Respected sports scientist Professor Tim Noakes is championing a controversial diet that has dieticians frothing. Could he change the fate of an ever-expanding obese population… or is he just a mad scientist?

“Once you tip over the precipice, you’re gone,” the professor tells me. “You are going to lose your legs. You are going to have strokes. You are going to shrivel up as a human being. You are going to die of diabetes. And if you want that, keep eating sugars and carbohydrates, and get fat. That’s where you are going.”

The professor is Tim Noakes, who’s sitting in his office at the Sports Science Institute of South Africa. He’s been around long enough to voice his outrageous views but garnered enough acclaim and accolades so as not to come across as completely senile. His opinions, respected across the sporting world, are frank, controversial and always delivered with a beaming smile.

Here’s his latest: remember high-carb diets? Well, forget them. Forget pasta. Forget grains. Forget fruit. Forget carbo-loading. Forget meat-free Mondays. Eat meat. Eat fish. But most importantly, eat fat.

Over a year ago, Noakes was in bad shape. He discovered he was pre-diabetic, knowing that diabetes took the lives of both his father and uncle. He had to run up to 200km a week – not for the love of it but to keep his weight manageable. His body was defined by a list of ailments. He suffered from irritable bowel syndrome. He had gastric reflux for 10 years. He was plagued by headaches. He had sleep apnoea. The wellbeing of South Africa’s venerated Voice of Sport was hardly as resilient as his provocative principles.

Then he came across a diet from an unlikely source: spam emails, messengers from mythical lands of willing women and obedient erections. “I got an email saying, ‘Effortless Weight Loss Without Hunger’”. It was about to feel the wrath of his delete key but then he noticed the brains behind the diet were three scientists he had collaborated with. He’s been on the diet for 14 months now, and he is the lightest he’s been in 20 years. “In the first week I lost a kilogram,” he says. “I dropped 40 minutes on my half marathon and 20 minutes on my 10km run.”

After a month, his sleep apnoea disappeared. The other afflictions followed. His headaches vanished. No more gastric reflux, no more spastic colon. Even his eyesight improved, he says.

WHAT DOES IT MEAN TO BE PRE-DIABETIC?

Noakes’s biggest medical concern was his pre-diabetic state. Registered dietician Dr Ingrid van Heerden says a pre-diabetic state is a condition of insulin resistance where the pancreas does produce insulin, but the body cells are “resistant” to this insulin and the insulin can’t transport blood glucose efficiently across the cell membrane to be used for energy purposes. “Instead, blood glucose accumulates and the levels in the blood rise causing hyperglycaemia, which can lead to deposition of body fat, particularly in the abdominal area, among other metabolic derangements,” she says.

The professor believes he isn’t alone in this. “I look around and I see 50% of people going this way. In my view, 50% of the South Africans I see in the mall on Saturday morning would benefit from this diet.”

The forgotten diet

The diet that Noakes is following is the Harvey-Banting Diet that became popular in the 19th century. William Banting was an English coffin-maker who was somewhat of a celebrity owing to the fact that he made coffins for the who’s who of the deceased, including the Duke of Wellington. Being an epicurean undertaker-about-town, he became larger than his larger-than-life lifestyle.

Banting tried plenty of diets without success until he met Dr William Harvey, who prescribed a high-fat, low-carbohydrate diet that produced astonishing results.
In an open letter entitled Letter On Corpulence, Banting writes, “I now feel under the extraordinary change – which might also be termed miraculous had it not been accomplished by the most simple common-sense means.”

Shortly after, to “bant” meant to go on a high-fat, low-carbohydrate diet. “There are very few names where the surname becomes a verb,” says Noakes, “Banting was one of them.”

Banting continued to bant until the age of 82, when he died and received a send-off in a personalised coffin designed to fit a slim man. Noakes stresses that this is not the contentious Atkins diet. “Atkins got demonised.”

WHAT’S THE MEALPLAN FOR THIS DIET?

“There are no meal times. No portion sizes. No kilojoule restriction. You let the body tell you how much to eat. The only thing you count is how many grams of sugar or carbohydrates. I look in the fridge and I choose the food.”

In his fridge you’ll find meat and fish. “I think fish should be the primary drive. I’ll eat pilchards and tinned fish for lunch.” He eats eggs, nuts – particularly macadamia nuts, almonds and Brazil nuts. “I don’t hold back on dairy produce, particularly full-cream yoghurt.” When it comes to vegetables, he’ll only eat the leafy kinds like broccoli. “That’s good fibre and low carbs, and a lot of bulk.”

Noakes isn’t a fan of fruit. “Fruit is a problem because it’s high-carbohydrate and high in fructose. It’s a killer in sugar.”

Registered dietician Megan Pentz-Kluyts disagrees. “We say eat a minimum of three servings of vegetables, so if we want to exclude fruit – which is not really advisable – then we would have to say five servings of vegetables a day to make up for that.” Pentz-Kluyts notes that a serving amounts to a cup of raw vegetables.
There’s a glaring absence of carbohydrates in Noakes’s meals. “Find the carbohydrates you can eat which don’t have sugar added. If it’s processed, it’s got sugar.”

The f-word

Dieticians and nutritionists haven’t taken lightly to Noakes’s diet. And perhaps rightly so – Prof Noakes is not a dietician, he’s a dieter. The diet was, and still is, incorrectly punted as a strictly high-protein diet. “Everybody got very angry with me because now I was rocking the boat big-time,” he says. “It’s actually not high-protein, it’s a high-fat, moderate-protein, low-carbohydrate, no-hunger diet.”

The challenge is a semantic one. Using the word “fat” in a diet doesn’t sell. It’s a word that’s deep-fried in negative preconceptions. You wouldn’t find it promoted on the cover of this magazine: Eat Fat, Lose Fat!; Your Fattest Year Ever! In its noun form, the word is an essential part of your RDA but as an adjective it can mean lazy, gluttonous, greedy. “You have to throw away the idea that fat causes disease, and that’s very difficult for people to release,” says Noakes.

According to the professor, fat is a US government-endorsed scapegoat. “It was made up initially with a couple of scientists and then the US Senate got behind it. They produced the US Dietary Guidelines and said fat was bad and that you should eat more carbohydrates. Industry got behind it because you can make more money selling carbohydrates. From that moment, Americans became more obese.”

The Harvey-Banting diet has been promoted by Gary Taubes, author of Good Calories, Bad Calories (R157, Kalahari.com) and Why We Get Fat And What To Do About It (R74, Kalahari.com). Taubes is one of the few nutritional experts with whom Noakes agrees. He has faith in Taubes’s work because, he says, Taubes doesn’t stick to the selective nature of science that governs nutrition. “It’s only the gospel in that he provides the information and you can make up your own mind.”

WHICH FATS ARE THE GOOD ONES?

Part of the trepidation with the word “fat” is that there are good and bad types, and once again, Noakes’s opinion differs from most. “The ones you are told are healthy are unhealthy. The polyunsaturated vegetable oils are very unhealthy because humans can’t metabolise them,” Noakes says. “We’re designed for the fish oils and the ones that come in cattle and meat. It doesn’t matter if it’s saturated, you don’t want the vegetable oils.”

Megan Pentz-Kluyts says polyunsaturated fats from vegetable oil aren’t all the enemy. “Your two good guys are the monounsaturated, like olive oil and avocados and the polyunsaturated, like canola seed oil, flaxseed oil and nuts. The bad guys are the saturated and the trans-fats.”

Fat: a lifeblood

As a scientist, Noakes’s take on nutrition comes with a side serving of Darwinism. “The nutritionists say you must eat lots of different types of food. But the evolutionary model is totally different.”

To explain, he uses animals. “What does a giraffe eat? Acacia leaves. Are you going to tell a giraffe, ‘I want you to eat grass as well.’ No, it can’t eat grass because it has competed and succeeded in its environment. The same with an antelope: you don’t tell an antelope to eat acacia leaves because it survives by learning to get all the nutrients out of what it could eat.”

The way Noakes sees it, it’s the same with us humans. Civilisation as we know it is a result of cultures in challenging environments chewing the fat. “Populations living around the equator were driven by fat, not by anything else,” he says. He picks up of a replica of a skull of Mrs Ples that’s serving time as a paperweight on his desk. “Now, this oke,” he says, waving the Australopithecus skull in his right hand, “arose around the Equator. The antelope, like the springbok and the impala, have no fat. If you just ate impala – the protein, that is – you couldn’t live. You have to have the marrow and you have to have the brains. If you only eat protein, you get fat hunger.” He points to me with his skull-bearing hand. “If we only fed you lean steak, you would be dying within a week.”

The ultimate reward for the San is an all-you-can-eat fat buffet in the sky. “Part of their mythology is when they go to heaven, there’s a gourd of fat at the heaven’s door, because their whole life is spent chasing fat,” says Noakes.
The Inuit’s sole means of survival was by eating fatty animals like fish, seals and penguin. Noakes’s ancestors from Western Europe survived on meat and the fat from mammoths and musk oxen. He says that if it was good enough for his monosyllabic relatives, it’s good enough for him today. “You can live on just meat,” he says, “provided you get enough fat.”

“I understand that it’s not going to be as simple as that,” he admits. “There are some people who have got other abnormalities, but the majority of people weren’t fat when we were eating high-fat, high-protein and low-carbohydrate diets.”

WHY ARE SO MANY PEOPLE PRE-DIABETIC?

Noakes believes there’s a reason for his pre-diabetic condition. “If I’m carbohydrate resistant and there are 300 million people with diabetes, that means 300 million people have the gene that makes them resistant to carbohydrates.”

When survival was measured between sunrises and sunsets, being pre-diabetic was a sign of good breeding. “If you saw carbohydrates you wanted to turn them into fat immediately because it had survival value. It could see you over the crisis. The ones that were carbohydrate-sensitive – who didn’t get fat – didn’t survive,” he says. It’s the body types like Hagar the Horrible and Obelix the Gaul that would have made it. It was survival of the fattest.

“What happened next,” says Noakes, “is that we converted the fat desire for carbohydrates. When we started eating carbohydrates, the brain says this stuff’s lekker, but the brain doesn’t regulate carbohydrates very well.”

I ask Noakes if this diet could work in today’s society, and he swiftly returns to our aforementioned giraffe. “Must we say ‘Because the giraffe has less space to live, we’re going to teach it to eat grass?’ It’s going to die. You can’t change in 20 000 years what we have adapted to over 2.5 million years. We were carnivorous and we’ve got to go back to being carnivorous if we are willing to survive.”

Against the grain

Noakes believes the change from a meat-based diet to a grain-based diet lead to two things: humans got shorter and nutrition-deficiency diseases appeared – beri beri, pellagra and scurvy.

CAN I LIVE WITHOUT BREAD?

Banishing bread is a big call. The stuff is Bible-endorsed. “Give us today our daily pilchards” doesn’t sound right. When it comes to the most important meal of the day, eating grains and carbs is all we know. We’ve been eating like this for years.

But we haven’t been eating like this for millennia. “You’ve got 10 000 years to slowly adapt, and then it will select out the ones who die very quickly because cereals are quite toxic and if your gut can’t metabolise them, you’ll die,” says Noakes.

Van Heerden says people on diets that are devoid of mainly insoluble dietary fibre from grains and cereals tend to suffer from constipation and need to eat large quantities of vegetables and fruit to make up for the fibre deficit.

Johannesburg-based dietician Pippa Mullins contends that with diets like Noakes’s, you lose out on fibre. “There’s no grains and very limited fruits and legumes,” Mullins says. “Your good bacteria ferments undigestable fibre in the gut, releasing short chain fatty acids. These are a source of fuel to the cells lining the GI tract which is important in maintaining a healthy bowel and protection against colon cancer.”

The emphasis on protein in his diet has to affect his cholesterol levels. “A very high protein diet can expose users to high intakes of total fat, saturated fat, cholesterol and some trans fat – all of which are not desirable if we want to prevent a variety of diseases such as cardiovascular disease and certain types of cancer,” says Van Heerden.

“My cholesterol is nice and high,” says Noakes. He wants it that way. “After age 60 your cholesterol starts dropping, your mortality’s going up. It just shows you: cholesterol’s got nothing to do with heart disease.”

Wait a minute. The type of cholesterol is important here. If there’s an increase in cholesterol, you want it to be your HDL cholesterol. According to a new study in the Annals of Internal Medicine, researchers found dieters who limited their carbohydrate intake to vegetable sources – but filled up on protein or fat – had 20% higher levels of HDL cholesterol after six months. The scientists speculate that the change may be due to the increase in fat consumption that boosts HDL levels.

Noakes admits the diet contradicts his opinions on carbohydrates in The Lore of Running (R269, Kalahari.com), his internationally acclaimed runners’ bible. “We used to say maximise your carbohydrate intake. Now, it’s minimise. I’m not saying eat no carbohydrates; I eat 50 grams of carbohydrates a day. Most people eat 300 to 400. You need to run 20km a day to justify that. If you’re only running 10km a day, drop it to 200 – you’ll lose a few kilos and you’ll run faster.”

The extra-large backlash

Critics have been frank with Noakes. “People say ‘You’re going to die of this,’ and I say, ‘But I’m not going to die of diabetes,’ and I was 100% certain I was.” He believes he would have gone over the precipice within 10 years, leaving the venerated sports expert with an insulin needle and damage which couldn’t be undone. “My pancreas would have run out of insulin, and I’d have to start injecting – and then you’re stuffed.”

HOW DANGEROUS IS THIS DIET?

There’s plenty of research that points out the dangers of the diet Noakes is practising. He, however, believes that epidemiological studies are flawed. “Epidemiology is a discipline that’s very good at finding a single cause for a single disease. When you have multifactorial diseases, it becomes diluted.”

However, the multifactorial nature could also work against his claims. Noakes is seeing impressive progress with his diet, but he is also more active than most, as his collection of ultramarathon medals can attest. Pentz-Kluyts says fit people have a better ability to burn fat, which means findings can’t be extrapolated to the population at large.

Pentz-Kluyts says that, with the exception of those with intolerances and allergies, leaving food groups out of a diet forces it into fad territory.

According to Van Heerden, strength lies in diversity when it comes to your plate. “I support a balanced diet which contains all food groups and doesn’t only concentrate on one macronutrient. How we select our carbohydrates, fats and proteins can determine our health. But at the end of the day, human beings are omnivores, not carnivores.”

CAN MODERN SOCIETY SURVIVE ON “PRIMITIVE” DIETS?

The problem with eating such hefty portions of fish and meat, argues Van Heerden, is that they aren’t the most affordable of foodstuffs, and are becoming a dwindling resource on an overpopulated earth.

She adds that when societies that used to survive on “primitive” diets are exposed to the negative aspects of a western diet – high intakes of fatty and sugary foods, particularly liquid sugars in beverages including sweetened cold drinks and fruit juices – they become extremely inactive, they invariably develop obesity, type-2 diabetes, hypertension, gout, arthritis, gallbladder disease and cancer.”

“It is, therefore, certain parts of the modern diet and the inactivity of our western lifestyle that are so damaging, not the fact that we don’t survive on meat, fat, blood and milk,” she says.

Mullins agrees. “The world is getting fatter but it’s not because we’re not following Tim Noakes’s diet, it’s because people are eating in excess and are less active. The foods eaten in excess are generally not the healthy and satiating whole-grain carbohydrates, fresh fruit and vegetables, legumes, lean proteins and unsaturated fats. Healthy eating combined with exercise can reduce the risk for developing the condition Noakes refers to as carb intolerance,” she says.

“People should avoid refined high-sugar carbs and replace them with whole-grain, high-fibre carbohydrates. There is certainly value in including protein in the diet but preference should be given to fish, legumes, game, skinless chicken and lean red meat,” says Mullins.

“Don’t forget your vegetables and fruit, she adds. “They’re an excellent source of antioxidants.”

“Not everyone is going to benefit from this diet,” says Noakes. “If you’re a bit overweight, it falls into my criteria and you’re going to benefit from it. The vast majority of people are overweight, and the only way they’re going to lose weight and become healthy is to eat more fat and less carbohydrates. The beauty of this is that you don’t have to listen to what I’m saying, just try it. You’ll get the answer within a week.”

And then he adds, perhaps slyly, “Just have the courage to try it.”