[2017] Lore of Nutrition: Challenging Conventional Dietary Beliefs
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Van der Nest is respected and revered as one of South Africa’s top senior counsel, a person of formidable intellect, integrity and courage. He has seen the effects of prosecutions by bodies such as the HPCSA and the negative effects on the lives of those prosecuted, even when they’ve won their cases down the line. He knows that there is almost always a negative impact on the accused’s life. He knows that, despite the obvious, some will want to believe that Noakes was found not guilty on legal technicalities. Van der Nest also knows that reputation is never fully restored in cases like this. Ramdass is a physician and vegetarian, who at the age of nearly 50 had the courage to change careers and start out as a junior advocate. He brought to the table his encyclopaedic medical knowledge, legal talent and a rare ability to make people listen to him and find themselves wanting to agree with him. Pike, along with his prodigious intelligence, has an acting background and thus naturally tends to see the theatrical side of litigation. However, while he sees the drama, he also sees the extensive damage.
As Van der Nest argued, statutory bodies such as the HPCSA have a duty to take care and never to prosecute for the wrong reasons. After all, anyone is free to agree or disagree with Noakes, but it is completely inappropriate for the HPCSA to prosecute him for his scientific views and to side with those who disagree with him. As we have shown in this book, the HPCSA showed an utter dereliction of duty.
And while Noakes won a decisive victory in Adams’s ruling, ADSA, the HPCSA and others have made it clear that their war with him continues. As our journey progressed, I frequently ended my emails to him with the following: A luta continua, vitória é certa.* It resonated with him.
Does he have any regrets? Of course. Only a fool has no regrets, and Noakes is clearly no fool. For more than three years – that Noakes has described as his ‘descent into darkness’ – the trial dominated his and his family’s life. Perhaps the worst part, he says, was the failure of his university to do anything to support him. Instead, it betrayed him. ‘It has estranged me from an organisation to which I have dedicated my working life,’ Noakes told me.
The unrecognised hero, the most powerful avenging angel who lifted him out of the darkness, is unquestionably Noakes’s wife of 45 years, Marilyn Anne. It is only fitting that she should have the last word in this book.
On 2 July 2017, Noakes’s 68th birthday, Marilyn gave him a card showing a magical blue malachite kingfisher rising effortlessly from the water. Inside, she had written the following:
Did you know that the Kingfisher is a symbol of Halcyon Days? According to the legend, during the 10 days around the winter solstice, the Kingfisher laid her eggs in a nest floating on the Aegean Sea. The bird, it is said, charmed the waves and the eggs were hatched on a tranquil sea beneath cloudless skies. These are the Halcyon Days; they signify peace and happiness.
I am so proud of how you weathered the storm of that most vindictive and harrowing HPCSA Hearing/Trial. The only blessing was the splendid performance of your defence team and those caring friends who came to support you. Getting to know these emotionally intelligent people was humbling and special.
When you were at last given the space to present your evidence to support the LCHF argument you did it with such integrity and eloquence. Well done! It is no wonder that Advocate Joan Adams found you Not Guilty!
Hold your head up high and don’t allow ‘them’ to rob you of your enthusiasm, optimism and wonderful engaging smile.
I wish you Happy Halcyon Days for ever more …
* ‘The struggle continues, victory is certain’. This was the rallying cry of the FRELIMO movement during Mozambique’s war for independence. The phrase is Portuguese and was used by FRELIMO leader Samora Machel to cultivate popular support against the Portuguese colonial presence.
Abbreviations and Acronyms
ADA American Diabetes Association
ADSA Association for Dietetics in South Africa
AHA American Heart Association
AHPRA Australian Health Practitioner Regulation Agency
AND Academy of Nutrition and Dietetics
AUT Auckland University of Technology
BMJ British Medical Journal
CDE Centre for Diabetes and Endocrinology
CHD coronary heart disease
CICO calories in, calories out
CNE Continuing Nutrition Education
CNF Cochrane Nutrition Field
CORIS Coronary Risk Factor Intervention Study
CPD Continuing Professional Development
CVD cardiovascular disease
EAHE exercise-associated hyponatraemic encephalopathy
ESSM Exercise Science and Sports Medicine
FH familial hypercholestrolaemia
GGT gamma-glutamyl transferase
GLiMMER Global Lifestyle Medicine Mobilizing to Effect Reform
HbA1c glycated haemoglobin
HDL high-density lipoprotein
HELP Healthy Eating & Lifestyle Program
HFCS high-fructose corn syrup
HPCSA Health Professions Council of South Africa
HSFSA Heart and Stroke Foundation of South Africa
ILSI International Life Sciences Institute
IR insulin resistance
JAMA Journal of the American Medical Association
LCHF low carbohydrate, high fat
LDL low-density lipoprotein
LFHC low fat, high carbohydrate
mmol/L millimoles per litre
NAFLD non-alcoholic fatty liver disease
NCD non-communicable diseases
NCGS non-coeliac gluten sensitivity
NIH National Institutes of Health
NRF National Research Foundation
NSRD Nutritional Solutions Registered Dietitians
NSSA Nutrition Society of South Africa
PAD peripheral artery disease
PAIA Promotion of Access to Information Act
PAJA Promotion of Administrative Justice Act
PoPI Protection of Personal Information Act
RCT randomised controlled trial
SAHA South African Heart Association
SAJCN South African Journal of Clinical Nutrition
SAMA South African Medical Association
SAMJ South African Medical Journal
SAMRC South African Medical Research Council
SASA South African Sugar Association
SSISA Sports Science Institute of South Africa
T1DM type-1 diabetes mellitus
T2DM type-2 diabetes mellitus
THUSA Transition and Health during Urbanisation of South Africans
UCT University of Cape Town
USDA United States Department of Agriculture
WHIRCDMT Women’s Health Initiative Randomized Controlled Dietary Modification Trial
WHO World Health Organization
Wits University of the Witwatersrand
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Notes
Preface: Tim Noakes
1.R.A. Irving, T.D. Noakes, R. Buck et al., ‘Evaluation of renal function and fluid homeostasis during recovery from exercise-induced hyponatremia’, Journal of Applied Physiology 70(1), 1991: 342–48.
2.T.D. Noakes, Waterlogged: The Serious Problem of Overhydration in Endurance Sports (Champaign, IL: Human Kinetics, 2012).
3.D. Ilbury, Quiet Maverick: Tim Noakes Chews the Fat (Johannesburg: Mampoer Shorts, 2015), 23.
4.T.D. Noakes, ‘Tainted glory: Doping and athletic performance’, New England Journal of Medicine 351(9), 2004: 847–49.
5.USADA, ‘Statement from USADA CEO Travis T. Tygart regarding the U.S. Postal Service Pro Cycling Team doping conspiracy’, 10 October 2012.
6.D. Walsh, The Program: Seven Deadly Sins – My Pursuit of Lance Armstrong (London: Simon & Schuster, 2012), 444.
7.Ibid., 413.
8.Ibid., 449.
9.L.G. Pugh, Achieving the Impossible: A Fearless Leader. A Fragile Earth (London: Simon & Schuster, 2010).
10.G. Claassen, Kwakke, Kwinte & Kwale (Cape Town: XLibris Publishing, 2014).
11.T.D. Noakes, ‘Low-carbohydrate and high-fat intake can manage obesity and associated conditions: Occasional survey’, SAMJ 103(11), 2013: 826–30.
12.P.C. Gøtzsche, Deadly Medicines and Organised Crime: How Big Pharma Has Corrupted Healthcare (Florida: CRC Press, 2013).
Preface: Marika Sboros
1.M. Jones, ‘Noakes goes too far - doctors’, IOL, 14 September 2012, available at http://www.iol.co.za/lifestyle/noakes-goes-too-far---doctors-1383310 (last accessed 31 July 2017).
2.K. Child, ‘Tim Noakes diet is “criminal” says doctor’, Times, 4 August 2014.
3.R. Smith, ‘Are some diets “mass murder”?’, BMJ 2014;349:g7654.
4.C.E Naudé, A. Schoonees, M. Senekal et al., ‘Low carbohydrate versus isoenergetic balanced diets for reducing weight and cardiovascular risk: A systematic review and meta-analysis’, PLoS One 9(7), 2014: e100652.
Introduction
1.Russ Greene, ‘Big Food vs. Tim Noakes: The final crusade’, The Russells, 5 January 2017, available at https://therussells.crossfit.com/2017/01/05/big-food-vs-tim-noakes-the-final-crusade/ (last accessed 31 July 2017).
PART I: THE LOW-CARB REVOLUTION
Chapter 1: The Low-carb Summit
1.C. Choi, ‘Study details sugar industry attempt to shape science’, Observer-Reporter US and World, 12 September 2016, available at http://www.observer-reporter.com/20160912/study_details_sugar_industry_attempt_to_shape_science (last accessed 22 September 2017).
2.A. O’Connor, ‘Coca-Cola funds scientists who shift blame for obesity away from bad diets’, New York Times, 9 August 2015, available at https://www.google.com/search?client=safari&rls=en&q=Coca-
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omised controlled trials did not support the introduction of dietary fat guidelines in 1977 and 1983: A systematic review and meta-analysis’, Open Heart 2(1), 2015: e000196.
7.A. Malhotra, J.J. DiNicolantonio and S. Capewell, ‘It is time to stop counting calories, and time instead to promote dietary changes that substantially and rapidly reduce cardiovascular morbidity and mortality’, Open Heart 2(1), 2015: e000273.
8.A. Malhotra, ‘Saturated fat is not the major issue’, BMJ 2013;347:f6340.
9.O. Warburg, ‘The prime cause and prevention of cancer’, Lindau Lecture, 30 June 1966, available at http://www.healingcancernaturally.com/warburgcancer-cause-prevention.html (last accessed 31 July 2017).
10.J. Rousseau, ‘Lessons in bad science – Tim Noakes and the SAMJ’, Synapses, 24 October 2013, available at http://synapses.co.za/lessons-bad-science-tim-noakes-samj/comment-page-1/ (last accessed 31 July 2017).
11.J. Rousseau, ‘More lessons in bad science (and reasoning) from Noakes’, Synapses, 27 October 2013, available at http://synapses.co.za/lessons-bad-science-reasoning-noakes/ (last accessed 31 July 2017).
12.S. Rousseau, ‘The celebrity quick-fix: When good food meets bad science’, Food, Culture & Society 18(2), 2015: 265–87.
13.J. Rousseau, ‘Roundup – 2015 LCHF summit’, Synapses, 22 February 2015, available at http://synapses.co.za/2015-lchf-summit/ (last accessed 31 July 2017).
14.S. Hawking, Black Holes and Baby Universes and Other Essays (London: Bantam Press, 1993), 36.
Chapter 2: The Most Important Experiment of My Life
1.W. Yellowlees, A Doctor in the Wilderness (Perthshire: Dr W.W. Yellowlees, 2001), 14.
2.Ibid.
3.Ibid.
4.Ibid., 17.
5.Ibid., 195.
6.Ibid., 15.
7.Ibid., 15–16.
8.Ibid., 195.
9.S.D. Phinney, B.R. Bistrian, W.J. Evans et al., ‘The human metabolic response to chronic ketosis without caloric restriction: Preservation of submaximal exercise capability with reduced carbohydrate oxidation’, Metabolism 32(8), 1983: 769–76.