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In conjunction with this discordance between our ancient, genetically determined biology and the nutritional, cultural, and activity patterns in contemporary Western populations, many of the so-called diseases of civilization have emerged (2–12).

In postmenopausal women aged ≥50 y, 7.2% have osteoporosis and 39.6% have osteopenia (16).During the ensuing Holocene (10000 y ago until the present), cereal grains were rarely consumed as year round staples by most worldwide hunter-gatherers (32,33), except by certain groups living in arid and marginal environments (32,34).Hence, as was the case with dairy foods, before the Epi-Paleolithic (10000–11000 y ago) and Neolithic (10000 to 5500 y ago) periods, there was little or no previous evolutionary experience for cereal grain consumption throughout hominin evolution.Ground stone mortars, bowls, and cup holes first appeared in the Upper Paleolithic (from 40000 y ago to 12000 y ago) (29), whereas the regular exploitation of cereal grains by any worldwide hunter-gatherer group arose with the emergence of the Natufian culture in the Levant ≈13000 BP (30).Domestication of emmer and einkorn wheat by the descendants of the Natufians heralded the beginnings of early agriculture and occurred by 10–11000 BP from strains of wild wheat localized to southeastern Turkey (31).In the 5–7 million-year period since the evolutionary emergence of hominins (bipedal primates within the taxonomic tribe hominini; note that the newer term ) ≥20 species may have existed (Figure 1) (19).

Similar to historically studied hunter-gatherers (20,21), there would have been no single universal diet consumed by all extinct hominin species.Rather, diets would have varied by geographic locale, climate, and specific ecologic niche.However, there are universal characteristics of preagricultural hominin diets that are useful in understanding how the current Western diet may predispose modern populations to chronic disease.Food types that would have generally been unavailable to preagricultural hominins are listed in Table 1 (22–24).Although dairy products, cereals, refined sugars, refined vegetable oils, and alcohol make up 72.1% of the total daily energy consumed by all people in the United States, these types of foods would have contributed little or none of the energy in the typical preagricultural hominin diet (20).Initially, when permanent environmental changes occur in a population, individuals bearing the previous average status quo genome experience evolutionary discordance (2,3).

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