Modern hunter-gatherer societies are located in the poorer parts of the world, and thus still face challenges in the control of infectious disease. When it comes to age-related disease they can be notably better off than those of us in the typist-shopper societies of wealthier regions, however. This, I would say, has less to do with the components of diet and more to do with overall calorie intake and level of fitness throughout life. There are those who would debate that, and suggest that the specific dietary components shape gut microbe populations, and those populations have just as significant an effect as exercise over the span of a lifetime. Regardless, eating a calorie restricted diet tends to solve both of those problems, making the debate moot in a practical sense, and no-one is arguing against aerobic fitness as a good thing in life.
From the standpoint of heart health, the Tsimane are a model group. A population indigenous to the Bolivian Amazon, the Tsimane demonstrate next to no heart disease. They have minimal hypertension, low prevalence of obesity, and their cholesterol levels are relatively healthy. And those factors don't seem to change with age. Also minimal is the incidence of type 2 diabetes. Researchers have now conducted the first systematic study that examines what the Tsimane consume on a regular basis and compares it to that of the Moseten, a neighboring population with similar language and ancestry, but whose eating habits and lifeways are more impacted by outside forces.
Using the same measurement strategy employed by the U.S. Centers for Disease Control and Prevention's National Health and Nutrition Examination Survey, the researchers interviewed 1,299 Tsimane and 229 Moseten multiple times about everything they had eaten or drunk in the previous 24 hours. Using published and their own nutritional estimates for all items, and a variety of methods to estimate portion size, they provided a detailed breakdown of daily food intake. The high-calorie (2,433-2,738 kcal/day) Tsimane diet was characterized by high carbohydrate and protein intake, and low fat intake (64, 21 and 15 percent of the diet, respectively). In addition, the Tsimane don't eat a wide variety of foods, relative to the average U.S. or Moseten diet. Almost two-thirds of their calories are derived from complex carbohydrates, particularly plantains and rice. Another 16 percent comes from over 40 species of fish, and 6 percent from wild game. Only 8 percent of the diet came from markets.
Despite the low dietary diversity, the researchers found little evidence of micronutrient deficiencies in the Tsimane's daily intake. Calcium and a few vitamins (D, E and K) were in short supply, but the intake of potassium, magnesium, and selenium - often linked to cardiovascular health - far exceeded U.S. levels. Dietary fiber intake was almost double U.S. and Moseten levels. The conclusion: A high-energy diet rich in complex carbohydrates is associated with low cardiovascular disease risk, at least when coupled with a physically active lifestyle (Tsimane adults average 17,000 or so steps per day, compared to Americans' 5,100). Moving away from a diet that is high in fiber and low in fat, salt, and processed sugar represents a serious health risk for transitioning populations.