TCS Daily


Cognitive Disconnect

By Sandy Szwarc - November 30, 2004 12:00 AM

One of the world's most renowned scientists, Ancel Benjamin Keys, PhD., died last week at the age of 100. Dr. Keys did much more than invent K-rations -- those indestructible transportable foodstuffs of white crackers, greasy sausage, chocolate and candy -- that kept our soldiers alive during World War II. But the mainstream media has noted his passing by disregarding some of his greatest scientific contributions to our understanding of the human body and eating. Only information which maintains the accepted orthodoxy makes the news, so few Americans will learn that over half a century ago he conducted some of the soundest clinical studies ever done on the adverse effects of dieting. His findings, which have been replicated hundreds of millions of times since, proved that dieting can cause severe physiological and psychological harm and can result in people being fatter, lead to eating disorders, increase the risk for heart disease and shorten lives.

In memory of Dr. Keys life's work, here are some of his findings -- revolutionary at the time and have been built upon since then by some of the country's top researchers -- that deserve acknowledgement.

Fat Findings

Paradoxically, even though Keys offered some of the strongest early evidence against today's anti-obesity hysteria and weight loss admonitions, he admitted in a 1961 Time Magazine interview that he personally found obesity "disgusting." He never appeared to make the connection between his research and dieting, and had "even more contempt for the weak will that presumably produced obesity" and the lack of self-discipline required to diet, noted Roberta Pollack Seid, PhD, of the University of California, Berkeley.11 Still, the evidence proved undeniable.

After examining 16 prospective studies of body weight and mortality in seven countries, Keys and colleagues concluded that obesity is not a risk factor for heart disease or premature deaths, even controlling for the effects of smoking.6,10 "The idea has been greatly oversold that the risk of dying prematurely or of having a heart attack is directly related to relative body weight," he said.7,11 Beyond population studies, both angiographic and autopsy examinations show no relationship between fatness and the degree or progression of atherosclerotic buildup in the coronary arteries, according to a 1954 study he led.5 Their Seven Countries Study also suggested that fatness was associated with significant health benefits, including an inverse relationship with cancer deaths.8

Keys scoffed at height-weight charts, calling them "arm-chair concoctions starting with questionable assumptions and ending with three sets of standards for 'body frames' which were never measured or even properly defined."6 Like their Seven Countries Study, the Framingham, Albany, Tecumseh, Chicago People's Gas, and Chicago Western Electric studies all found that people 20 to 40% over the insurance company weight charts lived the longest. In fact, those most at risk are at or below the charts, or at the very extreme of obese, rather than the average or even moderately obese groups, he concluded.7,10

Diet Data

In the 1940s when he realized that starvation "was going to be a huge problem" in war-torn countries, Keys led the first scientific studies of calorie restrictions, at the University of Minnesota. Their study was known as the Minnesota Starvation Study and the results were published in the legendary two-volume, Biology of Human Starvation.9 Decades later, it is still the definitive work on the subject. "I doubt another of its kind will ever be done," he said.2 Today, there are rights for human research subjects and it would be seen as too cruel and life-threatening.

Young male volunteers, all carefully selected for being especially psychologically and socially well-adjusted, good-humored, motivated, active and healthy, were put on diets meant to mimic what starving Europeans were enduring, of about 1,600 calorie/day -- but which included lots of fresh vegetables, complex carbohydrates and lean meats. The calories were more than many weight loss diets prescribe and precisely what's considered "conservative" treatment for obesity today. What they were actually studying, of course, was dieting -- our bodies can't tell the difference if they're being starved voluntarily or involuntarily! Dr. Keys and colleagues then painstakingly chronicled how the men did during the 6 months of dieting and for up to a year afterwards, scientifically defining "the starvation syndrome."

As the men lost weight, their physical endurance dropped by half, their strength about 10%, and their reflexes became sluggish -- with the men initially the most fit showing the greatest deterioration, according to Keys. The men's resting metabolic rates declined by 40%, their heart volume shrank about 20%, their pulses slowed and their body temperatures dropped. They complained of feeling cold, tired and hungry; having trouble concentrating; of impaired judgment and comprehension; dizzy spells; visual disturbances; ringing in their ears; tingling and numbing of their extremities; stomach aches, body aches and headaches; trouble sleeping; hair thinning; and their skin growing dry and thin. Their sexual function and testes size were reduced and they lost all interest in sex. They had every physical indication of accelerated aging.

But the psychological changes that were brought on by dieting, even among these robust men with only moderate calorie restrictions, were profound. So much so that Keys called it "semistarvation neurosis." The men became nervous, anxious, apathetic, withdrawn, impatient, self-critical with distorted body images and even feeling overweight, moody, emotional and depressed. A few even mutilated themselves, one chopping off three fingers in stress. ­They lost their ambition and feelings of adequacy, and their cultural and academic interests narrowed. They neglected their appearance, became loners and their social and family relationships suffered. They lost their senses of humor, love and compassion. Instead, they became obsessed with food, thinking, talking and reading about it constantly; developed weird eating rituals; began hoarding things; consumed vast amounts of coffee and tea; and chewed gum incessantly (as many as 40 packages a day). Binge eating episodes also became a problem as some of the men were unable to continue to restrict their eating.

Many of these traits are familiar with those who've spent their lives dieting. In fact, many of the symptoms once thought to be primary features of anorexia nervosa are actually symptoms of starvation and restrictive eating, said David M. Garner, PhD., director of River Centre Clinic in Sylvania, Ohio.1 Indeed, Keys' research indicates that the frenzied attack on fatness may have had the grave side effect of leading to increased incidences of eating disorders.4

The extreme physical and mental effects Keys observed led to his famous quote: "Starved people cannot be taught democracy. To talk about the will of the people when you aren't feeding them is perfect hogwash."9

Dangers of Yo-Yo Dieting

The last part of the Minnesota Starvation Study revealed additional devastating effects. When the men were allowed to eat ad libitum again, they had insatiable appetites and ate voraciously, some eating 8,000 to 10,000 calories a day, yet never felt full. After five months most of the men were beginning to regain some normalization of their eating, but for some, dysfunctional eating continued. As they regained their weights, their metabolisms and energy increased. Three months after the dieting, though, none of the men had regained his former physical capacity, noted Keys. On average, the men regained to their original weights plus 10%. But the weight regain was largely as fat and their lean body mass recovered much more slowly. Their weights then plateaued despite being given unlimited food, before finally, about 9 months later, most were near their initial weights -- giving scientists one of the first demonstrations that each body has a natural set point.9

Followup research by Keys in the 1970s found that blood cholesterol levels rise after dieting, possibly accelerating heart disease, and subsequent research has found the risk of death due to cardiovascular disease is double among those who diet and regain, compared to people who just gain weight. Such risks appear even after adjusting for age, blood pressure, smoking, alcohol intake and body mass index.3

Dieting can be dangerous and Keys put no stock in diets. "Diet fads are for the birds, if you don't like birds," he said in a 1979 University of Minnesota Update. He also noted diets such as those promoted by Adele Davis, based on natural foods and fears about processed foods, are "just full of hogwash." There's "no great sense to them at all." While most diet fads don't do a great deal of harm, he said, "things as the Zen macrobiotic diet definitely are harmful," as are liquid high-protein diets.2

Keys had further comments about today's "diet and exercise" prescriptions. He had no intention of ever jogging because he'd "seen just too many cases" of people dropping dead while jogging. "I try to persuade people to have some pleasurable, safe exercise, preferably useful, when they are older," he said. For their useful physical activity, "Margaret and I get lots of pleasure from working in our yard," he said. After retiring to Italy, while in their 70s they were caring for 80 olive trees and 75 citrus trees.2

[A memorial service is scheduled for 11 a.m. December 4 at Washburn-McReavy Funeral Home in Edina, Minnesota.]

References

1. Garner, D.M. "Psychoeducational principles in the treatment of eating disorders" pgs 145-177. In: Handbook for Treatment of Eating Disorders. Garner DM, Garfinkel PE, eds. (New York, NY: Guilford Press, 1997).

2. Hoffman W, Ancel Keys. University of Minnesota Update, Winter, 1979.

3. Keys A. Is overweight a risk factor for coronary heart disease? Cardiovascular Medicine, 1979; 4: 1233-1243.

4. Key A. Is there an ideal body weight? British Medical Journal, 1986; 293: 1023- 1024.

5. Keys A. Obesity and degenerative heart disease. American Journal of Public Health, 1954; 44, 864-871.

6. Keys A. Overweight, obesity, coronary heart disease and mortality. Nutrition Reviews, 1980; 38: 297- 307.

7. Keys A. Seven Countries: A Multivariate Analysis of Death and Coronary Heart Disease (Harvard University Press, January 1, 1980).

8. Keys A., Arvanis C, Blackburn H, Buzina R, Dontas A.S, Fidanza F, Karvonen M J, Menotti A, Nedeljkovic S, Punsar S, Toshima H. Serum cholesterol and cancer mortality in the Seven Countries Study. American Journal of Epidemiology, 1985; 121: 870-883.

9. Keys A, Brozek J, Henschel A, Mickelson O, Taylor HL. The biology of human starvation. (Minneapolis: University of Minneapolis, 1950).

10. Keys A., Menotti A, Aravanis C, Blackburn H, Djordevic BS, Buzina R, Dontas A.S, Fidanza F, Karvonen MJ, Kimura N, Mohacek I, Nedeljkovic S, Puddu V, Punsar S, Taylor HL, Conti S, Kromhout D, Toshima H. The seven countries study: 2,289 deaths in 15 years. Preventive Medicine, 1984; 13: 141-154.

11. Seid RP. Never Too Thin: Why Women are at War with Their Bodies (New York: Prentice Hall Press, 1989).

© 2004 Sandy Szwarc


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