Tim Noakes: where ‘Banting’ began, where it’s headed

Prof Tim Noakes. Picture: courtesy of the NOAKES FOUNDATION

Prof Tim Noakes. Picture: courtesy of the NOAKES FOUNDATION

By Marika Sboros

The organisers say it’s a world-first, a nutrition summit in Cape Town from February 20-22, 2015. They say that it could change the world of nutrition science.

It assembles the world’s top doctors and researchers on the efficacy and safety of low-carb, high-fat (LCHF) to treat and prevent serious disease.

Summit host is Prof Tim Noakes, a medical doctor, world-renowned scientist and University of Cape Town emeritus professor. Here, in his own words, Noakes gives the history behind the global LCHF movement and what he hopes the Summit will achieve: ‘A statement that will be heard around the world.’ 

By Timothy Noakes

The origins of the Old Mutual Health Convention can be traced to William Banting and his monograph Letter on Corpulence first published in London in 1862. His was the first description of the successful reversal of (resistant) obesity with a reduced dietary carbohydrate intake.

William Banting

William Banting

Predictably, members of the medical profession in Britain did not eagerly embrace  William Banting’s book. They rebuffed attempts to publish his idea in the leading medical journal, the Lancet.

How could a commoner possibly know that which the medical profession did not?

In time, professional pressure forced the true creator of Banting’s low carbohydrate eating plan, Dr William Harvey, to write a book. In it, he stated that the benefits of his diet were not from increased fat content. They were the result of its high protein composition.

Banting disagreed, stating that the key to his successful weight loss was the higher fat content of Harvey’s original diet.

It was left to German physician and professor of medicine at Gottingen University, Dr Wilhelm Ebstein, to publish the definitive description of the original LCHF diet. That was in his 1884 monograph, Corpulence and its treatment on physiological principles.

Property of fat

There he wrote: “This property of fat to produce satiety more rapidly, to diminish the craving for food and abate the feeling of thirst, facilitates to an extraordinary degree the introduction of the modified diet…The permission to enjoy certain things, always of course in moderation, as for instance salmon, pate de foie gras and such like delicacies reconciles the corpulent gourmet to his other sacrifices (which) consist in the exclusion of carbohydrates. Sugar, sweets of all kinds, potatoes in every form I forbid unconditionally.

He went on to say: “The quantity of bread is limited at most to 3 to 3 1/2 oz. a day, and of vegetables I allow asparagus, spinach, the various kinds of cabbage … Of meats I exclude none… I permit bacon fat, fat roast pork and mutton, kidney fat, and when no other fat is at hand I recommend marrow .. added to the soup. I allow the sauces as well as the vegetables to be made juicy, as did Hippocrates, only for his sesame-oil I substitute butter.

 “In spite of all this, it would be little to the point to say that I treat the corpulent with fat, whereas I simply vindicate the full claims to which fat is entitled as an article of food.” (pp. 43-44).

Sir William Osler published his revolutionary textbook, The Principles and Practices of Medicine, in 1892. Experts considered it the first “evidence-based” modern medical manuscript. In it, he included the following: “Many plans are now advised for the reduction of fat, the most important of which are those of Banting, Ebstein and Oertel … Ebstein recommends the use of fat and the rapid exclusion of the carbohydrates. (p. 1920).

The real ‘fad’ diets

Why is this information important? Because it shows that the carbohydrate-restricted or Harvey/Banting/Ebstein diet is the very first eating plan that the world’s most eminent physician of his time prescribed for obesity management. That relegates all subsequent diets that doctors have prescribed for this purpose, including the modern “heart-healthy” low-fat diet, to the status of “fads”. That’s most especially since humans ate the cereals and grains that this modern fad diet promotes only in the last two to 12 000 years.

Surely it is time for us to acknowledge that a diet based on foods that humans and their ancestors did not eat for more than 99% of our time on earth must be a fad?

All this hidden knowledge raises the important question: Why has it taken 153 years since the publication of the first edition of Banting’s book for anyone to organise the first (self-proclaimed) “International Low-Carb Summit”?

New Atkins for a New YouAs a conventionally trained medical doctor, I knew nothing of Banting or Ebstein (other than the eponymously named cardiac abnormality, Ebstein’s anomaly, known to all doctors) until a few years ago. Then by serendipitous chance, I came across the book, The New Atkins for A New You. The authors are Drs Eric Westman, Stephen Phinney and Jeff Volek.

Atkins, the ‘madman’?

At first, I was appalled. How could these three supposedly serious scientists associate their names with Dr Robert Atkins? Atkins was the madman who in the 1970s had encouraged us all to eat more saturated fat and less carbohydrate. How dare he!

For, thanks to the wisdom of a range of authority figures including the US Government, we who were properly educated “knew” that this advice could only kill us.

But after reading a few pages of their book, I was suddenly less certain. I sensed that Drs Westman, Phinney and Volek were advancing a crucial health message. It was based on a body of hard science, of which I was completely ignorant.

I soon decided to ignore my scepticism that 40 years of medical “education” had ingrained and put their advice to the test.

As they suggested, I embraced the idea that eating fat is a healthy choice and removed carbohydrates from my diet. Despite my advanced age, within weeks I saw an improvement in my health, well-being and running ability that I can only describe as astonishing. I knew then that I had to know more.

Raising inconvenient questions

In time, I came across Gary Taubes’s monumental works, Good Calories Bad Calories and Why We Get Fat. I discovered that like Drs Atkins, Westman, Phinney and Volek, Gary is one of the most important figures in the revival of the Banting/Ebstein legacy. In time, I discovered that already in 2002 he had published an article in the New York Times entitled What if it has all been a big fat lie?

I was left with one overriding question: If this information has been in the medical literature since 1884, and if it helped me improve my health so dramatically, why do lecturers not teach it at medical schools across the globe? One goal of this LCHF health summit is to raise that inconvenient question.

But this summit did not come about because this Harvey/Banting/Ebstein/Atkins/Westman eating plan revolutionised my life.

Rather, it began as the exclusive vision of Karen Thomson. Karen is granddaughter of the iconic Capetonian Professor Christiaan Barnard. He was the surgeon whose team performed the first successful human heart transplant operation at Groote Schuur Hospital in Cape Town in December 1967. It was Professor Barnard’s actions that inspired me to study medicine at the University of Cape Town.

The role of sugar addiction

Karen has heard me talk and had concluded that sugar addiction was an important factor driving her own dietary indiscretions. She adopted a sugar-free, low-carbohydrate diet with great success, even developing a novel intervention programme to treat sugar addiction in those struggling with obesity.

Sugar FreeThis, in turn, inspired her book Sugar Free: 8 Weeks to Freedom from Sugar and Carb Addiction. The launch of her book will coincide with the opening of this summit.

Karen had seen the negative consequences of an unconstrained and relentless press interest in the affairs of the Barnard family. She wondered how she could support me in my own skirmishes with the South African media, my profession and my University Faculty. Her preferred solution was to assemble the international purveyors of dietary truth in Cape Town for a ground-breaking meeting.

Without my knowledge, she invited the North American founding fathers of this meeting to attend: Drs Eric Westman from Durham, North Carolina; Jay Wortman from Alberta, Canada; Steve Phinney from Sacramento, California; and layman Jimmy Moore from Spartanburg, South Carolina. Without hesitation, they all agreed. At first, her vision was for a small meeting with just these four speakers.

At first, I was uncertain whether or not she was crazy. But in August 2014, I travelled to Melbourne, Australia, and spoke at their Low-Carb Conference organised by Dr Rod Taylor. Dr Taylor is the doyen of the low-carb movement in the Antipodes and will attend our summit. From the warm public response generated by that meeting, I knew that my doubts identified me as the crazy one.

Speakers line up to help

The result of that meeting was that another seven speakers all spontaneously offered their services at their own cost, simply because they wished to be part of this historic event. They include Dr Anne Childers from Lake Oswego, Oregon; Christine Cronau from Brisbane, Australia; Drs Andreas Eenfeldt from Stockholm, Sweden;  Gary Fettke from Launceston, Tasmania; Aseem Malhotra from London;  Michael Eades from Little Rock, Arkansas, and (soon to be PhD doctor) Zoe Harcombe from “the Welsh countryside”. But even then, we had not yet finalised our line-up.

In December, Prof Robert Cywes, now resident in West Palm Beach, Florida was on a visit to Cape Town to spend Christmas with his iconic father and Christiaan Barnard contemporary, Prof Sid Cywes. Robert called to discuss his experiences using a low-carb diet in the treatment of morbid obesity in children in the US. It did not take long for us to agree that he too must speak at our Summit.

In  January, we came across an intriguing lecture that Dr Jason Fung from Toronto, Canada, had delivered. I instantly knew that Dr Fung was an essential addition to our already stellar speaker line-up. But our good fortune had still not ended.

Gary Taubes

Gary Taubes

At a dinner in Cape Town, by chance, I met former owner and CEO of the Fleet Feet franchise in the US, Tom Raynor

Finding Gary Taubes

In the course of the dinner, Tom leaned over and asked: “If there was one additional person you would like to have at your summit, who would that be?” Without hesitation, I said: “That is easy. Gary Taubes (from Berkeley, California)”.

Tom responded “You have your wish. I will fund his attendance at your meeting”.

And so, our list of most wanted speakers was complete with perhaps one exception. Nina Teicholz author of The Big Fat Surprise, the most important medical book sinceGood Calories Bad Calories, had expressed her extreme willingness to attend.

But our invitation arrived a few hours after she had committed to other lectures in the US. She will be with us in spirit.

As our list of astonishing speakers continued to lengthen, I  broached the unmentionable issue that we had both ignored: “So Karen, now that we have all these great speakers, how are we ever going to find the millions that the conference will cost us?”

Karen’s Barnardesque response was: “Prof, you are always telling everyone to believe in the outcome. So you should just follow your own advice. Believe in the outcome. It will happen.”

The money comes

And so, of course, it did. When we approached Old Mutual as the potential title sponsor,  we were received with unbridled enthusiasm by Dr Peter Bond and his team.

Yes, they assured us, they would be the title sponsor of our summit and would help us make it a very special event. The final part of the puzzle was in place.

What then do we wish to achieve with this LCHF summit? Simple. We wish to make a statement that will be heard around the world. That statement is this:

“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 of 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 we must now change.

Road to change

So the choice is between continuing to apply a failed model to a growing global health crisis in the utterly irrational hope that what has not worked in the past will suddenly, miraculously, produce a different result. That, as Einstein noted, is the true marker of insanity – doing the same thing over and over again and expecting a different result.

But if we have the individual and collective courage, we can acknowledge our insanity. We can admit our errors and start the healing process by adopting the solutions that the speakers at this summit will present.

So, our greatest hope is that this summit will serve as the global tipping point for the final acceptance that what we have prescribed and practised as healthy nutrition for the past 40 years is not only not based on any good science. Tragically, it has been profoundly damaging to human health on a global scale.

Shortly before his untimely death, Karen’s grandfather Prof Christiaan Barnard wrote: “I have saved the lives of 150 people through heart transplantations. If I had focused on preventative medicine earlier I would have saved a 150 million people”.

It is our hope that through his unforeseen influence in inspiring this summit, the man who gave South Africa its greatest medical moment in history will also have his wish. That is to bring health and healing to billions of humans through the provision of dietary advice that is appropriate because it is scientifically-based.

And because it understands the biological consequences of our human evolution and recognises the widespread presence of insulin resistance in most populations across the globe.

Amen.