Noakes: backlash begins as UCT ‘big guns’ fire wildly

Prof Tim Noakes

By Marika Sboros

As I predicted, the backlash against University of Cape Town sports scientist Prof Tim Noakes has begun.

I knew it would happen after MPs invited him to address Parliament last week on Banting. I didn’t think it would happen quite so soon. Or that it would come from  his own colleagues at UCT.

The “guns” aimed at Noakes don’t get bigger than this. Academics from UCT’s highest reaches have written an open letter to the Cape Times attacking him. Here’s what they aimed at their target:

The letter’s signatories are  Prof Wim de Villiers, dean of Faculty of Health Sciences, Prof Bongani Mayosi, head of Department of Medicine, Prof Lionel Opie, emeritus cardiology professor,  and Dr Marjanne Senekal, associate professor and head of Division of Human Nutrition.

Stellenbsoch Prof Wim de Villiers

Stellenbsoch Prof Wim de Villiers

In it, they attack Noakes for what they say are “outrageous, unproven claims about disease prevention”.

It is the latest salvo in a war against Noakes that began a few years ago. That was after he dared to change his mind when faced with compelling evidence  that high-carb, low-fat eating was perhaps not so smart after all for certain sick people.

The academics also attack Noakes for “maligning the integrity and credibility of peers who criticise his diet for being evidence-deficient”.  They say nothing about the many peers, including one of the letter’s authors, who have publicly maligned  Noakes’s integrity and credibility.

They say he has not conformed “to the tenets of good and responsible science”.

It’s an action Noakes says is libellous. Certainly, it looks that way. It  is unprecedented in the history of UCT’s  Faculty of Health Sciences.

Dr Marjanne Senekal

Dr Marjanne Senekal

Noakes has responded, also in a letter to the Cape Times. He says UCT’s Faculty of Health Sciences of the University of Cape Town has consistently misrepresented his public message. And he disputes that what he is saying is not evidence-based.

“A high carbohydrate diet is detrimental to the health of persons with insulin resistance,” Noakes says.  Carbohydrate restriction in this group can be “profoundly beneficial” as it can reverse obesity and in some cases Type 2 diabetes mellitus. These two conditions will ultimately bankrupt South African medical services unless we take appropriate preventive actions, he says.

Noakes accuses the academics of “cognitive dissonance”.  Cognitive dissonance is the psychological term for what happens when you are faced with compelling evidence that conflicts with a deeply held belief. You either change your belief, or if you are cognivitely dissonant, you will stick to your old belief.

Noakes says the academics are  “guilty of failing fully to inform (UCT’s) past and present science, medical and dietetics graduates in a manner appropriate for a faculty that considers itself to be a world-leader”.

Prof Bongani Mayosi

Prof Bongani Mayosi

In a radio interview, he says he has written to UCT pointing out that the allegations against him are libellous, and unscientific. And the letter’s authors have not followed proper UCT procedure in scientific disputes.

It’s an ugly spat, and it is odd that the UCT academics attack a colleague so publicly with impunity. And that before doing any homework of their own.

The university should at the very least have had unbiased scientists look into the issue and  all the research available internationally on both sides of this controversy.

The fact is, as Noakes makes clear, that nutrition is not an exact science. It is unlikely ever to be one. No one, including Noakes, currently has all the answers. He hasn’t ever claimed that his  diet is a one-size-fits-all.

Here are the letters from UCT academics and Noakes’s response:

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

“The apparent endorsement by Members of Parliament of South Africa of the latest fashionable diet, ‘Banting’ (‘SA’s Ticking Time-bomb’, Cape Times, 19 August 2014) and the message it sends out to the public about healthy eating, is cause for deep concern – not only regarding Parliament’s support for it as an evidenced-based ‘diet revolution’, but sadly, the long-term impact this may have on the health of the very people they have been elected to serve.

Prof Lionel Opie

Prof Lionel Opie

“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 – such as Atkins, Paleo and South Beach, and in which Banting falls – are unproven, and in particular whether it is safe in pregnancy and childhood.

“Importantly, while the consumption of a low-carbohydrate, high-fat diet may lead to initial weight loss and associated health benefits – as indeed would a balanced weight loss diet – 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).

“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 ‘revolution’, 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.

Real Meal Revolution“This goes against the University of Cape Town’s commitment to academic freedom as the prerequisite to fostering responsible and respectful intellectual debate and free enquiry.

“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, ‘one- size-fits-all’ 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.

“Our bodies need a range of nutrients sourced from a variety of food groups to survive. Diets like the Banting are, however, typically ‘one dimensional’ 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 – like physical activity (the important of which we cannot emphasise enough), environmental factors, and individual health profiles.

“UCT’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.”

Letter in response from Prof Tim Noakes:

“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.

Challenging beliefs“This message first presented publicly in my book, Challenging Beliefs in 2011, has never changed.

“It is also the message I presented to members of staff at Parliament a week ago.

“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.

” 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.”