Wednesday, February 24, 2016

Ralph Waldo Noakes? Why Tim Noakes Changing His Mind About Carbohydrates and Fat Was an Act of Courage

If the Dietary Guidelines for Americans is one of the most embarrassing US publications foisted upon the English speaking global community, Ralph Waldo Emerson's "Self Reliance" may be one of its finest.

One of Emerson's most famous quote from this essay, "A foolish consistency is the hobgoblin of little minds," makes uttering the phrase, "I was wrong" an act of intellectual integrity instead of a shameful admission of fault.
Ralph Waldo Emerson

In the case of Professor Tim Noakes of South Africa, a medical doctor, scientist and marathoner, the heroic turnabout concerned his long-standing recommendation to consume a high-carb low-fat diet to enhance athletic performance.

Noakes was following the conventional dietary "wisdom" of his day, entrusting registered dietitians and nutrition researchers to make scientifically based dietary recommendations. Despite his "healthy" regimen, Noakes found himself overweight and pre-diabetic.

Serendipitously, the A-1 rated researcher read a book by medical doctors Eric Westman, Stephen Phinney and Jeff Volek and another by Gary Taubes that for the first time made him suspect that for carb resistant (CR) people -- possibly half of all adults -- consuming recommended amounts of carbohydrates could cause more harm than good. More shocking, the evidence to support nutritional advice given by most registered dietitians, medical doctors and government guidelines was very shaky.

Noakes' father and uncle suffered from Type 2 Diabetes and the scientist saw himself going down that pot-hole riddled road himself -- despite following his government's high carb low fat dietary guidelines and being an elite athlete.

Professor Tim Noakes, MD
The author of Lore of Running, first published in 1985, recommends tearing the chapter on nutrition out of his original book. His more recent books written after his dietary epiphany -- The Real Meal Revolution (for adults) and Raising Superheroes (for children) -- recommend a modified Banting diet (high fat, moderate protein and low carb).

Back in the 90s, I read the work of Dr. John McDougall, who convinced me the "rich Western diet" was the root cause of obesity and chronic disease. For several years I subsisted on a low-fat vegan diet but never realized the myriad health benefits promised by this way of eating; so I returned to a conventional (albeit, also wrong-headed) diet. Yet even as a totally obscure person with no followers other than my husband and children, it was still very difficult for me to acknowledge the extreme dietary regimen my family had been following for two years was not the most healthy way to eat.

So I can only imagine how hard it must have been for Dr. Tim Noakes to tell the world he had made a mistake by recommending a high-carb low-fat diet and that for many, if not most, people the optimal way to eat was virtually the complete opposite. Like Superman's Bizarro world, fat was good; carbs, bad.

Since following with keen interest the "Banting for Babies Trial" -- the Health Care Professions of South Africa (HCPSA) extended hearing on charges that Noakes acted unethically by providing unconventional dietary advice on Twitter to a nursing mother in response to her innocent suspicious query -- I have been struck by how courageous Noakes was to stray from the medical herd and admit he had given bad dietary advice for many years. (For details on this fascinating saga, read these articles.)

Just prior to the landmark Old Mutual Health Convention he hosted with Karen Thomson in South Africa in February of 2015, Noakes released this official statement:
"... “The mainstream dietary advice that we are currently giving to the world has simply not worked. Instead, it is the opinion of the speakers at this summit that this incorrect nutritional advice is the immediate cause of the global obesity and diabetes epidemics. This advice has failed because it completely ignores the history of why and how human nutrition has developed over the past 3 million years.

“More importantly, it refuses to acknowledge the presence of insulin resistance (carbohydrate intolerance) as the single most prevalent biological state in modern humans. Persons with insulin resistance are at increased risk for developing a wide range of chronic medical conditions if they ingest a high carbohydrate diet for any length of time (decades).

"Armed with this knowledge we have two choices. Either we can continue to ignore the evidence presented at this summit, and go on blaming the obese and diabetic for their sloth and gluttony (that is supposedly the sole cause of their obesity and diabetes). Or, if we are ever to reverse this epidemic that has become the greatest modern threat to human health, we need to admit that we have been wrong for the past 40 years, and must now change."
Sadly, too few famous people have the courage of Tim Noakes to change their mind in public and risk being ridiculed by their peers for flip-flopping or flouting convention. Noakes understands that cognitive dissonance makes it uncomfortable for most people to accept conflicting information and have a psychological need to ignore or impugn any data that does not fit their scheme.

Instead, they will continue dispensing the same bad dietary advice that has led to an epidemic of T2D and other metabolic diseases, most of it based on shaky science and funded by Big Food companies who control the message most registered dietitians dish out to a trusting public.
“A foolish consistency is the hobgoblin of little minds, adored by little statesmen and philosophers and divines. With consistency a great soul has simply nothing to do. He may as well concern himself with his shadow on the wall. Speak what you think now in hard words, and to-morrow speak what to-morrow thinks in hard words again, though it contradict every thing you said to-day. — 'Ah, so you shall be sure to be misunderstood.' — Is it so bad, then, to be misunderstood? Pythagoras was misunderstood, and Socrates, and Jesus, and Luther, and Copernicus, and Galileo, and Newton, and every pure and wise spirit that ever took flesh. To be great is to be misunderstood.”
― Ralph Waldo Emerson, Self-Reliance

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