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While some populations lived outside glacial extremes, all faced periodic cold stress, and their survival depended on a diverse set of strategies. Technological buffers, including fire use, hide processing tools, and possible clothing and footwear, likely played a primary role in reducing cold exposure. Anatomically, Neandertals exhibit high body mass, broad trunks, and abbreviated limbs, consistent with thermoregulatory principles. The Neandertal nasal region, long considered paradoxical, now appears well suited to cold\u2010dry air\u2010conditioning; computational fluid dynamics and new endoscopic data support a functionally integrated nasal cavity with substantial internal surface area. Physiological adaptations remain inferential but plausible, including elevated basal metabolism, energy\u2010dense diets, and potential use of brown adipose tissue. These factors likely contributed to high total energy expenditures, enabling thermoregulation in demanding environments. Rather than a single trait or \u201csignature\u201d adaptation, Neandertals present an integrated response to cold stress shaped by geography, development, culture, and genetics. This holistic view reframes Neandertal biology as deeply thermally engaged and sets the stage for targeted tests of function and mechanism in future research.<\/jats:p>","DOI":"10.1002\/ajhb.70150","type":"journal-article","created":{"date-parts":[[2025,10,1]],"date-time":"2025-10-01T06:03:06Z","timestamp":1759298586000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Neandertal Cold Adaptation: Technological, Anatomical, and Physiological Responses to Cold Stress in One of Our Closest Fossil Relatives"],"prefix":"10.1002","volume":"37","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2653-9122","authenticated-orcid":false,"given":"Trenton W.","family":"Holliday","sequence":"first","affiliation":[{"name":"Department of Anthropology Tulane University  New Orleans Louisiana USA"},{"name":"Centre for the Exploration of the Deep Human Journey, University of the Witwatersrand  Johannesburg South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6949-2029","authenticated-orcid":false,"given":"Cara","family":"Ocobock","sequence":"additional","affiliation":[{"name":"Department of Anthropology and Eck Institute for Global Health University of Notre Dame  South Bend Indiana USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Libby W.","family":"Cowgill","sequence":"additional","affiliation":[{"name":"Department of Anthropology University of Missouri  Columbia Missouri USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Scott D.","family":"Maddux","sequence":"additional","affiliation":[{"name":"Center for Anatomical Sciences, University of North Texas Health Science Center  Fort Worth Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,9,30]]},"reference":[{"key":"e_1_2_11_2_1","first-page":"230","article-title":"Ecogeographical Variation in the American Robin (Turdus migratorius)","volume":"108","author":"Aldrich J. 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