Dr. Burkitt’s F-Word Diet

Dr. Burkitt’s F-Word Diet
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The famous surgeon Denis Burkitt suggests an explanation for why many of our most common and deadliest diseases were rare or even nonexistent in populations eating plant-based diets.

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Below is an approximation of this video’s audio content. To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video.

The famous surgeon Denis Burkitt is better known for his discovery of a childhood cancer now known as Burkitt’s lymphoma than for his 1979 international bestseller, Don’t Forget the Fibre in Your Diet.

“Anyone asked to list the twenty or more most important advances in health made in the last few decades would be likely to include none of what [Dr. Burkitt] considered to be among the most significant.” What was the #1 most important advance in health, according to one of the most famous medical figures of the 20th century? The fact that “Many of the major and commonest diseases in modern Western culture are universally rare in third-world communities, were uncommon even in the United States until after World War I,” yet are now common in anyone following the Western lifestyle.” So, it’s not genetic; they’re lifestyle diseases, which means “they must be potentially preventable.”

Those eating the Standard American Diet have high rates of all of these diseases. Here are two examples. Similar rates of disease to the ruling white class in apartheid Africa, whereas the rates in the Bantu population were very low. These native Africans ate the same kind of Three Sisters diet of many Native Americans—a plant-based diet centered around corn, beans, and squash. In fact, it was reported that cancer was so seldom seen in native Americans a century ago that they were “considered practically immune” to cancer. But, what is meant by “very low” rates among rural Africans? 1,300 autopsied over five years in a Bantu hospital, and less than ten cases of ischemic heart disease, our #1 killer. 

Their rates of heart and intestinal disease was similar to poor Indians, whereas wealthier Indians who ate more animal and refined foods were closer to those in Japan—until they moved to the U.S,. and started living like us. And, you can do similar charts for all the other so-called Western diseases, which Burkitt thought related to the major dietary changes that followed the Industrial Revolution—a reduction in healthy plant foods (the sources of starch and fiber), and “a great increase in consumption of animal fats, salt, and sugar.”

His theory was that it was the fiber. “[N]one of these diseases [including our #1 killer] are common “in communities where large, soft stools are customarily passed.” His thought was that all of these major diseases may be caused by a diet deficient in whole plant foods—the only natural source of fiber. Fiber? In a survey of 2,000 Americans, “over 95% [of graduate school-educated participants and health care providers] weren’t even aware of the daily recommended fiber intake.” Doctors just don’t know.

“If a floor is flooded as a result of a dripping tap, it is of little use to mop up the floor unless the tap is turned off. The water from the tap represents the cause of disease, the flooded floor the diseases filling our hospital beds. Medical students learn far more about methods of floor mopping than about turning off taps, and doctors who are specialists in mops and brushes can earn infinitely more than [do] those dedicated to shutting off taps.”

And the drug companies sells rolls of paper towels, so patients can buy a new roll every day for the rest of their lives. To paraphrase Ogden Nash, modern medicine is “making great progress, but [just] headed in the wrong direction.”

Preventive medicine, is, frankly, bad for business.

Please consider volunteering to help out on the site.

Images thanks to maliasfeserc and misterbisson via flickr. Cartoon used with the kind permission of Dan Piraro. Thanks to Ellen Reid for her image-finding expertise and Jeff Thomas for his Keynote help.

Below is an approximation of this video’s audio content. To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video.

The famous surgeon Denis Burkitt is better known for his discovery of a childhood cancer now known as Burkitt’s lymphoma than for his 1979 international bestseller, Don’t Forget the Fibre in Your Diet.

“Anyone asked to list the twenty or more most important advances in health made in the last few decades would be likely to include none of what [Dr. Burkitt] considered to be among the most significant.” What was the #1 most important advance in health, according to one of the most famous medical figures of the 20th century? The fact that “Many of the major and commonest diseases in modern Western culture are universally rare in third-world communities, were uncommon even in the United States until after World War I,” yet are now common in anyone following the Western lifestyle.” So, it’s not genetic; they’re lifestyle diseases, which means “they must be potentially preventable.”

Those eating the Standard American Diet have high rates of all of these diseases. Here are two examples. Similar rates of disease to the ruling white class in apartheid Africa, whereas the rates in the Bantu population were very low. These native Africans ate the same kind of Three Sisters diet of many Native Americans—a plant-based diet centered around corn, beans, and squash. In fact, it was reported that cancer was so seldom seen in native Americans a century ago that they were “considered practically immune” to cancer. But, what is meant by “very low” rates among rural Africans? 1,300 autopsied over five years in a Bantu hospital, and less than ten cases of ischemic heart disease, our #1 killer. 

Their rates of heart and intestinal disease was similar to poor Indians, whereas wealthier Indians who ate more animal and refined foods were closer to those in Japan—until they moved to the U.S,. and started living like us. And, you can do similar charts for all the other so-called Western diseases, which Burkitt thought related to the major dietary changes that followed the Industrial Revolution—a reduction in healthy plant foods (the sources of starch and fiber), and “a great increase in consumption of animal fats, salt, and sugar.”

His theory was that it was the fiber. “[N]one of these diseases [including our #1 killer] are common “in communities where large, soft stools are customarily passed.” His thought was that all of these major diseases may be caused by a diet deficient in whole plant foods—the only natural source of fiber. Fiber? In a survey of 2,000 Americans, “over 95% [of graduate school-educated participants and health care providers] weren’t even aware of the daily recommended fiber intake.” Doctors just don’t know.

“If a floor is flooded as a result of a dripping tap, it is of little use to mop up the floor unless the tap is turned off. The water from the tap represents the cause of disease, the flooded floor the diseases filling our hospital beds. Medical students learn far more about methods of floor mopping than about turning off taps, and doctors who are specialists in mops and brushes can earn infinitely more than [do] those dedicated to shutting off taps.”

And the drug companies sells rolls of paper towels, so patients can buy a new roll every day for the rest of their lives. To paraphrase Ogden Nash, modern medicine is “making great progress, but [just] headed in the wrong direction.”

Preventive medicine, is, frankly, bad for business.

Please consider volunteering to help out on the site.

Images thanks to maliasfeserc and misterbisson via flickr. Cartoon used with the kind permission of Dan Piraro. Thanks to Ellen Reid for her image-finding expertise and Jeff Thomas for his Keynote help.

Doctor's Note

More on this incredible story in One in a Thousand: Ending the Heart Disease Epidemic. How do we know that diet was the critical factor? Because when we place people stricken with these diseases on plant-based diets, in some cases their disease can be reversed (Our #1 Killer Can Be Stopped). In fact it was the work of Burkitt and others in Africa that led to the disease reversal work of pioneers like Nathan Pritikin (Engineering a Cure).

So if our major and commonest diseases are a result of lifestyle, why don’t more doctors practice lifestyle medicine? See: Lifestyle Medicine: Treating the Causes of Disease. How can we inspire change in the profession? I’ll take a stab in my next video, Convincing Doctors to Embrace Lifestyle Medicine.

More on fiber:

And for more of the scoop on poop:

So what’s the answer? How much fiber should we shoot for? Our evolutionary past may give us a hint: Paleolithic Lessons.

If you haven’t yet, you can subscribe to my videos for free by clicking here.

48 responses to “Dr. Burkitt’s F-Word Diet

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    1. Do squat in a gym, If you want to exercise more ! My guess is that it will be more efficient than changing your toilets chair. But you still can put a footstool under your feets, to mimic a “more natural posture”. It can help people that are constipated.




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    2. I think its benefit is mechanical, in that it helps elimination of stool. If you are already backed up from lack of fiber it can help but it wouldn’t be a cure. There is a product I saw advertised on the net for some sort of stool designed to fit around your toilet to mimic squatting. It wasn’t really expensive if I remember..




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  1. I am assuming the life expectancy in rural Africa or among poor Indians is significantly lower than in the USA: was this variable taken into account in the mentioned research when comparing the causes of death? (PS: Thank you so much for your daily updates on nutritional science: what an amazing job, Dr. Greger!)




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    1. J. F. Brock, H. Gordon. Ischaemic Heart Disease in African Populations. Postgrad Med J. 1959 35(402):223–232.
      : “Inter-racial epidemiology is a well-established procedure for investigating the aetiology of disease and for assessing the importance of environmental and genetic factors.”

      Sorry Barb, no loophole there. You’ll have to find another rabbit trail.




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      1. Thank you for the reference. I am a huge fan of Dr. Greger’s videos and very much appreciate his ‘mission’. I am not an English native-speaker, and apologize if my comment sounded provocative, but it was not. As I don’t have access to the resource you mentioned, could you please tell me the bottom line? I know some of my “non-whole food, plant-based” friends, as well as relatives and co-workers will ask me the same question when I will show this video and would like to have an answer. Thanks.




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        1. Hi Barbara from Italy: the age variable was indeed taken into account. You can find more details on that in the video Dr. Greger mentions above: “One in a Thousand: Ending the Heart Disease Epidemic.” Good luck spreading the word!




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            1. It’s great to see another italian that seeks informations on this site, even for me this is one of my favourite sources of advices about human nutrition… che dire, ci becca in giro Barbara!! :-)




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              1. Dr. Greger deserves worldwide attention! I am doing my best in North-East Italy, Atlanta, GA, and Upstate South Carolina ;) Ciao Merio!! Che sorpresa, un compatriota!! :)




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            2. I don’t know the methodological details here, but I wonder, though, whether age-matching would be sufficient control. The sorts of populations compared here do have significantly different life expectancies; given this, those who reach the ages at which lifestyle diseases typically manifest themselves in the group with much lower life expectancy might plausibly be expected to be significantly hardier, and to have fewer ancillary characteristics that could (for all we know) predispose people for these diseases, than those in the higher life expectancy group. So I’m curious as to whether they tried to control for this, which I imagine would be very difficult.




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        2. I read it off the screen…on the video.
          Or
          Show them this one: http://nutritionfacts.org/video/one-in-a-thousand-ending-the-heart-disease-epidemic/

          I should be more polite. I am frustrated partly because I have had the course…a heart attack, bypass and extensive “counseling” by medical professionals. I followed the diet/exercise plan they recommended and within 5 years they were telling me I needed another bypass. Thankfully that was about the same time I saw FOK. 2.5 years eating WF/PB and my angina is gone, my chems are good.

          So forgive me if I have been too blunt. The bottom line is right there in bold with underlining. If people don’t get it, thats because they don’t want to, just as I didn’t until my little “warning”. Good luck.

          toto corde :)




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    2. Aloha,
      While the lifespan in many African countries is lower than the US, several countries in Africa due to overall economic improvements have moved up into the high 60’s regarding life span. The causes of death in Africa in general was not diet related but environmental and lack of adequate food supply.www.newjumpswing.com




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  2. Speaking of faucets, it’s important to increase your water consumption when you increase your fiber intake. This will help keep everything soft, and prevent you from getting “bunged up.” I have a 12-oz glass of water first thing in the morning before I have anything to eat, to get a good start.




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  3. I have an internist colleague who proudly flaunts the fact that he eats whatever he wants (he is in his early 60’s and about 50 lbs. overweight) and through aggressive pharmacological manipulation is able to produce what would be considered healthy test results with respect to lipids, blood pressure, inflammatory markers and blood sugar. Of the six physicians with whom I work on a daily basis, none has any interest prevention, either for their patients or themselves.




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    1. Psych MD: That’s just so sad.

      Since they include themselves in the “don’t care” category, that says to me that we don’t so much have a conspiracy problem as some people think, but a huge, huge cultural problem.

      Thanks for sharing.




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      1. the problem i think falls into the training of health practitioners when they’re at university… that period of time is fundamental to address a MD towards his final goal… a lot of instruments are explained (surgery, pharmaceuticals etc), but nutrition, uhm, that is an underestimate topic… so sad…




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      2. I 100% agree. Western food technology met “The Pleasure Trap” and we all lined up to mainline their junk. Outlawing McD’s is akin to soldiers trampling the poppy fields of Afghanistan… and would be about as effective. Hearts and minds…indeed:

        Today I met a man who stopped by while I was working in my veg garden. Said he’d heard I’d lost weight and beat diabetes. He’d had a silent heart attack. I was so excited at my fame. At last! A disciple. So natch, I blurted it all out, No meat, no coffee, Nothing with a face, or feet or earrings. He started reeling backwards, stumbling over a rake… No fish no eggs. My eyes started to bulge. NO OIL, I said. He was pushing me away… My heart was going like mad… No, I said, No I won’t NO.




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        1. Do you ever eat any corn chips, you know, the corn chips that are fried in oil, even the organic ones? And how about caffeine? Have you had to eliminate these things 100 percent from your diet?




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              1. Elsie, I know yours is a relatively old comment but I just gotta say fried corn chips are a nasty temptation. I do have a solution that works well for me. I get whole wheat pita bread, cut it up into the size chips I want, pull the two sides apart, spread on a cookie sheet and put it in a convection oven at about 290 for approximately 12 minutes. Just want to make them crisp. With fat free bean dip, humus or salsa, you’ve got a very healthy snack. I also make a fat free cauliflower “queso” dip that gives me a bit more miso, turmeric, and nutritional yeast in my diet. My adjustment to this in taste has been pretty simple. Start with the humus as the dip as that is actually pretty traditional and then move to other things. I like it a lot better because my awareness of the grease going in my gut with traditional corn chips is pretty off putting.




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                1. Thanks. I avoid wheat but your suggestion might inspire some other people here to try out. May I ask, why everything you mention “fat free”? Is your hummus fat-free?




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                  1. Ah yes, fate free. I moved to a whole food plant base diet in response to the inflammatory effects of animal products. Specifically I have type 1 diabetes which is a result of an auto immune inflammatory response to some foreign substance and then I developed psoriatic arthritis which is certainly inflammation resulting from an auto immune response. As a diabetic, I do tend to have more advanced glycation end products accumulating so eliminating animal products as a prime exogenous source was important. After all is said and done the inflammatory factors are extremely important in compromising one’s health in numerous ways. So I try (often unsuccessfully) to eliminate all inflammatory dietary factors like added oil. As soon as the only is pressed is begins oxidizing and as a result becomes inflammatory. This is especially true of olive oil with the exception of extra virgin. (EVOO has some antioxidants which slow the rancidity process.) Then there is also the fact that in getting older it is easier to wear calories than burn them so I am always looking for ways to eliminate the excess.

                    As to the “cheese” sauce I make, it looks like queso, tastes like it and has less that 10% of the calories of the real stuff. Humus can be made fat free with a food processor or high power blender. That way you get to spice it to your own taste and it can be great.




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                    1. I’d like to suggest you avoid nightshade family of plants : potatoes and tomatoes, some peppers, eggplant, those little red berries….goji berries. There may be more, but boy does this seem to make a difference for psoriatic arthritis for some. For me, knee pain, other joint pain, reduced 99 percent when eliminating nightshade plants, as in not even a bite or spoonful. Total abstinence.




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      3. It is a cultural problem and a problem of perceptions: People perceive they are successful if they eat steak and lobster, they are strong if they eat meat, they are good parents if their children drink their milk. All these perceptions are fueled by food industry marketing. As more strong, successful people (Clinton, Gore, athletes, etc.) talk about their WFPB diets, the perceptions will change. As more people reverse their health problems with this lifestyle, the perceptions will change.




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  4. It’s so true that doctors like to treat symptoms instead of causes. They want the patient in and out fast and get paid… because they don’t care.




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  5. Isn’t the lack of cancer due more to the lack of animal products than a particular item (fiber) – ie based on The China Study, etc. I’m getting less interested in ‘reductionist’ studies over time and more focused on whole foods.




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    1. It does seem that higher fiber diets are correlated with less animal products and more phyto nutrients, etc. But fiber itself is thought to have benefits like moving waste out of the body more efficiently. It seems to me that we can have a holistic approach, but still delve into some particulars of why our strategy works, as long as we don’t imagine we are ever going to reduce nutrition down to some set of reductionist edicts.




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    2. Excellent question! Despite the fact that fiber is one of the most crucial nutrients for gathering toxins in the body and removing them through the digestive tract, there are myriad factors that come into play in the reduction of risk for cancer and other chronic diseases. You are absolutely right that the reductionist idea ignores the synergistic effects of whole foods in the extraordinarily complex human body. Foods high in fiber come from plants, which also provide thousands of other health-promoting nutrients, such as phytochemicals, antioxidants, vitamins, and minerals. Similarly, on the flip side, opting for whole plant foods crowds out the intake of harmful substances found in animal products and processed foods. Thus, it is a combination of incorporating the most health-promoting foods and avoiding health-damaging foods that leads to optimal health. For examples of the complexity of plant compounds and its relationship to cancer, see Phytates for the Treatment of Cancer and Plant-Based Prevention




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    3. Excellent question! Despite the fact that fiber is one of the most crucial nutrients for gathering toxins in the body and removing them through the digestive tract, there are myriad factors that come into play in the reduction of risk for cancer and other chronic diseases. You are absolutely right that the reductionist idea ignores the synergistic effects of whole foods in the extraordinarily complex human body. Foods high in fiber come from plants, which also provide thousands of other health-promoting nutrients, such as phytochemicals, antioxidants, vitamins, and minerals. Similarly, on the flip side, opting for whole plant foods crowds out the intake of harmful substances found in animal products and processed foods. Thus, it is a combination of incorporating the most health-promoting foods and avoiding health-damaging foods that leads to optimal health. For examples of the complexity of plant compounds and its relationship to cancer, see Phytates for the Treatment of Cancer and Plant-Based Prevention




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  6. “Preventive medicine is bad for business.” Depends on what kind of
    business you’re talking about. A change to a more healthful lifestyle
    would reduce the amount of money people spend on medical care, leaving them more money to spend on other things, which would be good for the businesses that provide those other things.
    It is, after all, consumer demand that drives the profits of business.
    Unlike the government which can take your money at the point of a gun, a
    business must appeal to your voluntary
    consent. It is, therefore, up to consumers to change their tastes and
    desires if they want businesses to provide them with something other
    than fast food.




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  7. I have heard the belief that Native Americans, having long been used to a largely meat-based diet (perhaps like the Eskimos), do not do well on a high carb diet. Is there any scientific data to back up this belief?




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      1. Thank you so much for responding. That Forks Over Knives article has a lot of helpful information, as does this one. Much appreciated!




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