THE researches of the US physiologist Ancel Keys — nicknamed “Mr Cholesterol” after his findings gained public recognition — had a profound effect on society’s attitude to food and exercise. He introduced many of the assumptions which we now take for granted about the relationship between diet, energy expenditure, metabolic rates and health.
He led the way in the application of objectively quantifiable measurements to such physiological processes as the effects of ageing and responses to heat, cold or starvation; he applied mathematics to human biology, studying, for instance, the relationships between height and weight, diet and blood fats, blood fats and the incidence of heart attacks.
Ancel Benjamin Keys was born to teenage parents in Colorado Springs in 1904. The family soon moved to California, where his uncle, Lon Chaney, was forging a successful career as a silent-film star. Eventually his family settled in Berkeley, which proved a convenient academic springboard for the young Ancel — although because of his impetuous character, his initial career path was far from straight.
Keys’s interest in science began early. Finding little to interest him in the usual entertainments at his eighth birthday, he stepped out into the back hall with the intention of chloroforming a fly. His grandmother arrived on the scene in time to see the boy fall to the floor having rendered himself, rather than the fly, unconscious.
Later demonstrations of his wilfulness threatened to bypass science altogether. As a teenager he ran away from home to shovel bat guano in Arizona caves; he worked in Colorado goldmines and in a lumber camp. At 19 he married, only to be divorced a few years later. When he did start a degree in chemistry at Berkeley, he dropped out to work as an oiler on a ship bound for China. When he returned he took a BA in economics and political science and became a management trainee in a Woolworth’ s store. This career did not suit him, however, and in 1927 he began an MSc in zoology at Berkeley, which he achieved in just six months.
He moved to the Scripps Institute of Oceanography and took a doctorate in oceanography and biology in 1930. A National Research Council fellowship allowed him to travel to Europe. He spent his time in Copenhagen, where he worked under the Nobel laureate August Krogh, determining how eels regulate the salt level in their blood when migrating between fresh water and the sea, and King’s College, Cambridge, where he took another doctorate in physiology.
In 1936 Keys turned down a permanent post at Cambridge for a position at the Fatigue Laboratory at Harvard, which finally allowed him to turn his attention to the human body. He was interested in physiological reactions under extreme conditions and passed much of his time at Harvard writing up an expedition in the Andes, on which he had spent ten days at 20,000ft measuring the effects of high altitude on his own blood.
He repeated the experiment almost 30 years later, with five scientists from the original expedition, to test the ability of older men to function under the same conditions.
Keys moved to the University of Minnesota in 1937, where he was invited to organise what was to become the Laboratory of Physiological Hygiene, the term he coined for the new field of quantitative human biology which he was pioneering. From a makeshift space under the stands of the university football stadium, it became a world-famous research laboratory, of which Keys was director until his retirement in 1972. In 1939 he married a biochemist, Margaret Harvey.
When the US became involved in the Second World War, Keys was asked by the Government to develop compact but nutritionally adequate ration packs for paratroopers. The original ration included biscuits, dry sausage and chocolate and was soon being made by the million. The little packages had the letter “K” printed on them — in honour, Keys always maintained, of himself.
Later in the war, Keys turned his attention to the starving millions in Europe: “I wanted to find out what would be the effect of starvation, how long it would last and what would be required to bring them back to normal,” he said. The project involved 36 conscientious objectors who had volunteered to have their diets and energy expenditure closely monitored so as to re-create the conditions of those in Europe. There would be a period of normal eating; three months of semi-starvation coupled with the physical exertion of walking an equivalent of 22 miles a week, so that each volunteer would become the nutritional equivalent of a Pole or a Greek; and a rehabilitation phase. The results were written up in a two-volume book, The Biology of Human Starvation (1950), still the fullest account of the physiological effects of starvation, which also sets down in detail its psychological and cognitive effects.
Soon after this project, Keys shifted his focus to one of America’s growing problems — heart disease. He knew that in starving, postwar Europe instances of heart attacks had dropped dramatically. In 1950 he chaired the World Health Organisation’s first commission on food and agriculture in Rome and became a senior Fulbright Fellow at Oxford. During this spell in Europe an Italian colleague pointed out that in his country heart disease was not a problem. This spurred Keys to embark on one of his most ambitious studies in epidemiological research — the Seven Countries Study. For several decades he monitored more than 12,000 men between the ages of 40 and 59 from 16 communities in Italy, the Greek islands, Yugoslavia, the Netherlands, Finland, Japan and the United States. The communities were chosen for their contrasting dietary patterns and the relative uniformity of their rural labouring populations.
Keys discovered that in those societies where fat was a major component of every meal, such as America and most notably Finland — where butter is often spread on cheese — blood-stream cholesterol was highest and the heart-attack death rate was greatest. In cultures where a diet of fresh fruit and vegetables, bread and pasta and plenty of olive oil — such as around the Mediterranean — blood cholesterol was low and heart attacks were rare. For the first time a connection between diet and coronary disease had been established.
Keys’s findings were popularised by the publication of Eat Well, Stay Well (1959), The Benevolent Bean (1967) and Eat Well, Stay Well the Mediterranean Way (1975), which he wrote with his wife and which included hundreds of recipes. He featured on the cover of Time magazine in 1961.
The international impact of his findings arose from his observation that entire populations could be “sick”. He found that Finns were most at risk of heart attacks, with 992 occurring in every 10,000; Cretans, with nine attacks in every 10,000 people, had the lowest risk.
This finding prompted the Finnish Government to try to regulate the diet of certain communities in North Karelia. By the mid-1990s cardiovascular mortality had been cut by more than half in that region.
Keys promoted healthy, low-fat diet and regular exercise, and he stated, with characteristic bluntness, in an interview in 1959 that heart disease in the US was due to “the North American habit for making the stomach a garbage disposal unit for a long list of harmful foods”. However, he was suspicious of some of the trends which had followed his discoveries. “Diet fads are for birds, if you don’t like birds,” he said. He was an advocate of a reasonable diet and “safe, useful exercise”, for instance working in the garden at his house near Naples, where he spent much of the last period of his life. He was also a good advertisement for his beliefs: he continued to be active, lecturing all over the world, long after retirement and he lived to be 100.
Keys is survived by his wife, Margaret, and a son and a daughter. Another daughter was murdered in 1991 while on holiday in Jamaica.
Ancel Keys, physiologist and public health scientist, was born on January 20, 1904. He died on November 20, 2004, aged 100.
