Fight­ing or­tho­doxy Noakes’s sin

Book chron­i­cles how sci­en­tist made ene­mies in high­est ech­e­lons

Business Day - - LIFE - Marika Sboros

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.

David Har­ri­son

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. /

Newspapers in English

Newspapers from South Africa

© PressReader. All rights reserved.