Results from a cross-sectional cohort study presented at ACC.17 show that Bolivian Tsimane have the lowest prevalence of coronary artery disease (CAD) of any population yet studied, with only 3% of the studied individuals having significant atherosclerotic disease, despite having a high infectious inflammatory burden. This Tsimane population had low levels of LDL cholesterol, and the presence of cardiovascular risk factors, such as obesity, hypertension, or high levels of sugar in the blood, was rare. The Tsimane live in the Bolivian Amazon and have a pre-industrial, subsistence lifestyle of hunting, gathering, fishing, and farming. The low levels of CAD in this forager–horticulturalist population suggest that urbanization and elimination of a subsistence lifestyle might be important risk factors for CAD. The authors of the study acknowledge that a subsistence diet is generally not feasible in urban populations, but adoption of some aspects of subsistence lifestyles might benefit individuals in sedentary, industrialized environments.