Healthy enough to procreate is a low bar, and many natural things provide a benefit in terms of procreation but detrimental to health. Almost everything in nature is a trade-off between how much it'll harm you and how much it'll help you procreate.

This reminds me of how whales get the Bends from diving despite 50 million years of evolution. People question whether it causes them pain, and it stands to reason that it would cause them pain to prevent them from diving more than necessary. Nature isn't inherently kind, it is results oriented.

You can make a valid argument that avoiding something entirely is usually safer than something, as few things provide a protective effect. However, when you talk about substitutions, all bets are off.