Fighting orthodoxy Noakes’s sin
Book chronicles how scientist made enemies in highest echelons
In 2014, I began researching and writing about Tim Noakes and his nutrition “Damascene moment”, as he calls it. At the time, I was a vegetarian and had been for more than 25 years.
Actually, I wasn’t a “real” vegetarian…. With a perfectly straight face, I would tell anyone who asked that I was a “biltong-eating vegetarian”.
I was sticking to low-fat, high-carbohydrate foods because doctors and dietitians I trusted told me I should. In fact, they said everyone should eat that way. They said it would significantly reduce the risk of lifethreatening lifestyle diseases, such as obesity, diabetes, heart disease and even cancer.
I believed in the diet-heart hypothesis that saturated fat causes heart disease as if it were gospel. Cardiologists I trusted said it was written in stone. I believed them. Why wouldn’t I? They were clever, omniscient creatures — godlike, really. I was in the thrall of eminence-based medicine. I never thought to question their conventional nutrition “wisdom”.
I therefore avoided “fad” diets. I knew about Atkins. I believed it to be a “dangerous fad” because cardiologists told me it was.
And anyway, it seemed counterintuitive that you could eat fat to get thin. It seemed reasonable that fat in the diet would equal fat in the arteries.
I wrote about many different diets and tried most of them — for wellbeing, not weight loss. I was never overweight, although I was also never happy with my weight. I wasn’t a slave to the scale. Instead, my clothes were my slave master. When they grew too tight, as they often did … I would simply starve myself into submission.
I believed wholeheartedly in the calories-in, calories-out model of obesity. I arrogantly believed that obese people were mostly just slothful gluttons. They ate too much and moved too little.
Once or twice a year, I went on punishing water-only fasts. I believed the promise of a “detox” to my system that would leave me “good and clean and fresh”.
If anyone had told me that the real fad was the low-fat, highcarb (LCHF) diet I was eating, I would have instantly suffered a severe bout of confirmation bias. Confirmation bias is discounting or ignoring any evidence that flatly contradicts a deeply held belief. US physician and LCHF specialist Michael Eades says that confirmation bias suffuses everyone — including him. It’s how the bias is managed that counts, he says.
Of course, I knew about Noakes. He is one of the most well-known and respected South Africans in the global medical scientific community. Recently retired University of Cape Town (UCT) deputy vicechancellor Danie Visser has called him a “force in the world”. Former South African Comrades Marathon king Bruce Fordyce has described him as “a national treasure, one of the most important South Africans of all time”.
His peers in the medical profession (Noakes is also a medical doctor) were making statements that seemed to be defamatory. Even academics at UCT and other universities appeared to be defaming him with impunity. They were demonising him using cultish, religious terminology. They called him a zealot, a heretic, messianic, a “celebrity” scientist, a quack peddling dangerous snake oil to unsuspecting followers.
Noakes had clearly made enemies in the highest echelons of medical and academic establishments. He was probably lucky he wasn’t living in medieval times.
His peers would have burned him at the stake as a heretic for challenging orthodoxy.
I became aware of cardiologists, in particular, banding together to discredit him.
In September 2012, UCT cardiology professor Patrick Commerford and colleagues accused Noakes in an open letter of “cholesterol denialism”. They described his views on diet as “dangerous and potentially very harmful to good patient care”.
The previous month, Johannesburg cardiologist Anthony Dalby had been quoted in a media report calling Noakes’s dietary advice “criminal”.
Noakes has infuriated drug makers and raised many a cardiologist’s blood pressure with his antipathy to the cholesterollowering drugs known as statins. Statins are the most prescribed drug on the planet. Drug companies have made billions in profit. Yet research shows that the risks of statins far outweigh the benefits.
Cardiologists were not the only ones suggesting that Noakes would end up killing people with his dietary views and on a scale close to genocide. I found that claim extraordinarily shocking and hyperbolic. After all, I had known Noakes for decades — not personally, but as an interview subject.
I had interviewed him often, ironically, as it turned out, on the use of high-carb, low-fat diets for athletic performance. I had always found him to be a scientist of formidable intellect, as well as a caring medical doctor. He is charismatic, but I’d never considered that a crime.
I contacted Noakes to ask for a Skype interview. He agreed, and we spoke for hours.
He was his usual polite, patient self. He explained that there was nothing new to what he was saying, that the evidence had been there for years, and that those in positions of power and influence over public nutrition advice had either ignored or suppressed this evidence.
I ended the conversation feeling unsettled. Noakes sounded eminently rational, reasonable and robustly scientific. I started reading all the references he gave me.
I read US physician professors Stephen Phinney and Eric Westman, and Jeff Volek. I read Eades; US science journalist Gary Taubes, author of Good Calories, Bad Calories; and one of British obesity researcher Zoë Harcombe’s many books, The Obesity Epidemic.
I also read The Big Fat Surprise by US investigative journalist Nina Teicholz. That book thoroughly rocked my scientific world view, as it has done for countless others.
My research into LCHF left me uneasy. As a journalist, I’m a messenger. Had I unwittingly promoted advice that harmed people suffering from obesity, diabetes and heart disease?
Among those was my father Demetrius Sboros, who suffered from heart disease for years before his death in 2002. Had I given him advice and information that shortened his life?
I put those worries aside and wrote up the interview. The backlash was instant.
On Twitter, strangers called me irresponsible, unscientific, unethical and biased. And anyway, I readily confess to bias, but only in favour of good science. I’ve always said that if anyone can show me robust evidence that Noakes is wrong about LCHF, I will publish it.
Most of all, though, I was shocked at the venom behind the attacks on Noakes. He had simply done what any good scientist does when faced with compelling evidence that contradicts a belief: he had changed his mind. I’ve never seen much sense in having a mind if you can’t change it.
In August 2014, four of Noakes’s UCT colleagues published a letter in the Cape Times, accusing him of “making outrageous unproven claims about disease prevention”.
Noakes and all the other LCHF experts I have interviewed don’t say that LCHF is the only way or a one-size-fitsall approach. They do say that anyone who is obese, diabetic, has heart disease or has otherwise become ill on a high-carb, low-fat diet should try LCHF before drugs or invasive bariatric surgery.
That sounds reasonable and rational to me.
As I continued my research, it became apparent why so many doctors, dietitians, and food and drug industries want to silence Noakes: he threatens their businesses, reputations, careers, funding and sponsors.
And cardiologists and endocrinologists are not the only ones at risk of class-action lawsuits if, or more likely when, LCHF diets become mainstream, especially to treat health problems such as obesity, diabetes and heart disease.
All doctors and dietitians may be at risk if it is shown that they knew about LCHF but deliberately chose not to offer it as an option to their patients.
When the Health Professions Council of SA eventually charged Noakes in late 2014 with allegedly giving unconventional advice to a breastfeeding mother on Twitter, I prepared to report on the hearing.
The deeper I dug, the more unpleasant the experience became. In 2015, for example, I was having what I thought was a relatively civil phone call with Dalby. I asked for comment on research suggesting that the diet-heart hypothesis was unproven. “If you believe that, then I leave it to you,” he said, and hung up on me. Other doctors, academics and dietitians followed suit.
Like many, I enjoy a good conspiracy theory, yet I wasn’t convinced of an organised campaign to discredit Noakes. However, by the trial’s end, I was.
Johannesburg dietitian Claire Julsing Strydom and Association for Dietetics in SA (ADSA) deny a vendetta against Noakes. But the signs were always there.
And to me, Strydom and ADSA have always looked more like patsies — proxies for Big Food and other vested interests opposed to Noakes.
This book turned into not so much a “whodunnit” than a “why they dunnit?”
IF ANYONE CAN SHOW ME ROBUST EVIDENCE THAT NOAKES IS WRONG ABOUT LCHF, I WILL PUBLISH IT
This is an edited extract from the book Lore of Nutrition: Challenging Conventional Dietary Beliefs, written by Tim Noakes and Marika Sboros and published by Penguin Random House SA.
Industry threat: Tim Noakes at a Health Professions Council of SA hearing on allegations of unprofessional conduct in 2015. Although she was not convinced at the start of the hearing of an organised campaign to discredit Noakes, by its end she was, author Marika Sboros writes. /