Presence of the Diffuse Idiopathic Skeletal Hyperostosis in Avinganya rural population (Lleida, Iberian Peninsula).

Diffuse idiopathic skeletal hyperostosis (DISH) has largely been associated with high socioeconomic status rather than lower social status in paleopathological studies.  This difference has been explained as a consequence of a high intake of fats and sedentary lifestyle that could be related to metabolic syndrome and obesity, associated risk factors in DISH by some clinical authors. This association is also known as the ‘monastic way of life’. In this work, we present a DISH case corresponding to a male individual exhumed from a civil burial site  of the necropolis of the Trinitarian Monastery of Avinganya, in the North-East of Iberian Peninsula. In this case, DISH coexists with some evidences of occupational stress markers (back lesions and traumas) that indicate a non-sedentary lifestyle, despite the individuals overweight. Therefore, the present case of DISH seems to contradict the ‘monastic way of life’ association. The previous relationship can be explained as a bias in the sample analysed, where high status individuals have longer survival ratios, so more probabilities to develop DISH, because age is a proved risk factor. In this way, mechanical stress is proposed as another risk factor of DISH, which is more accurate to explain this case.