Different Paradigms and Communication Breakdown
Where are the points of difference between Stellenbosch University (SU) and Dr Tim Noakes (TN)?
SU Believes Diets Should be Measured by Calories:
SU believes that the body uses calories efficiently. So dietary calories measure intake and metabolism measures energy use and if they balance there is no weight gain. This assumes the body works like an oven. It's a brainless and non-biochemical model. They claim to test that when consuming the same calories, there was any difference between the balanced diet and a low-carbohydrate diet. According to their own theory there can be none. And that's exactly what they claim to have found. Is that a surprise? This is just playing with words, a definition game, it's not science.
It's easy to show that the efficient calorie theory is a nonsense. In the Women's Health Initiative there was a built in dietary deficit. Because of the good control, they know the women reduced total calories eaten by 350kcal a day. On the basis of 9000kcal a kg, they should have lost 14kg a year. It didn't happen. Calories in v calories out is a nonsense. Weight essentially remained stable.
Sam Feltham in a three week experiment ate on average 5794 calories a day. His was a high fat diet, with only 10% carbohydrates. He should have gained 7.3kg but his weight gain was a mere 1.3kg.
Morgan Spurlock did a similar experiment, but with a diet high in both fat and carbohydrates (30 days at McDonalds). His calorie intake was similar to Sam Feltham, but high in sugar, other carbohydrates and fat, 5000 calories a day. His weight gain was 11.1kg, when I calculate he should have only added 8.3kg. So clearly, the body is not a machine, and it does matter what foods you eat, and when you eat them. TN seldom talks about calories, he prefers to measure food intake in grams.
SU Believes that Macro Nutrient Ratios are not Important:
SU argues that so long as you eat a mixed diet, the ratio of carbohydrates, to fats and protein isn't very critical. For them calories are the best measure of dietary input. Dr Jeff Volek's lab has shown in carefully monitored controlled feeding studies that there is a significant change in metabolism that happens between 120g of carbohydrate per day and 80g of carbohydrate per day, in most people. This is when the body switches into lipid metabolism.
In this study "Effects of Step-Wise Increases in Dietary Carbohydrate on Circulating Saturated Fatty Acids" subjects on a diet of 47g of carbohydrate per day, or 83g of carbohydrate per day, were able to gain significant advantage in their blood profile and weight loss, that was largely gone on a diet of 131g of carbohydrate per day. (At 83g per day most people were using lipid metabolism, but at 131g per day they were all using glucose metabolism.) That was followed by a flat patch when eating more carbohydrate made not much difference. But in the step from 251g to 344g of carbohydrate per day, blood risk factors for cardiovascular disease began to worsen.
SU Believes that Slow Weight Loss is Better:
Many people on a very-low-carbohydrate diet (25g to 50g of carbohydrate a day.) report a rapid weight loss. In the first week that's mostly water, but significant weight loss continues if the amount of carbohydrate eaten per day is less than 80g, preferably less than 50g. Many people report ongoing weigh loss of 1kg a week, and over a year the loss of 40kg to 80kg is often reported.
SU claim that a slow weight loss is better and more likely to be maintained. That a weigh loss of 2.5kg is a real achievement with meaningful positive changes in risk factors. Many people on a low-fat "balanced diet" lose 10gk to 12kg in 6 months, they claim.
SU Believes that Dietary Saturated Fats are a Cardiovascular Risk Factor:
Dr Jeff Volek writes: "Researchers also have critically examined the premise that saturated fat is harmful. Multiple meta-analyses performed in the last 5 years have all come to the same conclusion—dietary saturated fat is not associated with increased risk of obesity or disease."
"However, the accumulation of saturated fat in the blood and tissues is consistently related to increased risk of obesity, diabetes and heart disease. Why is there an apparent contradiction here? My laboratory group has now published 3 studies that all show it is the over consumption of carbohydrate that drives up levels of saturated fat in the body."
The bottom line is that an unintended consequence of encouraging Americans to decrease saturated fat is that many people over-consumed carbohydrate, which manifested itself in an epidemic of obesity and diabetes.
SU Believes that Obesity is a Complex Problem:
TN would claim that obesity is a very simple problem. It's a disorder of carbohydrate metabolism, carbohydrate intolerance if you like, caused perhaps by genetic factors, but made much worse by our over consumption of carbohydrates over many years. Pharmaceutical companies and food manufacturers would like to keep people confused by pretending that obesity and type 2 diabetes are complex and difficult problems. They are not. SU of course would love research funding to "solve complex problems" so it's in their interest to compound the difficulty.
SU Believes in Balanced Diets:
SU makes a great deal of the "balanced diet" idea. In history humans have never eaten a balanced diet. We've mostly eaten a very varied diet depending on what was available. There was both feast and famine, and we seem to cope fairly well with that. The key idea behind the balance diet idea, is not to exclude any foods, and perhaps to eat everything in moderation. TN says that's the idea the food manufacturers push, particularly the sugar industry and the soft drink industry.
SU Believes in Isocaloric Comparison of Diets:
When the calories in a "balanced diet" and those in a Banting style diet are equalized by design, the Banting diet is at a severe disadvantage. When people eat carbohydrates they tend to get hungry every time their sugar level falls, every 2-3 hours. On a Banting diet because protein and fats don't create a glucose spike, people never feel hungry, and often go 5-6 hours before eating again. It will please SU to know that people who are Banting do eat fewer calories, because they don't feel hungry.
So SU and TN talk a different language, they are using different paradigms. Apples are not compared with apples. The debate is useless because it's not honest.