by Roger Kaza
Today, a heart doctor who wasn't. The University of Houston's Music School presents this program about the machines that make our civilization run, and the people whose ingenuity created them.
Next time your doctor tells you to get a cholesterol test, stir up some trouble. Ask who ordered it. There are probably a few answers to that question, but here's mine: the order came from a doctor — of oceanography!— turned physiologist named Ancel Keys. It was Keys who first studied the correlation between diet and heart disease in large ethnic populations. He came to a conclusion that we now take for granted. High levels of serum cholesterol are a risk factor for cardiovascular disease, and more important, we influence that number every day by what we eat. It's not quite so simple, though. We now know about "good" cholesterol, HDL, and we know that even so-called "bad" cholesterol, LDL, comes in two different sizes, one of which is relatively benign. Genes and lifestyle complicate matters further. But Keys' work, which he began in the 1950s, was groundbreaking.
Ancel Keys on the cover of TIME, January 13, 1961
Keys noticed that rates of heart disease varied tremendously throughout the world. Japan had far lower rates than Finland. The traditional Japanese diet was lower in fat, and especially saturated fat. In Finland, he observed that hard-working farmers buttered their cheese, and that they had heart disease. And Japanese who moved to Hawaii and changed their diet soon developed heart problems at the same rate as their fellow Americans.
But populations with the least heart disease weren't the ones who ate the least fat. People on Crete, for example, had the lowest rates of all. And they ate quite a bit of fat, but mostly unsaturated fats like those in fish and olive oil. So Keys promoted a "Mediterranean diet," emphasizing unsaturated fats over saturated, about 50 years before it became a marketing gimmick.
Unfortunately, his distinction between those fats got lost in translation. By the 1980s a "fat-is-bad" mantra had taken over the food industry. Fats were replaced with sugars, and no one's waistline benefited. We had fat-free cakes and ice-creams. Keys would have been horrified by such Frankenfoods. Reading his 1959 book Eat Well and Stay Well, you realize that the good doctor was a bit of a gourmand. He talks about cholesterol, but then has a chapter on choosing the correct wines. He endorses espresso coffee about 30 years before we heard of Starbucks. He suggests experimenting with wild game meats and fishes, which we now know contain valuable omega-3 essential fatty acids. Key's message was one of substituting fats, not "fat-free."
But nutrition is not yet a settled science, and nowadays, ironically, Ancel Keys gets slammed from two directions. Proponents of the ultra low-fat Ornish diet, for example, would say that Keys' recommendation of a diet of 30% fat calories is too high. Others, from the Atkins diet low-carbohydrate camp, would say 30% is much too low. You can find evidence supporting both positions. But Keys refuted his critics without saying a word. He died in 2004, a few months before his 101st birthday. His wife and co-researcher Margaret died a few years later at age 97. Living well is fine, but if you dare to write a diet book, living long is the best revenge of all.
I'm Roger Kaza, at the University of Houston, where we're interested in the way inventive minds work.
Keys made many other notable diet-related contributions. He performed a series of experiments in calorie deprivation, resulting in a book, Biology of Human Starvation (1950). Perhaps his most enduring legacy (among soldiers, at least) is the combat meal he developed during World War II, the infamous "K-ration."
Model of a cholesterol molecule
Wikipedia article on Keys.
1979 interview with Keys with more links.
Keys' obituary in the New York Times.
The debate over heart disease and diet rages on. Below is a very small sampling of divergent advice on the subject.
Atkins, Robert. Dr. Atkins' New Diet Revolution, Revised Edition (M. Evans, 2003)
Keys, Ancel and Margaret. Eat Well and Stay Well (Doubleday, 1959)
Ornish, Dean. The Spectrum: A Scientifically Proven Program to Feel Better, Live Longer, Lose Weight, and Gain Health (Ballantine, 2008)
Taubes, Gary. Good Calories, Bad Calories (Knopf, 2007)
Willett, Walter. Eat, Drink, and Be Healthy: The Harvard Medical School Guide to Healthy Eating(Free Press, 2005)
Illustrations courtesy of Wikipedia.