Marika Sboros on Noakes, exercise, and why you can’t outrun a bad diet

*This blog has been updated and corrected with new comment and information.

By Marika Sboros

obesity, weight loss, exercise
Picture:Photo credit: Sangudo / Source / CC BY-NC

It should probably come as no real surprise that a message  in an editorial in the British Journal of Sports Medicine (BJSM) by three of the world’s top experts in low-carb, high-fat (LCHF) was for a while lost in translation.

The BJSM editorial is co-authored by British interventional cardiologist Dr Aseem Malhotra, US physician scientist Prof Stephen Phinney and University of Cape Town emeritus professor Tim Noakes.

It  says exercise is not the most effective weight loss tool.

That’s a message Big Food and Big Pharma, and the doctors and scientists in their thrall don’t like to hear. They appear willing and able to do just about anything to suppress it. They seem to prefer that  people continue eating foods that make them fat and sick, and take drugs to treat all the symptoms of disease that follow.

The editorial was “temporarily removed”, according to BJSM editor Prof Karim Khan, after “expressions of concern” over non-disclosure of certain interests on the part of Noakes and Phinney.  The editorial is now back with fuller disclosure, presumably allaying any further  “concerned expressions”.

It turns out the non-disclosure was due to nothing more sinister than an administrative error,  a function, says Noakes, of “undue haste” in getting the editorial to publication.

Given the ongoing and unprecedented levels of antagonism  to both Noakes and LCHF in South Africa, it’s probably not all that surprising that critics seized upon the temporary removal with scarcely disguised glee. It was after all, the softer target.

Tim Noakes
Prof Tim Noakes

“If you can’t disprove what is written,” Noakes says, “make the public believe that the authors have an ulterior motive other than what they wrote.

“It’s the classic tactic of an industry under extreme pressure.”

Some experts have attacked the editorial’s premise as irresponsible for downplaying the role of exercise. Yet none of the editorial authors has ever said exercise isn’t important. They all know it is, and for many different reasons: it is a mood enhancer; it tones the body, and builds physical fitness and stamina; research also shows that exercise lengthens telomeres that contribute to longevity. Khan will give a keynote address to a Royal Society of Medicine event in June on exercise as “medicine for older people’s bones and brains”.

There’s just no way to get round the proof that while exercise can lead to some weight loss, it’s just not the best weightloss aid. That’s why exercise doesn’t feature in my Idiot’ Guide to the Tim Noakes diet because the science isn’t there to support it.

It’s a pity then that Noakes and Phinney unwittingly ended up giving their enemies ammunition to attack the message by attacking the messengers. Both professors are not the first, or last, to make mistakes by default rather than design over declarations of interests.

After all, it’s not as if they are in the pay of Big Food or Big Pharma, as are many of their critics. And they haven’t hidden any interests from public scrutiny.

Dr Aseem Malhotra
Dr Aseem Malhotra. Picture: LOUIS HIEMSTRA

On the contrary, Noakes, a scientist rated A1 by the National Research Foundation of SA, who has published more than 500 scientific papers, and  been cited more than 15 000 times in the scientific literature,  is  well known to be the author of  books on diet, nutrition and sport, including the LCHF “bible’, The Real Meal Revolution, and one devoted to exercise, The Lore of Running.

In more than 40 years of a scientific career he says he has “never been required to declare the books as conflicts of interest”. And even if he hadn’t been in such a rush to get the editorial published, he says he “would still not have declared the books”, as he has “never seen anyone before declare a book as a (conflict of interest).”

He later commented on Twitter: “At least I EARN my conflicts of interest by writing books.Truly influential conflicts are unearned, even if declared.”

I wasn’t able to contact Phinney in time to get comment for this blog, but he is acknowledged worldwide as an expert in his field, and a person of integrity. Phinney has now also declared all interests, including that he is on the Atkins Scientific Advisory Board, and is author of The New Atkins for a New You.

Prof Stephen Phinney
Prof Stephen Phinney

Clearly though,  Noakes and Phinney did get things wrong. They  should have known the knives would be out, waiting and sharpened. They should also have known by now that the goalposts on declaration of interests have moved radically and for good reason: rampant corruption and collusion between doctors, scientists, food and pharmaceutical industries, and journal editors that has still not been rooted out, and  has allowed bad science to survive and thrive.

The odd unwise tweet by Noakes about research commonly published on the basis of friendship hasn’t helped. I say unwise only because as ancient Eastern sages said, the best answer  at times may not always be to speak the truth, but to keep silent.

Much has been made of Noakes’ friendship with Khan, the timing of which is somewhat suspect. Khan has published many articles by Noakes over the years, without anyone suggesting there was anything untoward.

Noakes’ comment wasn’t so much about friendship as much it was about science,  and the hurdles facing researchers who challenge the status quo. It did give some of his implacable foes the opportunity to make irrelevant, emotional outbursts in the media, one of them about most doctors having to sweat “blood and tears” to get their research published – as if to say doctors haven’t sweated blood and tears to produce powerful research or editorials that journals refuse to publish simply because the message is goes up against the status quo and vested interests, and that any friends they might have among journal editors should be similarly without integrity and courage simply because of the connection.

So what became lost for a while, was an important message that even governments are receiving loudly and clearly these days.

The reality is that the science is there to support the editorial’s premise, but you don’t need it to prove exercise is not the best weight loss aid. You just have to look at all those poor souls who pay for expensive gym contracts, workout regularly, religiously follow conventional medical and dietary advice, and stay resolutely overweight and sick.

You just have to read people like top US investigate science journalists Gary Taubes, author of Good Calories, Bad Calories, and Why We Get Fat, and Nina Teicholz, author of Big Fat Surprise. 

You need to read top British obesity researcher Zoe Harcombe, who says:  “You can sit on the couch all day and still lose weight”. She’s right,  because it makes intuitive as well as scientific sense that exercise is not the best weightloss tool.

And you can read the entertaining, informative blog of Canadian nephrologist Dr Jason Fung on Exercise is not Total Energy Expenditure

More than exercise, it is becoming clear that people need to be taught what and when to eat. And a healthy diet is proving to be one rich in real foods, not processed or refined; foods that don’t constantly raise insulin levels and your risk of serious disease such obesity, cancer, heart disease, diabetes, and more recently dementia that is becoming so prevalent doctors are calling it type 3 diabetes.

A healthy diet is also one not based on official dietary guidelines in place for nearly 40 years; the guidelines that have left people sicker and fatter, despite religious adherence to them for decades; the guidelines Harcombe’s meta-analysis in the BMJ Open Heart  earlier this year showed to be without science when they were imposed on an unsuspecting public way back in 1977 in the US, and the rest of the world thereafter.

Harcombe has developed her eponymous  The Harcombe diet which she doesn’t call LCHF. she says people will tend naturally to eat that way because it’s the best diet  for optimum health, wellbeing and weight control.

Her research supports the BJSM editorial message that exercise simply isn’t the best way to beat the obesity epidemic.

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