—
## His Atherosclerosis: Agricultural Diet and Ancient Cardiovascular Risk
The 2012 genome flagged elevated genetic risk for cardiovascular disease in Ötzi, and subsequent physical examination of the mummy confirmed the presence of atherosclerotic plaques in his arteries. This finding — cardiovascular disease in a Copper Age man living thousands of years before the dietary patterns assumed to drive modern heart disease — contributed to a growing body of research suggesting that atherosclerosis is not a purely modern condition caused by modern diet and lifestyle.
The plaques identified in Ötzi’s arteries were real, documented through CT imaging of the mummy. His arteries showed calcifications consistent with atherosclerotic disease, in the aorta and in peripheral vessels. This was not mild early-stage disease; Ötzi appears to have had meaningful cardiovascular pathology for his age.
The causes of atherosclerosis in modern populations are debated, but risk factors include genetics, diet (particularly saturated fat and refined carbohydrates), inflammation, infection, and metabolic syndrome. For Ötzi, several of these factors were likely present. His genetic risk for cardiovascular disease was documented in the 2012 genome. His diet included significant quantities of red meat, with evidence of high dietary fat in the last-meal analysis. He had chronic infections (H. pylori, Borrelia, whipworm). He had the metabolic profile of an early farmer population adapted to a high-carbohydrate, grain-based diet rather than the high-fat diet that his apparent food intake suggests he may have been eating.
The five agriculture-adaptation SNPs documented in the 2023 genome — associated with slow fat metabolism and adaptation to plant-based diets — are interesting in this context. If Ötzi had genetically inherited the metabolic adaptations of early farming populations but was living on a substantial quantity of animal fat (as the last-meal analysis suggests), there might have been a mismatch between his metabolic genetics and his diet that contributed to his cardiovascular risk.