Why were Sardinians the shortest Europeans? A journey through genes, infections, nutrition, and sex

Abstract

Since ancient times the Mediterranean island of Sardinia has been known for harboring a population with an average body height shorter than almost every other ethnic group in Europe. After over a century of investigations, the cause(s) at the origin of this uniqueness are not yet clear. The shorter stature of Sardinians appears to have been documented since prehistoric times, as revealed by the analysis of skeletal remains discovered in archaeological sites on the island. Recently, a number of genetic, hormonal, environmental, infective and nutritional factors have been put forward to explain this unique anthropometric feature, which persisted for a long time, even when environmental and living conditions improved around 1960. Although some of the putative factors are supported by sound empirical evidence, weaker support is available for others. The recent advent of whole genome analysis techniques shed new light on specific variants at the origin of this short stature. However, the marked geographical variability of stature across time and space within the island, and the well-known presence of pockets of short height in the population of the southern districts, are still puzzling findings that have attracted the interest of anthropologists and geneticists. The purpose of this review is to focus on the state-of-the-art research on stature, as well as the factors that made Sardinians the shortest among Europeans.

Dietary Habits, Anthropometric Features and Daily Performance in Two Independent Long-Lived Populations from Nicoya peninsula (Costa Rica) and Ogliastra (Sardinia)

“…This outstanding height was attributed by the authors to a healthier growth of this population in the early stages of body development. On the other hand, the shorter stature of the Sardinian elderly cannot be attributed to insufficient nutrition during childhood and adolescence, but rather to a higher frequency of short-statured genetic variants [ 42 ].…”

The association of adult height with the risk of cardiovascular disease and cancer in the population of Sardinia

“…In this study we tested the hypothesis of an association between adult stature and the risk of developing non-communicable diseases, such as CV disease and cancer, in a population that is known as having the shortest average height in Europe [ 30 ], and in which an association between short stature and longevity had previously been reported [ 33 ]. Stratifying the study participants by sex and height tertiles, the relative risk of CV disease was significantly higher in the subjects in the lowest height category, irrespective of sex, and lower in those in the upper category.…”

“…Actually, the Mendelian randomization approach works well only when exposure is not time‒varying. In the past, the average stature of Sardinian population has been heavily influenced by non‒genetic factors [ 30 ] and showed one of the strongest “secular trend” in stature. This could explain at least in part the discrepancy.…”

“…The population living on the island of Sardinia is particularly suited to an investigation of this kind for a number of reasons: (i) traditionally Sardinians were characterized by a shorter‒than‒average stature due to the harsh living conditions in the pre-industrial era, as well as the diffusion of endemic infectious diseases such as malaria [ 29 , 30 ]; (ii) a marked secular trend in body height was documented in the Sardinian population [ 31 ], and recently the trend towards increased growth in height of Sardinian boys appears to have been the strongest in Europe with an increase of 1.2 cm per year [ 32 ]; (iii) an inverse relationship between height and longevity was reported in the male population of Central Sardinia with a 2‒years reduction in life span for taller people compared to their shorter peers [ 33 ]. These features of the Sardinian population can be interpreted in the light of evolutionary biology which postulates a trade‒off between growth and investment in reproduction [ 34 ].…”

“…These features of the Sardinian population can be interpreted in the light of evolutionary biology which postulates a trade‒off between growth and investment in reproduction [ 34 ]. More specifically, in a population historically characterized by poor environmental and nutritional conditions a stunting strategy may have represented an adaptive response resulting in greater fitness [ 30 ].…”