Volume 389, Issue 10080, Pages (April 2017)

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Volume 389, Issue 10080, Pages 1730-1739 (April 2017) Coronary atherosclerosis in indigenous South American Tsimane: a cross-sectional cohort study Prof Hillard Kaplan, PhD, Prof Randall C Thompson, MD, Benjamin C Trumble, PhD, L Samuel Wann, MD, Prof Adel H Allam, MD, Bret Beheim, PhD, Prof Bruno Frohlich, PhD, M Linda Sutherland, MD, James D Sutherland, MD, Jonathan Stieglitz, PhD, Daniel Eid Rodriguez, MD, David E Michalik, DO, Chris J Rowan, MD, Guido P Lombardi, MD, Ram Bedi, PhD, Angela R Garcia, MA, Prof James K Min, MD, Prof Jagat Narula, MD, Prof Caleb E Finch, PhD, Prof Michael Gurven, PhD, Prof Gregory S Thomas, MD The Lancet Volume 389, Issue 10080, Pages 1730-1739 (April 2017) DOI: 10.1016/S0140-6736(17)30752-3 Copyright © 2017 Elsevier Ltd Terms and Conditions

Figure 1 Study profile *Data were missing mainly because of broken laboratory equipment, electricity issues, missing supplies, or absent or sick laboratory personnel; data were missing for blood biomarkers, cholesterol, body fat, and confidence in the validity of the age estimate. The Lancet 2017 389, 1730-1739DOI: (10.1016/S0140-6736(17)30752-3) Copyright © 2017 Elsevier Ltd Terms and Conditions

Figure 2 CAC scores by age for US MESA, and Tsimane samples Tsimane have significantly lower CAC for each age category (all p ≤0·0001). Raw data and t tests for differences between Tsimane and MESA23 are given in the appendix. Error bars show 95% CI. CAC=coronary artery calcium. The Lancet 2017 389, 1730-1739DOI: (10.1016/S0140-6736(17)30752-3) Copyright © 2017 Elsevier Ltd Terms and Conditions

Figure 3 CAC score by age and CAC percentile in MESA white men (A) and Tsimane men (scaled to MESA men at 0–4800; B) and in MESA white women (C) and Tsimane women (D) and Tsimane men (scaled to MESA women at 0–1600; E) Raw Tsimane data in five percentile groups for each age group15 are in the appendix. MESA=Multi-Ethnic Study of Atherosclerosis. CAC=coronary artery calcium. The Lancet 2017 389, 1730-1739DOI: (10.1016/S0140-6736(17)30752-3) Copyright © 2017 Elsevier Ltd Terms and Conditions

Figure 4 75th percentile of CAC score in women (A) and men (B) across populations Data sources are in the appendix. Data were used from the Heinz Nixdorf RECALL Study (HNR),19 the Multi-Ethnic Study of Atherosclerosis (MESA),20–21, 23 Japan,22 the Mid America Heart Institute (MAHI),24 the University of Illinois at Chicago,25 and Korea.28 A bootstrapped 95% CI is displayed for the Tsimane data. CAC=coronary artery calcium. The Lancet 2017 389, 1730-1739DOI: (10.1016/S0140-6736(17)30752-3) Copyright © 2017 Elsevier Ltd Terms and Conditions

Figure 5 An extended Tsimane family at the entrance to their home (A), two sisters and their children harvesting manioc root (B), a man and his son fishing with bow and arrow (C), and two men butchering a deer after hunting in the forest (D) The Lancet 2017 389, 1730-1739DOI: (10.1016/S0140-6736(17)30752-3) Copyright © 2017 Elsevier Ltd Terms and Conditions