The Paradoxical Nature of Hunter-Gatherer Diets: Meat-Based, Yet Non-Atherogenic.

This review examines twentieth-century hunter-gatherer (HG) diets, which ethnographic studies (n=58 societies) and one quantitative study suggested were plant-dominated, yet HG populations showed minimal cardiovascular disease (CVD). Analyzing 13 quantitative dietary studies, we found animal foods provided 65% of energy, with plants contributing 35%, aligning with a broader ethnographic review (n=229 societies) indicating 68% reliance on animal foods versus 32% on plants. Supporting evidence includes isotopic analyses of Paleolithic hominid collagen, reduced gut size, enzyme activity, and foraging data, all suggesting a meat-based dietary history. Paradoxically, while Western meat-heavy diets increase CVD risk, HG societies consuming predominantly animal-based energy remained CVD-free. This may stem from high dietary protein (19–35% energy) and low carbohydrates (22–40% energy) exerting hypolipidemic effects, alongside fat intake (28–58% energy) featuring higher MUFA, PUFA, and a lower ω-6/ω-3 ratio compared to Western diets. Additional factors like antioxidants, fiber, vitamins, phytochemicals, and low salt, combined with lifestyle traits (exercise, low stress, no smoking), likely synergistically reduced CVD risk, suggesting HG diets offer insights for designing therapeutic diets to mitigate CVD in Westernized societies.