The peninsular keto diet of high medium chain triglycerides from coconut oil and high short chain fatty acids from dietary fibre is responsible for the Kerala syndromic model of high asymptomatic positive normal persons, low covid 19 symptomatic disease and fewer still covid 19 mortality disease. This paradoxical situation can be observed in countries taking a high peninsular keto diet based on dietary fibre and coconut oil as in Philippines, Srilanka and Malaysia. The Kerala syndromic model of high asymptomatic positive normal persons, low covid 19 symptomatic disease and fewer still covid 19 mortality disease is a natural extension of the lifestyle and nutritional habits of Keralites. The health infrastructure, social structure and educational status in other parts of the world especially the western world are comparable to Kerala and hence the Kerala syndromic model of high asymptomatic positive normal persons, low covid 19 symptomatic disease and fewer still covid 19 mortality disease is a result of the historic natural nutritional environment in Kerala.

Dr Ravikumar Kurup is the Director of the Metabolic Disorders Research Centre, Trivandrum.