The Great Starvation Experiment

One of my favorite podcasts is Malcolm Gladwell’s Revisionist History Podcast. Gladwell did an entire season dedicated to creating experiments – which brought me to this book. 

The Department of Physiological Hygiene Part I

The Rise of the Guinea Pigs (Part II)

The Mennonite National Anthem (Part III)

The premise of the episode was a key question – are human trials appropriate? Context is everything, but there have been a ton of circumstances where people were taken advantage of or lied to for the sake of clinical research. This makes answering this question really challenging, because as the book dives into the subjects were consciousness objectors to the war and used participating with an experiment to understand starvation as means to serve without fighting. Are willing and able volunteers forced against their will for the sake of science? 

One of the amazing things about this book was the story of each of the subjects. Why they chose a life of pacifism, their beliefs, their values, the hardships which made each subject more human. A 12 month study looking at the effects of 3 month calibration, 6 month of extreme caloric deprivation, and 3 month recovery can dehumanize its subjects. N= (sample size) can readily detract from the simple fact that humans were participating, and they have their own stories. When one pulls out for some reason, you can lose sight of their limits or personal circumstances that led to that decision. 

Something that kept coming up in my own mind is how common human trials are for S&C. It’s not like studies are devoid of challenging circumstances: maximal exertion, muscle biopsies, blood samples, saliva/urine samples are all common with S&C research. People volunteer all the time for this and there is not much of a thought around it. So why is this such a common practice for us, where the rest of the world is squeamish about it? 

One of the keys behind the volunteers was the feeling of purpose of the study. The promotion to get volunteers was centered on the tag line “Will you starve so others don’t have to?” is a powerful statement if you think about it. While your friends and family are off to war in Europe and Asia, you chose to object and not put your life at risk. You can imagine the guilt felt and what you would do to compensate for that. Which to me is the premise of the question being so difficult to understand. When research can manipulate people based on insecurity of their beliefs, is it really voluntary? 

Most of the subjects decreased their body mass 25% during the restriction phase. Average body mass of 125lbs. Each volunteer was required to restrict their eating to 50% of Basal Metabolic Rate Caloric intake (1500 calories/day) and walk over 20 miles a week. They were required to participate in various assessments such as treadmill exertion tests, blood/saliva tests, and cognitive tests on a recurring basis. 

The real point of the study was to find out what will lead to rehabilitation to normal weight most efficiently. Calories vs specific macronutrients or micronutrients were tested. What was very interesting is the struggle to rehabilitate even at 200% suggested caloric intake per day (5000 calories). Most men did not recover their baseline weight in the three months allotted. Which is another key difference between this and research for S&C, most believe they will get a positive effect when subjecting oneself to research. It was fairly obvious over time, this would be complete service to humanity to help understand the impact of extreme food deprivation. 

If you are familiar with the demonization of Cholesterol in cholesterol, you are aware of the man that put this study together – Ancel Keys. Keys was a famous medical scientist that came up with cholesterol as a risk factor for cholesterol heart disease. Keys actually created the K Ration (MRE) which was used for soldiers during World War II. His purpose for this study was to face head on the inevitable problem of starvation post WWII in Europe and Asia. Horror stories coming out with Holocaust survivors or starvation tactics in battle such as Leningrad made this critical research. Combine this with the guilt that your peers were dying, making this a very difficult experiment to leave. This is definitely not the same as a Randomized Control Study looking at one set versus multiple sets for testosterone production. 

The result was the seminal clinical research done on starvation with human subjects. Caloric Restricted Diets, Fasting, Timed Eating, Meal Frequency, Micronutrient Deficiency during weight loss, Eating Disorder Psychology has been linked directly to this study. The research design mixed with the circumstances with volunteers has made this a valuable contribution to nutritional science. The contribution these men made, even the research team that had to hold this standard, is undeniable. 

It is also a reminder that humans are participating with their own lives that matter more than any contribution their results from the study show. It is so easy to dehumanize a study we find on pubmed. We can bash the research design or methods, but we still need to acknowledge that a human came up with that study. Humans had to participate in that experiment. More than likely, that research was a whole lot of effort to prove very little. This approach to dehumanization of research can readily spill over to all of our training, we are in the people industry. Their safety and results matter. Phenomenal book, great resources, dive into this and the podcasts. Well worth your time. If you want to learn more about Ancel Keys and Cholesterol I recommend Gary Taubes Good Calories, Bad Calories.