We Can End The Heart Disease Epidemic

Image Credit: Sinn Fien / Flickr. This image has been modified.

We Can End the Heart Disease Epidemic

Many of the diseases that are common in United States are rare or even nonexistent in populations eating mainly whole plant foods.

These so-called Western Diseases are some of our most common conditions:

  • Obesity, the most important nutritional disease
  • Hiatal hernia, one of the most common stomach problems
  • Hemorrhoids and varicose veins, the most common venous disorders
  • Colorectal cancer, the number two cause of cancer death
  • Diverticulosis, the #1 disease of the intestine
  • Appendicitis, the #1 cause for emergency abdominal surgery
  • Gallbladder disease, the #1 cause for nonemergency abdominal surgery
  • Ischemic heart disease, the #1 cause of death

These diseases are common in the West, but are rarities among plant-based populations.

A landmark study in 1959 I profiled in my video Cavities and Coronaries: Our Choice, for example, suggested that coronary heart disease was practically non-existent among those eating traditional plant-based diets in Uganda.

“Doctors in sub-Saharan Africa during the ‘30s and ‘40s recognized that certain diseases commonly seen in Western communities were rare in rural African peasants. This hearsay talk greeted any new doctor on arrival in Africa. Even the teaching manuals stated that diabetes, coronary heart disease, appendicitis, peptic ulcer, gallstones, hemorrhoids, and constipation were rare in African blacks who eat foods that contain many skins and fibers, such as beans and corn, and pass a bulky stool two or three times a day. Surgeons noticed that the common acute abdominal emergencies in Western communities were virtually absent in rural African peasants.”

But did they have hard data to back it up? Yes.

Major autopsy series were performed. In one thousand Kenyan autopsies, there were “no cases of appendicitis, not a single heart attack, only three cases of diabetes, one peptic ulcer, no gallstones, and no evidence of high blood pressure” (which alone affects one out of three Americans).

Maybe the Africans were just dying early of other diseases and so never lived long enough to get heart disease? No. In the video One in a Thousand: Ending the Heart Disease Epidemic, you can see the age-matched heart attack rates in Uganda versus St. Louis. Out of 632 autopsies in Uganda, only one myocardial infarction. Out of 632 Missourians—with the same age and gender distribution—there were 136 myocardial infarctions. More than 100 times the rate of our number one killer. In fact, researchers were so blown away that they decided to do another 800 autopsies in Uganda. Still, just that one small healed infarct (meaning it wasn’t even the cause of death) out of 1,427 patients. Less than one in a thousand, whereas in the U.S., it’s an epidemic.

If heart disease is so rare in rural Africa, how do the local doctors even know what to look for? Though practically unheard of among the native population, the physicians are quite familiar with heart disease because of all the Westerners that immigrate to the country.

The famous surgeon Dr. Denis Burkitt insisted that modern medicine is treating disease all wrong:

“A highly unacceptable fact—that is rarely considered yet indisputable—is that, with rare exceptions, there is no evidence that the incidence of any disease was ever reduced by treatment. Improved therapies may reduce mortality but may not reduce the incidence of the disease.”

Take cancer, for example, where the vast majority of effort is devoted to advances in treatment, and second priority is given to screening programs attempting early diagnosis. Is there any evidence that the incidence of any form of cancer has been reduced by improved treatment or by early detection? Early diagnosis may reduce mortality rates, and medical services can have a profoundly beneficial effect on sick people, but neither have little (if any) effect on the number of people becoming ill. No matter how fancy heart disease surgery gets, it’s never going to reduce the number of people falling victim to the disease.

Dr. Burkitt compared the situation to an engine left out in the rain:

“If an engine repeatedly stops as a consequence of being exposed to the elements, it is of limited value to rely on the aid of mechanics to detect and remedy the fault. Examination of all engines would reveal that those out in the rain were stopping, but those under cover were running well. The correct approach would then be to provide protection from the offending environment. However, considering the failing engine as the ailing patient, this is seldom the priority of modern medicine.”

Dr. Burkitt sums it up with the analogy of The Cliff or the Ambulance:

“If people are falling over the edge of a cliff and sustaining injuries, the problem could be dealt with by stationing ambulances at the bottom or erecting a fence at the top. Unfortunately, we put far too much effort into the provision of ambulances and far too little into the simple approach of erecting fences.”

And of course there are all the industries enticing people to the edge, and profiting from pushing people off.

If all plant-based diets could do is reverse our number one killer, then shouldn’t that be the default diet until proven otherwise? The fact that it also appears to reverse other leading killers like diabetes and hypertension appears to make the case for plant-based eating overwhelming. So why doesn’t the medical profession embrace it? It may be because of The Tomato Effect. Why don’t many individual doctors do it? It may be because lifestyle medicine hurts the bottom line (see Lifestyle Medicine: Treating the Causes of Disease). Why doesn’t the federal government recommend it? It may be because of the self-interest of powerful industries (see The McGovern Report). But you can take your destiny into your own hands (mouth?) and work with your doctor to clean up your diet and maximize your chances of living happily ever after.

-Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my videos for free by clicking here and watch my full 2012 – 2015 presentations Uprooting the Leading Causes of Death, More than an Apple a Day, From Table to Able, and Food as Medicine.


Michael Greger M.D., FACLM

Michael Greger, M.D. FACLM, is a physician, New York Times bestselling author, and internationally recognized professional speaker on a number of important public health issues. Dr. Greger has lectured at the Conference on World Affairs, the National Institutes of Health, and the International Bird Flu Summit, testified before Congress, appeared on The Dr. Oz Show and The Colbert Report, and was invited as an expert witness in defense of Oprah Winfrey at the infamous "meat defamation" trial.

31 responses to “We Can End the Heart Disease Epidemic

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  1. Right on, Dr. Greger! I am glad to see that you are getting this important message across in your Tuesday/Thursday articles in addition to your videos, because the major search engines such as Google index text on web pages rather than imagery in videos. As much as I like your videos, I think the more often that you write about the concept of heart disease being preventable, the more likely that a search engine will deliver references to this concept on your website, and hopefully guide people towards better health.

  2. I suspect that the US government would be more willing to protect the population against diet-related diseases if not for the fact that US-based MNCs profit greatly from the selling of processed foods, and from beverages, most of which are clearly detrimental.

    Even though Americans are only 4% of the global population, they own more than 50% of all global market share, and, this disproportionate ownership has come to pass, in part, because the US Government, and the Fed, are enabling the process. Naturally, the US Government has always been supportive of private enterprise, but for the past few decades, it has been the aggressor in an all-out economic war. Accordingly, very profitable MNCs have been allowed to pay little or no taxes, and in most cases they are also subsidized. MNCs are also the benefactors of the 780 military bases across the globe, and they benefit too from intelligence being gathered by the long list of intelligence agencies (17). MNCs have also received vast financial aid from ZIRP and QE, these programs allowing them to borrow cheaply at home so as to keep taxable profits from repatriating. Thus, and all the way back to the ‘petro-dollar fix’ (which keeps the dollar strong), the restructuring of the tax codes in the 1980s, and the stubborn reluctance to eliminate ag subsidies, and many other such efforts, the US Government has become so intricately intertwined with big business that it is difficult to know where one starts and the other stops.

    My main point here being, that any admission by officials that any products being produced by US companies are suspect, is like an act of treason.

    1. Thanks Ray. Clear, concise and illuminating points. No wonder so many of us are removing the blinkers that informed us from childhood that America is a good big brother. It seems greedy corporations have become a cancer across the globe.

  3. Exactly, they are investing in early detection: Find patients before they are so ill they can no longer be cured. But so ill they are willing to pay their life savings for some chemo therapy… It’s all about profits you know.

  4. The statistics remind me of Mark Twain’s admonition regarding statistics. For example, while Uganda’s incidence of myocardial infarctions is far lower than Missouri’s (why Missouri?), it still doesn’t prove that Ugandans are not dying of something else, perhaps due to their plant-based diet. Perhaps their lack of animal based protein is leading to some other diseases. In other words, we are not getting the whole picture here. For example, there have been reports that the reason for the Japanese obesity being so low compared to American obesity is because they eat white rice. Hmmm. Would it be PC to point to Portion Control as the real reason? Compare a bento box with tea versus a dinner plate filled with carbs, sugar, and soda.

    1. Diet education (by parents) is a major concern, in relation to what you are talking about. I agree about portion control, and sadly most parents learn from their surroundings and their parents. The surroundings scream EAT THIS BIG FAT BURGER
      Everywhere you go.
      Society believes when you’ve been relegated to eating salad, you’re dieting, as well. Those two things put together are huge. Humans go the route of least resistance unfortunately :(

  5. The head of alibaba Jack Ma interview with Dave Faber this morning reflected this view. In the interview Jack suggested that in China, building hospitals and filling them with medical professionals is not the answer to health issues that are beginning to plague China. Instead, clean water and air should be the goals. Otherwise you are just enabling the problem.

  6. It seems the African diet does include meat (see link below). So is an all plant based diet really the answer? Is it perhaps the amount of meat or lack of refined sugars in their diet? If you eat an all plant based diet don’t you also need to take supplements of B12 and other nutrients? It would be good to know just how much meat we need to eat to get all the nutrients we require. What is the rough percentage of meat consumed in the diets of the African communities that were studied?

    1. I think you can look at the traditional mediterranean diet especially de Crete one (which have very low CVD rates) to have an idea? Two times fish a week and two small portions of poultry a week, red meat a couple of times a month.


      The African diet pyramid looks close to this: http://oldwayspt.org/sites/default/files/images/African_pyramid_flyer.jpg

      1. I LOVE the bottom half of that pyramid! The greens being at the very bottom, the emphasis on herbs and spices as their own group, and the instructions to “enjoy meals with others”. Thanks for sharing. :)

    2. A diet that can reverse heart disease can obviously prevent it. A purely plant-based diet has proven to do this. Does a diet that includes meat reverse heart disease? I’m sure if it really could, the meat industry would be all over it.

      1. If you look at the mediterranean diet, progression on vascular problems of high risk patients. This is what it can do:

        “Intervention with a MedDiet supplemented with 30 g/d of mixed nuts for a mean of 2.4 years induced regression of ICA-IMTmean and delayed the progression of both ICA-IMTmax and plaquemax, the ultrasound features that best predict future CVD events. Although ICA-IMTmax and plaquemax progressed in the control group, there were no changes in the MedDiet supplemented with EVOO group. ” (EVOO = exra virgin olive oil)

        So there can be some regression and for the rest stagnation of the process. Seems pretty healthy to me. The good thing to see is that nuts can make a difference!

        Still not really good news for the meat-industry… because the amounts and portions of meat consumed on a MedDiet are small. However dairy is consumed daily in moderate ammounts (and of grazing cows/goats/sheep).

        1. Interesting, and I have nuts daily myself, but “delayed the progression of both ICA-IMTmax and plaquemax” to me implies progression is still occurring. I don’t think this is the case with a whole foods, no-oils, plant-based diet.

          1. It’s also called “arrested progression” in the article. For me it’s like… if my heart-health is ok… a medDiet is probably ok to eat for me. If arteries are clogged I would have to stick to a whole foods, no-oils, plant-based diet for a while.

            I wonder if there has ever been studies on regression of heart disease on a whole foods, high fat (unsatureated), plant-based diet, a vegan MedDiet so to say. Because a low-fat version excludes nuts… and in this research it seems nuts had a very positive effect.

            1. The principle behind Dr. Dean Ornish’s Spectrum diet adheres to your thoughts in the first paragraph. Basically you must go towards the healthful end of the spectrum to the degree your health (or lack thereof) requires. But as always, prevention is easier than cure.

              Personally, I would find it hard to give up the satiation and the calories (I’m slim) that nuts provide.

  7. Thank You Dr.Greger for bringing Dr.Burkit’s name to the light of this world again – what a doctor and scientist he was and even more God devoted father !

    1. Dr. Burkitt certainly had extraordinary vision. One of my favorite Burkitt sayings is, “America is a constipated nation…. If you pass small stools,
      you have to have large hospitals.” It’s
      funny but it’s true. When you think
      about it, fiber is only naturally found in plants. The more plants, the more fiber. So the total amount of naturally occurring fiber
      consumed from plants also indicates the level of consumption of minerals and phytonutrients
      packed with it. The higher the fiber, the less toxicity from animal products. So, your poop is a general gauge of high
      nutrient consumption as well [http://nutritionfacts.org/2015/02/19/dont-forget-fiber/].

  8. Yes – important message. I am an avid reader and sharer and promoter of NutritionFacts.org. But, the recent addition of the annoying message to subscribe to receive it in my mailbox daily, when I am already subscribed, and (at least once) have donated to support your work – needs some tweeking! Please do something about this….

    1. PamyCST: I forwarded your message onto the staff at NutritionFacts. Just wanted to let you know that you message was heard. (And shared by me, by the way.)

      1. Thanks, PamyCST for your feedback. I’m sorry to hear that the subscribe box keeps popping up–that sounds really frustrating.

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        Thanks again for letting us know about this issue! I hope we can fix it soon. :)

  9. Is there any evidence that the incidence of any form of cancer has been reduced by improved treatment or by early detection?

    In the last week I have come across what looks like credible claims for the successful use of GcMaf for many cancers, particularly in conjunction with Nagalase testing. So, if what I have read is valid, we have an example of cancers being reduced by both improved treatment and by early detection.

  10. Coronary heart disease and colo-rectal disease are non-existant in Africa you say.. mmmm.. I wonder would it have anything to do with the sun.. vegetables are important alright in providing vitamin A to prevent Vitamin D toxicity from the sun but their good health has absolutely nothing to do with avoiding meat and healthy fats.. It’s all thanks to UVB…

  11. Dr. Gregor, Can a whole foods plant based diet help cure my hiatal hernia? If so, how does it help? I am following a wfpb diet and still struggling with acid reflux. I don’t want to have surgery which is what my physician is recommending. Thank you. Leslie Shedd

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