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

Monday, 31 December 2012




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.


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.

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.

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