The main issue is overconsumption leading to overweight and obesity. Food that’s high in refined sugars and/or saturated fats tend to contribute to this, because it’s palatable and calorie-dense
So in that sense, yes - I believe that as long as your diet is varied enough that you get sufficient intake of all, or at least most, of the essential nutrients, and you don’t eat too much (i.e. in moderation), the ratio of macronutrients doesn’t make a big difference to your health outcome
The crux is that moderation is hard when the food is jam-packed with calories, and it’s so delicious you just want to keep stuffing your face
You have to restrict yourself to produce and a few scant other options to escape with balanced nutritional products.
They even advertise cereals as a "part of a healthy breakfast". Which is a lie under any circumstances, because it's never a healthy part if you eat it long term. (Yes it could keep you from starving to death in a famine, still not 'healthy'.) Imagine if they could only say "it will keep you from starving, and may significantly contribute to diabetes"
In a lot of ways, it's actually been easier. Because my blood sugar isn't crashing every few hours, I can easily skip a meal and feel perfectly fine. Fasting is very easy for me now, which it wasn't at all on an unhealthy diet.
That is what I hate about the everything in moderation. We need to do better since some things should be in much larger amounts than others.
I think we all would agree that any amount of rat poison is a bad thing, thought perhaps this is too much of a strawman.
What I've seen is that the best and most well documented way to prevent CVD is the DASH diet paired with exercise and potentially statins.
If you are an unhealthy weight you are both eating too much and/or not exercising enough. High calorie foods can be fatty, sugary, or both.
