The Amazon rain forest extends over an area of 7.8x10(6)km(2) in nine countries. It harbors a diverse human population distributed in dense cities and isolated communities with extreme levels of infrastructure. Amazonian forest people, either autochthons or frontier riparians (ribeirinhos) living in isolated areas, share the same environment for survival and nutritional status. The peculiarities of the hydrological cycle determine disease patterns, agricultural conditions, and food availability. Feeding strategies depend heavily on cassava products and fish. These two foods carry toxic substances such as linamarin (naturally present in cassava) and monomethyl mercury (MMHg) (bioconcentrated in fish flesh) that cause neurotoxic diseases in other parts of the world but not in Amazonia, where neurotoxic cases of food origin are rare and not related to these staples. While cassava detoxification processes may partly explain its safe consumption, the Hg concentrations in Amazonian fish are within traditionally safe limits for this population and contribute to an important metabolic interaction with cassava. The gold rush of the 1970s and 1980s brought large-scale environmental disruption and physical destruction of ecosystems at impact points, along with a heavy discharge of metallic Hg. The discharged Hg has not yet impacted on MMHg concentrations in fish or in hair of fish consumers. Hair Hg concentration, used as a biomarker of fish consumption, indicates that the Amazonian riparians are acquiring an excellent source of protein carrying important nutrients, the lack of which could aggravate their existing health problems. Therefore, in a scenario of insufficient health services and an unhealthy environment, food habits based on fish consumption are part of a successful survival strategy and recommendations for changes are not yet justifiable.