Obituary

Abstract

Dr E.H. Ahrens Jr, always known as Pete, died at the age of 85 in New Jersey on 9 December 2000 from bladder cancer. He was one of the original pioneers of the diet-heart theory. Larry Kinsell and Ancel Keys had in the late 1940s and early 1950s proposed that the dietary intake of fat was a fundamental cause of atherosclerosis and coronary heart disease. Pete Ahrens argued that this was too simplistic and showed that the effects of fat was related to its saturation. He provided evidence from carefully conducted experiments using liquid formula fat feeds in the Rockefeller Institute in New York that different fats, such as corn oil, saff-flower oil and coconut oil lowered plasma lipid concentrations in man. Ahrens wrote in 1957 ‘recommendations for radical changes in food habits even in those most threatened by atherosclerosis, should await a clearer definition of the specific food factors which control serum lipid levels’. This view was supported by Hugh Sinclair in Oxford, who considered also that atherosclerosis might be due to an essential fatty acid deficiency. Soon, the results of some early epidemiological surveys and of a few small intervention trials in coronary patients suggested that the relationship between dietary saturated fat and coronary heart disease was firm but Ahrens wanted more evidence and in 1979 concluded in an article entitled ‘Dietary Fats and Coronary Heart disease: Unfinished Business’ that the time is not yet ripe for drawing up national guidelines and dietary recommendations for the general public. He differed, therefore, from the American Heart Association statement of 3 years later by stating that it is anything but a service to the public to postulate one dietary solution for hyperlipidaemia. Today, following Brown and Goldstein's demonstration of a receptor-mediated pathway for cholesterol homeostasis and the positive results of six very large randomised primary and secondary controlled statin trials, there is no longer any case for questioning whether reduction of LDL cholesterol is beneficial. But the accumulated evidence that restriction of dietary saturated fat alone indicates that the consequent reduction in serum cholesterol is too small to have any value in the clinical management of adults at risk. Ahrens’ views about the relative effects of different constituents of dietary fat are partly vindicated and he opposed the mantra that every patient should be ‘started on a low fat diet’. Ahrens can also be credited with pioneering use of gas–liquid chromatography in lipid research and the development of the sterol balance technique. Pete Ahrens went to Harvard, earning a bachelor's degree in history in 1937 and a medical degree in 1941. He served in the US Army Air Forces Medical Corps in WW II. He founded ‘The Journal of Lipid Research’ in 1958. He was elected to the National Academy of Sciences in 1973 and was Professor of Medicine at the Rockefeller Institute (now University) from 1960, he became emeritus in 1985. In his retirement, he wrote a definitive book ‘The Crisis in Clinical Research’ in which he argued that patient-orientated research is in jeopardy and needs far stronger support from US medical schools and the NIH. Also, in retirement he studied plant biology and he and his wife established an arboretum in the Catskill hills. Pete was an intense and focussed man. His high intelligence and erudition was a joy to his friends. His wife, Bonnie, two daughters and a son survive him.