Tim Noakes is a kook: a discussion of an infamous debate.

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Professor Timothy Noakes is well known in the world of science. His work has played an important role in the world of sports science. He has published more than 400 scientific articles–a remarkable and unusual feat of scientific productivity. He has earned both a medical degree and a doctor of science and received a remarkable number of accolades.

Tim Noakes is also a kook.

In 2014, for instance, he wrote a tweet suggesting a defense of Andrew Wakefield stating that the CDC was behind a conspiracy to cover up a link between vaccines and autism. https://en.wikipedia.org/wiki/Tim_Noakes 

Also in 2014, Noakes recommended that a woman wean her baby onto a low-carbohydrate diet and became embroiled in a nearly 4-year hearing by his country’s health professionals organization. https://en.wikipedia.org/wiki/Tim_Noakes

Tim Noakes rejects that LDL causes cardiovascular disease, a central lynchpin of modern medical science. https://en.wikipedia.org/wiki/Tim_Noakes

Correspondingly, he rejects the use of statins and has a long history on social media of suggesting that statins are harmful, and of endorsing the work of fringe figure and LDL denialist Uffe Ravnskov. https://twitter.com/search?l=&q=statin%20from%3Aproftimnoakes&src=typd&lang=en&lang=en

Noakes has been known to claim that not eating carbohydrates prevents or cures cancer on multiple occasions. (Carbohydrate restriction may help treat some forms of cancer, but research is still in the preliminary stages.) Noakes also endorses the view, rejected by the large majority of professional obesity researchers, that insulin resistance precedes and causes obesity. https://twitter.com/ProfTimNoakes/status/941026898091618304 …

Although Mendelian Randomization experiments suggest that high insulin secretion can precede obesity, such experiments suggest that only about 1-10% of obesity is explained in this way. http://clinchem.aaccjnls.org/content/64/1/192?ijkey=130c91dd6dcb0c60817738f98872ba7465543ea1&keytype2=tf_ipsecsha

Demonstrating the (unfortunate) weakness of present scientific capacity, Noakes in an editorial misinterprets this paper and indicates that he believes that it demonstrates the causality of insulin resistance for obesity. It does not. The most reasonable interpretation is that whatever Noakes’s past scientific performance, old age has likely not enhanced his abilities. Likewise, he seems at ease musing over extreme positions before a following that is not well trained to evaluate these positions.

In response to a thread that I posted on Twitter about Noakes, Jacques Rousseau, a longtime critic of Professor Noakes, sent the following very interesting link to a legendary debate that Noakes was involved in: https://twitter.com/JacquesR/status/1088902639134355456

In it, Noakes guaranteed the audience that a low-carbohydrate diet would make one immune to cancer, dementia, and diabetes. Learning this, I just had to listen to the entire debate.

As I was doing my laboratory work, I listened. Here is a point-by-point account.

At almost 20 minutes in, Noakes denied that saturated fat raises LDL. This is false, as Mensink and hundreds of studies have shown: https://apps.who.int/iris/bitstream/handle/10665/246104/9789241565349-eng.pdf. It is difficult to believe that a scientist could say such a thing. One of the only conclusions to be drawn is that he has not actually read the relevant research.

Just at 20 minutes, Noakes also claims that polyunsaturated fats are inflammatory. This is not supported by the evidence which shows that in humans polyunsaturated fats are either neutral or anti-inflammatory. Although theoretical considerations would cause people to think that polyunsaturated fats might be inflammatory, human studies have shown that these theoretical considerations have not been borne out. Yet they persist, apparently in Tim Noakes, who dismisses evidence in favor of them. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4424767/

(It is true that weight loss will reduce systemic inflammation, so one can have low inflammatory markers on a high-saturated fat diet. Likewise, one can also have high inflammation on a polyunsaturated fat diet if one’s body weight is high. Body weight and in particular body-fatness is the dominant determinant of the body’s inflammatory state, and if cutting added oils helps to reduce body fatness, good. But on an isocaloric basis, the research points overwhelmingly to oils being neutral or positive on inflammation. That is why when people lose weight, their systemic inflammatory markers decrease. When they gain weight, these markers increase. This is because being overweight is stressful on the body’s cells.)

Back to Noakes. Between minutes 20 and 50, there is much hand-waving but little actual evidence. By 50 minutes, it’s conspiracy theories: MRC and NIH won’t fund trials to test his ideas because they know he is right and want to prevent discovery of a cure for cardiovascular disease, cancer, diabetes, dementia, etc. After his claim that you won’t get dementia, diabetes, or cancer if you don’t eat carbohydrates, he then says, “Those diseases did not exist until we started eating the highly processed foods.”

This is in fact false. Dementia was documented since the beginning of recorded history: https://www.ncbi.nlm.nih.gov/pubmed/16442123.Cancer has also been documented in 1.7 million hominid ancestors: https://www.sajs.co.za/article/view/3566. (And of course “cancer” was coined by classical Greek physician Hippocrates. Oops.)

Many prehistoric animal fossils with tumors have been discovered, e.g.: https://www.sciencedaily.com/releases/2016/12/161208121323.htm So yes animals got tumors before the advent of McDonalds. (Another such report comes from Erwin Ackerknecht’s 1982 introductory chapter to his book on the history of medicine.

Diabetes is different. First documented in Egypt or India about two thousand years ago, diabetes mellitus has been remarkably rare throughout human history in the West, with physicians living in the grain-based Roman Empire rarely encountering the disease: https://en.wikipedia.org/wiki/History_of_diabetes. Some scholars have even maintained that diabetes was not first definitely documented in the West until after the middle ages (source: chapter from Burkitt and Trowell’s 1981 edited volume). This is probably because the degree of energy excess and food-processedness is indeed unprecedented today compared to the past.

Nearer the end, in response to people upset about the expense of his diet, Tim proposes that we should not be eating meat at all, but the guts, the bones, and the brain of the animal instead. He suggests that this approach will solve the problem and make his diet affordable to the poor.

An appropriate ending to this thread. Thank you for reading.

(This post is based on my January 25th, 2019 Twitter thread, here: https://twitter.com/kevinnbass/status/1088933196341960704.)

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