Matts notes from the book: Ancel Keys and the biology of human starvation (The Minnesota experiment).

p. 15

“In the individual the severity of clinical edema is not by itself a reliable guide to his nutritional state. Where the complications of malaria, dysentery, anemia, and vitamin deficiencies exist, the edema appears more readily and in more extreme form.”

p. 127

In the undernutrition experiment carried out by Benedict et al. the weight increased very rapidly on the termination of the reduced diet. Six weeks later the men not only regained all the weight lost but exceeded their pre-experimental weight by 3.1 kg.”

p. 177

“During the subsequent 8 weeks there was further increase in the body fat which brought the fat content of the body in all subjects well above the pre-starvation level. Thirty-three weeks after the end of the semi-starvation period the values for body fat showed a decrease and returned to a near normal level at 58 weeks.”

p. 256

“The evidence is overwhelming that anemia develops during prolonged periods of caloric restriction, and the degree of anemia appears to be related to the extent of starvation…The anemia… is not of the iron deficiency type.”

p. 267

“A definite leucopenia developed during semi-starvation; the leucocyte count, which was 6346 per cu. Mm. of blood in the control period, dropped to 4129 at S24, a decrease of 34.9 per cent.”

p. 338

“In the Minnesota experiment the total rate of basal metabolism at the end of semi-starvation was almost 40 per cent less than in the control period.”

p. 518

“The behavior of calcium is more difficult to interpret since it tends to be excreted throughout a starvation period at a rate which may be of the order of 10 times that calculated on the basis of the body tissue lost.”

p. 545

“To test this, he reduced his own food intake by one half for 5 days and then for an additional 3 days went completely without food. The increase in his blood sugar level following glucose was much greater after the starvation period than before. Sevringhaus observed the same thing after 2 days of starvation.”

p. 578

“Along with the increased water consumption, starving persons tend to have a marked salt hunger and will consume several times the normal quota of salt if it is available.”

p. 581

“…the starving man is weak and cold, both physiologically and subjectively, and his behavior bears this out. On the other hand, his behavior is often misleading. He acts dull and insensitive; he looks and behaves as though he were unaware of or incapable of feeling many of the ordinary stimuli of sound, sight, or touch.”

p. 607

“In any list of the cardinal signs and symptoms of severe undernutrition there will be several items which pertain directly or indirectly to the heart and circulation. These include bradycardia, hypotension, a lowering of the skin temperature, and frequently vertigo and slight cyanosis.”

“Rates as low as 30 to 40 beats per minute were often observed in bed rest…”

p. 612

 Leyton found the average 4 p.m. temperature in 100 men to be 35.7 C (96.3F). 

p. 613

“In 40 persons who received subcutaneous injections of 1 mg. of adrenalin there was extraordinarily little response to the drug.”

p. 621

“Obviously, many factors may have been involved in this epidemic of hypertension in Leningrad, but the outstanding peculiarity of the period was severe semi-starvation for 6 months, followed by refeeding, with the necessity for hard work at all times.”

p. 659

“The decrease of the QRS and T wave amplitudes is probably the most remarkable change in the electrocardiogram in starvation. It may be due to the following factors:

1) Decrease of heart size. The decrease of the amplitudes was accompanied by a very marked decrease of the heart size as determined by teleroentgenograms…

2) Myocardial degeneration…

3) Rotation of the heart around a transversal axis…

4) Decreased metabolic rate…

5) Fluid accumulation in chest or pericardium…”

p. 664

“Polyuria and nocturia have been reported by practically every observer of starvation conditions.”

p. 753

“Jaworski found no changes in the vagina in starved Polish women but concluded there was considerable reduction in the size of the ovaries.”

p. 777

“The official daily ration in the Auschwitz concentration camp was one liter of watery soup, 250 gm. of bread, and about 25 gm. of margarine or sausage or imitation honey, providing an estimated maximum intake of 1000 cal. per day.”

p. 827-828

“The subjects reported that their nails grew more slowly and that their hair was falling out in large amounts. Shaving was necessary less frequently. The men noted, particularly in shaving, that cuts and wounds bled less than normally and were slower to heal. Physical ability to laugh heartily, sneeze, or blush was reduced or absent during the later stages of semi-starvation. Muscle cramps and particularly muscle soreness were frequently reported. The jarring of knee joints, especially when walking on hard pavements, was an annoyance to some. Pigmentation, thinning, and roughening of the skin occurred. Changes in the sensitivity of the skin, paresthetic and hypesthetic in character, were observed in only three cases, but there were many complaints that the extremities ‘went to sleep.’

Tolerance to heat was increased; for example, subjects could hold hot plates without discomfort. They asked that their food, coffee, and tea be served unusually hot.  Standard measurements of hearing showed a slight but consistent increase in auditory acuity during the period of semi-starvation. . Sensations of ringing in the head were reported. 

During rehabilitation the recovery from dizziness, apathy, and lethargy was most rapid. Tiredness, loss of sex drive, and weakness were slow to improve. Although visible edema tended to disappear, in some men there was little change or even an increase in edema. Cramps, vague aches and pains, and paresthesias were unrelieved from some time. Some of the men had new complaints such as flatus, distention, belching, and stomach-ache. Those subjects who gained the most weight became concerned about their increasing sluggishness, general flabbiness, and the tendency of fat to accumulate in the abdomen and buttocks. At the end of 3 months of rehabilitation, even in those subjects who were maintained on the highest caloric intake the over-all physical condition was considerably inferior to the pre-starvation status.Later reports from the subjects indicated that it was not until after an additional 3 months of ‘normal’ living and supernormal eating that their physical capacity approached pre-experimental levels.”

p. 836-837

Their earlier active interest in having a voice in the making of policies and rules for the conduct of the non-scientific aspects of the experiment dwindled. They spent more and more time alone.”

p. 846

“During… (R13), of 17 men who made a reference to food cravings, 7 had no specific cravings. The remaining 10 men had a predilection, in about equal proportion, for sweets (ice cream and pastries) and dairy products.”

p. 1003

“There is reason to believe that the epithelial lining of the gastrointestinal tract becomes more permeable to microorganisms in severe undernutrition. The morphological changes in the intestinal tract would strongly suggest this.”

p. 1041

“There is a fundamental connection between obesity and diabetes. Kisch found that 50 per cent of all the obese persons he examined exhibited some degree of glycosuria.”