By Marika Sboros
You could say that Prof Tim Noakes is at it again, spreading the word about low-carb,high-fat (LCHF), ketogenic therapies, busily challenging orthodoxy. This time though, the vehicle is really his eponymous family-founded Noakes Foundation.
The Foundation launched its Nutrition Network in Cape Town at the weekend. It is a world’s first professional training in low-carb, high-fat therapies for patient treatment.
Foundation COO Jayne Bullen says the Nutrition Network has a specific aim: to support medical and allied health professionals in implementing LCHF and keto lifestyles in their practice.
The two-day conference featured an impressive line-up of speakers from a wide range of medical fields, including the founding Medical Board of the Nutrition Network. The Board includes Noakes, Cape Town GP Dr Neville Wellington and specialist physician Dr Hassina Kajee.
Bullen was suitably expansive. “This is the healthcare of the future,” she said.
The Network has already become “an informed forum where we talk about the important issues of nutrition, research and human health and work together for better collaborative outcomes”.
The focus is “better conversations around health and diet”, she said.
Never was that more needed, given skyrocketing rates of diet-related diseases in South Africa. Among those are obesity, diabetes, heart disease, cancer and dementia, to name but a few.
On her own and in her talk to the conference, Kajee was worth her weight in medical scientific gold. She spoke from personal and professional experience of LCHF and best treatment protocols for high-care patients.
She raised the need for healthier eating to be accessible to everyone, especially under-resourced communities.
Kajee elaborated on the Foundation’s Eat Better South Africa (EBSA) community education programme. EBSA effectively dispels abiding myths that LCHF is an expensive lifestyle.
Wellington gave case histories of his diabetic patients who have significantly reduced medication by changing to low-carb diets. He also supported intermittent fasting for diabetics. He said that some patients don’t even go five hours between meals – on conventional advice.
Another who spoke from personal experience was Stellenbosch GP Dr Gerhard Schoonbee. Schoonbee told how he was suffering the consequences of metabolic syndrome. In 2012, he changed to an LCHF lifestyle (he takes care to call it healthy rather than high-fat) and was able to reverse all the effects, including type 2 diabetes.
Armed with the knowledge of personal experience and hours of further study, he now gives practical advice to patients who can benefit from LCHF lifestyles. These include people suffering from type 2 diabetes, obesity, auto-immune diseases and chronic inflammatory diseases.
Schoonbee was scathing about those who demand RCT proof before they will believe in the benefits of LCHF. “If they haven’t experienced it for themselves, they don’t know what they are talking about.”
Other speakers included Cape Town medical doctor and integrative medicine specialist Dr Bernard Brom. Brom said that the focus of integrative medicine focus is health rather than disease. It emphasises lifestyle changes that are essential to improve health. These include better food choices, exercise, stress management.
He also made the case for supplements. Merely eating “good food” won’t be enough to resolve all health problems, Brom said. That’s because we live in a toxic environment.
We live in “an astonishingly toxic” world, he said. The food supply is deficient, people are on all sorts of drugs, including hormones and antibiotics. These all disturb the microbiome and biochemical processes.
Australian fitness trainer and LCHF coach Andre Obradovic focused on the role of mindfulness in changing dietary lifestyles. It also involves ignoring what he calls “conventional stupidity”. By that, of course, he meant conventional, unscientific advice that some doctors and dietitians still dish up to the public.
Noakes did what he does best in his nutrition-related talk. He laid waste to the diet-heart hypothesis and its close cousin, the lipid hypothesis. Both hypotheses are the basis for conventional low-fat, high-carb dietary guidelines worldwide.
He gave evidence to support his opinion that both hypotheses are currently unproven. According to the diet-heart model of coronary disease: elevated cholesterol causes clogged arteries that cause cardiovascular disease (CVD) and can lead to a heart attack.
However, CVD “events” (the medical profession’s quaint term for things like heart attack and stroke) require plaque rupture and the model does not explain the cause of that rupture.
Therefore, the model is not proven.
Noakes also presented evidence to show why familial hypercholesterolaemia is not the grave danger to hearts as many cardiologists believe. He also gave evidence in support of his view that criticism of statins, blockbuster cholesterol-lowering drugs, are well-founded.
Cholesterol is simply not the best marker of heart attack risk, Noakes told the audience.
He directed the audience to statistics on numbers needed to treat. These show, among others, that the significant risk profile attached to these drugs really does far outweigh benefit, he said.
Noakes joins medical experts, including cardiologists globally, in his opinion that statins are “the single most ineffective drug ever invented”. He also gave evidence to show that the real cause of non-alcoholic fatty liver disease, gallstones and other health issues is sugar, not fat.
Cape Town attorney Adam Pike gave an entertaining talk on the legal pitfalls facing doctors on social media. Pike heads Noakes’s defence team in the Health Professions Council of SA (HPCSA) case against him on a charge of unprofessional conduct for a single tweet.
The HPCSA’s own and independent committee comprehensively vindicated Noakes on all 10 aspects of the charge against him. Committee chair Pretoria advocate Joan Adams read the four to one majority ruling in April 21, 2017.
The HPCSA is appealing the verdict. The appeal will go ahead in Pretoria from February 21 to 23.
Once again, the HPCSA are keeping resolutely mum and have declined to answer all my questions on the appeal committee composition. They appear to hope that the committee they have set up will give the decision they want this time round.
They are going for a reversal of the verdict and a whole new hearing of all the evidence by the appeal committee. That’s despite not challenging the close to 40 hours of evidence Noakes gave in his defence.
And the evidence of his three overseas experts. They were British obesity and public health researchers Dr Zoe Harcombe, US science writer Nina Teicholz and New Zealand-based South African dietitian and academic Dr Caryn Zinn.
The content of the talks will serve as guidance for the development of the Online Professional Training Course, which the Foundation will launch soon.
It will, therefore, provide training on implementation of LCHF and keto diets for health professionals. The course will cover the latest and most up-to-date science and research in the field of low carb nutrition, Bullen said.
It will also form the basis of “a more rigorous certification path for doctors in future”.
- I was a speaker at the Nutrition Network launch. My talk was on the evidence for ketogenic diets as adjuncts to conventional medicine for certain cancers.
- I am co-author with Prof Tim Noakes of Lore of Nutrition, Challenging Conventional Dietary Beliefs (Penguin 2017)
- Follow me on Twitter @MarikaSboros
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