The study explores the dietary habits of people associated with the Early Iron Age Bolsherechenskaya culture of the Novosibirsk stretch of the Ob, using paleopathological and paleobotanical methods. Despite the cattle-breeding specialization of people represented by the Bystrovka burial ground, previous studies have revealed a significant proportion of plant-based food in their diet, attesting to occasional crises in their lives. Here, we analyze a much larger human skeletal sample from Bystrovka (336 individuals). The trait battery included dental pathologies evidencing the composition of diet (caries, calculus, periodontitis, fluorosis, antemortem enamel chips) and stress (enamel hypoplasia, children’s caries). Also, we analyzed symptoms of advanced inflammatory processes of various etiology, including abscesses and antemortem tooth loss. Paleobotanical study included the analysis of microfossils—phytoliths and starches—preserved in the calculus collected from 30 Bystrovka individuals. We conclude that the diet was mixed, with a considerable share of plant-based component, apparently including wild cereals such as barley, millet, and wheat, as well as Liliaceae roots. Identified cases of dental fluorosis possibly attest to a migration of small groups of people from the Kuznetsk Alatau foothills. Biological stress markers indicate short-term episodes of distress.