For decades, doctors across the world have observed a striking pattern: the diseases that dominate modern societies—heart disease, obesity, diabetes, gallstones, hypertension, appendicitis, constipation, and colorectal cancer—are rare or virtually absent in communities eating diets based on whole, minimally processed plant foods. This was true in rural Africa in the 1930s–1960s, and it is true today in many traditional Asian and tribal populations, including India’s own long-living rural communities where millets, lentils, vegetables, fruits, and fibre-rich staples have been the norm.
In contrast, India is now facing an unprecedented epidemic of lifestyle diseases. Urban India today mirrors the US pattern: rising rates of premature heart disease, obesity in children, high blood pressure even in the twenties and thirties, and soaring rates of type-2 diabetes. According to the Indian Council of Medical Research (ICMR 2023), India now has 101 million diabetics, 136 million prediabetics, and almost one-third of adults have hypertension. These conditions were once rare in our villages. What changed is not our DNA—but our diet and lifestyle.
The early African studies are worth revisiting because they hold a mirror to India today. In the 1930s and 40s, doctors working in sub-Saharan Africa observed that many diseases common in Western countries—diabetes, coronary heart disease, gallstones, constipation, appendicitis, and even hemorrhoids—were almost never seen among rural Africans. Medical manuals of the time openly stated that these conditions were rare among people who ate traditional diets “rich in skins and fibres—beans, corn, vegetables—passing large stools two or three times a day.”
But was this observation merely anecdotal? No. Large autopsy studies confirmed it. In the first thousand Kenyan autopsies, doctors reported: not a single heart attack, no appendicitis, one peptic ulcer, no gallstones, and only three diabetics in a thousand. At a time when the US already had high rates of these diseases, rural Africans had none—because they ate whole, unrefined plant foods and lived active lives.
Some argued that Africans died young, so they never lived long enough to develop heart disease. But this was not true. When scientists compared age-matched autopsies—632 deaths in Uganda vs. 632 in St. Louis (USA)—the contrast was astonishing. Uganda had one heart attack; St. Louis had 136. That’s a 100-fold difference. Later, after 800 more autopsies in Uganda, there was still only one small healed heart attack in 1,427 cases—less than one in a thousand.
Today, India faces the opposite situation: rising cholesterol levels, processed food addiction, decline of traditional millets, almost no fibre in urban diets, and a rapid shift to oil-heavy, restaurant-style food at home. Heart attacks in young Indians are now so common that the WHO warns that Indians get heart disease 5–10 years earlier than Western populations.
The legendary surgeon Dr. Denis Burkitt—who worked extensively in Africa—called this global shift a tragic failure of modern medicine. He said something radical yet uncomfortably true:
“With rare exceptions, there is no evidence that the incidence of any disease has been reduced by treatment. Medical care can reduce death rates, but it does not reduce the number of people becoming ill.”
—Dr. Denis Burkitt
In simple terms: better surgeries and better medicines can save lives, but they cannot prevent disease. Preventing disease requires changing what causes the problem in the first place.
Burkitt used a powerful analogy. If engines parked in the rain keep breaking down, the solution is not to send better mechanics—it is to build a shelter so the rain cannot damage them. Yet medicine spends most of its time improving “mechanics”—surgical techniques, drugs, stents—while spending little time preventing the “rain,” which is our modern environment:
- high-fat, low-fibre junk food,
- extreme sedentary lifestyle,
- excess salt, sugar, and oil,
- stress, smoking, alcohol,
- environmental pollution.
He famously said we either station ambulances at the bottom of the cliff, or build a fence at the top. Unfortunately, health systems—and the food industry—are more invested in ambulances. Because ambulances make money. The fence does not.
In India, too, entire industries profit from us eating more processed food, more dairy, more meat, more packaged snacks, more refined flour, more deep-fried items. These push us closer to the cliff-edge daily. And then another set of industries profits when we fall—cardiac hospitals, stents, surgeries, lifelong medications.
But the science is clear. Modern research reveals that heart disease can be prevented—and even reversed—by returning to the foods our grandparents ate: whole plant foods, minimally processed grains, vegetables, pulses, fruits, nuts, seeds, almost no trans fats, very little oil, and a lifestyle rich in movement and sunlight.
Studies from India, too, confirm this. The PURE study (Lancet 2022) found that higher intake of whole plant foods—fruits, legumes, vegetables—was strongly linked to lower cardiovascular mortality in Indian populations. The ICMR-INdia DIABetes study (2023) directly linked India’s soaring diabetes rates to refined grains, excess cooking oil, and high-fat dairy. Research from AIIMS and PGI Chandigarh repeatedly shows that traditional Indian patterns—dal, roti made from millets or whole wheat, green sabzi, and fruit—offer powerful protection.
The message from history and modern science is the same:
When populations eat traditional whole-food plant-based diets, heart disease becomes rare—less than one in a thousand. When they shift to processed, oily, sugary, low-fibre diets, heart disease becomes an epidemic.
India once naturally protected itself with a fence of whole grains, fresh vegetables, seasonal fruits, legumes, and low-oil home cooking. Today, the fence has been removed—and the ambulances at the bottom of the cliff are overflowing.
The good news is: we can rebuild the fence.
References
1. ICMR–INDIAB Study 2023 – “Prevalence of diabetes and prediabetes in India”, Indian Council of Medical Research.
2. WHO South-East Asia Report (2021–2023) – Premature cardiovascular mortality in India.
3. Lancet, PURE Study (2022) – Miller et al., “Diet quality and mortality in 21 countries including India.”
4. Denis Burkitt – Burkitt DP, “Some diseases characteristic of modern Western civilization,” British Medical Journal.
5. Denis Burkitt – Burkitt DP, “The fibre hypothesis,” Lancet.
6. Autopsy studies from Kenya and Uganda – Shaper, MG; Jones, KW; “Autopsy studies on rural Africans,” British Heart Journal.
7. AIIMS & PGI Chandigarh Lifestyle Medicine Research – Multiple publications on Indian dietary patterns and metabolic disease (2018–2024).