BACKGROUND: Dietary changes, especially declines in traditional food diversity and increases in the consumption of processed foods, have previously been shown to increase the risk of developing cardiovascular diseases. AIM: We evaluated the prevalence and risk factors for metabolic syndrome in four Awajún communities in the Peruvian Amazon. SUBJECTS AND METHODS: A total of 222 participants answered a socioeconomic questionnaire, a 24-hour food recall, and completed a physical examination for metabolic syndrome diagnosis. A Poisson regression with robust variance was used in the statistical analysis of risk factors for metabolic syndrome. RESULTS: We found an overall prevalence of 24% for metabolic syndrome. Being female, increased age, and body mass index were significant risk factors for metabolic syndrome. Surprisingly, risk more than doubled with the ratio of traditional foods. However, this study revealed that there are fewer traditional foods being consumed in this study compared to prior studies among the Awajún. CONCLUSION: We suggest that the unexpected relationship between traditional food consumption and metabolic syndrome may be due to substantial reductions in the diversity of traditional foods. Currently available traditional foods are primarily high in carbohydrates and are supplemented with cheap, non-perishable, and carbohydrate heavy market food items.