Denis Burkitt

What Denis says, topic by topic

Oil

In his interview with John McDougall, Burkitt said Western diets drew about 45% of their energy from fat, nearly all of it saturated animal fat, and ranked cutting it near the top of his list¹. His practical steps were semi-skimmed milk, vegetable margarine in place of butter, and as little fried food as possible¹.

What all the experts say about oil

Calcium, dairy and bones

Burkitt told McDougall he did not see calcium as a reason to drink milk, since communities that stop drinking it after childhood hardly suffer from osteoporosis in old age². He said he did not know the cause of osteoporosis but doubted that taking calcium helps, and thought hormones after menopause and lack of exercise matter more².

He added that Africans in South Africa have about one eleventh the risk of hip fracture while taking in less calcium than Westerners, so he doubted calcium tablets do much³.

What all the experts say about calcium, dairy and bones

Salt

Burkitt listed less salt among his main dietary changes, saying Westerners eat about five times as much as communities whose blood pressure does not climb with age⁴. He praised potatoes for their potassium, noting that Western man is the only mammal taking in more sodium than potassium⁵.

What all the experts say about salt

Sugar

Burkitt recalled that Peter Cleave had blamed the Western diseases on sugar, which did not satisfy him because sugar is absorbed before it ever reaches the colon⁶. His alternative was that refining sugar first strips out the fiber, so the missing fiber, rather than the added sugar, might be the problem; he still listed far less sugar among the traits of diets in places free of these diseases⁶⁷.

What all the experts say about sugar

Starches

Asked what people should eat, Burkitt put more fiber first and far more starch second, insisting that starch is never fattening and naming bread, potatoes and pasta⁸. He wanted much more cereal food, especially brown or homemade bread, noting that ancestral diets included over a pound of bread a day while the English then ate under a quarter of a pound⁹.

He called peas and beans very good for their soluble fiber, and described potatoes as nutritious and slimming as long as they are neither cooked nor eaten with fat¹⁰⁵.

What all the experts say about starches

Supplements

Burkitt told McDougall he did not think anyone in America was short of vitamins, and said he had never taken a vitamin tablet in his life¹¹.

What all the experts say about supplements

Fish and eggs

Burkitt said he was not a vegetarian, but that farmed meat carries about seven times the carcass fat of wild meat¹². His household bought red meat only about once every three weeks and ate fish and poultry instead, which he called better for health, and he said nobody should eat meat twice a day¹³.

He saw no need to add meat to a vegetarian diet, but declined to judge diets without milk or eggs, saying he could not speak with authority on them¹⁴.

What all the experts say about fish and eggs

Fiber

Fiber was the center of Burkitt’s work. He told McDougall that the idea led him to measure stool weight and gut transit time in Africa, India and among Seventh-day Adventists, since stool output tracks fiber intake¹⁵. He put the average American intake at about 15 grams a day against more than 100 grams for our ancestors and in much of the third world¹⁶.

He said typical Western stools weigh about 80 to 130 grams a day, against roughly 300 to 500 grams where bowel cancer, gallstones and heart disease are rare¹⁷. Food took about three days to pass through the gut of Westerners, and up to two weeks in the elderly, but around 36 hours in rural India or Africa¹⁸.

He said high fiber diets had nearly removed the need for surgery for hemorrhoids and for diverticular disease¹⁹.

What all the experts say about fiber

Fruit

Burkitt told McDougall that fruit and vegetables are all good foods, but pointed out that most fruit is about 98% water and so supplies little fiber²⁰.

What all the experts say about fruit

Beans and lentils

Among the foods he wanted people to eat more of, Burkitt singled out peas and beans as extraordinarily good, because their soluble fiber helps with diabetes and coronary heart disease¹⁰.

What all the experts say about beans and lentils

Whole grains, bread and flour

Burkitt urged a far greater intake of cereal foods, above all bread, and specified brown or homemade bread rather than white. He said our ancestors ate roughly a pound to a pound and a quarter of brown bread per person each day, while the English of his time ate less than a quarter of a pound⁹.

He recalled that around 1972 the British milling industry told the press that fiber had no value at all in human nutrition. He described a century of millers finding ever better ways to strip fiber from flour, yet chose talks over a fight; the millers then invited him to address British bakers and millers and the American millers, and he said they were by then producing plenty of good high fiber bread²¹.

He added that cereals are a good source of protein, while stressing that he spoke as a surgeon rather than a dietitian²².

What all the experts say about whole grains, bread and flour

Potatoes

Burkitt called potatoes very good food. He valued their potassium, noting that Western people are the only mammals taking in more sodium than potassium, and said potatoes are slimming provided they are neither cooked in fat nor eaten with it⁵. He also repeated what he had been told: that hardly any other single food supplies nearly everything a person needs⁵.

What all the experts say about potatoes

Meat

Asked whether a vegetarian diet needs meat added, Burkitt said there is no need¹⁴. He was not a vegetarian himself, but argued that farm-raised meat carries about seven times the carcass fat of wild meat, with five times as much saturated fat, and thought wild meat such as venison would do little harm¹².

At home his family bought red meat only about once every three weeks, did not eat meat every day, and never ate it twice in one day, which he said nobody should do¹³.

What all the experts say about meat

Low-fat eating

Burkitt said the countries spared the common Western diseases eat far less fat, and named more fiber and less fat as the two biggest changes needed⁷. Western diets, he said, got about 45% of their calories from fat, and cutting it might almost come first on his list¹.

He drew on studies of early human diets: our distant ancestors, to whose food our genes are adapted, ate far less fat, and especially less saturated fat, than Westerners do today²³.

What all the experts say about low-fat eating

Saturated fat

Burkitt said almost all the fat in Western diets is saturated animal fat. To cut it he suggested semi-skimmed milk, vegetable margarine instead of butter and as little fried food as possible¹ (the margarine tip reflects the nutrition thinking of its time). He noted that farmed meat holds five times as much saturated fat as wild meat¹², and that ancestral diets were much lower in saturated fat²³.

What all the experts say about saturated fat

Carbohydrates and low-carb diets

Burkitt rejected the fear of starch: he said people think it is fattening but it never is, and he wanted far more bread, potatoes and pasta⁸. The diets of communities free of Western diseases, he said, are much higher in starch and much lower in sugar than ours⁷.

What all the experts say about carbohydrates and low-carb diets

Weight loss

Burkitt did not discuss weight loss at length, but he said starch is never fattening⁸ and called potatoes a slimming food as long as no fat is added in cooking or at the table⁵.

What all the experts say about weight loss

Exercise

Discussing osteoporosis, Burkitt said he thought exercise was probably a major factor: active communities seemed not to develop it in old age, and he did not see elderly people in African villages bent over by it².

What all the experts say about exercise

Heart disease

Burkitt described surveying more than a thousand mission hospitals across the developing world by questionnaire; their doctors reported never seeing gallstones, hiatus hernia or coronary heart disease, which he used to persuade the profession that these were diseases of Western lifestyle²⁴.

He named the soluble fiber of peas and beans as helpful against coronary heart disease¹⁰. He also contrasted costs: three months of coronary bypass surgery in the United States, he said, cost as much as ten years of the campaign that wiped out smallpox, yet the media gave a few heart transplants more coverage²⁵.

What all the experts say about heart disease

High blood pressure

Burkitt said Westerners eat about five times as much salt as communities whose blood pressure does not rise over a lifetime, and listed cutting salt among his main changes⁴. He also stressed potassium, saying Western people are unusual among mammals in taking in more sodium than potassium, and praised potatoes on that score⁵.

What all the experts say about high blood pressure

Diabetes

Burkitt counted diabetes among the Western diseases rare in traditional communities. He said Pacific Islanders have little diabetes at home, but after moving to New Zealand and adopting Western habits within two generations they overtake the white population in some of these diseases²⁶.

He also pointed to the Pima Indians of the American Southwest, who after a large diet change around the Second World War came to have the second highest diabetes rate in the world, while other indigenous groups in Central America and Brazil remained almost free of it; he concluded the cause must be lifestyle, not genes²⁷. He recommended peas and beans because their soluble fiber helps with diabetes¹⁰.

What all the experts say about diabetes

Cancer

Burkitt’s first research was on the jaw tumor in Uganda that now bears his name; he said mapping where it occurred showed it needed warmth and moisture, which led on to the search for a virus²⁸.

On the cancers of Western countries, he argued that early diagnosis and treatment can never lower how often a disease occurs; only finding and reducing its causes can, yet most money went to diagnosis and treatment²⁹. He estimated that perhaps a third of American cancers are due to diet, but doubted that changing diet does much once a cancer has formed; he said it might help the immune system but he knew of no figures³⁰.

He called colon cancer, the second most common cancer in men, almost entirely due to diet, and said breast cancer had been linked to diet, largely to fat³¹.

What all the experts say about cancer

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