Take a Trip Back to 1960 and Meet "Mr. Cholesterol" - Ancel Keys - the Man Who Figured Out That Fat & Cholesterol Contribute to Heart Disease

 

 

Let's take a time machine trip back 50 years.

It's December, 1960 and the American Heart Association has just "sanctioned" Ancel Keys' theories on diet, fat, cholesterol & heart disease.

Here's what "Mr. Cholesterol" was saying about the state of American Health back then:

• Americans eat too much. 
• Americans eat too much fat.  With meat, milk, butter and ice cream, the calorie-heavy U.S. diet is 40% fat, and most of that is saturated fat--the insidious kind, that increases blood cholesterol, damages arteries, and leads to coronary disease.
• "The only sure way to control blood cholesterol effectively is to reduce fat calories in the U.S. diet from 40% to 15% of total calories, and cut saturated fat from 17% to 4% of total calories," according to Keys.
  

--Time Magazine, January 13, 1961, "Medicine: The Fat of the Land"-

 

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This morning one of my blog readers sent me a link to a January 13, 1961 Time Magazine article about Ancel Keys--who was 57 years old at the time.  Keys is the man responsible for making the cholesterol-fat-heart disease connection.  This University of Minnesota physiologist traveled the world, meticulously collecting the data that helped to link diet, fat and elevated cholesterol to heart disease.  It's fascinating reading, and I was stunned by how much we knew back then--yet how little seems to have changed.  Like this:

"The Metropolitan Life Insurance Co., clucks that 48 million Americans are overweight. 

For the first time in history, the U.S. has produced a society in which less than one-tenth of the people turn out so much food that the Government's most embarrassing problem is how to dispose inconspicuously of 100 million tons of surplus farm produce. (My comment: which is right around the time that cheap fast food, corn-fed farm animals, & high-fructose corn syrup were born--thanks to farm surplus)

In this same society, the plain citizen can with an average of only one-fifth his income buy more calories than he can consume.  The typical U.S. daily menu contains 3,000 calories, when it should contain 2,300.  And extra weight increases the risk of cancer, diabetes, artery disease and heart attack."    Yes, this was written in January 1961. I had just turned eleven.

Fast forward fifty years to 2010 and not much has changed.  We're still overweight, heart disease is still our number one killer--and type 2 diabetes & hypertension are commonplace.  The only difference between 1960 & 2010 is that now many of us are taking 3 or 4 prescriptions to control these diseases & the cost of health care is now through the roof. 

If only we'd listened to Keys & ditched the fat back then.  Maybe we wouldn't be in such a mess right now.

But Keys was pretty one-dimensional in his viewpoint.  For him, coronary disease was mostly about the fat, and saturated fat, in particular. 

"Though Keys's theory gained sanction from the American Heart Association in 1960, it is still questioned by some other researchers with conflicting ideas of what causes coronary disease.  The main difference is that they variously blame hypertension, stress, smoking and physical inactivity, while Keys gives these causes only minor roles.  Keys's chief weapon has been the sheer weight of solid statistics.  Says one Philadelphia physician:  "Every time you question this man Keys, he says, 'I've got 5,000 cases.  How many do you have?'"  (Time Magazine Jan. 13, 1961)

Keys' Mission - To Find the Relationship Between Diet & the Nation's Number One Killer--Coronary Heart Disease

When Keys set up his Laboratory of Physiological Hygiene at the University of Minnesota back in 1940 he had one aim: "To try to find out why people got sick before they got sick."  He already knew that:  Being overweight strained the heart, increased the death rate from cancer by 25%, made one vulnerable to diabetes, & made even moderate exertion uncomfortable, hampering breathing, and restricting muscular movement. 

• Through his University of Minnesota Lab, Keys directed an ambitious diet experiment that covered three continents and seven nations.  Traveling over 500,000 miles he "meticulously collected the physiological data on the health and eating habits of 10,000 individuals from Bantu tribesmen to Italian contadini.  He measured the skinfolds of Neapolitan firemen, studied the metabolism of Finnish woodcutters,  and analyzed the 'mealie-meal" eaten by Capetown African natives.

• In 1946 he persuaded 286 Minneapolis-St. Paul businessmen (then aged 45-54) to submit to detailed annual physicals, including weight, blood pressure, EKGs, and cholesterol count.  By 1960, among other diseases, 27 of them had suffered heart attacks, 16 of them fatal.  "The common element in 18 of the cases was high (240-360) cholesterol levels.  Moreover, it was the only significant common element.  The EKG 'doesn't hurt anybody and looks impressive in a doctor's office, but it is a poor predictor of coronary disease,'"  according to Keys.
• "Later, Keys studied the eating habits and coronary death rates of middle-aged Japanese--in Japan, Hawaii and California.  The native Japanese get only 13% of their calories from fats.  They eat a high-carbohydrate diet of rice, fish and vegetables, and have an average cholestrol count of 120.  The Hawaiian Japanese, also eat fish, along with meat, eggs and dairy products--they get 32% of their calories from fats, and have an average cholesterol count of 183.  The Los Angeles [Japanese] diet is typically American; they get 45% of their calories from fatty foods, and their average cholesterol count is 213.  For every one heart attack in Japan, Keys notes, the Hawaiian Japanese have four, the Los Angeles Japanese have ten."
• Keys was well aware that coronary artery disease dipped dramatically in the Netherlands & Scandinavia during the World War II Nazi occupation.  It wasn't until 1950 that he knew the reason for the decline:  the "increasingly severe restrictions on fatty foods (meat & dairy) that occurred during the Nazi occupation.  
• Then in 1950 Dr. Laurance Kinsell of the University of California was tinkering with the oxidation rates of blood fats when he stumbled on the fact that animal fats caused blood cholesterol rates to rise--adding the scientific explanation to support Keys' epidemiologic findings.
• Keys' biggest hurdle:  It's difficult for a physician to convince a patient who feels fine that he must give up something he likes, to preserve his health--but according to Keys--that's exactly what many Americans need to do.  (some things never change) "The average blood cholesterol count among middle-aged (40-60) U.S. men," says Keys, "is an uncomfortable 240.  People should know the facts.  Then if they want to eat themselves to death, let them."

Who funded Keys' work:  The bulk of his funding came from the U.S. Public Health Service, with additional dollars from the American Heart Association, the International Society of Cardiology, six foreign governments, and about a dozen other "no-strings" sources.  Keys says he used to get money from the National Dairy Council and the American Meat Institute.  Shrugs, Keys: "They didn't like my findings."

 

What Did Keys Eat?  Was He As Healthy As He Expected Others To Be?

 

Here's how my friend described Keys' retirement:

Ancel Keys was 155 pounds and 5' 71/2"  with a BMI of 23.9--a tad on the heavy side, but certainly not overweight.   He left academia at the age of 68 in 1972 and retired to a small seaside village south of Naples Italy in the area where he first discovered the lack of heart disease and the Mediterranean Diet--in the southern Italian population.

He and his wife Magaret built a seaside villa there from the royalties that they got from their three diet books.

Here are their typical meals:

Breakfast:  1/2 grapefruit, dry cereal with skim milk (2% fat), unbuttered toast, jam & coffee

Lunch : sardine sandwich, olives, cookies and a glass of skim milk -- always brown bagged when he was working; he followed lunch with a 10-minute doze.

Dinner: 2 hours with classical music & candlelight, multiple courses, a pre-dinner cocktail (a martini or negroni -- (¼ gin, ¼ Campari bitters, ¼ sweet or dry vermouth, ¼ soda water, over ice in an old-fashioned glass)), 1,000 calorie meal with less than 20% fat.

Sample menu: Turkey broth with noodles, veal scallopini a la Marsala, green beans, tossed salad dressed with tarragon vinegar and corn oil, homemade bread, cookies, expresso, fruit.  They would have meat no more than 3X a week in the form of a "carving roast"-steaks, chops or roast.

This was a much more moderate diet than I would have expected, but it still generated the right results in the end for both of the Keys.  They were getting a daily dose of alcohol from their cocktails and their "a la Marsala" cooking style.  Keys did like his cookies.    Ancel died at age 100 in 2004.  His wife Magaret died at age 97 in 2006.

His diet recommendations are fairly simple: "Eat less fat meat, fewer eggs and dairy products. Spend more time on fish, chicken, calves' liver(?), Canadian bacon, Italian food, Chinese food, supplemented by fresh fruits, vegetables and casseroles."

Adds Keys: "Nobody wants to live on mush. But reasonably low-fat diets can provide infinite variety and aesthetic satisfaction for the most fastidious—if not the most gluttonous—among us." On such fare,  Keys-the gourmet-keeps his own weight at a moderate 155, his cholesterol count at a comfortable 209.

Some glaring diet contradictions, perhaps?:  Keys recommended calf livers (high in saturated fats and cholesterol) as well as Canadian bacon.  These recommendations seem to contradict his research. I guess both Keys & his wife must have really liked liver and Canadian bacon--and yes, he could definitely be described as a "foodie".  He also had a cholesterol level of 209, in spite of the fact that he knew that other populations with low heart disease had much lower levels.   This high of a cholesterol level would suggest that his diet was not as perfect as what he was recommending.

But when all is said & done, it certainly seems to have worked for him!

Want to learn more about Ancel Keys?  Click here.

 

 

 

 

 

Comments

[Chris G.]

Truly a scientific pioneer.

If the sample diet is comprehensive, it seems he barely got 4 fruits/veggie serving per day, ate inflammatory, high omega 6 foods he (dairy, meats, corn oil, cookies), had a cholesterol which exceeded 200, and lived to 100 yrs old. Good genes for this good scientist. It would seem Richard Holbrooke (69) or my grandfather (dead of a heart attack at 49) were not as fortunate. This emphasizes the large unknown in the 'healthy, long life' equation: Genetic predisposition to disease (heart/artery issues, cancers, etc).

[Betsy]

And Keys and wife were fairly healthy up until their ends?

There are some significant differences between 1961 and now, don't you think? My family and I have recently been reviewing family photos from the early '60s and everyone remarks on how comparatively slim the people in large scene photos look, for instance at a boy scout picnic. Today you would not find that many people at a healthy weight at such a function. The sheer numbers of overweight people have to influence health care costs as well.

[Ken Leebow]

As always, thanks for your interesting post!

Fat in our diet can be confusing and sadly, has been used as a marketing ploy. I like to use Dr. David L. Katz's observation: "As a population, we cut dietary fat in a rather dysfunctional way, and we grew even fatter."

By way of example, in my presentations, I use the following low fat peanut butter example: http://bit.ly/gMZXyJ

Unfortunately, it can be applied to most "low fat" products. Next time you walk into the "healthy" yogurt store observe all the "low fat" choices.

Again, thanks for all the great info. and happy and healthy new year to you.

Ken Leebow

[DPS]

Thank you for this topic. I enjoyed reading about the man who conducted the Seven Countries Study. He was truly a pioneer in the field.

With regard to his health, I learned the following from the link below. He lived until 2 months shy of his 101st birthday. He spent part of each year of his retirement living in Italy. However during the last few years of his life, several strokes and a broken hip kept him in Minneapolis. Check out the photo and story at http://www.washingtonpost.com/ac2/wp-dyn?pagename=article&contentId=A53532-2002Oct19&notFound=true

[DPS]

There is a photo of Ancel Keys taken when he was 100 at
http://www.proteinpower.com/drmike/low-carb-diets/jack-lalanne-vs-ancel-keys/

[Andrea Reiman]

Ohmygosh! The photos that compare Jack LaLanne at age 93 and Ancel Keys at 100 (see link above) are hugely informative! My take home message is that there may be some of us that get lucky with certain genetics regarding diet - and can be more moderate - but NONE of us can ignore the importance of vigorous exercise. Whenever I'm tempted to skip a workout, this is the new picture in my mind's eye I will carry!