Who Was Ancel Keys?
Robin L. Shearer, M.F.T., M.A., M.P.H., R.N.
Alternative Group staff members are frequently engaged in public education on the subject of eating disorders. Invariably, the name Ancel Keys is mentioned. So, who is he? Ancel Keys, Professor Emertus, University of Minnesota, School of Public Health, was a researcher whose findings are essential to an understanding of eating disorders.
About 55 years ago, Ancel Keys and his colleagues at the University of Minnesota conducted perhaps the most systematic study ever undertaken of the effects of starvation. The study involved restricting the caloric intake of 36 young, healthy, psychologically normal young men who had volunteered for the experiment as an alternative to military service.
During the first three months of the study, the men ate normally while their behavior, personality, and eating patterns were studied in detail. During the next six months, the men had their food intake reduced by half and lost an average of 25% of their original body weight. This was followed by three months of rehabilitation, during which time they were gradually refed.
The men experienced dramatic physical, psychological, and social changes as a result of the starvation, AND, these changes persisted during the re-feeding phase.
Let’s first examine how starvation affected the men’s attitudes and behavior related to eating. An inevitable result was a dramatic increase in preoccupation with food. The men found it difficult to concentrate on their usual activities. They were plagued by persistent thoughts of eating and food. Food became a main topic of conversation, reading, and daydreams. Many began reading cookbooks and collecting recipes. Some developed a sudden interest in collecting kitchen utensils and other food related items. This hoarding extended to nonfood related items as in some cases.
During the starvation phase, the men often ate in total silence, focusing all their attention on eating. They made strange concoctions of the available food and increased their use of salt and spices. Despite little interest in culinary matters prior to the experiment, almost 40% of the men mentioned cooking as a part of their post experiment plans. Some even went so far as to change occupations--three became chefs and one went into farming.
Other symptoms the researchers noted included excessive gum chewing (one subject was discovered to be chewing as many as 40 packages per day), increased consumption of coffee and tea, and dawdling for several hours over a meal that normally would be eaten in a matter of minutes. All of the subjects reported increased hunger. Some even had episodes of binge eating and bulimia (consuming as much as 8,000-10,000 calories) followed by self-loathing.
When the men were given greater amounts of food during the refeeding phase, many of the men ate more or less continuously. Even after twelve weeks of rehabilitation, the men frequently experienced an increase in hunger immediately following a large meal. Bulimic behavior persisted many months after the men were permitted access to food.
Although the men had pleasant, tolerant dispositions prior to the experiment, many experienced depression, irritability, and frequent outbursts of anger as a result of semi-starvation. Many of the men began biting their nails or smoking because they felt nervous. Most experienced periods of severe emotional distress. Personality testing using the Minnesota Mutiphasic Personality Inventory revealed significant increases in depression, hysteria, and hypochondriasis. Again, these emotional changes did not vanish immediately during rehabilitation, but persisted for weeks.
The volunteers also experienced dramatic social changes in behavior. A the experiment progressed, the men became more withdrawn and isolated. Sense of humor and comraderie diminished as feelings of social inadequacy grew. Sexual interest dramatically decreased.
As the six months of semi-starvation progressed, the young men showed many physical changes: headaches, dizziness, hypersensitivity to noise and light, ringing in the ears, eye aches, inability to focus, “spots” in the visual fields, tingling of the hands and feet, decreased tolerance for cold temperatures (cold hands and feet), decreased need for sleep, poor motor control, edema, hair loss, and gastrointestinal discomfort.
Other changes reflected an overall slowing of the body’s physiological responses. Body temperature decreased as well as heart rate, respiration, and basal metabolic rate (BMR). BMR is the amount of energy, expressed in calories, the body requires at rest in order to carry out normal physiological processes. BMR accounts for about two-thirds of the body’s total energy needs, with the remainder being used for physical activity. At the end of the semi-starvation phase, the men’s BMR had dropped by about 40% from normal. This drop reflects the body’s extraordinary ability to adapt to low caloric intake by reducing its need for energy (Dieters take note).
Interesting changes in body fat and muscle in relation to overall body weight occurred during semi-starvation and rehabilitation. While weight declined about 25%, percentage of body fat decreased by about 70%, and muscle fell about 40%. On refeeding, a greater portion of the “new weight” was fat; in the eight month of rehabilitation, the young men were at about 110% of original weight, but approximately 140% of original body fat! The men who gained the most weight became concerned about their increased sluggishness, general flabbiness, and tendency to accumulate fat in the abdomen and buttocks. The men reported “feeling fat” and worried about acquiring distended stomachs.
These men also responded to semi-starvation with reduced physical activity. They became tired, listless, apathetic, and complained of lack of energy. In spite of this, some of the volunteers exercised deliberately at times. Some of them attempted to lose weight by driving themselves through periods of excessive exercise in order to obtain more food or avoid a reduction in their rations, not unlike bulimics or anorexics who will allow themselves a bit more to eat if they exercise strenuously.
The Keys study has special significance for those working in the area of eating disorder treatment. It is important to remember this experiment was conducted with physiologically healthy young males in 1950, not young women in 2005 who have been programmed by societal standards to believe that thin is the ideal body shape and food intake must be rigidly controlled by dieting.
Many of the symptoms thought to be specific to anorexia nervosa or bulimia are actually the result of starvation or restraint. The volunteers’ symptoms extended beyond food and weight and affected virtually all areas of their psychological and social functioning. Instead of being the cause of eating disorders (as many health professional have postulated), these symptoms may actually be the result of under nutrition. Therefore, it is absolutely essential that eating disordered patients be returned to normal weight and fairly normal eating patterns in order to accurately assess emotional disturbances and before any type of “talk therapy” will be of major value.
his study also demonstrates how tremendously adaptive the human body is and how biological processes function under intense caloric deprivation to maintain a certain weight. The evidence strongly suggests that dieting sets up conditions for increased weight management problems in the future.
Robin L. Shearer M.F.T., R.N., M.A., M.P.H.