We are what our ancestors did or didn't eat.

Ann Gibbons does a nice summary of our human ancestral diet and how it has changed to give us a modern array of diseases. Some slightly edited clips:

By the time hunter-gatherer modern humans swept into Europe about 40,000 years ago, they were adept at hunting large game and had also expanded their palates to dine regularly on small animals and freshwater fish....By studying the ratios of carbon and nitrogen isotopes from collagen in bones, ...the main sources of dietary protein of 27 early Europeans and Neandertals is known; fish eaters, for example, have more nitrogen-15 in their bones than meat eaters...the oldest known modern human in Europe—the 35,000-year-old jawbone from Pestera cu Oase cave in Romania—got much of his protein from fish. By 30,000 years ago, other modern humans got as much as 20% of their protein from fish.

The next big dietary shift came about 10,000 years ago, when humans began to domesticate plants and, later, animals. The move to agriculture introduced staples of the Western diet: cereal grains, sugars, and milk after weaning...The agricultural revolution favored people lucky enough to have gene variants that helped them digest milk, alcohol, and starch...when ethnic groups abandon traditional lifestyles and rapidly adopt Western diets, they often suffer. Researchers have known for more than a decade that the Pima of the southwestern United States have "thrifty phenotypes": sluggish metabolisms that store fat efficiently and boost survival on low-calorie diets. That's probably because their ancestors in Mexico underwent frequent famine. When they eat the calorie-rich Western diet, the Pima develop high rates of obesity, diabetes, and high cholesterol, although their blood pressure stays relatively low...the Evenki reindeer herders and other indigenous peoples of Siberia have very high metabolisms, an adaptation to the cold that allows them to convert fat into energy efficiently. When the Soviet Union collapsed in the 1990s, many Siberians abandoned traditional lifestyles and diets. They too became obese and developed heart disease but in a different way from the Pima: The Evenki retained low levels of cholesterol and diabetes but developed high blood pressure.

Although we are what our ancestors ate, we are also what they didn't eat. In India, for example, more than 66% of the population in some regions experienced famine during British colonialism a century ago. Women who survived tended to have low-birth-weight babies, whose bodies were small and efficient at storing fat. It's as though these babies took cues during fetal and early development about their mothers' lifelong nutritional experience and adjusted their growth and body and organ size accordingly. Human stature often tracks the nutritional status of mothers, and it can take generations for descendants to recover. In India, average height in males dropped at a rate of almost 2 centimeters per century in the decades following colonialism...When these small babies gain weight in childhood, though, it stresses their smaller organs, such as the pancreas and heart, making them more susceptible to obesity, diabetes, and heart disease. This is the case in south India today, where many people have thrifty phenotypes with less muscle and more fat per body size. Yet they are shifting rapidly to a high-fat, high-sugar diet. As a result, India risks becoming the diabetes capital of the world.