In recent years, researchers have turned their attention to the long-term health and aging of the few remaining populations of hunter-gatherers, such as the Tsimane that are the subject of today’s open access paper. The lifestyle led by these individuals is characterized by high levels of exercise and a diet low in all of the usual line items that we know are not that good for us, such as processed sugars. Hunter-gatherer populations exhibit dramatically lower levels of cardiovascular disease and dysfunction than is the case for people in wealthier parts of the world. Their existence is a mirror, held up to show the rest of us just how much harm can be done by a sedentary life and a bad diet.
The Tsimane have been the subject of a range of studies of late. They exhibit slower onset of neurodegeneration, minimal degrees of atrial fibrillation, little hypertension and obesity, superior metabolic health, little to no increase in systemic inflammation with age, and so forth. We should all be so lucky – but there is no luck involved here, this is all the outcome of a particular lifestyle. Today’s open access paper produces the expected data on arterial stiffness to accompany other published work on the cardiovascular health of the Tsimane; there are a few eye-opening numbers in that data set. The few metabolically unhealthy Tsimane are outperforming the healthy US populations in the metric of arterial stiffness, for example. We might take that as a measure of the degree to which a sedentary lifestyle is actively harmful to long-term health.
Arterial Stiffness in Heart-Healthy Indigenous Tsimane Forager-Horticulturalists
We conducted a cross-sectional study comparing 3 arterial stiffness metrics among Tsimane forager-horticulturalists with 2 representative US cohorts. Tsimane participants exhibited superior arterial health compared with US cohorts, with higher elasticity and lower stiffness. Stiffness measures were 47.3% and 35.7% better than US cohort participants by age 40 years, respectively, and differences remained sustained throughout adulthood. The carotid–femoral pulse wave velocity in Tsimane participants was 33.9% lower and showed a minimal age-related increase, with carotid-femoral pulse wave velocity only higher by age 70+. Tsimane participants with ≥2 comorbidities (hypertension, obesity, and diabetes) had ≈25% higher arterial elasticity than healthy Americans with no comorbidities.
The disparities in arterial stiffness between Tsimane and urbanized cohorts can be attributed to their subsistence-oriented lifestyle and environmental context, which align with key metrics in cardiovascular health promotion, such as a lean diet, high physical activity, and consistently low blood glucose and blood pressure. The combined effect of the aforementioned factors might promote optimal vascular health from early life and contribute to sustained cardiovascular well-being. In fact, Tsimane individuals lifestyle exemplifies many of the core principles outlined in the American Heart Association’s Life’s Essential 8 metrics, a framework that emphasizes proactive cardiovascular health improvement and preservation across the life course. Based on that framework, the primary distinctions between Tsimane and their urbanized peers are diet and physical activity, the 2 criteria in which US adults scored the lowest among all 8 cardiovascular health metrics between 2013 and 2020.
Tsimane individuals typically engage in high levels of low- and moderate-intensity activities year-round, despite seasonality of production tasks. Men and women typically engage in physical activity for 6 to 7 hours/day and 4 to 6 hours/day, respectively, averaging ≈17,000 steps daily. Activity levels remain relatively high throughout adulthood, though decline at late ages. Studies have reported an attenuated age-related arterial stiffness increase in physically active populations. A recent meta-analysis found that sustained aerobic exercise interventions reduce arterial stiffness, particularly measures of pulse wave velocity. The underlying mechanism involves improved vessel wall homeostasis through a combination of pathways, including decreased vascular oxidative stress, increased endothelial nitric oxide bioavailability, and upregulation of vascular growth factors. Moreover, the diet of Tsimane individuals is best characterized as high-carbohydrate, fiber-rich, and low-fat, with a high intake of micronutrients, such as potassium and magnesium. This dietary pattern, centered on cultigens, freshwater fish, and wild game, closely resembles the recommended heart-healthy diet, with an emphasis on healthy fats, dietary fiber, whole grains, healthy-sourced proteins, and limited refined sugars and processed foods.
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