Numerous indications in literature argue that diffuse idiopathic skeletal hyperostosis (DISH) is aetiologically linked with obesity and late onset (type II) diabetes. Thus its incidence should differ in socially stratified societies where individuals have different access to food resources. The incidence of DISH was evaluated in a skeletal sample of 458 adult individuals from the Iron Age, Mediaeval, and Early Modern periods. Social status was defined either by grave inventory (Iron Age) or burial location (within a church, or urban or rural cemeteries). Diagnostic criteria for DISH were right side anterior longitudinal spinal ligament or extra-spinal ligament (enthesis) ossification. No differences between chronological groups were found. The incidence of DISH had definite age affinity: it increased with age: from 0.00% in 20–30 year olds to 30.23% in the 50+ year old group (p<0.001). It was also closely associated with sex: male/female ratio was 6.9 (p<0.01). Social status was slightly but significantly related with DISH: incidence among high social status individuals was 27.14%, average or urban was 11.86%, poor or rural was 7.14% (p<0.001). Our results confirm that DISH is associated with the male sex and advanced age and support the hypothesis that the incidence of DISH is related to life style, possibly as a result of different nutritional patterns. Copyright © 2003 John Wiley & Sons, Ltd.