The â??gunsâ? donâ??t get bigger than this: academics from the highest reaches of the University of Cape Town have written to the Cape Times attacking their own colleague, sport scientist Prof Tim Noakes for making â??outrageous, unproven claims about disease preventionâ?.
The war on Tim Noakes
It is the latest salvo in an ongoing war against Noakes documented in my Q&A with him. It began after he changed his mind nearly four years ago on high-carb, low-fat eating, to promote high-fat, low-carb (HFLC) regimens to treat insulin resistance, and shows no signs of abating.
The academics also attack him for â??maligning the integrity and credibility of peers who criticise his diet for being evidence-deficient and not conforming to the tenets of good and responsible scienceâ? (They say nothing about the many peers, including one of the letterâ??s authors, who have publicly maligned and attacked Noakesâ??s integrity and credibility).
The letter is signed by Prof Wim de Villiers dean of Faculty of Health Sciences, Prof Bongani Mayosi, Head of Department of Medicine, and emeritus professor, cardiologist Dr Lionel Opie, and Dr Marjanne Senekal, associate professor and head of Division of Human Nutrition, copied to Noakes and others.
Tim Noakesâ??s response
Noakes has responded, also in a letter to the Cape Times, saying UCTâ??s Faculty of Health Sciences of the University of Cape Town has consistently misrepresented his public message; there is science behind it; and it simply says, â??A high carbohydrate diet is detrimental to the health of persons with insulin resistance, whereas carbohydrate restriction in this group can be profoundly beneficial as it can reverse obesity and in some cases Type 2 diabetes mellitus, the two conditions that will ultimately bankrupt South African medical services unless we take appropriate preventive actionsâ?.
Noakes accuses the academics of â??cognitive dissonanceâ? in denying the existence of scientific evidence in support of his views. Cognitive dissonance is the psychological term for a situation involving conflicting attitudes, beliefs or behaviours, that produces a feeling of discomfort leading to an alteration in one of the attitudes, beliefs or behaviours to reduce the discomfort and restore balance, etc.
They are also ultimately â??guilty of failing fully to inform its past and present science, medical and dietetics graduates in a manner appropriate for a faculty that considers itself to be a world-leaderâ?, he says.
He has gone further in a radio interview, saying he has written to the Faculty, pointing out that the allegations against him are libellous, and without any scientific basis whatsoever, and that the universityâ??s correct procedure has not been followed.
Itâ??s an ugly spat, and I have to agree with Noakes that it is peculiar that the UCT academics have been allowed to attack a colleague so publicly before doing any homework of their own. The least that should have been done was a proper investigation, by unbiased scientists, and including all the research available internationally â?? on both sides of this extremely contentious topic.
The fact is, as Noakes has always made clear, nutrition is not exact science and is unlikely ever to be one. No one, including him, currently has all the answers, and he has never claimed that his diet is a one-size-fits-all.
Here are the letters from UCT and Noakes to the Cape Times:
From Prof Wim de Villiers dean of Faculty of Health Sciences, Prof Bongani Mayosi, Head of Department of Medicine, and emeritus professor, cardiologist Dr Lionel Opie, and Dr Marjanne Senekal
â??The apparent endorsement by Members of Parliament of South Africa of the latest fashionable diet, â??Bantingâ?? (â??SAâ??s Ticking Time-bombâ??, Cape Times, 19 August 2014) and the message it sends out to the public about healthy eating, is cause for deep concern â?? not only regarding Parliamentâ??s support for it as an evidenced-based â??diet revolutionâ??, but sadly, the long-term impact this may have on the health of the very people they have been elected to serve.
â??Any diet for weight loss and maintenance should be safe and promote health in the long-term. Currently the long term safety and health benefits of low carbohydrate, high fat diets â?? such as Atkins, Paleo and South Beach, and in which Banting falls â?? are unproven, and in particular whether it is safe in pregnancy and childhood.
â??Importantly, while the consumption of a low carbohydrate, high fat diet may lead to initial weight loss and associated health benefits â?? as indeed would a balanced weight loss diet â?? there is good reason for concern that this diet may rather result in nutritional deficiencies, increased risk for heart disease, diabetes mellitus, kidney problems, constipation, certain cancers and excessive iron stores in some individuals in the long term. Research leaves no doubt that healthy balanced eating is very important in reducing disease risk (see web page below dedicated to this debate).
â??It is therefore a serious concern that Professor Timothy Noakes, a colleague respected for his research in sports science, is aggressively promoting this diet as a â??revolutionâ??, making outrageous unproven claims about disease prevention, and maligning the integrity and credibility of peers who criticise his diet for being evidence-deficient and not conforming to the tenets of good and responsible science. This goes against the University of Cape Townâ??s commitment to academic freedom as the prerequisite to fostering responsible and respectful intellectual debate and free enquiry.
â?This is not the forum to debate details of diets, but to draw attention to the need for us to be pragmatic. Research in this field has proven time and again that the quest for lean and healthy bodies cannot be a quick-fix, â??one-size-fits-allâ?? solution. The major challenge lies in establishing sustainable and healthy dietary and physical activity patterns to promote long term weight maintenance and health after weight loss, and includes addressing psychosocial, environmental and physiological factors.
â??Our bodies need a range of nutrients sourced from a variety of food groups to survive. Diets like the Banting are, however, typically â??one dimensionalâ?? in focus. They promote increased intake of protein and fat containing foods at the expense of healthy carbohydrate containing foods, and focus on adherence to a limited food plan. Ignored are the other important factors impacting on health â?? like physical activity (the important of which we cannot emphasise enough), environmental factors, and individual health profiles.
â??UCTâ??s Faculty of Health Sciences, a leading research institution in Africa, has a reputation for research excellence to uphold. Above all, our research must be socially responsible. We have therefore taken the unusual step of distancing ourselves from the proponents of this diet. To foster informed engagement of the issues related to the Diet debate, the Faculty has established a (page on its website) with material on this.â?
Letter in response from Prof Tim Noakes:
â??For whatever reasons, the Faculty of Health Sciences of the University of Cape Town manages consistently to misrepresent my public message which is simply the following: a high carbohydrate diet is detrimental to the health of persons with insulin resistance whereas carbohydrate restriction in this group can be profoundly beneficial as it can reverse obesity and in some cases Type 2 diabetes mellitus, the two conditions that will ultimately bankrupt South African medical services unless we take appropriate preventive actions. This message first presented publicly in my book Challenging Beliefs in 2011, has never changed.
â??It is also the message I presented to members of staff at Parliament a week ago.
â??If that message is without scientific support, then the Faculty of Health Sciences has every right to cross the civil divide as it has now chosen; an action which, I suspect, is unprecedented in the history of the Faculty of Health Sciences and perhaps the history of the University of Cape Town. But if there is evidence for my position, then the Faculty is guilty of failing fully to inform its past and present science, medical and dietetics graduates in a manner appropriate for a Faculty that considers itself to be a world-leader.
â?An outline of the scientific evidence for my position is presented in about 20 000 words in our book Real Meal Revolution. That work includes references to the most important scientific works (of an abundant literature) supporting my interpretation. For the Faculty of Health Sciences of the University of Cape Town consistently to deny that peer-reviewed evidence is a classic example of cognitive dissonance.â?
Recommended reading: What Patrick Holford thinks of the Banting diet