TheHealthFanatic

Q&A with Professor Tim Noakes on LCHF, Endurance Sport and Surfing!

Monday 31 December 2012

 

 Noakes

Nutrition:

THFTwitterLogoShould all sugars be considered as being bad? We know that high fructose corn syrup is poison, but does that mean that other sugars such as lactose (milk), fructose (fruit) and sucrose (cane sugar) are okay in moderation or are they smaller doses of poison?
Noakes (1)None has any particular value; none is an essential foodstuff.  So all can be avoided.

THFTwitterLogoI’ve heard you say that carbohydrate resistant (CR) individuals should be on a Low Carb High Fat (LCHF) diet but does that mean that an individual that is not CR should avoid eating LCHF? Why is a LCHF diet for everyone?
Noakes (1)I said this partially to protect myself from even more severe criticism.  The evidence for benefit from this diet is most obvious for those with unquestionable CR - i.e. those with diabetes or pre-diabetes.  However I suspect that most will benefit since most have some degree of CR.
In addition the key benefit of the LCHF is that it removes most of the addictive food choices. I believe that it is the addictive food choices that are the real problem in modern nutrition and if we can remove those choices for our diets, we will be much healthier. The LCHF diet is very low in addictive food choices.


THFTwitterLogoPeople tend to fear eating fat and often make the mistake of eating low carb and low fat when they start a LCHF diet. Why is it so important to eat fat, and what exactly does ‘High Fat’ mean?
Noakes (1)Dr Walter Willett, one of the world's leading nutrition scientists responded to my question some time ago that we do not need to put any limit on the amount of fat that we have in the diet. I aim to eat about 60-70% fat since that is best for my blood glucose regulation. In my case my liver overproduces glucose when I eat more protein. I am also heavier when eating more protein and am at my lowest weight when I eat the most fat. So that is why I go with a higher fat diet. 

THFTwitterLogoMost people can’t imagine 70% fat on a plate and accept that it’s good for you. What would a typical LCHF meal look like?

Noakes (1)Fat is so energy dense that one does not have to eat much fat to have a high fat diet.  A high fat meal would include dairy, yoghurt, eggs, bacon, butter, avocado, coconut or olive oil, macadamia nuts. Not all together but those are the higher fat foods.

Social:

THFTwitterLogoLet’s pretend that authorities and mainstream accept that a LCHF diet is a preferred diet, how do we make this cost effective for the average South African when foods high in carbs are relatively inexpensive?
Noakes (1)High carb foods are cheap in part because they are subsidized especially in the US where corn growers receive subsidies worth 5 billion dollars. That is why sugary drink sweetened in the US by high fructose corn syrup (derived from corn) is so cheap.
Then the medical consequences of eating that diet is subsidized by government so that industry outsources the long-term medical costs for generating its profits. If the sugar industry had to pay forward the costs of the diseases to which its product contributes, it is possible that the industry might not be viable.

Kidneys are the cheapest source of protein in South Africa. Eggs and sardines are also cheap sources of protein. In our abattoirs valuable offal is not collected – for example brains.  Nor is bone marrow collected. If the carcasses of slaughtered animals were properly treated as they were in hunter-gatherer populations, there would be less wastage of high quality animal protein and fat.
So if there was incentive, it might be possible to provide high quality and high protein at a cheaper price to the poorer communities.

Finally if you eat a high fat diet you eat only about 66% of the calories you eat on a high carbohydrate diet.  That is why this diet causes such effective weight loss – it makes it so easy to eat less.  So there is a large saving on calories that you are not eating and so do not need to buy.


THFTwitterLogoDoes the food industry as we know it have a future in a LCHF real food world?

Noakes (1)Has to have. Producing real foods not food-like substances.

Fitness and Endurance Sport:

THFTwitterLogoIf losing weight is not about exercise, should people bother to exercise and is exercise as important as diet?

Noakes (1)Exercise is very important. But my experience and that of the other 3 athletic “fatties” – Bruce Fordyce, Oscar Chalupsky and Shaun Meiklejohn, who together lost 62kg that we could not lose despite huge amounts of exercise during our lives – shows me that if you are CR and eat addictive food choices, you cannot control your weight regardless of how much exercise you do.
The problem is that the purveyors of addictive food choices, like the cola drink manufacturers, are investing a large amount of money in luring scientists to their side (just as did the sports drink industry entrap scientists to promote the overconsumption of sports drinks as described in my book Waterlogged) to promote the idea that as long as you do enough exercise, you can ingest as much of their addictive foods or drinks as you like.  This is completely wrong. If you are carb-resistant, then you can do all the exercise you like, but you are not going to be able to regulate your body weight if you eat a high carbohydrate diet.

I have a great US friend who is at the front of this research effort to show that if you exercise enough you will be fine regardless of how fat you are.  He receives substantial funding from Coca-Cola and was even invited (by Coca-Cola) to participate in the Olympic Torch Relay for the 2012 London Olympics.  But he does not see the anomaly that all the exercise he has done has not kept him lean nor prevented him from developing a serious medical condition. To me it seems obvious: If my friend had stopped eating carbohydrates 20 years ago he would now be lean and might have prevented the development of his current medical condition. But perhaps loyalty to his commercial sponsor has blinded his interpretation of his personal life experience.
Bruce Fordyce has run more than 200 marathons.  But as he aged he could not regulate his body weight until he cut out the carbs.

 
THFTwitterLogoWhat advice would you give someone beginning a LCHF diet and engaged in an endurance sport? Should you avoid endurance events until you completely keto-adapted or can you fuel with carbs on race day only?

Noakes (1)Don’t race a long race until you have adapted for 3 months. Then try to run without taking any carbs before or during the race and see what happens.  It took me about 6 months before I had the certainty that I did not need to take any carbs regardless of how hard or long I exercised.

THFTwitterLogoIt’s now accepted that intense cardio plays a small role in weight loss. Is this true for keto-adapted individuals also, since their primary fuel source is fat?
Noakes (1)I now believe that body weight regulation is linked very closely to blood glucose regulation. In other words, the closer is your blood glucose regulation to perfect, the leaner you will be. So the key is to regulate your blood glucose concentration. Exercise assists in this regulation but if you are carb-resistant and eating a high carb diet, then the exercise cannot make much difference (since blood glucose regulation will be overwhelmed by the high carbohydrate diet).

THFTwitterLogoIn the book Art and Science of Low Carbohydrate Performance, Phinney and Volek (Chapter 2) state that in terms of endurance sport optimal fat burning occurs at medium intensity. At higher intensity levels the body switches over to carbohydrate stores. They do state this is based on studies involving individuals eating LCHF over a 2 week period. Does a fully keto-adapted person need to utilize carbohydrate stores at high intensity levels?
Noakes (1)I think that it may take much longer (6-12 months) to change this so that fat can be burned at very high exercise intensities.  Dr Peter Atilla (The Eating Academy) is leading the discussion on this topic. He has pre-publication information about the value of high fat diets in elite exercise performance which I think is going to blow the whole field wide open in the next 6-12 months.

Personal:
THFTwitterLogoWhat was going through your mind when you wrote that first article promoting a LCHF diet in runner’s world? Did you think it would be as controversial as it has become?
Noakes (1)Not at all. I was just describing what had happened to me. I could not imagine why that would cause anyone great problems. But I failed to understand three facts. First that there are 3 religions which one should never discuss in public – one’s religion, one’s politics and one’s diet. Second that there are vast commercial interests that benefit from the modern unhealthy eating choices. Third that a number of “health promoting” NGO’s are dependent on industry for their survival.  Unfortunately the purveyors of unhealthy foods know this and so they make sure that those NGO’s are under their financial control and will not ever promote any ideas that might effect their profitability. I had also forgotten what writing my book Waterlogged had taught me - specifically that industry uses “science” to brainwash athletes to buy products based on mythical claims. 
The running magazines are trapped into a commercial reality and will not publish material that conflicts with what their advertisers are promoting. I did a long interview with the editor of the local edition of Runner’s World on LCHF. When I asked why he had never used it, he said that it was too controversial and he was not sure it was the “truth”. Of course he could list any number of experts willing to say that what I am saying is nonsense. Does that mean that every article ever published in Runner’s World has been checked to insure that it is scientifically correct? I doubt it since most of their articles are not commercially sensitive.
So I think there is a much easier explanation why that interview will never be published. Come to think of it – I am not sure that there has ever been a review of Waterlogged in Runner’s World.


THFTwitterLogoHow is the new book coming along and who is the target audience? Laymen or individuals with some background in nutrition?
 
Noakes (1)It will be written like Lore of Running and Waterlogged.  For educated laypersons. Will not require any background in nutrition. I will provide all the background that is necessary.
I am writing the book to show that there is a larger body of scientific evidence supporting the LCHF than that which supports the Prudent high carbohydrate low fat diet. I plan it to be like Waterlogged. Here is the evidence. Now you make the decision whether it is a low fat or a high fat diet that is killing us.


THFTwitterLogoWhen you not challenging and debunking accepted dogma, what do you do to unwind?

Noakes (1)I read, write, attend to my correspondence, run, and walk and garden with my wife.  I lead a very Puritan lifestyle.  My big indulgence in the next year will be to start surfing again.  I first surfed in April 1965, almost 50 years ago.

THFTwitterLogoWhat does “wellness” mean to you (mental and physical)?


Noakes (1)Having the energy, enthusiasm and optimism to get up each day full of excitement for the day ahead.  Then to do what I have to do, to run for 30-60 minutes and then when the surf is right also to have a surf.


THFTwitterLogoAre there any other goals, whether as an athlete or as an academic and scientist, that you would want to achieve?

Noakes (1)I want the diet book to make a real difference. Now that I understand nutrition I finally realize what is causing so much global ill-health. In time the nutrition world will “tip” and the current advice will be understood as completely wrong.  I would like to play a part in producing that tipping point earlier than if I had not done what I am now doing.
I would like also to produce some relevant research on this topic.  I have some ideas about how the liver is a key organ in diabetes that I would like to study as well as the metabolic adaptations that occur with keto-adaptation in ultra-distance athletes. Then I would like to determine how we define carb-resistance and how prevalent it is in athletes and the general population.
So there is much research to be done.
In running I would like to break 2:05 in the 2013 Two Oceans 21km and get closer to 50:00 for 10km. And to become a reasonable surfer again.
Then after the diet book it will be time to start on the 5th Edition of Lore of Running.


THFTwitterLogoWhat are your favourite foods now that its open season on fat?  


Noakes (1)I eat a very restricted diet because of my diabetes.  I love protein in fish and meat but have had to curtail my protein intake because it causes havoc with my blood glucose regulation.  So I am learning to enjoy high fat foods – avocados, eggs, bacon, olive oil, butter, yoghurt, macadamia nuts and macadamia butter, cheese – and vegetables and salads.  Liver has become a favourite.  As a child I loved sheep’s brains but since I dissected human brains in my medical training, I now feel at bit sickly at the sight of brain tissue.  
Beauty is that you cannot binge on fatty foods.  A few mouthfuls and one is full. 
My diet continues to evolve.  My blood glucose regulation is now so much better than before that I may not need to be as restrictive as I have been.  But even if I must continue to eating this way I am more than happy to do so.  The difference from my condition before I started 2 years ago is beyond description.

Is A Low Carbohydrate Way Of Life Sustainable? - Part 1

Saturday 29 December 2012

 

PART 1
The road to a Low Carbohydrate Lifestyle has not been easy, filled with many mistakes made, adjustments required and the all-important paradigm shift from years of believing in the low fat high carbohydrate diet which I have followed for years.

After months of changes, I sat down and reflected, asking myself the question – Is a Low Carbohydrate Way of Life Sustainable for me?

The quick answer to that question was - Yes! Most whom have tried this “diet” will disagree with me. It is for this reason that I have decided to share the approach that I have taken to address the many challenges that beginner “low carbers” face when starting out. Thus far this approach has worked for me as yet I have not had the desire to put this way of life in the dustbin.

1. A grain is a grain is a grain
I held a belief that if I substituted rye for wheat it is a healthier option and I would be able to follow my newly found low carbohydrate lifestyle with one carbohydrate for another. I was quite shocked that the carbohydrate content of a slice of rye bread was greater than that of a slice of whole wheat bread.

Further to this, as a great lover of oats, I was equally horrified that the carbohydrate content of a cup of cooked oats was about three times the slice of whole wheat and twice the content of a slice of rye bread. After this discovery, oats was reduced and eliminated altogether.

The common argument which I am confronted with is that whole grains are high in fibre. It is true that whole grains do contain fibre, but if compared to certain vegetables, whole grains pale in comparison. To put things in context, one avocado contains 13.5 grams of fibre compared to the 4 grams found in two slices of whole grain bread. With this in mind, I would need to eat at least six slices to match the fibre content of an avocado.

As a lover of bread and oats, cutting out grains was a difficult decision. What about my favourite chicken and avocado sandwiches or a bowl of cooked oats topped with honey and berries? With a little research I found great substitutes for these, which taste just as great, some even better than the original.

2. Low carb eating at social gatherings
I am writing this in the midst of the South African festive period, well known for excess and over-indulgence of all things carbohydrates, including sugar. Office year end parties, Christmas family get-togethers and the festivities of the New Year’s Eve party can wreak havoc on our lifestyle if not kept in check.

As my first festive period on low carb, I was concerned about this and I found it difficult at first, but through trial and error and practicing some restraint, I have come out unscathed. To easy me through this period I put the following rules in place;

* Stick to simple dishes, each item containing only one main ingredient, such as a portion of roast poultry or meat with a side salad filled with leafy  greens
* Steer clear of starchy vegetables, baked dishes and pasta
* I personally did not have dessert, however if berries were offered I would have some in limited portions. Alternatively if my low carb cheese cake was available, I would not think twice of having 2 slices.
* Limit alcohol to the type with lower carbohydrates, such as dry wines and light beers (contains between 5 – 6 grams of carbohydrate per glass respectively) or alternatively cut out alcoholic drinks altogether and substitute for sugar free beverages

Not all of us are fortunate enough to have a family in friends whom support us through this transitional or maintenance phase. If you find yourself in a situation where your eating habits are constantly questioned and food and beverages are constantly forced on you, see below extract from Dana Carpendar’s website on this topic. I could not have wrote this better.

(Courtesy: www.danaslowcarbforlife.com/)
Now let’s talk about the food-pusher problem. If you’ve decided to declare Thanksgiving an Indulgence Day, this is not a big deal. Eat your high protein breakfast — no starving till the feast! — and then eat whatever appeals to you. On the other hand, if you’d rather not gorge on carbs, or if you’re simply following my (unbelievably wise) advice to pick and choose only those carbs that you really and truly love, someone may notice. Worse, someone may comment. “But you’re not eating my famous candied sweeeeet potaaaatooooes!” they’ll whine. “It’s a tradition! You have to have some!”

May I betray an unholiday-like spirit by admitting that I hate people like this? They are not being “nice,” they are being controlling busy-bodies. Please, please accept that you owe it to no one to put anything into your body that you don’t want to. These people are no different from the kids back in high school who pushed you to try drugs, or those extreme jerks who get ugly when someone doesn’t want a drink — or another drink.

The words you are looking for are “No, thanks.” That’s it. It’s an appropriate response, and all the response required, no matter how many times they push you. Let’s practice, shall we?

“Oh, but you haven’t had any mashed potatoes! Here, have some.”
“No, thanks.”
“But it’s a holiday! C’mon, you can’t diet on Thanksgiving!”
“No, thanks.”
“What, you’re not going to eat your grandmother’s mashed potatoes? You loved them as a child!”
“No, thanks.”
“Geez, can’t you have any fun anymore?”
“No, thanks.” (Notice Dana gritting teeth to keep from saying “What, the only fun you can think of is food? I prefer sex, myself.”)
“I’ll just put a spoonful on your plate. There, now you’ll have to eat them!”
(Scooping up potatoes and putting them back in the serving bowl) “No, thanks.”
Etc…
The big thing to notice here is the lack of excuses, explanations, justifications, etc, for not eating whatever it is these morons (sorry, I know they’re your family, but they are, in this context at least, morons) are pushing. YOU DO NOT OWE THEM AN EXPLANATION. Any explanation on your part will be taken as an invitation to argue it away, just as giving a four-year-old any explanation for a rule past “Because I’m the mom and I said so” is just begging for endless argument.
Beyond “no thank you,” it’s a good idea to add a quick subject change. Like this:
“But you have to have another slice of pie!”
“No, thanks. Hey, have you seen the new Happy Feet movie yet? Maybe we should take the kids tomorrow.”
“You have to have some of my famous sweet potato casserole!”
“No, thanks. Hey, anyone interested in doing some Black Friday shopping? Where’s the best shopping around here, anyway?”
This is very powerful. After you’ve changed the subject, the Obnoxious Relative is going to look pretty crazed to keep coming back to “but you have to have some pie.” It’s a neat piece of social ju-jitsu, and it’s helpful all year long, any time someone is pushing a sensitive subject..
The most important thing is to get very, very clear in your own mind that you have no obligation to eat anything you do not want to eat. You are not being rude, the person pushing and nagging is being rude. Unspeakably rude, actually. If you had a deadly allergy, one that would cause you to go into anaphylaxis at a single bite, would you feel like you were being rude to say “No, thank you” to a serving of that food? Well, obesity, diabetes, high blood pressure, and other carb-intolerance illnesses kill more people than anything else. Just takes a little longer, that’s all.
So speak up for yourself. Be calm, but be firm.
And next year, have Thanksgiving with people who aren’t such boneheads, ‘kay?

3. The monotony of it all
Man and woman cannot live on eggs, butter and avocado alone on a low carb diet. Contrary to popular belief, the menu options are endless. At the beginning stage of this life style, I lived mostly on dark green leafy vegetables, eggs, chicken, avocado and cheese. This was quite limiting and became boring after a while. I am a believer that variety is the spice of life. Incorporating this belief into my new way of life I have (re) discovered the following foods:
· Offal – This includes liver, hearts, and kidneys. I know many of you are turning your noses up at this, but not only are they tasty, it is high in vitamins and minerals
· Full fat cream cheese – If quite firm is a great addition in salads. I personally prefer Philadelphia Cream Cheese.
· Almond milk – Is a great substitute for dairy or the horrid soy variety. I found the health store variety had added sugar so I have decided to make my own, using stevia instead of dates or honey. (see recipe on youtube: How to Make Almond Milk - Creamy & Simple)
· Stevia – Use instead of sugar, honey or the extremely unhealthy artificial sweeteners. I use this to sweeten baked goods, non-alcoholic and hot beverages as well as smoothies.
· Berries – This is the only fruit I eat, especially blueberries.
· Nuts – This is limited to raw nuts and I personally prefer almonds and macadamia’s, however I have snacked on pecan nuts.
· Sugar and grain free meat products – Ask your local free range butcher if their meat products contain sugar and or grains. I found a local German butcher that only sells grain free sausages.
The above list however are the latest additions, however once these become monotonous, I will be on the search again for newer and more exciting offerings.
Besides these whole foods, we need not deprive ourselves by eliminating our favourites. Great substitutes I have found are:
* Pasta and Bolognaise – Substitute the pasta with shaved baby marrow (Zucchini)
* Baked cheese cake – Eliminate the sugar and wheat and substitute with ground almonds and stevia
* Muffins and bread – Substitute wheat flour with ground almonds
* Tiramisu – Substitute the lady fingers with the home made kind prepared from ground almonds. Stevia can be used instead of sugar in the dessert.
* Creamed mushrooms or Cauliflower Au Gratin – Substitute the cheese sauce with sour cream and full fat cheese
* Pizza – The base made with eggs and topped with your favourite low carb topping
* Cheese / Hamburger – Discard the bun and serve the meat on a bed of fresh baby spinach topped with, a generous slab of cheddar, Dijon mustard and bacon.

End of part 1

Trail Running Episode 1

Thursday 27 December 2012



So Wesley and I decided that we should try trail running. Our trail of choice for our first run was the Muizenberg mountains. I think we might have been suffering from amnesia because we definately underestimated the steepness of the incline. It was a blast though!

 

2012-12-22-497 

 

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