Denise Minger has a great article dissecting Ancel Keyes' take on heart disease and saturated fat.

http://rawfoodsos.com/2011/12/22/the-truth-about-ancel-keys-weve-all-got-it-wrong/

Which of course set up a comment-war. The usual war is about saturated fat. Some people think it is the only safe fat; others believe it is just exceedingly bad and causes heart attacks. I tend to think it a bystander, a red herring.

So in this detective novel we are doing, who might be the real villian? I mean, it does seem true that "the Western diet" leads to heart disease. The usual causes are supposed to be smoking, lack of exercise, saturated fat. And it's supposed to be a "modern" disorder, which is showing up mainly because we are living longer.
The problem is, we are getting heart plaque in kids these days, and there are cultures that smoke way more than we do without so many heart problems.

The two dietary factors that seem to come out, when you look at the pattern of eating, is that the wheat/red meat diet seems to be associated with heart disease. It's hard to tease the two out, since this is diet used mainly inland, where there is also lack of iodine, lack of Omega 3, and probably other issues. But let's look at the "modern" part of the equation. If the issue is meat or wheat, is this caused by our modern GMO wheat and our factory farmed meat? Or is there some intrinsic issue in these foods?

First, I'd note that the "narrow faces" that Price talked about are mainly found in cultures that eat wheat. I don't know why that is, but you first see it in the Egyptian mummies. Nefertiti is a classic example; super-narrow face, long neck. In the Old Testament, the Egyptians were quoted as saying the Israelites had an easier time of having babies, and were more robust. Anyway, those Egyptians were not healthy, and had heart disease at a young age:

http://io9.com/5788551/mummies-reveal-ancient-egyptian-heart-disease-epidemic'

Of these, 44 mummies still possessed cardiovascular tissue that was well enough preserved to undergo further analysis. And, in turn, 45% of the mummies tested revealed definite or probable signs of atherosclerosis, which is the hardening of the arteries that ultimately can lead to strokes and heart attacks. That's a very high percentage, as radiologist and team member James Sutherland explains: 

"We were a bit surprised by how just how much atherosclerosis we found on ancient Egyptians who were young. The average age of death was around 40." 

In modern times, there are four main risk factors for heart disease: smoking, overeating, not getting enough exercise, and genetics. Heiroglyphics tell us that wealthy Egyptians enjoyed some pretty fatty foods, and we can assume genetics also played a role. But there's no evidence (cocaine mummies aside) that Egyptians smoked tobacco, and it's hard to imagine how even the laziest Egyptian could avoid exercise in a time before automobiles or other technology.

The Egyptians had pretty bad dental health too. They regarded narrow hips as a sign of beauty, but the skeletons also commonly show narrow pelvises, which would be a problem with childbirth.

http://news.discovery.com/history/mummies-teeth-disease-diagnosis.html

Worn teeth, periodontal diseases, abscesses and cavities tormented the ancient Egyptians, according to the first systematic review of all studies performed on Egyptian mummies in the past 30 years.
After examining research of more than 3,000 mummies, anatomists and paleopathologists at the University of Zurich concluded that 18 percent of all mummies in case reports showed a nightmare array of dental diseases.
"Evidence of dental disorders is plentiful because usually teeth are among the best preserved parts of a body. As for other diseases, the published studies do not always provide in-depth details. Nevertheless, we came across some interesting findings," senior author and medical doctor Frank Ruhli, head of the Swiss Mummy Project at the University of Zurich, told Discovery News.

Oetzi, the iceman, was similarly unhealthy. He had heart problems, and cavities. From the look of his picture, he seemed to have a rather narrow face also. He certainly got exercise, hiking around the Tyrolean mountains and getting into fights, but couldn't be a smoker and wouldn't have distilled liquor either.

http://articles.nydailynews.com/2012-03-05/news/31125231_1_south-tyrol-museum-lactose-intolerance-heart-disease
http://news.discovery.com/history/oetzi-iceman-bad-teeth-110615.html

There are a few other cultures where mummified remains can be found. They don't seem to be mentioned in conjunction with heart disease or dental problems much though.

Now the question is, where does diet fit in? They probably didn't get much mammal fat. Wild deer and grassfed beef just don't have much fat, but milk was available. Ducks and geese have fat, but it's not saturated. They did eat a fair bit of meat, and of course wheat/barley.

One thing that saturated fat is known to do though, is increase the amount of iron in a meal that is absorbed. Wheat may well do the same thing, since it causes temporary gut permeability. So then it comes back around to iron, and specifically red meat in conjunction with wheat, and maybe in conjunction with saturated fats. Besides meat, the only two sources I know of for saturated fat are dairy, and coconut oil. Coconut oil does enhance iron absorption, but most of the cultures that consume coconut oil are fish-eaters.

So we have this study from Japan:

http://archives.cnn.com/2000/HEALTH/10/26/health.heart.iron.reut/

This could mean that the Western diet, rich in red meat, causes heart disease not only because it has so much fat, but because it is too rich in iron, Matsuoka said.
"There have been a number of studies that suggest iron stores are closely linked to the incidence of (heart attack) and coronary artery disease," Dr. Hidehiro Matsuoka, chief of the division of hypertension at the Kurume Medical School in Kurume, Japan, who led the research, said in an interview.
...

In the first study of 10 healthy men, they overloaded them with iron intravenously and then looked at their blood vessels using ultrasound.
The iron overload raised levels of the chemical malondialdehyde, a marker of oxidation and of impaired endothelial function. Then they used a drug to lower iron levels in 10 healthy male smokers, and found iron removal lowered levels of the chemical and made the endothelium work better.
According to the American Heart Association, the Japanese study is the first to show that iron loading hurts the lining of the blood vessels.
"Our study shows that we should recognize iron as a risk factor for atherosclerosis and understand the need to control our body iron levels to prevent cardiovascular disease," Matsuoka said in a statement.
He said he believed that iron somehow interferes with nitric oxide, a chemical that relaxes blood vessel walls. allowing the blood to flow more freely.
He believes that doctors should measure endothelial function as part of a standard physical exam, just as blood pressure is now measured. The test is simple and uses harmless ultrasound, Matsuoka said.
"It only takes 30 minutes," he said.
He also noted that kidney dialysis patients, because they are anemic, often get intravenous iron, and that they also have very high rates of heart disease. It could be that giving iron intravenously stresses the arteries.

Ha. No saturated fat needed! They don't mention the iron absorption issues, which of course I think are huge.