better dene the evolutionary trend
of stature variation over time and the events and conditions that inuenced it.
Conclusion
e present paper describes the results of the rst study on the stature of the Milanese population over a time
interval of about 2000years. is comes as part of a larger project aimed at reconstructing the city of Milan
throughout time and better understanding the history of its inhabitants, and in particular those oen forgotten
and neglected by History, such as the poor masses of the common people.
As a result of the study, we observed that the diachronic trend of mean stature in both males and females
remained stable over time and statistical analyses showed that historical periods did not signicantly inuence
the variation of the data. Since all samples were processed according to the same methods, there is no reason to
assume a source of discontinuity between the taken measurements. e statistical results must therefore depend
on other factors, not necessarily isolated from each other. e most reasonable is the fact that by drawing exclu-
sively from the Milan urban area, the variability of the studied sample would be more limited. We propose that
the stable trend of stature over time may be related to the relatively better living conditions in the city of Milan,
with respect to other areas.
Data availability
All data generated and analyzed during this study are included in this published article and its supplementary
information le.
Received: 21 October 2022; Accepted: 18 January 2023
References
1. Kemkes-Grottenthaler, A. e short die young: e interrelationship between stature and longevity—Evidence from skeletal
remains. Am. J. Phys. Anthropol. 128, 340–347 (2005).
2. Marciniak, S. et al. An integrative skeletal and paleogenomic analysis of stature variation suggests relatively reduced health for
early European farmers. PNAS 119, e2106743119 (2022).
3. Steckel, R. H. New light on the ‘Dark Ages’: the remarkably tall stature of northern European men during the medieval era. Soc.
Sci. Hist. 28, 211–229 (2004).
4. Larsen, C. S. Bioarchaeology: Interpreting Behavior from the Human Skeleton (Cambridge University Press, 2015).
5. Formicola, V. & Giannecchini, M. Evolutionary trends of stature in Upper Paleolithic and Mesolithic Europe. J. Hum. Evol. 36,
319–333 (1999).
6. Shin, D. H., Oh, C. S., Kim, Y. S. & Hwang, Y. I. Ancient-to-modern secular changes in Korean stature. Am. J. Phys. Anthropol.
147, 433–442 (2012).
7. McCullough, J. M. Secular trend for stature in adult male Yucatec Maya to 1968. Am. J. Phys. Anthropol. 58, 221–225 (1982).
8. de Beer, H. Observations on the history of Dutch physical stature from the late-Middle Ages to the present. Econ. Hum. Biol. 2,
45–55 (2004).
9. Cardoso, H. F. V. & Gomes, J. E. A. Trends in adult stature of peoples who inhabited the modern Portuguese territory from the
mesolithic to the late twentieth century. Int. J. Osteoarchaeol. 19, 711–725 (2009).
10. A’Hearn, B. Anthropometric evidence on living standards in Northern Italy, 1730–1860. J. Econom. Hist. 63, 351–381 (2003).
11. Maat, G. J. R. Two millennia of male stature development and population health and wealth in the Low Countries. Int. J. Osteoar-
chaeol. 15, 276–290 (2005).
12. Styne, D. M. & McHenry, H. e evolution of stature in humans. Horm. Res. 39, 3–6 (1993).
13. Jørkov, M. L. S. Stature in 19th and early 20th century Copenhagen. A comparative study based on skeletal remains. Econ. Hum.
Biol. 19, 13–26 (2015).
14. Koepke, N. & Baten, J. e biological standard of living in Europe during the last two millennia. Eur. Rev. Econ. Hist. 9, 61–95
(2005).
15. Koepke, N. & Baten, J. Agricultural specialization and height in ancient and medieval Europe. Explor. Econ. Hist. 45, 127–146
(2008).
16. Baten, J., Steckel, R. H., Larsen, C. S. & Roberts, C. A. Multidimensional patterns of European health, work, and violence over the
past two millennia. In e Backbone of Europe: Health, Diet, Work and Violence Over Two Millennia Vol. 80 (eds Steckel, R. H. et
al.) 381–396 (Cambridge University Press, 2019).
17. Mattia, M. et al. “Man is what he eats”. Plant residues from dental calculus in the ancient population of Milano from Roman times
to modern age. J. Archaeol. Sci. Rep. 39, 103180 (2021).
18. Biehler-Gomez, L. et al. Ye must have faith’ how anthropology can contribute to religious heritage: e osteobiography of Italian
martyr Saint Nazarius. Int. J. Osteoarchaeol. https:// doi. org/ 10. 1002/ oa. 2967 (2021).
19. Biehler-Gomez, L. et al. Mercury poisoning in two patients with tertiary syphilis from the Ca’Granda hospital (Seventeenth-century
Milan). Archaeometry 64, 1–11 (2021).
20. Cattaneo, C. et al. Vita Nella Milano Romana: Evidenze Antropologiche E Paleopatologiche Provenienti Dalla Necropoli. (2001).
21. Biehler-Gomez, L. et al. Physical disability in Late Antiquity Milan: slipped capital femoral epiphysis with severe secondary joint
disease in the Basilica of San Dionigi. HOMO J. Comp. Hum. Biol. 73(1), 61–67 (2022).
22. Cattaneo, C., Cotti, C., Gibelli, D., Mazzarelli, D. & Sguazza, E. La necropoli di Piazza Sant’Ambrogio. in Il Volto di una Piazza
51–58 (2015).
23. Mattia, M., Piccolo, E., Poppa, P. & Cattaneo, C. Studio antropologico e patologico sugli scheletri rinvenuti nello scavo di via Monte
Napoleone. in Notiziario della Soprintendenza per i Beni Archeologici della Lombardia (2020).
24. Caruso, V. et al. Gli scheletri della fossa comune di viale Sabotino a Milano: le vittime della peste manzoniana?. FOLD&R FastiOn-
Line Doc. Res. 285, 1–11 (2013).
25. Mattia, M. et al. Ca’ Granda, an avant-garde hospital between the Renaissance and Modern age: A unique scenario in European
history. Med. Hist. 66, 24–33 (2022).
26. Cattaneo, C. et al. A modern documented Italian identied skeletal collection of 2127 skeletons: the CAL Milano Cemetery Skeletal
Collection. Forensic Sci. Int. 287(219), e1-219.e5 (2018).
27. Phenice, T. W. A newly developed visual method of sexing the os pubis. Am. J. Phys. Anthropol. 30, 297–301 (1969).
28. Klales, A. R., Ousley, S. D. & Vollner, J. M. A revised method of sexing the human innominate using Phenice’s nonmetric traits
and statistical methods. Am. J. Phys. Anthropol. 149, 104–114 (2012).
Content courtesy of Springer Nature, terms of use apply. Rights reserved

8
Vol:.(1234567890)
Scientic Reports | (2023) 13:1343 | https://doi.org/10.1038/s41598-023-28406-5
www.nature.com/scientificreports/
29. Walker, P. L. Sexing skulls using discriminant function analysis of visually assessed traits. Am. J. Phys. Anthropol. 136, 39–50 (2008).
30. Walker, P. L. Greater sciatic notch morphology: Sex, age, and population dierences. Am. J. Phys. Anthropol. 127, 385–391 (2005).
31. Spradley, K. & Jantz, R. L. Sex estimation in forensic anthropology: Skull versus postcranial elements. J. Forensic Sci. 56, 289–296
(2011).
32. Trotter, M. Estimation of stature from intact long limb bones. In Personal Identication in Mass Disasters (ed. Stewart, T. D.) 71–83
(Smithsonian Institution, National Museum of Natural History, 1970).
33. Biehler-Gomez, L., Mattia, M., Mondellini, M., Palazzolo, L. & Cattaneo, C. Dierential skeletal preservation between sexes: A
diachronic study in Milan over 2000 years. Archaeol. Anthropol. Sci. 14, 147 (2022).
34. Giannecchini, M. & Moggi-Cecchi, J. Stature in archeological samples from central Italy: Methodological issues and diachronic
changes. Am. J. Phys. Anthropol. 135, 284–292 (2008).
35. Pearson, K. IV. Mathematical contributions to the theory of evolution.—V. On the reconstruction of the stature of prehistoric
races. Philos. Trans. R. Soc. Lond. Ser. A Contain. Pap. Math. Phys. Character 169–244 (1899).
36. Trotter, M. & Gleser, G. C. Estimation of stature from long bones of American Whites and Negroes. Am. J. Phys. Anthropol. 10,
463–514 (1952).
37. Trotter, M. & Gleser, G. C. A re-evaluation of estimation of stature based on measurements of stature taken during life and of long
bones aer death. Am. J. Phys. Anthropol. 16, 79–123 (1958).
38. Olivier, G., Aaron, C., Fully, G. & Tissier, G. New estimations of stature and cranial capacity in modern man. J. Hum. Evol. 7,
513–518 (1978).
39. Formicola, V. Stature reconstruction from long bones in ancient population samples: An Approach to the problem of its reliability.
Am. J. Phys. Anthropol. 90, 351358 (1993).
40. Violante, C. La Società Milanese nell’Età Precomunale (Laterza, 1953).
41. Santos Salazar, I. Governare la Lombardia Carolingia (774–924) (Viella, 2021).
42. Tabacco, G. Egemonie Sociali e Strutture del Potere nel Medioevo Italiano (Einaudi, 1979).
43. Albini, G. Poveri e Povertà nel Medioevo Vol. 223 (Carocci, 2016).
44. Versus de Verona. Versum de Mediolano civitate. (1960).
45. da la Riva, B. De magnalibus Mediolani. Meraviglie di Milano. Testo critico e traduzione (Libri Scheiwiller, 1997).
46. Reggiani, F. Sotto le ali della Colomba. Famiglie assistenziali e relaizoni di genere a Milano dall’età moderna alla Restaurazione
(Viella, 2014).
47. Gasparri, S. & la Rocca, C. Tempi barbarici. L’Europa occidentale tra antichità e medioevo (300–900) (Carocci, 2013).
48. Wenskus, R. Stammesbildung und Verfassung Das Werden der frühmittelalterrlichen Gentes (Böhlau, 1961).
49. Rodella, L. et al. 2000 Years of female condition narrated from the skeletons of Milan: Preliminary results. in 14th Congress of the
Italian Anthropological Association (2022).
Author contributions
L.B.-G.: Conceptualization, Methodology, Investigation, Writing Original Dra and Writing Review and editing;
B. del B.: Data Curation and Interpretation, Writing-Review and Editing; D.P.: Data Acquisition, Curation and
Interpretation; P.M.: Data Acquisition, Curation and Interpretation; M.M.: Methodology, Data Curation and
Interpretation; L.P.: Validation, Writing-Review and Editing; U.G.: Validation, Writing-Review and Editing;
C.C.: Conceptualization, Supervision.
Funding
L.B.G. was awarded a L’Oréal-UNESCO grant ‘For Women in Science’ Italian edition. e authors acknowledge
the support of the FAITH (Fighting Against Injustice through Humanities) project and of the APC central fund
of the University of Milan.
Competing interests
e authors declare no competing interests.
Additional information
Supplementary Information e online version contains supplementary material available at https:// doi. org/
10. 1038/ s41598- 023- 28406-5.
Correspondence and requests for materials should be addressed to M.M.
Reprints and permissions information is available at www.nature.com/reprints.
Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and
institutional aliations.
Open Access is article is licensed under a Creative Commons Attribution 4.0 International
License, which permits use, sharing, adaptation, distribution and reproduction in any medium or
format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the
Creative Commons licence, and indicate if changes were made. e images or other third party material in this
article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the
material. If material is not included in the article’s Creative Commons licence and your intended use is not
permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from
the copyright holder. To view a copy of this licence, visit http:// creat iveco mmons. org/ licen ses/ by/4. 0/.
© e Author(s) 2023
Content courtesy of Springer Nature, terms of use apply. Rights reserved

1.
2.
3.
4.
5.
6.
Terms and Conditions
Springer Nature journal content, brought to you courtesy of Springer Nature Customer Service Center GmbH (“Springer Nature”).
Springer Nature supports a reasonable amount of sharing of research papers by authors, subscribers and authorised users (“Users”), for small-
scale personal, non-commercial use provided that all copyright, trade and service marks and other proprietary notices are maintained. By
accessing, sharing, receiving or otherwise using the Springer Nature journal content you agree to these terms of use (“Terms”). For these
purposes, Springer Nature considers academic use (by researchers and students) to be non-commercial.
These Terms are supplementary and will apply in addition to any applicable website terms and conditions, a relevant site licence or a personal
subscription. These Terms will prevail over any conflict or ambiguity with regards to the relevant terms, a site licence or a personal subscription
(to the extent of the conflict or ambiguity only). For Creative Commons-licensed articles, the terms of the Creative Commons license used will
apply.
We collect and use personal data to provide access to the Springer Nature journal content. We may also use these personal data internally within
ResearchGate and Springer Nature and as agreed share it, in an anonymised way, for purposes of tracking, analysis and reporting. We will not
otherwise disclose your personal data outside the ResearchGate or the Springer Nature group of companies unless we have your permission as
detailed in the Privacy Policy.
While Users may use the Springer Nature journal content for small scale, personal non-commercial use, it is important to note that Users may
not:
use such content for the purpose of providing other users with access on a regular or large scale basis or as a means to circumvent access
control;
use such content where to do so would be considered a criminal or statutory offence in any jurisdiction, or gives rise to civil liability, or is
otherwise unlawful;
falsely or misleadingly imply or suggest endorsement, approval , sponsorship, or association unless explicitly agreed to by Springer Nature in
writing;
use bots or other automated methods to access the content or redirect messages
override any security feature or exclusionary protocol; or
share the content in order to create substitute for Springer Nature products or services or a systematic database of Springer Nature journal
content.
In line with the restriction against commercial use, Springer Nature does not permit the creation of a product or service that creates revenue,
royalties, rent or income from our content or its inclusion as part of a paid for service or for other commercial gain. Springer Nature journal
content cannot be used for inter-library loans and librarians may not upload Springer Nature journal content on a large scale into their, or any
other, institutional repository.
These terms of use are reviewed regularly and may be amended at any time. Springer Nature is not obligated to publish any information or
content on this website and may remove it or features or functionality at our sole discretion, at any time with or without notice. Springer Nature
may revoke this licence to you at any time and remove access to any copies of the Springer Nature journal content which have been saved.
To the fullest extent permitted by law, Springer Nature makes no warranties, representations or guarantees to Users, either express or implied
with respect to the Springer nature journal content and all parties disclaim and waive any implied warranties or warranties imposed by law,
including merchantability or fitness for any particular purpose.
Please note that these rights do not automatically extend to content, data or other material published by Springer Nature that may be licensed
from third parties.
If you would like to use or distribute our Springer Nature journal content to a wider audience or on a regular basis or in any other manner not
expressly permitted by these Terms, please contact Springer Nature at
onlineservice@springernature.com