HPCSA v Prof. Tim Noakes in Context

The Choice this Court is Making

In evidence (From Video 21) Prof. Noakes said; "This is a unique event in medical history. It's much easier to shoot the messenger than to re-examine the ideas on which one's whole career is based. ... My profession has tried to shoot me. This court will determine if they are successful.

I told people on Twitter to wean children onto a LCHF diet. I was talking to people who know what LCHF means, there was no misunderstanding. I did not use the term ketogenic diet, at all, and I was not referring to a therapeutic Ketogenic diet.

The public deserves to know the truth. South Africa deserves to know a truth that we've denied for 50 years. We don't need to be dominated by other interests (By commercial and sponsorship arrangements, by the opinion of researchers at Harvard University, or by the Dietary Guidelines of the USA.)

When the current charges were first proposed, I didn't take it seriously. (From Video 34) I knew that I had not given medical advice to any individual, there was no consultation. And I knew that the opinion that I offered was strongly supported by current nutritional science. Since only the science was in question. I wrote to the HPCSA a three page letter outlining the science. They had the evidence from the beginning. I thought that would be the end of it.

What's this About?

Prof. Tim Noakes, was a celebrated academic, Emeritus Professor in the Division of Exercise Science and Sports Medicine at University of Cape Town, and Co-Founder and Executive Co-Director, Sports Science Institute of South Africa. Among his awards in 2013 - nominated as one of 100 World Class South Africans.

As he retired in 2012, he published a book "Challenging Beliefs: Memoirs of a Career." From the publicity for the book, "Tim Noakes is the world's leading authority on the science behind sport. Through a lifetime of research, he has developed key scientific concepts in sport that have not only redefined the way elite athletes and teams approach their professions, but challenged conventional global thinking in these areas."

In February 2014, Dr Noakes was researching for the book "Raising Superheroes" (360 pages) which was published by Jacana; 1st edition (2015). He was primed therefore, to answer a question about weaning babies, and to be very specific about what he recommended. (The book is only currently available in South Africa. I expect a second edition in May-June 2017)

In the 1980's sports medicine was considered "Mickey Mouse medicine." Sports science was undeveloped, (Still is) and full of legends and myths about what the best ways to ensure best sports performance might be. Time after time Noakes has been able to identify an important myth, examine it's source and expose the lack of science in the thinking. Each time he's done that he's been strongly opposed, by other scientists, by coaches, by sports administrators, and sometimes by commercial interests.

Noakes writes: "The search for truth has always kept me focused, in the face of these attacks." ... "If you challenge someone's hallowed beliefs you must expect an aggressive reaction."

"Nothing in my medical education suggested that the choice of the food I ate might be important in preventing future disease conditions." .. "It's taken me 61 years to realise that bread, cereals, rice and pasta in my diet, may be toxic to my body."

We were taught that nutrition was complex and difficult. Now I ask why? Is it because it suits the food companies, the nutritional researchers and the pharmaceutical companies to maintain that illusion? In 1958. Richard Mackarness, in a book called "Eat Fat and Grow Slim" made it very simple. Eat a diet based on animal foods, supplemented by vegetables. Avoid both sugars and starches.

In two publications, Challenging Beliefs (2012), and The Real Meal Revolution (2013), Dr. Noakes directly challenges the common medical practice of putting most people onto statins to control their cholesterol, and he recommends the Banting Diet, low-carbohydrate and high-fat, an idea which medical practitioners are very wary of. He's made some enemies. Noakes says, "We can't go on ignoring what we know;" and pretending that we are doing evidence-based science. "Industry wants us to believe we don't know the cause of obesity, since that lets them keep driving the sales of their addictive foods."

Heart specialists were horrified when he claims that high cholesterol does not cause heart disease. The sporting fraternity was mortified that he was admitting his previous "carbo-loading for athletes" theory was not a good idea after all, and dietitians could barely contain their fury that a sports scientist could make the claim that the Banting Diet was both a better way to lose weight, and the most healthy diet for people who are insulin resistant.

These forces come together in the disciplinary action of the Health Professions Council of South Africa, against Dr Noakes. In particular the success of the Banting Diet in South Africa, is a direct challenge to the prestige of Stellenbosch University, and the South African Food Based Dietary Guidelines. Prof HH (Esté) Vorster, from North-West University, as the lead author has a professional reputation to protect. Perhaps more importantly, the food manufacturers, the sugar industry and the producers of soft drinks and ice cream, stand to loose a lot of sales if the Banting concept of a "healthy diet" is accepted widely. The hidden player in this story is not in court, as this blog from Cross Fit explains.

Challenging the Nutrition Paradigm

Dr. Eric Westman, from Duke University, tested the ideas of Dr Robert Atkins in his laboratory. He discovered the Atkins' ideas worked, and worked especially well for people with type 2 diabetes. He was surprised at the vigorous opposition he encountered. He wrote, "When an unscientific fear of dietary fat pervades the culture so much that researchers who ... provide finding will not allow research into high fat diets for fear of "harming people." ... "The situation will not allow science to self-correct." ... "A sort of scientific taboo is created" which discourages research applications and prevents research funding.

So that's a general reason for nutritional science being caught in a trap from which there is no escape. Prof. Tim Noakes says that we deny what we know, if it's inconvenient for us. With regard to fats and weight loss diets nutrition science has been denying what we know for a long time. In the 1950's we knew that carbohydrates made people fat and the dietary fat was healthy. In the 1960's we reversed ourselves because of rising heart disease rates. That's made our health worse, not better. Surely it's time to relearn what we once knew.

When a new paradigm appears there is communication failure between the people who support the old concepts and the people supporting the new idea. Often the ideas have very few common elements, although they may use the same words, they use those words to mean entirely different things.

If the new paradigm is successful, it imposes itself on the field. It then determines what good science questions might be, and also what might be considered a valid scientific response. That appears to be happening with the Banting Diet in South Africa, and across the world. Why? Because the Banting Diet works and the low-fat diet that's been recommended to us for 50 years is making many of us sick. The new paradigm, will define "the agreed understanding of fact and theory", will soon be accepted, and taken for granted.

So let's look at two failures to learn from the latest science available. In both cases the decision makers feel fully justified in their decision, claiming that their work is "evidence based." In setting the objectives for your research, you can make decisions to exclude whatever you choose not to know. You can then avoid facing the need to adapt to unwelcome knowledge, that might be forced on you by "the evidence." The evidence isn't there because you refuse to see it.

Advice to eat a Low-Fat Diet. Saturated Fats are "bad."

For instance we have been told that a diet low in saturated fat is heart protective. That may only be true provided you don't eat a lot of carbohydrates, and/or if you are insulin sensitive. (As most young people are.) Excess carbohydrate in the diet over many years slowly causes insulin resistance. The diet that used to be good becomes bad. Now those excess carbohydrates cause obesity and create a host of small dense particles in your LDL-C which have the potential to be heart harmful.

Thirty years ago we were encouraged to eat more "natural" vegetable oils and avoid saturated fat. We added many omega-6 oils to the diet to reduce cholesterol. MISTAKE. That a diet high in omega-6 fats is dangerous because excess omega-6 is cancer promoting. Margarine and many other foods based on seed oils are bad for you.

In contrast, a ketogenic diet, very low in glucose is cancer inhibiting, because most cancers depend on glucose for their rapid growth. Ketogenic diets make it particularly difficult for new cancers to get established. In addition, a proven strategy to stop cancer growth is a combination of a therapeutic nutritional ketogenic diet (medically supervised) and a bariatric chamber supplying high pressure oxygen. That attacks the growth potential of cancer in two ways, a method called "press pulse". (Press is starving the cancer with glucose restriction, and pulse is oxygen pressure or sometimes radiotherapy.)

Advice on Type 2 Diabetes.

For 60 years people with type 2 diabetes have been told to eat a normal diet and correct their blood sugars by taking tablets, or with insulin injections. This corrects the blood sugars, but creates a worse problem, severe insulin resistance and disseminated vascular disease. Diabetes gets progressively worse the longer "treatment" continues. Type 2 diabetes is described as an incurable progressive disease by doctors.

Sadly the doctors are wrong. The fact that this advice is wrong is very slowly being acknowledged. Dr Richard K Bernstein, defined the correct treatment in 1982. He was strongly criticised and then ignored. Thirty years later the validity of what he said is being acknowledged.

I now believe that a simple dietary cure for type 2 diabetes is not promoted because it threatens too many powerful interests. The WHO is silent and compliant on this issue. Likewise, around the world governments are captive to industry objectives. The business objective is to increase sales, not improve the health of the nation.

Many "Diseases" have a Dietary Root.

The six very common "diseases" we call metabolic syndrome are all resolved by the right diet. That may not be the end of the health advantages of eating a low-carbohydrate high-fat diet. Several more health improvements are being claimed, but without good evidence yet.

We can now make a list of new problems that we should be able to solve, like Parkinson's Disease, and Alzheimer's Disease, and to assist people with general brain injury. Within the rules of the paradigm that's one key area for new research. Those who accept the rules and adapt themselves to work within this paradigm, can get funding, win support and build careers.

Those who choose to work outside the paradigm, must proceed in isolation or attach themselves to some other discipline.

Many researchers understand that the current dietary paradigm is wrong. There a good number of them mentioned in this site. Soon I expect, Dr Tim Noakes will be hailed as a South African hero. Then everyone will agree that poor diet; too much carbohydrate, caused metabolic syndrome, created inflammation in our blood vessels and caused heart disease. Case closed.

Paradigms gain status because they are more successful than their competitors in solving a few problems that practitioners in the field consider important. Working inside the paradigm is to be scientific. Working outside the paradigm is to cease practice in the science the paradigm defines. I look forward to a time quite soon, when Banting is inside the paradigm and not outside it.

Stellenbosch Study in the News

Quoting from Health-e News, an article where Wilma Stassen reports on the "Stellenbosch Study": “This study shows that when the amount of energy consumed by people following the low carbohydrate and balanced diets was similar, there was no difference in weight loss,” says lead researcher, Dr Celeste Naudé, from the Centre for Evidence-based Health Care at Stellenbosch University Faculty of Medicine and Health Sciences.

“Decades of research have shown the balanced diet to be safe and healthy in the long term, and along with a healthy lifestyle, is associated with a lower risk of heart disease, stroke, diabetes and certain cancers,” says Heart and Stroke Foundation South Africa CEO Dr Vash Munghal-Singh.

The Heart and Stroke Foundation South Africa points out that the fats promoted in Noakes's popular The Real Meal Revolution cookbook are mostly saturated fats like animal fats such as lard and butter, which have linked to high cholesterol and in turn increased heart disease and stroke risks.

The above statements are clearly intended to undermine the success of the Banting program. As stated elsewhere, they did not put the Banting program or other programs like it to the test. The Banting Diet works, and the diet Stellenbosch University been recommending does not work unless you are insulin sensitive. For Stellenbosch University, and their financial backers, that's a problem.

A Background to the Noakes Trial