WEBVTT - The Basement Tapes 0:00:15.356 --> 0:00:25.156 Pushkin right out of the blue. 0:00:24.796 --> 0:00:27.036 Out of the blue, and what does he say? 0:00:27.796 --> 0:00:32.276 He says, doctor Franz, I've heard the possibility that there 0:00:32.356 --> 0:00:36.516 might be some very interesting data in your father's basement. 0:00:37.596 --> 0:00:40.636 I'm talking to Robert Frantz, a cardiologist at the Mayo 0:00:40.676 --> 0:00:43.996 Clinic in Rochester, Minnesota, about a phone call he'd got 0:00:44.116 --> 0:00:47.516 not long ago from a man named Chris Ramsden. He 0:00:47.596 --> 0:00:50.196 had a question for Robert Frantz about his father. 0:00:50.756 --> 0:00:54.156 My parents lived in the same house for over fifty years, 0:00:54.356 --> 0:00:58.836 and essentially my father passed and then my mother was 0:00:58.836 --> 0:00:59.996 living and assisted living. 0:01:00.556 --> 0:01:03.516 The house was empty. The family hadn't gotten around to 0:01:03.596 --> 0:01:04.156 selling it. 0:01:04.316 --> 0:01:06.836 So we just sort of left it. Nobody was necessarily 0:01:06.876 --> 0:01:09.476 living in it, but it was there. And so when 0:01:09.556 --> 0:01:12.916 Chris said there might be something in the basement of interest. 0:01:13.276 --> 0:01:16.356 I feel like every great Midwestern detective story begins with 0:01:16.436 --> 0:01:19.996 the line there might be something in the basement of interest. 0:01:20.956 --> 0:01:25.396 I had some concern because the joke in our family 0:01:25.556 --> 0:01:27.916 was that if we ever need to sell that house, 0:01:28.556 --> 0:01:30.676 we should just call the Air Force and call in 0:01:30.756 --> 0:01:35.596 a n apalm strike. There were files that had every 0:01:35.636 --> 0:01:39.836 paper that my father had ever published, and every PhD 0:01:39.996 --> 0:01:42.916 thesis that he'd ever reviewed. And he was also an 0:01:42.956 --> 0:01:46.436 amateur radio operator and he built his own radios. He 0:01:46.476 --> 0:01:50.396 handwound his own coils and built his own receivers, and 0:01:50.476 --> 0:01:54.716 so there's all this radio stuff down there. So there 0:01:54.756 --> 0:01:56.396 was a lot of stuff in that basement. 0:01:56.556 --> 0:02:03.516 When Chris called, my name is Malcolm Gladwell. You're listening 0:02:03.596 --> 0:02:07.996 to Revisionist History, my podcast about things overlooked and misunderstood. 0:02:14.396 --> 0:02:17.996 This episode is the final episode of the season, season two. 0:02:19.076 --> 0:02:22.676 It's a medical mystery, a detective story about a long 0:02:22.796 --> 0:02:28.196 forgotten scientific study, a study with a crucial clue. I 0:02:28.276 --> 0:02:31.316 left this episode to the last for a reason because 0:02:31.356 --> 0:02:34.316 it is also, in many ways, the most personal of 0:02:34.316 --> 0:02:37.436 this year's stories. And it was Robert Franz who got 0:02:37.436 --> 0:02:50.556 me thinking about all this. I didn't meet Robert Franz 0:02:50.556 --> 0:02:53.116 in person. I was just calling him to clarify a 0:02:53.156 --> 0:02:55.876 few questions from another story I was working on. The 0:02:55.956 --> 0:02:59.556 previous episode, in fact, the one about French Fries. It 0:02:59.596 --> 0:03:01.716 wasn't worth flying all the way to Minnesota for this 0:03:01.796 --> 0:03:04.916 one interview. I thought I was at my parents' home 0:03:04.956 --> 0:03:08.476 in Canada and preoccupied. I actually conducted the interview with 0:03:08.516 --> 0:03:11.436 France in my rental car on my cell phone with 0:03:11.476 --> 0:03:14.396 my little tape recorder on the dashboard, with someone in 0:03:14.436 --> 0:03:18.796 Minnesota recording Robert France's end of the conversation. But now 0:03:18.916 --> 0:03:21.876 I wish I'd met him face to face, because I 0:03:21.916 --> 0:03:24.076 found what he had to say about the obligation of 0:03:24.116 --> 0:03:28.236 a son to his father to be unexpectedly beautiful. How 0:03:28.236 --> 0:03:30.356 hard was it for you to find what he was 0:03:30.396 --> 0:03:30.956 looking for? 0:03:31.316 --> 0:03:35.076 Well, their home is about ninety miles from where I 0:03:35.116 --> 0:03:38.036 live down here in Rochester at the mail clinic, And 0:03:38.076 --> 0:03:39.996 so what I did is I would drive up there 0:03:40.316 --> 0:03:43.636 after work and spend a couple hours in the evening 0:03:44.116 --> 0:03:47.596 looking around and going through files. And I did that 0:03:48.036 --> 0:03:51.596 three or four times before I actually found the files 0:03:51.636 --> 0:03:55.116 that were of interest. And on that third or fourth time, 0:03:55.196 --> 0:03:57.596 I really came to truly one of the back corners 0:03:57.636 --> 0:04:01.196 of the basement, and there was a moldering, old cardboard 0:04:01.316 --> 0:04:05.436 box there that I opened up, and I just immediately 0:04:05.476 --> 0:04:08.916 thought to myself, Eureka, I have found. 0:04:08.716 --> 0:04:16.516 It Robert Franz's father. The man who left the box 0:04:16.556 --> 0:04:20.316 in the basement was Ivan Franz Junior, born in Smithville, 0:04:20.356 --> 0:04:24.236 West Virginia, in nineteen sixteen. He was slender and upright, 0:04:24.516 --> 0:04:26.956 with a magnificent head of hair, which he kept all 0:04:26.996 --> 0:04:32.236 his life. He flew planes, tinkered with radios, played the clarinet. 0:04:32.636 --> 0:04:35.236 He wrote his scientific paper's long hand, sitting at the 0:04:35.236 --> 0:04:40.076 dining room table in immaculate handwriting on yellow legal pads, pencil, eraser, 0:04:40.196 --> 0:04:45.516 pencil sharpener, all just so he was precise, punctual. Neither 0:04:45.556 --> 0:04:47.796 of his parents had finished high school. He ended up 0:04:47.796 --> 0:04:50.556 getting a degree from Harvard Medical School and then taught 0:04:50.596 --> 0:04:54.996 for thirty four years at the University of Minnesota. Ivan 0:04:55.036 --> 0:04:58.716 France was one of those unstoppable smart kids from the provinces. 0:05:00.436 --> 0:05:03.476 Not long before his death, Ivan Franz was interviewed for 0:05:03.556 --> 0:05:04.756 the university's archives. 0:05:05.996 --> 0:05:09.076 I made the final decision to go to medical school 0:05:10.756 --> 0:05:12.756 when I was a freshman in high school. 0:05:14.916 --> 0:05:16.276 That's a story I'd like to hear. 0:05:16.996 --> 0:05:18.756 And how did I decide to do that? 0:05:19.316 --> 0:05:19.636 Well. 0:05:19.756 --> 0:05:25.076 I noticed how my parents felt about people, and the 0:05:25.116 --> 0:05:28.236 only people that I could see that they really respected 0:05:29.196 --> 0:05:34.556 were the Baptist preacher and the physician that took care 0:05:34.596 --> 0:05:37.876 of them. I knew I would never make it as 0:05:37.876 --> 0:05:38.716 a preacher. 0:05:40.476 --> 0:05:42.316 I'd run this whole interview if I could. 0:05:42.596 --> 0:05:45.796 I had another decision at that point too, that I 0:05:45.956 --> 0:05:48.916 was offered a chance to play in a band in 0:05:49.036 --> 0:05:56.956 a cruise ship going between New York and Livermore, and 0:05:57.036 --> 0:06:00.596 at the same time the chemistry department asked me to 0:06:00.956 --> 0:06:06.076 do a little research project in the summer, saying, there again, 0:06:06.196 --> 0:06:10.916 I made the wrong decision with the counsels department. 0:06:11.036 --> 0:06:13.516 I see you never got to play the clarinet then 0:06:13.636 --> 0:06:16.516 for rich people on the luxury ship. 0:06:16.796 --> 0:06:23.676 No, what a loss to music. Yeah. 0:06:23.796 --> 0:06:26.716 Ivan France did not end up on cruise ships. He 0:06:26.836 --> 0:06:29.596 chose instead to devote his life to studying heart disease, 0:06:30.236 --> 0:06:34.156 specifically to understanding the role of cholesterol and blood lipids 0:06:34.196 --> 0:06:38.196 in heart attacks. He took his research seriously. Robert Franz 0:06:38.236 --> 0:06:41.116 says that his father raised his five boys according to 0:06:41.196 --> 0:06:43.396 the best practices of nutritional science. 0:06:43.716 --> 0:06:46.556 My dad would occasionally come home and say, hey, let's 0:06:46.556 --> 0:06:49.036 look at the lipids and the family and we'd line 0:06:49.116 --> 0:06:52.036 up and my mom would draw our blood because she 0:06:52.156 --> 0:06:54.036 felt she was better at it than my father, and 0:06:54.076 --> 0:06:56.036 he'd bring it down to the lab and look at 0:06:56.036 --> 0:06:57.076 our lipid profiles. 0:06:57.676 --> 0:07:00.476 You don't remember your lipid profile, do you, Well. 0:07:00.356 --> 0:07:03.236 They're always pretty good, you know, because I think from 0:07:03.436 --> 0:07:08.196 an early stage, my family tended to eat a low 0:07:08.316 --> 0:07:12.756 saturated fa diet. I remember a day when my dad 0:07:12.796 --> 0:07:17.836 brought back a piece of something that was the first 0:07:18.036 --> 0:07:22.236 efforts at making something like supposed to taste like steak 0:07:22.316 --> 0:07:25.956 or hamburg er, but was actually had no meat in it. 0:07:26.516 --> 0:07:30.356 And so these early efforts were foisted upon us, and 0:07:30.476 --> 0:07:33.156 we did our best to help my father to understand 0:07:33.156 --> 0:07:35.396 that making something it tastes like meat that isn't meat 0:07:35.476 --> 0:07:36.876 is not going to be an easy thing to do. 0:07:37.476 --> 0:07:39.276 You were his guinea pigs, well, in a. 0:07:39.196 --> 0:07:41.916 Way, we were, and I think it's true that he 0:07:41.916 --> 0:07:44.876 would have these ideas about things and say, well, let's 0:07:44.876 --> 0:07:46.996 try this. It's not really meat, but it's supposed to 0:07:47.076 --> 0:07:49.716 taste like meat, and maybe this is a way we 0:07:49.756 --> 0:07:52.756 can try to reduce our saturated fat intake. 0:07:53.036 --> 0:07:55.596 Yeah, did he weigh in on He sounds like he 0:07:55.676 --> 0:07:57.756 must have weighed in on what the family should be eating. 0:07:58.516 --> 0:08:01.196 We basically ate a lot of vegetables, you know, like 0:08:01.356 --> 0:08:04.316 lightly steamed broccoli with some lemon and pepper on it 0:08:04.436 --> 0:08:06.916 or something, and maybe a little bit of margarine. 0:08:11.756 --> 0:08:15.156 In the nineteen sixties, Robert's father decided he'd gone as 0:08:15.156 --> 0:08:17.716 far as he could in answering technical questions about the 0:08:17.756 --> 0:08:19.996 way in which Gleustro was sit theesized by the body. 0:08:20.676 --> 0:08:24.836 He wanted to do something more practical or useful, so 0:08:24.876 --> 0:08:26.636 he ran an idea by the head of the Heart 0:08:26.676 --> 0:08:28.756 Institute at the National Institutes of Health. 0:08:29.716 --> 0:08:34.756 This guy that wasn't ahead of that down there used 0:08:34.796 --> 0:08:37.396 to come up and visit me once in a while 0:08:37.476 --> 0:08:40.316 to see if I was doing what I was supposed 0:08:40.316 --> 0:08:45.676 to do with NIH. My he he wanted to play chess, 0:08:45.716 --> 0:08:47.836 so every time he would come up here, we'd have 0:08:47.876 --> 0:08:52.076 to get together in the evening and play chess fair enough. 0:08:54.196 --> 0:08:57.196 So I was starting to become a common old boys network, 0:08:57.276 --> 0:09:00.836 and I told him that I thought that that was 0:09:00.876 --> 0:09:05.476 something that the NIH should do, was to organize a 0:09:05.516 --> 0:09:09.476 big study in the general population to find out if 0:09:09.516 --> 0:09:14.316 there really was a relationship between diet, cholesterol and hard disease. 0:09:18.476 --> 0:09:21.116 Let's take a step backwards for a moment, because you 0:09:21.156 --> 0:09:24.676 can't understand the importance of what France was suggesting and 0:09:24.716 --> 0:09:28.116 why the basement tapes would ultimately matter so much until 0:09:28.116 --> 0:09:31.916 you understand how scientists usually study diet. There are lots 0:09:31.916 --> 0:09:34.596 of ways to analyze the effect that diet has on health. 0:09:35.276 --> 0:09:39.156 You can do an observational study, for example, identify tens 0:09:39.156 --> 0:09:41.956 of thousands of people, have them fill out a questionnaire 0:09:41.956 --> 0:09:44.876 on their diet at regular intervals over many years. Then 0:09:44.956 --> 0:09:47.356 keep track of when they die and what they die of, 0:09:47.556 --> 0:09:51.236 and look for patterns. That's what an epidemiological study is. 0:09:52.316 --> 0:09:54.636 France had a colleague at the University of Minnesota named 0:09:54.676 --> 0:09:58.956 Ansel Keys who conducted maybe the most famous epidemiological study 0:09:58.956 --> 0:10:02.036 of diet and health in history. For twenty five years. 0:10:02.156 --> 0:10:05.716 Keys collected data on about twelve thousand middle aged men 0:10:05.956 --> 0:10:11.116 in Italy, Greece, Yugoslavia, Finland, the Japan and the United States, 0:10:11.676 --> 0:10:14.196 and he came to the conclusion that the people eating 0:10:14.236 --> 0:10:17.916 what he called a Mediterranean diet lots of fish, vegetables, 0:10:17.956 --> 0:10:21.516 olive oil, and very little saturated fat, those people had 0:10:21.556 --> 0:10:30.116 the fewest heart attacks. Keys was massively influential. The problem 0:10:30.196 --> 0:10:34.916 is epidemiological studies are really tricky. For example, in France, 0:10:34.956 --> 0:10:37.396 people eat lots of butter and cheese and things cooked 0:10:37.396 --> 0:10:40.396 in fat, yet they have really low rates of heart disease. 0:10:41.316 --> 0:10:44.676 France was not included in the seven country study. Would 0:10:44.716 --> 0:10:47.756 Ansel Keys's results have been different? If he'd added France 0:10:47.956 --> 0:10:51.996 and done an eight country study. With epidemiological studies, you 0:10:52.036 --> 0:10:54.956 can get in real trouble if you pick the wrong populations. 0:10:55.676 --> 0:10:57.876 And how does Keys know that it's all the olive 0:10:57.876 --> 0:11:00.836 oil and fish and vegetables of the Mediterranean diet that 0:11:00.916 --> 0:11:04.556 make people from those places live so long. He's noticed 0:11:04.596 --> 0:11:08.476 an association between that diet and good health, but an 0:11:08.476 --> 0:11:14.236 epidemial logical study can't prove causation. Many years later, another 0:11:14.276 --> 0:11:17.916 researcher went back and reanalyzed Keys data and showed that 0:11:17.956 --> 0:11:21.196 people's consumption of sugar was a much better predictor of 0:11:21.236 --> 0:11:25.436 their health than their consumption of saturated fat. The only 0:11:25.476 --> 0:11:29.916 way around these problems is to do a controlled clinical trial, 0:11:30.316 --> 0:11:32.676 a study where you gather together two large groups of 0:11:32.716 --> 0:11:35.796 people who you think are identical on every variable you 0:11:35.836 --> 0:11:40.436 can imagine, age, weight, lifestyle, social class. Have one group 0:11:40.476 --> 0:11:43.076 eat their normal diet and have the other eat something 0:11:43.116 --> 0:11:45.836 you think is way healthier, and then follow them for 0:11:45.956 --> 0:11:51.036 years and see what happens. That's what Ivan Frantz suggests 0:11:51.076 --> 0:11:54.636 to his friend from the National Institutes of Health, and. 0:11:54.596 --> 0:11:57.476 He said, well, that's very interesting, because I have a 0:11:57.636 --> 0:12:01.076 summer message from a couple of other people who will 0:12:01.116 --> 0:12:01.796 just do that. 0:12:02.676 --> 0:12:06.436 The result was the National Diet Heart Study, a massive 0:12:06.556 --> 0:12:10.316 undertaking starting in the early nineteen sixties one hundred thousand 0:12:10.316 --> 0:12:17.116 people Baltimore, Boston, Chicago, Oakland, and eventually Minnesota. France faced 0:12:17.116 --> 0:12:21.356 a challenge, though even clinical trials are not perfect, because 0:12:21.396 --> 0:12:23.276 how can you be sure that the group chosen to 0:12:23.276 --> 0:12:26.116 eat the normal diet doesn't start to eat healthier on 0:12:26.156 --> 0:12:28.996 their own overtime, or that the people chosen to eat 0:12:29.036 --> 0:12:32.036 healthy keep to their diet. How do you know they 0:12:32.076 --> 0:12:35.836 aren't sneaking big slices of chocolate cake every night. So 0:12:36.316 --> 0:12:39.396 alone among the participants in the National Diet Heart Study, 0:12:39.756 --> 0:12:43.996 Ivan France goes one step further because he's mister meticulous. 0:12:44.276 --> 0:12:47.836 He says, for my portion of the study in Minnesota, 0:12:47.996 --> 0:12:50.436 I'm going to use people who are living in an institution, 0:12:51.116 --> 0:12:53.156 so I know exactly what they're eating. 0:12:53.556 --> 0:12:57.036 Well, what I finally decided though, on was the school 0:12:57.156 --> 0:13:03.276 for people with low IQs down Ferrebou. Yes. So everybody 0:13:03.276 --> 0:13:06.436 else wanted to do it in the open population, and 0:13:06.516 --> 0:13:09.316 I said, well, you get a lot better control it 0:13:09.356 --> 0:13:12.756 in the close population. And so what they finally did 0:13:12.956 --> 0:13:14.916 was let me do it the way I wanted to, 0:13:15.116 --> 0:13:18.836 and the other five people do it in the open population. 0:13:19.676 --> 0:13:22.516 The patients in France's study would go for their meals 0:13:22.516 --> 0:13:25.756 in the cafeteria and get one of two trays. They'd 0:13:25.756 --> 0:13:28.836 look completely identical, so nobody knew what side of the 0:13:28.916 --> 0:13:32.116 experiment they were on. The term researchers used for that 0:13:32.316 --> 0:13:35.596 is double blind. But one tray was food cooked with 0:13:35.716 --> 0:13:38.996 vegetable oil and everything low fat. The other had everything 0:13:38.996 --> 0:13:42.396 cooked in saturated fat. Once I got butter, once I 0:13:42.516 --> 0:13:46.436 got margarine, And even that little detail France made perfect. 0:13:46.836 --> 0:13:50.756 At that time, there was a law in Minnesota that 0:13:51.236 --> 0:13:56.276 margarine had to be cut in triangles. I remember that. 0:13:56.556 --> 0:13:59.476 Remember that, sure so would look as good as the 0:13:59.956 --> 0:14:04.116 little butter. That was a big problem for me in 0:14:04.236 --> 0:14:09.076 my institutional study because that would have racked my double 0:14:09.676 --> 0:14:15.636 Aha and so funny you think I did about that? 0:14:15.716 --> 0:14:18.476 Yeah, we're a bright fellow. 0:14:18.516 --> 0:14:21.916 What did you do? I got a little wall pass 0:14:22.196 --> 0:14:30.516 the legislature. Let me cut my margins from the squares. 0:14:33.756 --> 0:14:35.956 Like I said, mystery meticulous. 0:14:37.316 --> 0:14:40.636 This was a beautiful organized study. There was lots of 0:14:40.676 --> 0:14:45.756 money and nothing. No holes were barre to try to 0:14:45.796 --> 0:14:46.836 do a good job. 0:14:47.796 --> 0:14:50.596 The Minnesota portion of the heart study took years to 0:14:50.636 --> 0:14:55.116 set up. It involved six different mental hospitals around Minnesota 0:14:55.156 --> 0:14:57.596 and one nursing home for a total of more than 0:14:57.716 --> 0:15:01.796 nine thousand research subjects. It ran for five years from 0:15:01.916 --> 0:15:04.916 nineteen sixty eight to nineteen seventy three, with a long 0:15:05.076 --> 0:15:08.316 follow up period. To this day, it stands as one 0:15:08.356 --> 0:15:11.396 of the most rigorous diet trials ever conducted. 0:15:12.276 --> 0:15:16.356 The different state hospitals where this project was conducted were 0:15:16.396 --> 0:15:20.196 scattered around Minnesota, and so my father would he actually 0:15:20.196 --> 0:15:24.116 had a small airplane, was a private pilot, and would 0:15:24.156 --> 0:15:27.396 this puddle jump around from one little place to another, 0:15:28.196 --> 0:15:33.076 troubleshooting these issues. It consumed his life and he sort 0:15:33.116 --> 0:15:35.756 of rarely took vacation and was always working on something, 0:15:35.796 --> 0:15:38.196 and it was just that what he wanted to do. 0:15:38.276 --> 0:15:43.156 Really, So what does the Minnesota study show, Well, that 0:15:43.356 --> 0:15:46.276 was the problem. The patients on the vegetable oil diet 0:15:46.396 --> 0:15:48.716 did end up with lower cholesterol than the people who 0:15:48.876 --> 0:15:52.356 ate food cooked with animal fats. That part worked according 0:15:52.396 --> 0:15:56.796 to expectation, but the vegetable oil people didn't live longer, 0:15:57.116 --> 0:15:59.556 which made no sense. They were eating the kind of 0:15:59.596 --> 0:16:03.796 diet everyone believed should help you live longer. Ivan France 0:16:03.876 --> 0:16:06.316 brought in a graduate student named Steve Brosty to help 0:16:06.356 --> 0:16:10.276 crunch the data. Brosty remembers everyone just be baffled. 0:16:10.116 --> 0:16:12.996 And they were hoping that with some new statistical techniques 0:16:13.076 --> 0:16:15.956 that had just come out, that they might be able 0:16:15.996 --> 0:16:19.516 to either understand why the results came out the way 0:16:19.556 --> 0:16:24.756 they did, or perhaps after some adjustments for various explanatory factors, 0:16:24.796 --> 0:16:27.156 that maybe the results would change. 0:16:27.636 --> 0:16:31.596 The results didn't change. When Brosty talked to Ivan Franz, 0:16:32.036 --> 0:16:33.196 France just shook his head. 0:16:33.836 --> 0:16:39.756 I remember him just expressing his bewilderment at how this 0:16:39.836 --> 0:16:41.316 could possibly have happened. 0:16:45.716 --> 0:16:48.636 Brosty wrote up his results for his master's thesis, but 0:16:48.716 --> 0:16:52.716 he never published it. In nineteen eighty nine, fifteen years 0:16:52.756 --> 0:16:57.356 after the Minnesota experiment ended, Ivan France finally published his results, 0:16:57.876 --> 0:17:00.796 but the paper was vague and didn't really go into detail, 0:17:01.116 --> 0:17:03.756 as if after thinking it over for fifteen years, he 0:17:03.836 --> 0:17:06.676 still couldn't make sense of what happened. This was a 0:17:06.676 --> 0:17:10.116 man who never ate butter who regularly checked the lipid 0:17:10.196 --> 0:17:13.396 levels of his children's blood. This was what he believed. 0:17:13.436 --> 0:17:17.276 In to test that belief, he spent years and millions 0:17:17.316 --> 0:17:21.436 of dollars designing the perfect clinical trial, perfect one step 0:17:21.476 --> 0:17:25.716 beyond everyone else in the National Diet Heart Study. And 0:17:25.796 --> 0:17:30.596 after all that the results were equivocal, he put a 0:17:30.636 --> 0:17:33.036 box full of all of his old data in his basement. 0:17:33.156 --> 0:17:36.156 Because he didn't believe in throwing anything out. He retired. 0:17:36.556 --> 0:17:39.236 He died in two thousand and nine, and his study 0:17:39.316 --> 0:17:43.476 was all but forgotten for a quarter century until Ivan 0:17:43.516 --> 0:17:46.276 Franz's son Robert, got a call out of the blue 0:17:46.676 --> 0:17:47.836 from Christopher Ramsden. 0:17:48.156 --> 0:17:51.316 It's pretty fun to try and track down missing data, 0:17:51.516 --> 0:17:53.276 so one clue led to another. 0:17:53.956 --> 0:17:57.236 Christopher Ramsden is a researcher at the National Institutes of Health. 0:17:57.756 --> 0:18:00.316 For seven years, he served as a Lieutenant commander in 0:18:00.316 --> 0:18:03.596 the Commissioned Corps of the US Public Health Service. He 0:18:03.716 --> 0:18:06.116 comes to the field of diet research from a different 0:18:06.156 --> 0:18:10.076 perspective than the majority of his peers. Ivan Frantz or 0:18:10.196 --> 0:18:13.676 Enseil Keys were interested in the effects of saturated fats. 0:18:14.156 --> 0:18:16.556 If you eat lots of butter, what happens to you? 0:18:17.316 --> 0:18:19.756 Ramsden is interested in the effects of the thing we 0:18:19.796 --> 0:18:24.476 are replacing butter with vegetable oils corn oil, sunflower oil, 0:18:24.636 --> 0:18:29.396 grape seed oil, canola oil, margarine. These are probably unsaturated fats, 0:18:29.716 --> 0:18:32.396 and they're all rich in something called linolaic acid. 0:18:32.796 --> 0:18:36.636 So for perspective, if you were to eat corn, you know, 0:18:36.756 --> 0:18:40.476 corn is about one percent of it by weight is fat, 0:18:41.316 --> 0:18:44.516 Whereas if you eat corn oil, it's one hundred percent 0:18:44.556 --> 0:18:47.756 of fat, and about fifty five to sixty percent of 0:18:47.796 --> 0:18:52.116 that is one compound linelaic acid. So I kind of 0:18:52.196 --> 0:18:55.556 view things like corn oil as kind of a cross 0:18:55.596 --> 0:18:57.636 between a food and a dietary supplement. 0:18:58.396 --> 0:19:02.036 Human beings need at least some linelaic acid for nutritional purposes, 0:19:02.556 --> 0:19:05.236 but in our attempt to keep our hearts healthier, we've 0:19:05.356 --> 0:19:10.236 essentially started to put vegetable oils in everything. Ramsen estimates 0:19:10.316 --> 0:19:12.716 that up until one hundred years ago, human beings would 0:19:12.756 --> 0:19:15.156 have gotten roughly two to three percent of their calories 0:19:15.156 --> 0:19:19.276 from linelaic acid. Now we're eating three, four, even five 0:19:19.356 --> 0:19:22.836 times that much. And the thing about linelaic acid is 0:19:23.196 --> 0:19:26.716 it's not benign. It builds up in certain tissues, it 0:19:26.756 --> 0:19:29.476 may play a role in inflammation. So what does it 0:19:29.556 --> 0:19:32.756 mean that we've suddenly decided to consume large quantities of 0:19:32.796 --> 0:19:34.116 something so problematic? 0:19:34.756 --> 0:19:37.636 Yeah, I think it's fair to say we're performing sort 0:19:37.676 --> 0:19:39.716 of an uncontrolled human experiment. 0:19:40.476 --> 0:19:42.836 Ramsen wanted some way to compare the health of people 0:19:42.876 --> 0:19:45.916 who eat lots of linelaic acid with people who eat 0:19:45.956 --> 0:19:49.716 a traditional diet of almost no linelaic acid. But what 0:19:49.876 --> 0:19:52.476 was he going to do? Somehow convinced the government to 0:19:52.476 --> 0:19:54.876 give him hundreds of millions of dollars for the study 0:19:55.316 --> 0:19:57.996 and then find thousands of people willing to turn their 0:19:58.036 --> 0:20:02.876 diets upside down. Then he realizes, wait, those studies have 0:20:02.996 --> 0:20:06.036 already been done. In all of the mountains of data 0:20:06.076 --> 0:20:09.316 collected half a century ago in the name of studying cholesterol, 0:20:09.636 --> 0:20:12.076 there should be an answer to the linelaic acid question. 0:20:13.476 --> 0:20:17.316 Ramsden first comes across something called the Sydney Diet Heart Study, 0:20:17.716 --> 0:20:20.276 the Australian counterpart to the big heart studies that were 0:20:20.276 --> 0:20:21.996 going on in the United States at the same time. 0:20:22.996 --> 0:20:25.876 He needs the raw data, but the studies main authors 0:20:25.916 --> 0:20:29.596 are long dead. One of the research assistants on the project, though, 0:20:29.836 --> 0:20:33.556 is still alive. Ramsen tracks him down. I think you 0:20:33.596 --> 0:20:34.476 know what happens next. 0:20:39.516 --> 0:20:42.756 So these data were actually in the house, I believe 0:20:42.836 --> 0:20:46.956 in the attic of influencing Lelar Thapen, who was a 0:20:47.396 --> 0:20:49.916 research assistant at the time of the study, who went 0:20:49.956 --> 0:20:53.796 on to have a prominent career and got his PhD 0:20:53.876 --> 0:20:56.636 and luckily had the foresight to hold on to this 0:20:56.796 --> 0:20:59.996 nine track magnetic tape. 0:21:00.676 --> 0:21:03.716 The attic tapes are exactly what Ramsden is looking for, 0:21:04.356 --> 0:21:07.516 but the Sydney study is small, four hundred and fifty 0:21:07.556 --> 0:21:10.436 eight people, all middle aged men, and it wasn't done 0:21:10.436 --> 0:21:14.996 in a controlled environment. That's when Ramsden calls Robert Franz 0:21:15.236 --> 0:21:17.876 and asks him to go rooting through his father's files 0:21:18.316 --> 0:21:21.756 to get his hands on the Minnesota experiment, the mother 0:21:21.836 --> 0:21:22.876 of all diet studies. 0:21:23.356 --> 0:21:26.116 You know, at a certain point universities make a decision 0:21:26.156 --> 0:21:29.316 to throw things out that they think are just taking 0:21:29.396 --> 0:21:32.076 up space and nobody's going to do anything with them anymore, 0:21:32.236 --> 0:21:35.476 and what's the value in preserving all these old things? 0:21:35.556 --> 0:21:39.756 And so it turns out that my father felt that 0:21:39.916 --> 0:21:42.316 was just a huge mistake, that why would you ever 0:21:42.396 --> 0:21:44.996 throw away the raw data? 0:21:45.276 --> 0:21:48.956 And sure enough, there they were on magnetic tapes in 0:21:49.036 --> 0:21:52.036 a moldering box in the back of the France basement. 0:21:56.396 --> 0:21:58.956 Chris must have been sharing with you the results that 0:21:59.116 --> 0:22:01.996 they were doing the work. How actively he engaged with you? 0:22:02.156 --> 0:22:03.956 Was he when he was working through the data? 0:22:04.036 --> 0:22:06.676 Well, when they started getting to a point where they 0:22:06.676 --> 0:22:12.636 had kind of dug this analysis of the people who 0:22:12.676 --> 0:22:15.716 had been on the diet for more than a year 0:22:15.916 --> 0:22:20.036 and who were over sixty five, which was then showing 0:22:20.076 --> 0:22:23.716 a trend towards this finding that the more their cholesterol 0:22:23.836 --> 0:22:27.236 was lowered, the higher the risk of an adverse outcome. 0:22:27.956 --> 0:22:31.716 Adverse outcome the great medical euphemism for death. 0:22:32.636 --> 0:22:35.556 Then he called me up and says, Bob, this is 0:22:35.596 --> 0:22:40.996 a little controversial, perhaps because it's suggesting that there might 0:22:41.036 --> 0:22:44.596 actually be an adverse effect in some of these people 0:22:44.836 --> 0:22:45.916 of this diet. 0:22:46.796 --> 0:22:49.956 With the basement tapes, Ramsden could now drill down into 0:22:49.956 --> 0:22:52.836 the specifics of the trial, and what he found was 0:22:52.876 --> 0:22:56.316 that people over sixty five, the most vulnerable people in 0:22:56.356 --> 0:22:59.596 the experiment, were dying faster if they ate a so 0:22:59.756 --> 0:23:03.796 called healthy diet. The reanalysis of the Sydney trial, by 0:23:03.836 --> 0:23:08.476 the way, reached the same conclusion vegetable oil lowers your cholesterol, 0:23:08.516 --> 0:23:10.516 which is, of course it's a good thing. But now 0:23:10.596 --> 0:23:13.276 Ramsden had two bits of evidence showing that all that 0:23:13.356 --> 0:23:17.596 extra linelaic acid seemed to be doing something else, something 0:23:17.596 --> 0:23:20.356 that more than canceled out all the other benefits of 0:23:20.396 --> 0:23:27.516 vegetable oil. If you listened to the previous episode of 0:23:27.516 --> 0:23:31.316 revisionist History, you heard me complaining about how McDonald's ruined 0:23:31.316 --> 0:23:34.036 French fries. They used to cook them in animal fat 0:23:34.276 --> 0:23:37.356 and they were divine, but then in nineteen ninety they 0:23:37.396 --> 0:23:40.116 switched to frying them in vegetable oils, and that's why 0:23:40.116 --> 0:23:43.156 they now taste like cardboard. We had to give up 0:23:43.196 --> 0:23:45.996 on one of the most delicious foods ever because we 0:23:45.996 --> 0:23:49.996 were told it was better for us. Healthier saturated fats 0:23:50.076 --> 0:23:52.836 were bad. Look in your kitchen. Look at how much 0:23:52.916 --> 0:23:55.796 vegetable oil you have in your cupboard. Your ancestors did 0:23:55.836 --> 0:23:59.116 not have big bottles of corn oil lying around. But 0:23:59.196 --> 0:24:02.676 now Ramsden comes along and says, wait a minute, the 0:24:02.716 --> 0:24:05.916 basement tape suggests that stuff is not so healthy after all. 0:24:06.596 --> 0:24:12.836 Linilaic acid might be a real problem. Let me just 0:24:12.916 --> 0:24:15.956 read to you from the conclusion of Ramsden's research article 0:24:15.996 --> 0:24:19.076 on the Minnesota study. It's in the British Medical Journal. 0:24:19.636 --> 0:24:22.596 And remember that this is a super cautious scientist speaking 0:24:23.116 --> 0:24:26.156 in the final paragraphs of a peer reviewed research paper 0:24:26.236 --> 0:24:29.796 that was probably rewritten and rewritten ten times to tone 0:24:29.836 --> 0:24:34.916 it down as much as possible. It concludes available evidence 0:24:34.916 --> 0:24:39.756