29 Mar Tim Noakes on carbohydrates – fad or fact?

Tim Noakes has moved from advocating carbo-loading to suggesting that carbohydrates are an addiction posing severe health risks. But while his revised recommendations are couched in the language of science, does the science support them? [Excellent opinion piece from the Daily Maverick].

Opinionista on Daily Maverick, Jacques Rousseau, writes:

In one of my first columns on Daily Maverick, Michael Pollan and his food rules (“the whiter the bread, the sooner you will be dead”) were used to illustrate the modern obsession with eating “healthy” food, or orthorexia. Pollan is an example of a celebrity nutritionist, who – while not necessarily offering harmful advice – could be accused of simplifying things to such an extent that what starts as sound advice mostly ends up being accepted on faith or as dogma.

Recently, South Africa’s sports-science guru Tim Noakes has been receiving plenty of media coverage following his apparent about-turn on matters dietary. Many of you will recall Noakes as an advocate of carbo-loading, especially for athletes. But even those of us who aspired to complete a 10km shuffle had little to fear from the carbohydrate. Until now, where for many of us our fondness for carbohydrates “is an addiction that is at least as powerful as those associated with cigarette consumption and some recreational drugs like heroin”.

In general it’s a good thing to see scientists change their minds, because it’s evidence of the scientific method at work. When the evidence changes, so should our views. But such is the current fear of food, manifested in daily articles about epidemics of obesity and the various ways we’re killing ourselves through what we eat, that it’s sometimes a little easy to join the next dietary fashion without thinking enough about whether we’re convinced by the evidence rather than by the hysteria.

A form of cultural amnesia is apparent in most dietary programmes – they spawn books and instructional DVDs, but are quite often simple revisions of advice we’ve heard before, packaged under a different name with a different guru’s face on the cover. But if the advice is good and presented in a way that doesn’t encourage mindless obedience, us non-specialists could certainly benefit from knowing about what, in this instance at least, appears to be somewhat of a breakthrough moment for dietary knowledge.

The breakthrough is not Noakes’s and he’s the first to admit that, citing William Harvey and William Banting, and more recently Robert Atkins and Gary Taubes as those who introduced him to the concept that most of us would apparently lose weight and live healthier lives on low-carbohydrate diets. I say “apparently” not only because I haven’t tried it myself, but also because the evidence for Noakes’s claim doesn’t seem nearly as convincing as he’d like us to believe.

While some philosophers of science (like Nancy Cartwright for one) disagree, the gold-standard in science is generally held to be the RCT, or randomised controlled trial. In an RCT, subjects are randomly allocated to receive one or another of the different drugs or interventions being tested, and those subjects are then treated differently only in respect of differences that are intrinsic to the different treatments under comparison…..

Daily Maverick: Read the full article

Read more:

• A Calorie Is a Calorie Is a Calorie: All Diets Work if You Stick to Them, on The Atlantic.
• Thin Body of Evidence: Why I Have Doubts about Gary Taubes’s Why We Get Fat, on Scientific American.
• A Diet Manifesto: Drop the Apple and Walk Away, in The New York Times.