Conversations with Prof Tim Noakes

Prof Tim Noakes: My talk was not primarily about what people should eat. It is about the absence of science behind the current dietary guidelines. I then state what I think nutrition should be about especially for those with insulin resistance. I wish you would represent what I said more honestly.

Nutritional Solutions Response: There where 7 dietitians present at your talk, what was said was very clearly recorded to prevent misinterpretations.

Prof Tim Noakes: Suggest you listen to all 13 hours of what I have said on the internet

Nutritional Solutions Response: The general public is not going to sit and go through 13 hours of comments.  Each time you speak on radio or TV you convey various nutrition messages – we are specifically giving feedback on what you said at the “Extraordinary people” talk last week.

Prof Tim Noakes: Why not focus on the absence of evidence for the 1977 Dietary Guidelines

Nutritional Solutions Response: Why focus on something that was used 37 years ago? Dietary guidelines have changes, nutrition is an evolving science.  Getting stuck on evidence for outdated guidelines will get us nowhere – for us to move forward in this debate we suggest that the focus is on current research

Prof Tim Noakes: My point is that the internet has changed everything. The general public is now better informed on nutritional issues than ever before in our collective history. They are searching for what works. If they are given by me or anyone else information that does not work, they will no longer feel compelled to listen to that advice. They will simply go onto the internet to find what others have found to work for them. And they will follow that advice.

Nutritional Solutions Response: Better informed, or misinformed?  Yes, there is plenty of nutrition advice available, but what is the source?  The majority of people are not surfing websites with scientific journals.  The problem is that there is information out there that is also harmful and misleading, with quick fixes and false promises, leaving people conflicted, unsure and more confused than ever.

Prof Tim Noakes: The success of Real Meal Revolution is because the book provides a simple explanation of what people who are struggling with their weight or health, because they are insulin-resistant, should be eating. They try this “unhealthy” diet and suddenly find renewed vigour and health as did I. Then they wonder why they had been mislead to believe that what they had been eating and which caused their ill-health continues to be promoted as healthy for all by a majority of dieticians globally.

Nutritional Solutions Response: A simple explanation to a complex problem is a concern in any scientific field.  In your opinion what do you think dietitians have been prescribing to insulin resistant patients? It seems to me that you think we put our patients on a diet of sugar, refined carbs and no fat – which is certainly not the case.  We have successfully treated many insulin resistance patients with a diet that is high in monounsatured fat (35-40%) 20 % protein and 40-45% carbs – but only from portion controlled amounts of fruit, vegetables and whole grain carbohydrates).  

The question you would need to answer is how would your recommendation of 80% fat (mostly saturated) 10% carb and 10% protein (as described at the “Extraordinary people” talk) compare to a dietitians recommendation of 40% Fat (mainly monounsaturated fat, 20% protein and 40% carbs (whole grains, fruits and vegetables)?  That would be a fair questions instead of comparing your recommendations to the food pyramid and pretending dietitians are still using these recommendations.

Prof Tim Noakes: Because if you fail to answer it, your profession will pass into history as an interesting anomaly. And it will happen very quickly. In this modern world with modern communication, bad ideas can become obsolete very quickly (think Nokia and Blackberry). My profession, especially the medical care of chronic illness, faces exactly the same problem.  I always say that your profession is the most important of all the caring profession.

Nutritional Solutions Response: We appreciate that, Dietitians are the fore runners of nutritional advice and information.  We fail to understand what the “bad ideas” you mention are?  To clarify (please correct us if we are wrong); the advice Dietitians give is not working? Is it not presumptuous of you to lump the cause of obesity and chronic diseases of lifestyle on Dietitians laps?  Perhaps consider the effects of modern day living and the individuals food choices, higher disposable incomes and increased reliance on processed and convenience food options and the decrease in physical activity levels worldwide.  As you can see in the Figure below (5-1 How do typical American diets compare to recommended intake levels or limits?), people aren’t eating according to guidelines, instead they are consuming a diet high in saturated fats, refined grains and sodium.  To blame Dietitians for the worlds current state is taking the easy way out.

Prof Tim Noakes: You need to embrace and act on these ideas and not see them as threatening. 

Nutritional Solutions Response: We are not threatened and that is why we are writing a series of blog posts to engage and discuss various topics relating to the LCHF.  In our opinion it is great that people are really taking ownership of their health and talking nutrition.  We at Nutritional Solutions are however concerned that there are risks involved with your recommendations and question the validity of some of your statements – as will be covered in the blog: Prof Tim Noakes Talk: Fact and fiction.

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46 thoughts on “Conversations with Prof Tim Noakes

  1. Hi guys. Reading the back and forth there is interesting. From an outsider’s perspective, it looks as if Prof. Noakes – in saying that dietitians the world over, are essentially giving their patients the wrong advice – has indeed hit a nerve. Of course if my profession were being slandered, I too would have my back up.

    But what I also see, are two approaches to the same thing – Prof is suggesting a LCH(saturated)F diet as a solution to insulin-resistance, while it seems you suggest a medium fat, medium carb approach as a solution to insulin-resistance. If you have indeed seen good results from your approach, then clearly both are useful, working, methods. However, it also seems that the issue is being oversimplified, as the real question we should be asking is, “To what degree is one approach better or worse for the overall healthiness of an individual?”.

    There is mounting evidence that suggests total cholesterol is of far less importance than that of the ratios of HDL to Triglycerides & LDL – with even that being overshadowed by the supposed inflammation we are subjecting ourselves to, by over-consumption of Omega-6 fatty acids found in foods like avocados, nuts, cereals, durum wheat, wholegain breads, olive oil, and eggs from chickens farmed on grain. Ensuring an increased intake of Omega-3, through flaxseed, walnuts, sardines (fish in general), cauliflower/broccoli, and pasture-raised meats/eggs is supposed to combat the skewed 6-3 ratio.

    Furthermore, there is also some evidence that suggests consumption of wheat (I’m not talking about gluten here), can have a negative inflammatory response for many people too. So to get back to the question on which is a healthier approach to diet, the consumption of saturated fats, over fats high in Omega-6, is purportedly healthier for your heart. But as a simple layman, how are we supposed to “pick a side” in all of this? Saturated fats are supposedly linked with cardiovascular benefits, bone health, optimal liver function, stronger lungs, a healthier brain, better nerve communication, and stronger immune system function etc etc, so as a layman it seems like a good idea, along side the fact that one can lose a lot of weight with the LCHF approach.

    For me, what is becoming increasingly evident, is that people seem to have lost faith in the dietitian industry, and are very clearly turning to their own guidelines based on what they read on the internet. And yes, I agree with you, that can be very dangerous, but where there’s smoke there’s often fire, so is the onus not then on the dietitian industry to up the ante, so to speak, by proving to the “googlers”, beyond a shadow of doubt, why the LCHF is a bad approach?

    1. 1300 academic studies in favor of saturated fat: healthydietsandscience.blogspot.com Now besides the big killer diseases, a diet with saturated fat is also showing powerful relevance for various chronic conditions: http://perfecthealthdiet.com/reader-results/

      As the extremely amicable Prof frustratedly mentions, there is a wall of scientific research and grassroots, matter-of-fact testimonial that is able to lay bare the current religion.

      What is perhaps more intriguing is to understand how and why our trusted institutions and industries are leading us into this mess on a global scale.

    2. There is LC and LC… As a RD I prescribe a LC diet (not as extreme as TN) to avoid all refined processed starch, starchy veg & sugar, but NOT to limit veg&fruit, and people who are not sensitive to grains,whole natural unprocessed grains. I always combine carbs with protein, to lower the GI and avoid blodd glucose & Insulin peaks. Then HF & HF.. huge difference what kind of fat ppl choose, & the amount. I strongly believe to reflect in a diet what we find in nature.. very seldom you will find a whole/complete food with more than 30% fat… So FAT in the diet should NOT be added fat, or extracted or processed fat, but natural fat IN the food or in the concentration as nature provides it. History have shown that as soon as man tampers with the natural complete food, extract or remove certain parts, and eat the unbalanced/damaged food, disease occurs. Extracted sugar/oil/fat eaten in bigger quantities as nature intended, WILL affect your health. so FAT & sugar should only be consumed as part of the natural food where it is found: eg sugar in the WHOLE fruit, FAT in the avo/nuts/dairy/grass-fed meat etc.. So added fat (up to 80%!!) will also cause disease over time… just as unhealthy&damaging as added sugar.

  2. Just a thought – that diagram you put up – on what are the percentages based ? If is is an official study, then surely the goals and limits are based on the USDA food pyramid guidelines ? On my reading of what you stated in your debate with Tim Noakes above 11 % Sat Fat would be well below what you recommend.

    1. Gerrit, have you actually read that Swedish report yourself, or have you relied on what mass media outlets like Dietdoctor and Twitter reported. I agree with Marlene here, this was no “official” statement from the Swedish government, and it did not say what you claim it said … This is the problem with lay people, they too easily believe anything, without doing the research themselves. Tim Noakes the other day claimed that ALL cancer is glucose dependent and that there is NO RISK for people trying a ketogenic diet when they have cancer. Well, it turned out he was wrong on that, and had to back track his statement. If no one took him on, how many people could not have tried dangerous diets in the belief that they might “cure ” their cancer, because Tim Noakes said so ! I support many things prof Noakes say, but there are also a lot he is just not right about. No one can know everything. Prof Noakes also have to be applauded for bringing this debate into the public domain where everyone can benefit from the knowledge learned.

  3. Gerrit I am so glad you asked this question because this illustrates our points so beautifully….

    The Swedish Government DOES NOT promote a LCHF lifestyle. This media, DietDoctor and Tim Noakes propaganda.

    Please see the link below of the report your articles refers to. The report is named “Dietary treatment of Obesity” which already gives a clue about who should follow these recommendations in the Swedish and not the entire South Africa to prevent obesity as Noakes claims

    I also quote paragraphs from the report: very much in line what dietitians recommend, remember they have looked at 16 000 different studies.

    “The various diets examined in such directly comparative studies are
    moderate and strict low carbohydrate diets, low fat diets, diets with a low glycaemic index,
    high protein diets and Mediterranean diets. Overall, these studies show that all diet
    interventions examined lead to weight loss and improved blood lipid and glucose values
    among obese individuals. The effects are generally greatest at six months and then decline
    over time. It is likely that this is a consequence of reduced compliance, and the same reason
    is likely to be the cause of the differences declining after six months.”

    “A comparative study between low fat diets and diets with a standard fat content showed no difference in the
    incidence of diabetes among obese post-menopausal women over six years. In the biggest
    randomised study of diet patterns to date, the risk of suffering (or dying) from cardiovascular
    disease was slightly lower among obese individuals who were given advice on
    Mediterranean diets (and support to stick to this diet) compared with individuals who were
    given advice on low fat diets”

    “Nevertheless, the long-term effects among obese individuals, including safety, can be said to
    be documented more effectively for Mediterranean diets than for other diets, including low
    fat and low carbohydrate diets”

    “This report indicates that there may be a range of alternative diets
    available which can all lead to weight loss, at least in the short term”

    “However, studies have shown that there is a link between the price and the
    food we buy. This report has calculated what it costs to eat in accordance with the various
    elements of dietary advice, and this calculation shows that low fat diets are cheaper than
    low carbohydrate diets which are slightly more effective, at least in the short term. As
    obesity affects individuals with poorer financial conditions to a greater extent, there is a
    clear risk of the choice of diet being influenced by cost rather than the effects on health.
    Therefore, if the diets which may be relevant for weight loss attempts are more expensive
    that consumers’ regular diets, this is problematic”

    “Metaanalyses of randomised studies have been carried out and indicated that the risk of cardiovascular events is reduced
    when saturated fat is swapped for unsaturated. However, a number of the studies included
    had shortcomings which make them more difficult to interpret, and none of them have
    specifically examined low carbohydrate diets. This means that it is not possible to draw any
    conclusions on the link between low carbohydrate diets – irrespective of fat content type –
    and cardiovascular morbidity. The precautionary principle could be applied here. This may
    result in restraint on the intake of saturated fat when advice is given on low carbohydrate
    diets, as long as the documentation on the long-term effects is so inadequate”

    I can go on and on…but read the report for yourself and see.
    http://www.sbu.se/upload/Publikationer/Content1/1/Diets_among_obese_individuals.pdf

    As for the Auz cricket team. I can not comment as I have not looked in their diets.
    But I refuse to believe that their win against England is a result of a LCHF diets!

    Marlene

    1. Just a question… is there a difference between a registered dietician opposed to just being a dietician? Would being registered persuade such a dietician to abide by a certain code of conduct? It seems to me that the hammering from the dieticians side that being “registered” is somehow important suggests that there is something to uphold. If being registered would somehow change the way in which a dietician would conduct his/her profession there more than likely has to be some form of continuing professional development and transfer/update of knowledge. I deduce that all registered dieticians are therefore a united front riding on the back of their professional registering body. Thus there is no use in debating with a registered dietician, they are all programmed to argue in exactly the same manner. The debate (and for me there is no debate) needs to be between who ever conducts the registering body and the rest of the healthy world, who is obviously lead in argument by knowledgeable individuals who spend time and effort on perusing tested facts and clinical truths. Textbook “facts” without proof is poppycock.

      The biggest single reason for me to follow this LCHF diet, apart the simplicity and total lack of hunger and cravings, is the fight against the biggest threat to society, and it will become an even grater pandemic in the near future: cancer. The fact is: if you live long enough, you WILL get cancer.

      I’ll refrain from writing a book, at the moment at least. In short (very short), my father was diagnosed with colon cancer after a colonoscopy in December of 2012. He was probably Discovery Vitality’s fittest, healthiest client. Followed the registered dieticians diet to the teeth, physically active, slightly over weight (1.83m 86kg) BMI 25.7, but its tough keeping as active as a 60 year old as you were in youth. The histology report after removal of the tumour and lymph nodes were damning to say the least, 6 visible metastases in the liver alone, also in the gall bladder, and pancreas. Four oncologists gave him a chance of full recovery at 5%, best scenario. Their recovery plans were all totally un alike, chemo therapy, radio therapy, combinations of these with surgery… after a lot of research on the internet, yes, that place, many paths started to lead to alternative methods or rather holistic methods. This included first and foremost a change in diet, zero carbs – the idea – stop feeding the cancer. High fat intake, polyunsaturated, monounsaturated, saturated any fats apart from seed oils. All the treatments were administered in Germany by dieticians (not registered of course) under the guidance of a very alternative prof (oncologist) and a gastroenterologist. No black magic was used. All the tests, PET – CT – MRI scans and sonars were done in South Africa, at the same clinic by the same radiologists. At the stage that the liver metastases we shrunken enough a partial (entire right lobe and partial left lobe) hepatectomy was performed. The final tests (including a liver biopsy) was performed 3 weeks ago… from 5% chance of survival after one year to full cure, not recession, full cure. Not only that, he has not hat one day of ill health (apart from numerous surgeries and procedures) in the past year.

      These results are published, he is part of the German study on cancer, holistic healing approach with emphasis on diet. The results of 60 years of diet, as prescribed, failed us. Grains and hydrogenated fats, the kind found in butter and approved by the heart foundation, reduced healthy fat intake failed us. I’ve asked many of my friends registered dietician wives, with the results we see today, are you now convinced that LCHF is the better lifestyle to follow? The unanimous spontaneous answer is “No”. Let me rephrase the question, if you or any of your loved ones were diagnosed with the same as above, would you opt for the chemo therapy of holistic approach? Unanimous answer is “holistic approach”… so why not follow it today? Easy answer – we aren’t diagnosed with cancer… not yet anyway.

      I have no faith in registered dieticians. The fact that The Real Meal Revolution is the no. 1 selling book in South Africa is testament to the fact that the rest of South Africans don’t trust dieticians. The prudent diet was advocated for many years and it makes us sick. I’ve seen results first hand, this shook our foundations and caused us to wake up. As a family we have never been healthier and never felt better and never performed better. We don’t all have the time to research the diet and supporting papers and tests ourselves and therefore I need to trust someone who is bound by some code of conduct to give a true summary of these facts. Registered dieticians don’t make the grade. Professor Noakes and many other researchers such as prof Eric Westman do however and I trust their guidance, supported by proof, clinical studies and randomised trials. The fact that more and more medical doctors are following the diet is overwhelming.

      1. Hi Johan
        On a more personal note…this one was a real kick in the gut. It might be perhaps getting a bit emotional here, but hey I am a woman too so I guess it is sometimes allowed.

        Firstly can I say, I am delighted with the outcome of your father and you and your family must be celebrating him and life on a daily basis. As a dietitian who often work with children with cancer I can celebrate this with you. Nothing in the world gives me more pleasure than these stories.

        Secondly, all the term registered dietitian means is that we are recognized and registered with the Health Professions Council of SA (and UK in my case). In other words we are licensed to practice in the area of nutrition related to diseases and medical nutrition therapy. The only reason why we hammer on the word registered dietitian is to protect the public against false nutritional claim.

        Anyone can be a nutritionist, and do a six weeks course and dish our nutritional advice without having to be accountable in a court of law. Just as a “Sangoma” or a Holistic Healer can not be registered with the HPCSA, a person who does not have a degree in dietetics and uphold to CPD standards can not be registered as a dietitian.

        This does not mean you can not go to one who isn’t registered and consult them for advice. It remains your choice. But if you keep that person accountable for a mistake made or misconduct in some way the HPCSA can not protect you.

        There are many professions registered with the HPCSA. Physio’s, Doctors, Nurses, etc etc etc.

        I would like to highlight to you that dietitians have a very important role to play in the medical and healthcare society.

        I myself worked in a tertiary academic children’s hospital in London, that says a wide variety of paediatric conditions and diseases.

        We are a team of 35 specialist paediatric dietitians who each fulfill various different roles. We might be responsible for the prescription of IV nutrition in the neonatal ICU, we may help surgical infants with short guts to grow again and to optimize nutrition whilst they are unable to eat, we may give a cancer child overnight artificial feeding via a tube when they are too sick to eat, we may relieve severe infant allergies with the appropriate diet, we might reduce epilepsy with a ketogenic diet, we might avoid blood clotting through diet in a child connected to an artificial heart, we help diabetic children to live a normal life as possible and we help children with severe kidney diseases to grow up to adulthood.

        This is only my personal experience and only a small role of the overall role of what a dietitian can play.

        To hear that South Africans do not trust dietitians based on a book that is a recent best seller, really makes me wonder what the public understand about a role of a dietitian and what has happened to common sense and logic. To quote the person you love and trust with your life: “Group think?”

        We are but the messengers. We implement guidelines to the best of our knowledge and available science, we work very hard to keep up to date with medical and nutritional sciences. We do the best we can at any given point in time.

        We first attempt to do no harm. We don’t sell books to make our point, because that forms part of our daily job. That is what we get paid for. We do not publish millions of fan letters telling us how we have changed their lives, because its part of our daily job, what we get paid for. We do get acknowledged daily in our patient’s lives. We do receive fan mail. and gratitude and thank you’s. You just don’t hear about it because I do not announce it on 5FM.

        Whether a dietitian is right or wrong, to be judged by the amount of fans, or the fact that a book sells so well, surely is a very one-sided view?

        If you as a family to do better and healthier according to a diet book by Tim Noakes, then wonderful for you. But to blame the worlds problems and shoot the messenger, and nullifying a role of a dietitian is unnecessary.

        There are many ways to kill a kat. And your way might not be my patient’s mother’s way whom I consulted this morning and walked out of my office with the largest grin on her face and the world’s weight off her shoulders.

        Marlene

        1. Marlene,

          First and foremost I did not intend to offend you, for that I apologise. I do believe that there is a need for nutritionists and dieticians and I agree with you wole heartedly. Being a dietician yourself puts you at the forefront of interaction with people or patients with a specific need and therefore you see the value in what you do first hand.

          The offence taken by dieticians with regards to prof Noakes’, which is by no means a brand new discovery, the fact that all the references are available to publish support that, is what puts me off. You see, look at is from a layman’s perspective and I’ll use myself as an example:

          We strive to be healthy, fit and conform to some norm regarding appearance and weigh that society impose on us. Only after putting on a lot of weight after settling in with a demanding career and still thinking you can eat and drink as you did at varsity you start to put some emphasis on nutrition and diet. The problem with all these diets (or lifestyles) are that they really are not sustainable. Take the abs diet for instance (I’m sure you approve of this, only polyunsaturated and monounsaturated fats, lean meat (turkey), legumes, nuts, low fat and fat free dairy and fresh fruit an vegetables) is that you can try as hard as you like, but somewhere you get to the point where you just can’t sustain it. If you are not active enough you just have a constant battle with picking up weight, controlling hunger and cravings and trying to eat low glycemic to avoid spikes and falling asleep at your desk.

          The only alternative was to really get very active. The road to and taking part in an Iron Man event solved it all. I could eat as much I needed and still lose weight. I just had to train vigorously twice a day. In a modern world with demands of a professional career you can only be that active up to a point. After scaling down on such vigorous activity you start picking up weight again and then the starving and cravings control the rest of your day.

          I’ve been to at least three dieticians for advice, none of the diets are the same. Although they make sense nutritionally I’m constantly hungry…

          For me it’s about quality of life. After adopting the “Banting” or “Modified Paleo with dairy” or “Noakes” or “Westman” or what ever you want to call it diet, my quality of life has improved. In fact, I have not heard a single complaint from anyone who I talk to about this way of living. I don’t get hungry I never have cravings, I can do a olympic triathlon without eating breakfast and not eating anything in a better time than in the past. My total cholesterol is down drown 6.8mmol/l to 4.9mmol/l. I have not been ill since staring this lifestyle and my allergic rhinitis subsided.

          Sustainability and quality of life are paramount in my opinion. Of course health and long term effect are important. Prof Eric Westman’s work on this diet is telling. I’m not going to start quoting articles, anyone who want’s to read up on this can google Eric C Westman.

          So let me rephrase. The fact that The Real Meal Revolution is the best selling book in South Africa at the moment is testament to a tremendous need of the average South African to be guided in nutrition and to have a sustainable diet or eating plan with proven results and science to back up all the claims.

      2. Thanks Johan

        We do hear about all the positive outcomes and do take note. It is very rewarding if a diet benefits our health. It gives us a sense of ownership and control.
        The issue of sustainability is questionable IMHO, due to effects on long term health, agriculture and economy. I guess time will give us our answer.

        Marlene

      3. Yes Johan,
        to answer some of your q’s /remarks: 1) There is a HUGE difference. a Registered dietician (RD) is a registered health professional with the HPCSA or Medical council, completed a 4yr BSc degree & a Post graduate qualification in dietetics, and also comply with CPD points, with a clean record & no medical misconduct. RDs (just like HP registered doctors, dentists, physios) must read & study latest research and answer in-depth questions on the content to get CPD points, to stay registered – so RDs are professionals, and VERY WELL informed about all the latest research. & yes, we have read exactly the same research as Tim Noakes! We are not prescribed by the HPCSA how to treat patients -we treat them according to their individaul situation, applying the latest evidence based, meat_analysis studies.. not a guideline that is as outdated as bobby socks!! 2)Your fathers’ cancer cant be blamed on advice given after doing a Discovery vitality VNA (at a dietician)!! (see *) The vitality program started a few years ago & HIS cancer was caused by his eating habits & lifestyle LONG before he did the VNA. Very many factors are PROVEN to cause colon cancer, NOT the ratio of fat/carbs/protein… but factors like ingestion of chemicals, colorants, additives, ALCOHOL use, smoking, fibre in his diet! secondly: the VNA report is a pre-written pc generated report that is sent to all who completed a VNA, -NOT an individual report written by the dietician! So don’t blame a dietician & pc generated guidelines sent by Discovery vitality after answering a few pc generated questions for your fathers cancer!- that is just SO unfair, and SO wrong!! HOW DID HE LIVE & EAT BEFORE HE DID HIS VNA? Limit alcohol to less than 2 units per day? Non-smoker? Correct weight? No fast foods, sodas &fries? No history of cancer in his family? I am 3 years younger than your dad, and perhaps i have a better idea how healthy men who grew up with me lived, what they ate, how many smoked, alcohol habits.. so even if he was an angel on those aspects, you still can”t blame a visit to a RD for his VNA for his colon cancer.
        As a dietician(RD) i feel very frustrated because our profession IS being attacked/damaged by the whole Tim Noakes debacle! If you read all the comments, you would swear we as dieticians are responsible for all the Obesity, Diabetes etc… as if ALL overweight people followed recommendation set out by a dietician! NO! Most people dont care a tick about guidelines, they eat & drink merrily whatever taste good, and only seek advice AFTER their health deteriorates… so the cancer, diabetes, Insulin resistance, obesity start LONG before they visit a registered dietician…
        *explain this to me: Before fast foods, most black people follwed a traditional diet very high in carbs: mealie pap(stiff porridge), fermented milk(magau/amazi),self-brewed fermented beer, spinach/marogo, bean&samp, isishebo(tomato&onion shaba on the pap), little bit of meat high in fat. They were NOT overweight, their teeth healthy, and they did NOT suffer from diabetes (i worked @ Kalafong hospital long before the 1980 guidelines started(as TN say) _ whats the difference from now? They ate natural foods, not fried fast foods, tehy drank magau/amazi(not bottled sodas).. & they did not use bottled/extracted oils… only natural fat IN the (cheaper)fatty meat cuts they could afford. on the same- why dont long-term prisoners, who eat a high carb /low protein diet dont become overweight?
        Dieticians prescribe LC diets for a long time… we give more carbs than TimN, but NOT the carbs you & the public are made to believe- we give more/boost healthy fruit & veg (the healthy ones, not the starchy ones!)-because it is PROVEN to protect against cancer & CAD, we advise against all fried foods (that is our LF), we advise against sugar, & ALL refined products. I always tell my patients they dont need grains/grown carbs, but they DO need their veggies & fruit, and to rather follow guidelines set by nature. Extract sugar/fat from whole foods & apply it in the wrong % in your diet, and you WILL get sick over time, THAT is a fact. so in my opinion, added sugar, added fat, and refined/damaged foods will damage your health. In nature, where do you find a single whole food with more than 50% fat? or except from honey, a food that is very high in sugar without fibre, nutrients?! that is where the problem start… extracted sugar, extracted fat(oils), refined carbs, refined oils, added chemicals.. THINK, and stop blaming dieticians!!

      4. Yes Johan,
        to answer some of your q’s /remarks: 1) There is a HUGE difference. a Registered dietician (RD) is a registered health professional with the HPCSA or Medical council, completed a 4yr BSc degree & a Post graduate qualification in dietetics, and also comply with CPD points, with a clean record & no medical misconduct. RDs (just like HP registered doctors, dentists, physios) must read & study latest research and answer in-depth questions on the content to get CPD points, to stay registered – so RDs are professionals, and VERY WELL informed about all the latest research. & yes, we have read exactly the same research as Tim Noakes! We are not prescribed by the HPCSA how to treat patients -we treat them according to their individaul situation, applying the latest evidence based, meta-analysis studies.. (not by guidelines as OUTdated as bobby socks!! 2)Your fathers’ cancer cant be blamed on advice given after doing a Discovery vitality VNA (at a dietician)!! (see *) The vitality program started a few years ago & HIS cancer was caused by his eating habits & lifestyle LONG before he did the VNA. Very many factors are PROVEN to cause colon cancer, NOT the ratio of fat/carbs/protein… but factors like ingestion of chemicals, colorants, additives, ALCOHOL use, smoking, fibre in his diet! secondly: the VNA report is a pre-written pc generated report that is sent to all who completed a VNA, -NOT an individual report written by the dietician! So don’t blame a dietician & pc generated guidelines sent by Discovery vitality after answering a few pc generated questions for your fathers cancer!- that is just SO unfair, and SO wrong!! HOW DID HE LIVE & EAT BEFORE HE DID HIS VNA? Limit alcohol to less than 2 units per day? Non-smoker? Correct weight? No fast foods, sodas &fries? No history of cancer in his family? I am 3 years younger than your dad, and perhaps i have a better idea how healthy men who grew up with me lived, what they ate, how many smoked, alcohol habits.. so even if he was an angel on those aspects, you still can”t blame a visit to a RD for his VNA for his colon cancer.
        As a dietician(RD) i feel very frustrated because our profession IS being attacked/damaged by the whole Tim Noakes debacle! If you read all the comments, you would swear we as dieticians are responsible for all the Obesity, Diabetes etc… as if ALL overweight people followed recommendation set out by a dietician! NO! Most people dont care a tick about guidelines, they eat & drink merrily whatever taste good, and only seek advice AFTER their health deteriorates… so the cancer, diabetes, Insulin resistance, obesity start LONG before they visit a registered dietician…
        *explain this to me: Before fast foods, most black people follwed a traditional diet very high in carbs: mealie pap(stiff porridge), fermented milk(magau/amazi),self-brewed fermented beer, spinach/marogo, bean&samp, isishebo(tomato&onion shaba on the pap), little bit of meat high in fat. They were NOT overweight, their teeth healthy, and they did NOT suffer from diabetes (i worked @ Kalafong hospital long before the 1980 guidelines started(as TN say) _ whats the difference from now? They ate natural foods, not fried fast foods, tehy drank magau/amazi(not bottled sodas).. & they did not use bottled/extracted oils… only natural fat IN the (cheaper)fatty meat cuts they could afford. on the same- why dont long-term prisoners, who eat a high carb /low protein diet dont become overweight?
        Dieticians prescribe LC diets for a long time… we give more carbs than TimN, but NOT the carbs you & the public are made to believe- we give more/boost healthy fruit & veg (the healthy ones, not the starchy ones!)-because it is PROVEN to protect against cancer & CAD, we advise against all fried foods (that is our LF), we advise against sugar, & ALL refined products. I always tell my patients they dont need grains/grown carbs, but they DO need their veggies & fruit, and to rather follow guidelines set by nature. Extract sugar/fat from whole foods & apply it in the wrong % in your diet, and you WILL get sick over time, THAT is a fact. so in my opinion, added sugar, added fat, and refined/damaged foods will damage your health. In nature, where do you find a single whole food with more than 50% fat? or except from honey, a food that is very high in sugar without fibre, nutrients?! that is where the problem start… extracted sugar, extracted fat(oils), refined carbs, refined oils, added chemicals.. THINK, and stop blaming dieticians!!

  4. Great response because you have now placed your stake in the ground. Look forward to a week long debate on this topic overseen by a legal team so that we can be certain that every single statement any of us make is factually correct. Until then loose statements will continue to be made to support weak arguments.

    A couple of simple points:

    It is impossible to prove that saturated fat is dangerous for health since there is no food that contains only saturated fat (as required for an RCT). Similarly it is impossible to eat an 80% saturated fat diet. To write that indicates a certain failure of understanding of the fat composition of different foodstuffs.

    The scientific basis for the adoption of the 1977 Food Pyramid is critical to the debate since obesity and diabetes begin only AFTER 1980. Thus adoption of the Food Pyramid has to be central to what happened thereafter. On what scientific grounds was that decision made? Answer: None. So why should we have ever changed to a high carbohydrate diet in the first place?

    Politics and then industry drove the adoption of those recommendations. Need to read: Gary Taubes Good Calories Bad Calories.

    To say that obesity is a complex problem would be fine if it had not happened so abruptly after adoption of the 1977 Dietary Guidelines and if there was not a simple explanation that is already acknowledge by those accountable – the processed food industry. Suggest you read Michael Moss’s classic Salt, Sugar and Fat.

    A 40% carbohydrate diet will not help the vast majority of persons with more severe insulin resistance since it contains far too much carbohydrate for the insulin resistant to tolerate. The biology is clear – if you cannot store carbohydrates in the liver or muscle because of insulin resistance, you have to turn carbohydrate into triglyceride in the liver with consequent hyperglycaemia, hyperinsulinaemia, hypertriglyceridaemia, production of small dense (atherogenic) LDL-Cholesterol particles and reduction in HDL-cholesterol. These are precisely the changes that predict future ill-health but which are reversible on diets that restrict carbohydrate intake to less than ~50 grams per day.

    Furthermore the key abnormality in type 2 diabetes is resistance of the liver to the action of insulin with resulting glucose overproduction by the liver. The inability of the muscles to store carbohydrate is NOT the primary problem. The only way to reduce liver glucose production and hence to improve blood glucose control (without drug use) is by reducing glucose delivery to the liver from the diet – i.e. by cutting carbohydrate intake to less than 25 grams per day. A 40% carbohydrate diet is, in my humble opinion, essentially a death sentence for the Type 2 diabetic (like myself).

    These are biochemical facts that cannot be ignored for ever. Not to incorporate them into your thinking will be detrimental to your cause in the long term.

    Then there is the growing evidence for a link between high carbohydrate diets, cancer and dementia that is conveniently ignored.

    Finally the influence of fat and protein on satiety is never mentioned. The body is a complex organism with a brain that direct what we eat and how much. The brainless calories in/calories out model of obesity ignores the fact that nutrient poor, high carbohydrate diets do not satiate hunger and lead to the overconsumption of calories in very many. One needs to understand the control of hunger fully to appreciate this effect.

    So in my opinion, promoting a high carbohydrate diet has to promote obesity simply because, for many, it does not satiate. And there is a strong biological explanation for this. Then you add in sugar addiction and the results are the explosive rise in obesity since 1980.

    But glad at least that the concept of insulin resistance is being acknowledged if still reluctantly.

    We are much closer than you really think. My goal is not to demonise dieticians (I focus almost exclusively on the distortion of science and the inability of my profession to see the reality especially as it relates to diet and heart disease) but to point out that current dietary advice is not working. There is no evidence that this is because the public is deviating greatly from these guidelines. They are eating low fat, high carbohydrate diets as they have been told to do. Interestingly the real deviation is in the carbohydrate intake. Those South African populations eating the most carbohydrate are amongst the illest – a paradox that no one seems too keen to address.

    But the other evidence is that when people do the opposite to the guidelines and reduce their carbohydrate intakes, they suddenly start to do a whole lot better in all the health measurements that we have.

    My privilege is to be insulin resistant and to have eaten both the prudent diet and the high fat diet and to have observed the quite opposite effects on myself and my health. I wish more dieticians could share my personal experiences because it would definitely influence how they see the “science”. And whether they are prepared to dig deeply into the very large body of evidence showing the benefits of low carbohydrate diets in those with insulin resistance. A good place to start might be with the premier researchers in the field – Jeff Volek and colleagues – The Art and Science of Low Carbohydrate LIving and The Art and Science of Low Carbohydrate Performance.

    Good luck in advancing your profession!

    1. I still feel this whole debate is damaging our profession hugely! if you read all the comments, it seems as if we as RDs created the whole epidemic of diabetes/obesity/IR/CAD! your guidelines & the ones we use are very similar, there are small differences – but still you are hailed as the great hero, and we not. We do not only treat IR/DMT2 patients – and when I do, i use a LC diet.. but with more veggies&fruit (not juice, not the starchy type, the colorful nutrient-rich type)than you do, spread throughout the day (because it is proven to protect against many diseases). No fried foods. Natural fat as IN the food. Portion control, in the sense that from childhood a person should STOP eating as soon as you feel satisfied, not ONE bite more..
      I also have the following very un-scientifiic believes, not proven anywhere: – No added fat(it is just as bad as added sugar, and added chemicals/flavourants), no extracted refined oils/sugar… if you mess with the balance of macro-nutrients in food as nature provide it, that same damaged/altered food will damage your health.
      Respect satiety – that sensitive tool we were all born with &ignore – don”t override/damage it, respect it! Respect from birth a child’s inborn right to say “i am full”, and do NOT teach them/reward them (for over-eating after they indicated they were full & you forced them to eat more)with something sweet… increasing the “value” of sweet tasting food as something special, and healthy veggies&food as something you are forced to eat… bad habits are born!
      Another believe of mine is that every person is born with the ability to handle a certain quota of sugar in a lifetime, supposed to be taken as a small % IN natural occuring food(fruit), spread out in small amounts as part of a meal, or in a whole fruit or vegetable When we extract & concentrate this sugar, we will quickly reach the end of our quota, over-use the limited sensitive systems in place to handle it… & then you cant have anymore again, you’ve had your quota, and the body can’t deal with any more.. used up the systems to do so.. For years i’ve seen patiets who overloaded on sweets & sodas & refined starch.. and they end up with IR and DM, overweight/obese.

      For interesting sake, give your opinion on this: I have a close female family member, 53yrs, 1.75cm tall, weighs 52-54kg (very thin). She suddenly developed a sensitivity to grains in 2001 after going through a terrible trauma(her husband &her brother were both brutally murdered in a farm attack)- She suffered terrible pain after ingesting grains. So she stopped eating all grains, carbs, sugar & starchy veggies, except veggies high in water, like tomatoes, cucumber, lettuce, broccoli, etc. Coming from a farm, she always LOVED fat on her meat, marrow bones, etc, and still eat her protein this way. She use very little milk, full cream, a wee bit in her 2 cups of coffee per day, max 100ml in total/day
      After starting to eat this way, her weight dropped from 70kg(normal) to 52-54kg. She does not touch any sugar, grains, starch & live on fatty meat& salads, don’t like fruit, will perhaps have 1glass of wine on social events (being a single mom with 4 children she say she cant afford to drink more) She is very fit & active.
      She went for a GTT after a fasting finger-prick showed a bld glc of 7, and she is on the brink of diabetes. Here is her blood results of last week, after following a strict LCHPHF diet for 12 years:

      S−CHOLESTEROL 7.3 H 1.20 mmol/L
      LDL CHOLESTEROL (GEMEET) 5.4 H < 3.0 mmol/l

      S−TRIGLISERIED 0.78 Nie−HDL−Cholesteroll 5.69 CHOLESTEROL:HDL VERHOUDING 4.5
      (HbA1c) 6.0 3.9−6.1 %
      GTT
      Glukose inname 75 grams
      > B−GLUKOSE VASTEND 5.8 H 3.5 − 5.5 mmol/L
      > B−GLUKOSE 2 Uur 7.2 mmol/L

      Why not perfect after following LCHFHP for 12 years?

  5. The ideal macronutrient distribution?
    Thank you all for a great discussion thus far. Let me start by referencing the 2013 Nutritional Guidelines from the American Diabetes Association. “Evidence suggests that there is not an ideal percentage of calories from carbohydrate, protein, and fat for all people with diabetes (B)”
    The guideline clearly indicates that there is no evidence to support the use of any particular macronutrient distribution over another. E.g. 40% carbs vs. 20% carbs or 30% fat vs. 60% fat. etc. Thus, if we want to follow true evidence, we would not prescribe a diet with any particular macronutrient distribution. Why, because there is no evidence to support this!
    Let us take a look at my next point from the article ‘therefore, macronutrient distribution should be based on individualized assessment of current eating patterns, preferences, and metabolic goals. (E)’
    For those of us with a key interest in DM, we continuously hear of patient specific treatment. Prescribing a diet according to a specific macronutrient goal is not patient specific! We need to focus on trying to guide the patient to eat a lower calorie diet (and yes appetite plays a huge role in determining this!). If the patient would prefer a low carb diet, which may very well decrease their appetite then great. Give the patient what he/she wants to eat. The biggest issue in nutrition is compliance. Maybe we can improve compliance if we give people a diet that they want to eat, instead of a set macronutrient distribution which is way off from what they enjoy eating.

    A quick section on fat: (ADA, 2013)
    ‘Evidence is inconclusive for an ideal amount of total fat intake for people with diabetes; therefore, goals should be individualized (C); fat quality appears to be far more important than quantity. (B)’
    ‘The amount of dietary saturated fat, cholesterol, and trans fat recommended for people with diabetes is the same as that recommended for the general population.’

    My own opinion.
    I would like to think Tim Noakes for honing in on the lack of evidence of the prudent dietary guidelines. If we look at South Africa, a great deal of people are overweight and obese. So what do we need to do? We need to get their caloric intake down. Is pushing a high carb diet the best way, well no. We don’t have evidence to support that it is (Yet that is the bases of the South African Food based dietary guidelines!). We need to get people eating food which has very few calories (be it from carbs, fat or protein).
    Let me focus on what we all agree on. Increase intake of low calorie vegetables. Why not push that? A low carb diet suggests eating more low calorie vegetables, a low fat diet suggests the same thing. And yes, a Mediterranean diet the same. Let us fill up people (i.e. majority of their meals, or plate) on vegetables and not calorie containing fats, carbs and protein. Let us work together to attack the fast food industry, and selling calorie rich refined carbs that only ensure satiety at huge portions (Mielie meal!)

    Lastly, I work and live in a rural area in the Eastern Cape, Peddie. I buy my groceries with the poorest of the poor. I see what they eat. They eat large amounts of refined carbohydrates, that is cooked in huge amounts of oil. Why, because that is what they can afford. They are the most overweight people you can imagine. 80% of people who have diabetes live in moderate to low income bracket. If you want to stop diabetes, target the poor (IDF, 2013).
    Tim and all the dietitians, this is a time to bring change in the lives of millions. Let us not spend so much time fighting over the ideal macronutrient distribution (which is appears really not to be important), that we forget what we agree on: SA is very overweight and needs help.

    Reference
    Evert, et al. (2013) ‘Nutritional Therapy, Recommendations for the Management of Adults With Diabetes.’ Diabetes Care, 36(1), pp. 3821 -3842 [Online]. Available at: http://care.diabetesjournals.org/content/36/11/3821.full.pdf (Accessed: 6 February 2014).

    IDF (2013). ‘Diabetes Altus’ [Online]. Available at: http://www.idf.org/diabetesatlas (Accessed: 6 February 2014).

    1. I agree with you. As a dietician(RD) i feel very frustrated because our profession IS being attacked/damaged by the whole Tim Noakes debacle! If you read all the comments, you would swear we as dieticians are responsible for all the Obesity, Diabetes etc… as if ALL overweight people followed recommendation by a dietician! NO! They become overweight, because they eat a diet based on high ADDED sugar, refined starch, &food fried in extracted OILS!! Most are also inactive! Our profession is also damaged, because we are registered with the HPCSA and like all registered medical professionals, are NOT allowed to advertise, promote & market ourselves like TN do – we must comply to very strict rules, or are scrapped. For years i do NOT follow the food piramide or guidelines _ i treat each patient as an individual, and take ALL the factors in account: Financials, family ties, activity, blood values, age, disease & family history, as well as carefully study the way they were eating up to know, and WHY the problem developed. I NEVER/do NOT give a one-size-fits-all approach! i treat my patients with the greatest care to resolve their problems, and they ARE very successful, although i cant shout it from roof-tops! If we look at the diet-related problems we face now(ir, DMt2, Obesity, Cancer) it started with readily available fried fast foods, high in refined carbs (not healthy natural veggie-carbs!) high sugar(blame sodas!) & packaged foods full of trans fats, refined carbs, sugar & fat, also an increased use of alcohol in the general public. NOT because of advice dieticians gave!! And not because people follwed “guidelines” – most people dont care a tick about guidelines, they eat & drink whatever taste good, and only seek advice AFTER their health deteriorates… so the cancer, diabetes, Insulin resistance, obesity start LONG before they visit a registered dietician…

  6. 1300 academic studies in favor of saturated fat: healthydietsandscience.blogspot.com Now besides the big killer diseases, a diet with saturated fat is also showing powerful relevance for various chronic conditions: http://perfecthealthdiet.com/reader-results/

    As the extremely amicable Prof frustratedly mentions, there is a wall of scientific research and grassroots, matter-of-fact testimonial that is able to lay bare the current religion.

    What is perhaps more intriguing is to understand how and why our trusted institutions and industries are leading us into this mess on a global scale.

  7. According to the first law of thermodynamics the calories in 1 gram of: carbohydrate= 4; protein= 4 and fat=9 calories. That means if you know how many grams of each one are in a spesific food item one can calculate the total calories. Nobody can argue that a calorie is a calorie and indeed the 1st law of TD is correct. But this is not the problem. If two people eat in total, say 17 calories ( 1 gram of each of the three macro-nutrients) the energy generated will not be the same for the two persons. It is as simple as that and now a calorie is not a calorie anymore. This is because the metabolism of the two persons is not the same. And even more important is that each person will react differently to the 1 gram of carbs, protein and fats once swallowed. E.g. for myself 1 gram of carbs may yield 4.2 calories and not 4 calories. And similar the 1 gram of fat, 8.5 calories and not the expected 9. It is as simple as that. Therefor each person must find out for themselves which ratio of fat:carbs:protein is the most effective for weight control and health. For me it turns out to be 50:20:30. For a type 2 diabetic my guess is that more or less a ratio of 70:10:20 will be most probably the best.

    So a calorie is not a calorie.

  8. An interesting debate, to which I have some comments and observations.

    I do not believe that Prof Tim and Dietitians are currently that far apart.

    Dietitians recommending 40/20/40, to all patients? lean T1 and obese T2. This sounds like the accusation against Prof. Tim of LCHF for all, which he clearly does not.

    Where on earth does the claim of 80% SFA come from? Prof. Tim recommends (and thus probably eats) steak, eggs, olive oil, coconut oil, butter, fish, nuts, avos, etc…..and these are only/all SFA?

    Pleased to see the new generation of Dietitians are now allowing some…ie up to 10% SFA and eggs. This is not what I experienced from the CDE. They recommended a limit of 3 to 4 eggs per week, (not fried in butter), soft ‘Heart and Stroke Foundation approved’ margarine only (no butter), skim milk only, low fat everything (despite having more sugar), no Greek yoghurt, lean meat and skinless chicken ….etc, they did however positively guide me on low GI products and taught me the basics of food.

    I know a little girl who had gold standard formula from day 2, later also had kiddies fruit juice…result, theatre at age 3 to save her teeth…

    Science and evidence…wow what a mess…how can there be so many divergent results. Surely results are replicate-able every time by each project. (Some interesting reports today by Gary Taubes and his oponents). Apparently (WHI) if researchers find something that they are not looking for it can be ignored. Also if only 3% of participants show a certain result…tough for them they must eat as per the 97%.

    Further to what Hamish said above about the ADA guidelines, LCHF is now accepted for T2’s. http://care.diabetesjournals.org/content/37/Supplement_1/S120.full.pdf

    Throughout this debate ‘crowds’ have supported and thanked Prof. Tim for changing their lives. I have not seen one patient thank the army of ‘Dietitians opposing’ for ‘curing’ them of their Metabolic Syndrome, T2DM and/or amazing weight loss and/or obesity (without hunger and enjoying their food).

    I do not know what my ‘splits’ are as I have never weighed or counted anything. I just avoid all obvious carbs have full cream (and double cream) everything and seek out fat. This is how simple it is. I eat more veg and salads than ever before. No constipation, in fact stools the best of my entire adult life. Our (met/synd and T2DMs) bodies are damaged for what ever reason and due to our own fault (nobody force fed us) and LCHF appears to be working miracles.

    This is my story as was published in another forum http://www.sanparks.org/forums/viewtopic.php?f=27&t=70298&start=78 with observations of what has happened to the Mier Community (as evidenced in pics on prior pages). This paper http://upetd.up.ac.za/thesis/submitted/etd-12202007-100806/unrestricted/dissertation.pdf explained to me what happened to the Mier Community and why their health is the way it is presently.

    ps I was my CDE’s star patient (did not get the impression that any others had ‘cured’ themselves) until I mentioned that I was eating FAT!

  9. Hi there – interesting discussion ! Indeed. You have still not responded to my comment related to your graph inserted above. You say that you do not follow the USDA food pyramid, yet you also say that according to this diagram people are eating “a diet high in saturated fats,” As I understand it the official guidelines recommend only 10% of intake should be saturated fat, so 110 of the recommended would be 11% – which is a lot less than what you say you recommend ? How can you then single out Saturated Fat as the problem. Isn’t the problem in fact that the dietary recommendations are wrong ?

  10. Etienne, if I can offer my 2 cents again…

    As I understand it, the point that was being made was that according to the NHANES 2001 to 2004 or 2005 to 2006 the population’s intake of solid fats, refined carbohydrates, sodium and sat fat was high (regardless of the ‘limits’ set) where as the intake of whole-grain, vegetables and fruit etc was low.

    This was in spite of ANY dietary guidelines (scientific or not).
    To argue that populations of today are fat and sick because of low fat, high carbs diet and therefore we should change our diets to what is suggested, is not true.

    Perhaps if everyone left out the solid fat, sugar, refined carbohydrates, increase intake of monounsaturated fat, whole-grains, fruit etc etc we would not have a soaring diabesity epidemic? Rather than blaming it all on carbs in general and advise increased intake of fat?

    They did not listen then, they aren’t listening now, regardless of the basis of the dietary guidelines.

    An interesting point made by David Katz was that, even if Ancel Keys was wrong, and advocated a general low fat diet (of all fats) this offered the food industry a gap in the market to promote “low fat” sugary food and people assumed it was ok to eat (easy way out as it is low in fat) which contributed in a soaring intake of refined CHO and sugar. The old outdated dietary guidelines never encouraged sugar and refined carb intake either.

    To blame all carbs now and go the other direction, it will have the same effect in 20 years. Shouldn’t we try to find something a bit more balanced and just stick to that?

  11. Marlene – I think you are missing my point completely. The graph shows it’s HIGH – yes…but that is based on the Food Pyramid, which you say you don’t support. What is your recommended macro-nutrient breakdown and compared to that would the Sat fat intake be high or low ? I recall seeing your fat intake recommendation being around 30% which would mean most Americans have been starving themselves of Sat fat over the last 20 years !

  12. Etienne, I am struggling to understand where we get lost in translation.

    The 1977 dietary guidelines state:
    Increase carbohydrate intake to 55 to 60 percent of calories, decrease dietary fat intake to no more than 30 percent of calories, with a reduction in intake of saturated fat, and recommended approximately equivalent distributions among saturated, polyunsaturated, and monounsaturated fats to meet the 30 percent target, decrease cholesterol intake to 300 mg per day, decrease sugar intake to 15 percent of calories, decrease salt intake to 3 g per day

    Tim Noakes maintains the high carbohydrate, low fat dietary guidelines (as above) is the reason why obesity, diabetes and heart disease statistics have increased, whereas Nutritional Solutions are trying to say the issue is far more complex than that, shown in the graph i.e. there are many other factors that come into play and it is NOT just as simple has reducing your carbohydrate intake.
    We still recommend 7 – 10% from saturated fat until we see evidence that it safe to recommend more. We now recommend higher fat intake (up to 45% TOTAL FAT) with the focus on mono-unsaturated fat. We also now say it is not acceptable to recommend 15% sugar anymore and it is now less than 10% according to the WHO. These recommendations are generally, and will differentiate between individuals and disease states.

    We don’t eat saturated fat. We eat food containing saturated fat, protein, carbohydrate etc. We are trying to related healthy guidelines to food rather than focusing on one nutrient like saturated fat or carbohydrate.

    Lets wait for their blog on saturated fat.

  13. Hi Marlene. USDA 2010 guidelines are for less than 10% Saturated Fat. This graph shows that the actual intake is 110 % of limit. In other words 11 % of total diet. Seems to me that people are eating far too much processed food. I stopped eating most processed food once I started banting, because I no longer feel the urge to snack, or have cravings for biscuits, chips etc. I wonder if the lack of adequate fats in the diet is not what is making people crave all those processed foods ? The other question that you don’t address are the health risks of consuming too much omega 6 fatty acids (in relation to omega 2 fatty acids). Then of course we have the food industry that is brilliant at selling processed food as “healthy”. The point that Tim Noakes is simply repeating (it is not new) is that the promotion of Low-Fat high-grain dietary guidelines have co-incided with the obesity epidemic. Thanks for a very interesting discussion!

  14. Think we are getting closer and closer to the truth. We are all in agreement that we eat far too much processed food, trans fats, refined carbohydrate and sugar in our diets. We are also in agreement that this leads to over-consumption of these foods due to its hyperphagic response. This is not disputed.

    However, would you have seen the same effect Etienne, if your diet was say 40% fat (focus on mono-unsaturated fat) and moderate portions of whole-grains, fruit and vegetable (40% carbs) as well as excluding sugar, biscuits, cakes, chips, white bread, jam, pastries, chocolate etc etc?

    We certainly do see this in practice. Many people loose weight and control cravings this way. To date, this is the best recommendations we have to avoid all the other health risks and implications for LCHF diets described in the literature.

    If Tim Noakes simply said, promotion of low fat, high carbohydrate diets lead to obesity epidemic we would certainly not have this debate. I think many dietitians including myself actually agree with this statement of his. Our counter argument is however that we no longer use those dietary guidelines anymore and his diets does have implications that people choose to ignore because it “works so well” i.e. < 50g carbs per day, high sat fat intake etc. People choose to eat high sugar, low fat food as fat received bad press, we are all human, and want the easy way out.

    The public seems to think because we are encouraging whole-grain carbohydrate and fruit we are suggesting "high carbohydrate diets". You only need one cup of brown rice and 1-2 portions of fruit, 2 – 3 portions of vegetables and 2 portions of dairy per DAY to have the maximum goodness of these foods and you will still feel full, healthy, with no cravings. Its not "high carbohydrate".

    On the issue of Omega 6: I am eager to wait for future blogs as I am sure it will be discussed.
    You are right when you say it is mostly about the Omega 6: Omega 3 ratio rather than Omega 6 intake as Omega 6 is still an essential fatty acid. We as dietitians constantly push for higher intakes of Omega 3 for this reason.

    Thanks for interesting discussions indeed. We are constantly pushed to come up with plausible answers and we are learning too!

  15. It is stated above that there is growing evidence for increased cancer on high carb diets that is “conveniently ignored”. But many analyses and meta-analyses indicate that red meat (especially processed and cured meats – and that includes bacon) is positively associated with higher risk of several cancers [see refs 1 – 6 – and there are many more]. So why do we conveniently ignore these? Why state that we shouldn’t eat X because it is linked to Y, but then state that we should eat Z even though it is also linked to Y! Noakes might then argue that we should actually be eating natural, grass-fed beef that we can conveniently go and get from our high-end butchery somewhere down in trendy Cape Town city centre. If we are rich, of course. Because this doesn’t offer a solution for the many obese and poor people in South Africa. He states that we can’t keep feeding our population on sugary foods etc, as this leads to obesity and disease. I don’t believe anyone would disagree with this. But at the same time, only a tiny percent of the population are able to buy the high quality organic meats that he and others are fortunate to have access to.

    Its suggested that those with insulin resistance should adopt this LCHF diet, but we know that many are having a go at this diet, including those who are [probably] able to tolerate carbs, and just want to get skinny quickly. Is there any data on what percentage of the population might be insulin-resistant? Please someone, provide references. I understand that those with insulin-resitance are more prone to developing T2D, but surely this is onset by diets high in refined sugars and starches and convenience foods and complex refined carbohydrates, and not those based on high-fibre, low-starch vegetables, legumes, fruits and limited meat ? Or not? Is there actually data to suggest that people develop insulin-resistance following a largely plant-based diet with little calories from refined carbohydrates and sugars, such as a “Mediterranean” -style diet (e.g. high intake of olive oil, fruit, nuts, vegetables, and cereals; a moderate intake of fish and poultry; a low intake of dairy products, red meat, processed meats, and sweets; and wine in moderation). The data I find strongly suggests that this kind of balanced Mediterranean diet reduces your risk of T2D, Alzheimer’s etc [10,11,12,13].

    This isn’t a challenge – what I want to know, is how did Noakes et al. develop their guidelines on what to eat? How could I work out an eating plan based on his guidelines? Where is the data that the guideline is based on? Would, for instance, a dish made with 1 cup tempeh or tofu (caloric ratio [CR]: 19% carb, 49% fat, 32% protein), 1 C spinach (CR: 56% carbs, 14% fats, 30% protein), 1/3 C sunflower seeds (14% carbs, 74% fats, 12% protein) and 2 TBSP olive oil (CR: 100% fat), be appropriate ? And if so, why then push a diet which is so unsustainable and ethically questionable? We are severely straining our resources; animal production is the highest contributor to global warming, environmental degradation, deforestation and it wastes precious water resources [www.fao.org, 7-9], yet these diets which are extremely high in these products are being pushed as if our resources are limitless (which they are not).

    And also, while the obesity epidemic happened after the adoption of the 1977 guidelines, how is this cause and effect proven? This is also around the same time that convenience foods and “TV dinners” (high in empty calories) proliferated. Surely dietary guidelines don’t suggest sugary muffins for breakfast, KFC for lunch and pap n wors for supper, and potato chips and sweets in-between? And surely, this is why we see increased obesity and diabetes, cancers etc?

    I just don’t see how this kind of “Paleo” diet can offer a sustainable solution for everyone.

    1. Chan, D. S., Lau, R., Aune, D., Vieira, R., Greenwood, D. C., Kampman, E., & Norat, T. (2011). Red and processed meat and colorectal cancer incidence: meta-analysis of prospective studies. PloS one, 6(6), e20456.

    2. Larsson, S. C., & Wolk, A. (2006). Meat consumption and risk of colorectal cancer: a meta‐analysis of prospective studies. International Journal of Cancer, 119(11), 2657-2664.

    3. Sandhu, M. S., White, I. R., & McPherson, K. (2001). Systematic Review of the Prospective Cohort Studies on Meat Consumption and Colorectal Cancer Risk A Meta-Analytical Approach. Cancer Epidemiology Biomarkers & Prevention, 10(5), 439-446.

    4. Cross, A. J., Leitzmann, M. F., Gail, M. H., Hollenbeck, A. R., Schatzkin, A., & Sinha, R. (2007). A prospective study of red and processed meat intake in relation to cancer risk. PLoS medicine, 4(12), e325.

    5. Norat, T., Bingham, S., Ferrari, P., Slimani, N., Jenab, M., Mazuir, M., … & Riboli, E. (2005). Meat, fish, and colorectal cancer risk: the European Prospective Investigation into cancer and nutrition. Journal of the National Cancer Institute, 97(12), 906-916.

    6. Chao, A., Thun, M. J., Connell, C. J., McCullough, M. L., Jacobs, E. J., Flanders, W. D., … & Calle, E. E. (2005). Meat consumption and risk of colorectal cancer. Jama, 293(2), 172-182.

    7. Koneswaran, G., & Nierenberg, D. (2008). Global farm animal production and global warming: impacting and mitigating climate change. Environmental Health Perspectives, 116(5), 578.

    8. Carlsson-Kanyama, A., & González, A. D. (2009). Potential contributions of food consumption patterns to climate change. The American journal of clinical nutrition, 89(5), 1704S-1709S.

    9. Fiala, N. (2008). Meeting the demand: An estimation of potential future greenhouse gas emissions from meat production. Ecological Economics, 67(3), 412-419.

    10. Giugliano, D., & Esposito, K. (2008). Mediterranean diet and metabolic diseases. Current opinion in lipidology, 19(1), 63-68.

    11. Scarmeas, N., Stern, Y., Tang, M. X., Mayeux, R., & Luchsinger, J. A. (2006). Mediterranean diet and risk for Alzheimer’s disease. Annals of neurology, 59(6), 912-921.

    12. Martínez-González, M. Á., De la Fuente-Arrillaga, C., Nuñez-Cordoba, J. M., Basterra-Gortari, F. J., Beunza, J. J., Vazquez, Z., … & Bes-Rastrollo, M. (2008). Adherence to Mediterranean diet and risk of developing diabetes: prospective cohort study. Bmj, 336(7657), 1348-1351.

    13. Estruch, R., Ros, E., Salas-Salvadó, J., Covas, M. I., Corella, D., Arós, F., … & Martínez-González, M. A. (2013). Primary prevention of cardiovascular disease with a Mediterranean diet. New England Journal of Medicine, 368(14), 1279-1290.

  16. Thanks Jo.

    My response is the 25 000 words that I wrote in Real Meal Revolution. There is a totality of evidence that must be considered. One cannot base a case on associational studies which, let us again re-iterate, can prove absolutely nothing. They can only generate hypotheses to be investigated by long term prospective studies. Until this is understood, much wrong advice will continue to be given as some suggest that as many as 85% of associational studies will produce the incorrect conclusions.

    So you really need to stick to prospective studies for your solid evidence base. I am not aware of any long term prospective intervention studies which show that meat increases all-cause mortality. And until such time, it is scientifically incorrect and potentially harmful (given the evidence for excellent health in meat-eating societies before those societies were suddenly exposed to the modern industrial diet) to be dogmatic about the dangers of meat eating. I refer to the writings of Weston Price and others. In any case the low carbohydrate diet that we promote is not a high meat diet – so you are setting up a straw man argument.

    I have no argument that the Mediterranean diet is healthy but exactly what is the diet and exactly what component(s) of the diet is health-giving has not been established. There are many overlaps between the low carbohydrate diets and the Mediterranean diet and it could be those overlapping components – fish, nuts, oils, fats, vegetables – that are the healthy components. Or it could be that both avoid similar toxic dietary elements like sugar and vegetable oils. The true Mediterranean diet that was followed before and shortly after the Second World War is quite different from what is now considered a Mediterranean diet which contains more cereals and grains and perhaps less meat including perhaps lamb and pork (I don’t know, I am just suggesting). My argument would be that the increased cereals and grains in the diet makes it less healthy than the original pre-World War II version. Interestingly the healthiest Mediterranean dieters studied by Ancel Keys in the 50s and 60s were also orthodox Greeks who fast for a very large proportion of each year. But Keys and everyone since has never asked: Was it their fasting which made these orthodox Greeks so healthy when eating their Mediterranean diet? Such is the problem with associational studies. Maybe regular fasting is more important that the composition of the diet?

    But if you read your reference 13 carefully you will notice that the extent of benefit of the Mediterranean diet in that study population was extremely small and absent in certain disease categories. It may have been a significant effect (when analysed in the way the authors did) but the effects seemed remarkably small and amounted to a tiny number of lives that were “saved” by the diet. Not a particularly encouraging finding in my view as I would have expected a much larger effect if the Mediterranean diet is all that it is made out to be. Maybe the subjects in that trial did not fast enough? I am being facetious but science is always about asking the right questions.

    I do not believe that nutrition need be an exact science. All creatures on this earth (including most humans) eat in response to biological signals that keep them healthy when eating the foods with which they co-evolved over millions of years. Provided humans are eating the foods with which they co-evolved, their brains should be able to tell them how much of the different foods they should eat. We do not need to tell a single animal in the Kruger National Part how much of which different foods each needs to eat. But put them in a zoo and feed them foods which differ by the tiniest amount from that with which they co-evolved, and they rapidly become ill as are most elephants in North American zoos suffering as they do now from obesity, heart disease and infertility. But this does not happen to anywhere near the same extent in the wild.

    My opinion is that the same applies to humans – direct them to eat only healthy foods and let them decide how much of which different foods they need to eat. This may conflict with the core belief of your profession, but if it does, then we need to see which is true: Are humans healthier when told exactly how much of each foodstuff they must eat each day? Or when left to their own choices from a selection of foods considered to be healthy because they are the foods with which humans co-evolved?

    That would be a most interesting clinical trial and since it addresses a core component of your professional belief, it would seem something that needs to be done as a matter of some urgency.

    With regard to sustainability of food production, you might want to ask the question: From where is all the fertiliser coming to sustain global grain production? How is fertiliser produced? Life is not easy and your analysis is unbalanced.

    Finally insulin resistance is in my opinion a human trait (of variable penetrance) that had significant survival value in the course of our evolution. For 3.5 million years of our evolution, this trait was advantageous (in ways that perhaps we don’t yet fully understand). But with the introduction of high carbohydrate diets after 1977, this trait became a killer in those with the more severe degrees of insulin resistance who would develop the metabolic syndrome including obesity, hypertension and Type 2 diabetes, when exposed to diets containing more than about 200g of carbohydrate per day (irrespective of whether that carbohydrate is low or high GI). Dr Gerald Reavan was the man who in the late 1960s began the studies showing the toxic combination of insulin resistance and high carbohydrate diets. For reason that remain unclear his brilliant work (like that of Dr Jeff Volek on the effects of high fat diets on human health) have been largely ignored especially by my profession.

    Dr Reavan’s work predicted the obesity epidemic because it explains the biology of what happens when those with insulin resistance eat high carbohydrate diets.

    Either we appreciate the importance of his work or we continue to ignore it.

    The choice is ours.

    But either way the truth always wins in the end.

    1. Dear Prof Noakes

      Please provide a reference for the work of Dr Reavan that predicts ” the obesity epidemic because it explains the biology of what happens when those with insulin resistance eat high carbohydrate diets ” I am especially interested in understanding the biology of HOW this happen.

      In the words of Dr Reavan himself, “the European Group for the Study of Insulin Resistance (EGIR) concluded on the basis of over 1100 direct measures of insulin-mediated glucose disposal that ≈25% of obese individuals could be classified as being insulin resistant.” http://circ.ahajournals.org/content/106/3/286.full

      So only 25% of obese people are insulin resistant. How can one then blame insulin resistance as solely responsible for the obesity epidemic?

      I will not be buying your new recipe book to get my facts. When I bought your “challenging beliefs” book more than a year ago, it was one of the best books I have read in a long time and I had huge respect for how you challenge dogma. However, your charge against sugar as being poison, in any dose , is up to now, without any scientific cause and effect proof and based on the same “associative” data and studies that you yourself claim above cannot be used. You also make similar claims as to the cause of cancer, the safety of ketogenic diets for pregnant mothers, babies and children, without any scientific evidence to prove their safety, while at the same time ignoring data that suggest such diets might be very detrimental to their health.

      This is not the Prof I love and respect, and while I applaud and support you for taking the whole real foods debate into the public domain and trying to make SA a healthier place, I beg you to not lose the scientific approach for which you have become famous, loved and respected.

      1. Albie,
        the paper you cite is 12 years old. In this it states in the end something like “there is more to CHD risk than cholesterol”. In fact it is now plain that cholesterol is WAY behind the predictive power of fasting blood sugar, serum insulin, abnormal glucose tolerance test, HbA1c etc. Sticking rigidly to the metabolic syndrome as defined in the table in that paper may not be of any benefit to patients. Definitions of syndromes have a historic tendency to slide. Another thing, it is stated that the role of serum insulin in CHD was “explicated” (only an American could commit such a sin against English!) in 1998. John Yudkin explicated it in Pure White and Deadly long ago. I’ve actually read all that book.
        Tim Noakes is being as scientific as knowledge will allow him. I ask you this, how does he compare to those whose entire argument is based on a fraudulent paper, i.e. that of Ansel Keys, and whose whole dietary advice is based on a farrago, i.e. the food pyramid?
        Dr.Garry Lee,
        Cork,
        Ireland.

    2. Paragraph 1:
      One cannot base a case on associational studies which, let us again re-iterate, can prove absolutely nothing.”

      Paragraph 2::
      “given the evidence for excellent health in meat-eating societies before those societies were suddenly exposed to the modern industrial diet”

      Pick dem cherries.

  17. Perhaps you should read the book by Noakes et al. Should answer most of your questions.

    This is not the forum to really discuss the matter, the comments are moderated in bias and therefore any valid statement, such as my previous comment never see the light of day. But in short, to any reference you placed there is another to disprove it or to prove the contrary. If you are of the opinion that the diet favours the rich or trendy then so be it. If carbohydrates weren’t elevated to the status of staple then meats would have been more accessible and probably priced accordingly.

    On the matter of methane and global warming, if global warming actually exists due to human intervention, perhaps we should focus on industry’s contribution rather than to put the consumption of meat at an elevated environmental risk.

    I just don’t see how a high carbohydrate diet can offer a sustainable solution for everyone… and when you do read the book, you will find that there are many diets suited to many different individuals.

      1. Funny – I have much more energy on a high fat diet then I ever had on a high carb diet ? Most of my friends who have tried it report the same. There is also some quite interesting research showing that REE (Resting energy expenditure) is higher on a high fat-low carb diet than other diets. So there is more to this energy efficiency than meets the eye!

  18. Hi all

    If I could make a suggestion. Please can we discuss academic material, not opinions of various people (or experts) to match what we believe. Let us discuss clinical guidelines and evidence based medicine.
    Evidence, will prevail. So let us discuss this, not a history lesson.
    Here is an interesting piece: ‘Frequently, individuals reduce the carbohydrate content of their diet as a weight loss strategy. As glycogen stores are depleted in response to low carbohydrate intake, the resultant diuresis produces an initial dramatic weight loss. On very-low-carbohydrate diets (eg, 20 g/day) the body produces ketones to sustain fuel utilization in the brain, which may in
    turn help with diet adherence by decreasing hunger (36). Individuals assigned to the ad libitum low-carbohydrate diet in recent randomized controlled trials lost more weight at 6 months than individuals assigned to the low-fat, reduced-energy diet, but
    this difference was no longer significant at 12 months (11,37,38). Concerns regarding an increase in cardiovascular risks with low-carbohydrate diets do not appear to be as problematic as first thought (37).’

    Gaesser,G. (2007) highlights that American (and the world) are becoming more overweight. Gaeser, G. (2007) mentions that there has been an association with carbohydrate intake and obesity. The review mentions that total % carbohydrate intake was not associated with weight gain. In some cases a higher carbohydrate intake was associated with weightloss. Even GI was not a predictor of weight loss or weight gain.

    As I have previously mentioned, there is no evidence for one diet over the other.

    Tim, please can you shed some light on a matter for me? According to my understand, Banting restricted 6 food items: Bread, milk, butter, beer, sugar and potatoes. Although, finding his original text on this matter has been some what of a challenge. Have you got an electronic copy of his original text? As from what I have found online (although, poorly referenced) Banting suggested that we restrict our intake of butter. Please help me clarify this.

    Regards
    Hamish

    Reference:
    American Dietetics Association (2009) ‘Position of the American Dietetic Association: Weight Management ‘ Journal of the American Dietetics Association, February 2009 [Online]. Available at: http://andevidencelibrary.com/files/Docs/WM%20Position%20Paper.pdf (Accessed: 19 February 2014).

      1. Thank you.
        So it does appear that Banting suggested that we limit the intake of butter. Several of the patients I have seen have followed the ‘Banting/Tim Noakes diet’, they make use of a large amount of butter. Has the diet been subsequently changed, or are we not truly following the advice set out by Banting? Or was it simply, poor understanding from the patients perspective?

        Regards
        Hamish

  19. Hamish, you make very valid comments and have valuable insight.

    Although this is not my blog post and I merely comment on it as a South African dietitian in the UK, can I just make the comment that we cannot ask to keep it academic on a public blog.

    We need to keep it on a level for the general public to understand our medical terms and science and allow the public to engage with us and enjoy this blog too.

    An academic debate should happen on another platform

    Thanks
    Marlene

  20. Thanks Tim for your response, which I will need to think about. But rather than buy your book, some links to some relevant journal papers would be easier for me to access (?). I’m a poor student, after all. And I’m not dead set on way or another. My objections are based on evidence I find.

    You state: “So you really need to stick to prospective studies for your solid evidence base. I am not aware of any long term prospective intervention studies which show that meat increases all-cause mortality. And until such time, it is scientifically incorrect and potentially harmful (given the evidence for excellent health in meat-eating societies before those societies were suddenly exposed to the modern industrial diet) to be dogmatic about the dangers of meat eating. I refer to the writings of Weston Price and others. In any case the low carbohydrate diet that we promote is not a high meat diet – so you are setting up a straw man argument”

    A few things:

    – Just as you suggest that studies suggesting the benefits of cereals and grains cannot be trusted because they are funded by these industries, how can you expect others to accept the writings of Weston Price, which is sponsored by the meat industry?

    – Where is the evidence for “excellent health in meat-eating societies before those societies were suddenly exposed to the modern industrial diet” – is this based on life expectancy? When did the modern industrial diet happen? How was health measured back then?

    -As for the straw man argument, don’t typical high fat high protein diets promote eating animal products daily (perhaps bacon as part of breakfast, beef/chicken/turkey etc as part of lunch or supper, biltong to snack on)? In my opinion, that is a high meat diet.

    – Do you know of some “long term prospective intervention studies” that show that a high [animal] fat and protein diet is safe, given that it would be scientifically incorrect and harmful otherwise? (As an aside, this looks interesting, though dated: Willett, W. C., Stampfer, M. J., Colditz, G. A., Rosner, B. A., & Speizer, F. E. (1990). Relation of meat, fat, and fiber intake to the risk of colon cancer in a prospective study among women. New England Journal of Medicine, 323(24), 1664-1672).

    Of course, I cannot sit here and do a cost-benefit analysis of our entire agricultural production systems. But luckily, others have, and there is much consensus that animal production in particular is problematic. You probably know this, but most of the grains we produce are fed to animals, not humans. For e.g. Producing 1 kg of beef requires 10kg of grain, and 100,000 litres of water (data obtained from the non-partisan Council for Agricultural Science and Technology and FAO).

    It is suggested that if the current growth rate of animal product consumption continues, by 2050, livestock will consume as much food as the entire human population did in 1970. One major issue in the demand for more animal feed is for farmland to grow feed crops such as soya; driving massive deforestation in the Amazon, thus driving species extinction. In the EU alone, meat and milk consumption is responsible for 24% of the total environmental impact within the EU (1).

    The FAO (2006) suggest that 17% of global greenhouse emissions are from animal agriculture – 70% of all agricultural land, and 30% of the Earth’s land surface is directly or indirectly involved in livestock production (FAO 2006). The livestock sector in particular is in the top 3 contributors to land degradation, water pollution, and increased health problems (resulting from intensive agriculture – note – bird and swine flu, antibiotics etc ; FAO 2006).

    And the suggestion that “If carbohydrates weren’t elevated to the status of staple then meats would have been more accessible and probably priced accordingly” is just fallacious. The fact is that we don’t have enough space/resources on this planet to grow all the crops (and crop-inputs) needed to feed animals, and then, of course, the space needed to house these animals, the carbon emissions from trucks transporting animals, the emissions from trucks/planes transporting the grains from across the world to feed the animals, the amount of water needed, the inherent methane in animal production, and etc. Red meats are expensive to rear, hence costly. But in the end, poor societies will be those hardest hit by environmental destruction and land degradation.

    I could go on, but I won’t. But this is a real ethics issue.

    1. Nguyen, T. L. T., Hermansen, J. E., & Mogensen, L. (2010). Environmental consequences of different beef production systems in the EU. Journal of Cleaner Production, 18(8), 756-766.

  21. Tim Noakes’s reply was as usual meandering around from topic to topic without focussing on any one point too clearly, all of which could be very easily rebutted or is astonishingly hypocritical. For example he is anti-association studies above, while his main scientific contribution on this was writing up a series of letters to him praising ‘his diet’ as a scientific article, and telling people to read his books as if they are the purveyors of all truth – while of course books are by definition someone’s own interpretation of events or issues. Added to this is the usual, simplifying of complex issues such as saying if you put animals in zoos it is the change in food choices that make them ill, while of course not saying that captivity itself could be responsible for most of the changes; or that if you gave people natural food choices they would all choose the right them because their ‘brain’ would choose right for them, when food choice is of course so much more complex then just eating food types (social and psychological for example). Lets not even start discussing the idea a specific incident / publication in a certain year suddenly started people eating more sugars – that is getting on to alice in wonderland type discourse and stuff that makes most experienced scientists shake there heads and stop reading stuff.

    Of course also all dieticians who disagree with Tim will probably be thought of or described as being in the pay of some big company (while perhaps someone should ask Tim how exactly his research of the last 30 years has been funded), and if they don’t agree with Tim it will indicate that dieticians / nutritionists as a whole are not credible and their discipline is deteriorating and is falling to pieces. Same pattern from earlier times with folk / researchers who didn’t agree with his drinking guidelines and increasingly bizarre fatigue theories before that. Interesting that Tim is now blasting practicing nutrition / dietician folk – real ‘flat track bully’ stuff – there are some long in the tooth / hard-core scientists that would I suspect love to ‘have a go’ at this meandering waffle but are just not interested in wasting time doing so.

    And as for the 25 000 words from Tim within which is the ‘totality of evidence’ – cringeworthy stuff – what about all the thousands of words written in the decades before when good Tim was the purveyor of carbohydrates as gospel – and a decade ago his carbohydrate supporting writing was I suppose also the ‘totality of evidence’ then! (-:

    The most fascinating thing about this to me is why would someone want to shout so loud to everyone about their own condition and how they perceive they treated themselves with a specific diet, then ramming it down everyone’s throat that they should all do as they do based on their own experience – but I guess as Tim has said before, it is all about being ‘relevant’ (whatever that means) and I guess being heard for as long as possible, by as many as possible, whatever the message….

  22. Noakes is a FRAUD!! Don’t buy into his GIMMICKS!! It’s that simple. He chops and changes his advice every few years so that he can sell new ideas. I had a family member who against my advice followed his plan and nearly had a heart attack. According to the cardiologist, it was the diet that was the route cause.

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