Wednesday, September 19, 2012

Game On

Cape Town - Sports scientist Tim Noakes goes too far in suggesting that a switch to a high-fat, high-protein diet is advisable for everyone, say six top doctors and academics.
It may, in fact, be dangerous for anyone with or at risk of heart problems, they say, adding in a letter to the Cape Times (full text below): “Having survived ‘Aids denialism’ we do not need to be exposed to ‘cholesterol denialism’.”
The six signatories of the letter were doctors Patrick Commerford (professor of cardiology and head of the cardiac clinic at UCT and Groote Schuur Hospital), Miko Ntsekhe (of the cardiac clinic at UCT and Groote Schuur Hospital), Dirk Blom (of the lipid clinic department of medicine at UCT and Groote Schuur Hospital), David Marais (of chemical pathology and clinical laboratory services at UCT’s Health Science Faculty), and cardiologists Elwyn Lloyd and Adrian Horak.
Noakes, a professor of exercise and sports science and head of the Sports Science Institute of SA, launched an updated edition of his book, Challenging Beliefs, earlier this year, which contained an abrupt turnaround on his previous views toward carboloading – instead promoting a high protein and fat, low-carbohydrate diet.

Summary of the case represented by the six complainants:

"We are experts, and we think this is wrong.  If we had evidence, we know it wouldn't take a fight in public like this, because we could just show data from intervention studies instead.  But since we don't have science on our side, we expert you to take our expert word for it."

Here's the funny part - the diet these doctors likely advocate - high carb, low fat - has no more evidence to support its long term goodness than does a high fat diet.  In fact, in short term studies, high fat diets win hands down.  There was a time when the best info one could get was expert opinion.  That time has passed.  We all have access to information, and relying on experts is not longer smart.   Instead, you can sort things out for yourself by self experimentation.

Full fledged advocacy of statins is based on belief but not science - it requires that 100 people take stains every day for five years in order to save a statistical life - ridiculous.

The complainants say:  "We understand some patients are placing their health at risk by discontinuing statin therapy and their prudent diets on the basis of this “expert opinion”."

"Such a diet may have allowed him to lose weight and run faster but its widespread implementation is contrary to the recommendations of all major cardiovascular societies worldwide, is of unproven benefit and may be dangerous for patients with coronary heart disease or persons at risk of coronary heart disease."

In other words, "experts think this might be bad for some people".  Hardly a convincing scientific case, and in short a feeble, pathetic response.

For what it is worth, it probably is true that high fat diets are not good for everyone.  But there's no reason to be fussy about this since it's clear that high carb diets are bad for almost everyone!  For folks who respond well to high fat diets, they'd be foolish to listen to the huffying and puffing of these statinators.  Anyone who cares to can simply check and see if their smart, low carb diet reduces their waistline, their triglycerides, their blood pressure, their gout and their appetite, while raising their HDL.  Having accomplished that, there's not a respectable doctor on the planet that could argue with the results.

Folks who don't respond well to high fat diets - typically ectomophs - would be able to figure this out by their non-favorable response in the above criteria.

We'd all be better off if there were conclusive long term science on the topic, but until then I recommend you sort out these issues for your own satisfaction and ignore the blow hards who can do no more than appeal to authority.

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