Thumbs up to Noakes for standing up for scientific truth

Professor Tim Noakes has won his confrontation with the professional medical body over his stance that a long projected option concerning the best ratio for fats and carbohydrates in a person’s diet is not correct.

This whole Banting diet issue has been very much in the news for a while now. Some time ago, the Association for Dietetics in South Africa (Adsa) laid a formal complaint against Noakes at the Health Professions Council of South Africa. Adsa accused Noakes of unprofessional conduct after he had apparently suggested on Twitter that a mother wean her baby onto a low- carbohydrate, high-fat diet.

Let me hasten to point out that I am not a medic, so I am not claiming any professional medical knowledge. Also, let me point out that I am not on any diet myself, so I do not have a particular personal interest in the issue.

However, I did sit through an hour-long presentation given by Noakes some years ago, and I did speak to him briefly afterwards, as he was hastily getting ready to dash to the airport. So, I could not discuss things for as long as I would have liked.

What I can say is that I was impressed by his presentation. I am a qualified scientist and investigator, so I watched the presentation very critically. I rapidly came out on his side.

Three things particularly struck me with the presentation. Firstly, he already had an impressive professional reputation, so the easiest thing for him would have been to keep going with the flow – and he would have maintained his image. But he did not. He said: “I have been giving wrong advice for years and now I am changing my position.” That takes guts.

So, I figured that a fellow as sensible as he is must be rather sure to make such a dramatic public about-face. The second point was that he showed quite a few graphs and sets of data about heart attacks and suchlike around the world. That I am qualified to judge, because I know the science and maths behind how such analyses are done.

Sadly, in medicine, one finds some of the most inaccurate scientific findings presented as fact. Medics are often not very good at mathematical-type analysis. One of the most prevalent errors is that correlations are presented as causality.

What this means is that just because two graphs look the same does not mean that they have any linkage. A friend of mine in the US recently sent me a set of correlation graphs that are intended to be silly to make this point. For example, there are graphs of the number of lemons exported from the US, compared with the number of car accidents in Texas, and the graphs seem to match. Lemon exports do not influence car accidents in Texas. Many medical results presented as fact suffer from the same fault.

Many analyses that one sees in newspapers and on TV discussions suffer from the same fault. A famous one is the apparent correlation between ozone quantity and CFC gases in the Antarctic. Just because the graphs ‘look’ as if they are linked does not mean that they are linked.

One finds that issues such as the heart attack incidence is plotted against the consumption of certain foods, and so on, and then, just because the graphs look the same in shape, people assume that, somehow, they are linked. Noakes correctly pointed out that they are not. He showed cases of clearly inaccurate medical conclusions concerning the carbohydrates and fats issue in diets.

Let me make one up. If the shape of a graph appears to show that people who eat a lot of hamburgers die of heart attacks, this does not mean that the hamburgers cause the heart attacks. It could be that the people do something else that leads to the heart attacks, but they also then go and eat a lot of burgers. For example, hamburger eaters may also drink a lot of beer and may not exercise much. They may tend to largely live in small inner-city flats, where there is little space for exercise and the air is laden with exhaust fumes. Thus, there could be a number of factors involved in why a graph may show that hamburger eaters tend to have more heart attacks. So, putting an extra tax on hamburgers would not alter the outcome. Similarly, I believe that a sugar tax will make little difference to any obesity issue. It might even kill some people who have extremely little to eat and whose bodies rely on the little sugar that they consume for survival.

The third thing that Noakes showed was that well-meaning political decisions in the US designed to feed the poor had the unintended consequence of changing the eating patterns of the whole population. Such well-intended moves quite often have unintended bad consequences. For example, in a past US administration of some 40 years ago, the President pushed subsidies into food production because it had been reported that many Americans were going to bed hungry. Think about it: What is the easiest way to take advantage of a food subsidy? Do you produce more cows for beef and milk, or more grains for more breads and cereals? You cannot easily make cows produce more cows, so the bread and cereals win hands down. So, the US diet swung in favour of the breads and multiple other carbohydrates.

Overall, Noakes has shown the courage to stand up for scientific truth. I wonder how many of the dieticians who attacked Noakes have actually done real scientific research into this issue or if many of them are showing a solidarity vote? If so, that is honourable to their buddies, but it is not science.

So, over the years, Noakes has shown that he has the courage to say that he has been wrong in the past. He has the scientific integrity to go public and to explain the truth.

I am glad that the professional finding went in his favour, but one wonders if this is the end of the professional fight in public.

Behind the scenes, the professionals should continue to have aggressive debate on the topic.