What’s the fuss over Noakes’ Banting advice?

Tongues have continued to wag over the advice that Professor Tim Noakes dished out via Twitter to a breastfeeding mother and the subsequent trial. But if you have been living under a rock in the last couple of months or are confused as to what exactly is going on Moneybags journalist, Ochega Ataguba looks at what went down at the hearing against Professor Noakes so far and finds out what all the fuss is about.

Firstly, who is Professor Tim Noakes?

He’s a professor of exercise and science at the University of Cape Town and has authored several books on exercise and diet. Nowadays he’s also known for his support of the Low-Carb High-Fat (LCHF) and his book ‘The Real Meal Revolution’, but experts are divided over his stance on the diet.

OK, so what’s the trial about?

Noakes is appearing before the Health Profession Council of South Africa and is being accused of professional misconduct for doling out health advice to a breastfeeding mother on Twitter.

What’s the big deal about the advice he gave out on Twitter?

According to reports, Noakes advised a mother on Twitter, a social media platform, to wean her child onto LCHF foods, which he described as ‘real foods’. Noakes explained that he implied that the child should not be weaned onto the traditional high sugar, high carbohydrate processed cereals.

Research indicates that Africa is experiencing the coexistence of over- and under-nutrition, and an increasing incidence of hypokinetic diseases in both child and adult populations, as well as stunting which pose a significant public health challenge.

To deal with these challenges many nutrition professionals have recommended “extreme” changes in the way we eat. This involves engaging in intense physical activity and a restricted calorie intake especially Low-Carb and ketogenic diets. This new way of eating has become increasingly popular and many South Africans are adopting diet fixes like Dukan, Paleo and Banting—many of which require cutting back on carbohydrates.

But there’s a great deal of information out there on ‘healthy diets’ for weight loss. And with so many conflicting views it may be difficult to determine what really constitutes a healthy diet, especially when it involves children.

What exactly is Banting?

Banting is a ketogenic diet. In other words, it is a low carbohydrate, high-fat diet. It was first prescribed in 1861 by William Harvey to William Banting, a British undertaker who had been obese at the time until he was put on this low-carb diet and lost weight.

So Banting was the first person in history to go on this diet. But in South Africa it has now became known as Tim Noakes’ Banting diet— after the professor published his book, Real Meal Revolution, which sold more than 250 000 copies.

In the book, Noakes advocates that this method of eating will address insulin resistance, weight loss and other lifestyle related illnesses. The key is to replace carbs with fats, as fats reduce hunger more effectively. Consequently, you are expected to consume as few as five grams of carbs daily. The whole idea behind this ketogenic diet is that your body switches from using carbohydrates to burn energy, to using fat as fuel instead.

Is Noakes going overboard with this stringent recommendation about high fat intake?

Noakes, who has since become a viral phenomenon, has been in the spotlight for quite a while now. The hearing which began on Monday 23 November has taken a new turn during which Noakes’ professional conduct was brought under intense scrutiny.

But this has not deterred his fellow Banters and admirers, many of whom have sworn that the diet is ‘amazing’ and ‘effective’.

The beauty about the diet is that you cut out very few ‘favourites’. Banting dieters can load up on butter, nuts, cheeses and bacon and greasy steak and still shed tons of weight! This is so as long as they are willing to ditch pizzas, pastas, etc., and cut out most grains and vegetables, even carrots!

But those who are ‘against’ him believe he is going to far in recommending this diet to children. For a start they believe that children should get exposed to a balanced diet, which should include carbs.

Is Professor Noakes being smeared unfairly?

Noakes has taken a beating ever since, in a message posted on Twitter, he advised a breastfeeding mother, Pippa Leenstra, to wean her baby onto a LCHF diet.

Perhaps recommending the LCHF diet for a baby might have seemed innocuous, since he is also a medical doctor and nutrition specialist, but this move has been met with a barrage of criticism. Noakes is now appearing before the professional conduct hearing in Cape Town, following a complaint by Claire Julsing Strydom, a dietician and former president of the Association for Dietetics in South Africa (ADSA) to the Health Professions Council of South Africa (HPCSA).

The main problem, which Strydom pointed out during the hearing, is that “Noakes is a highly regarded professional” and people take what he says as truth and that Twitter should not be used as a medium for health advice, as an assessment should have been conducted before any advice was given.

Other professionals have come out saying that it was irresponsible and inappropriate for Noakes to offer such advice to a breastfeeding mother, particularly over a medium such as Twitter.

What has Noakes done to defend his position?

Noakes submitted a 4 000 word research paper for the hearing. His fans have come out in support too. Noakes’ followers made a bit of a splash when they turned out in Red T-shirts to offer their support and earnest devotion during the hearing last week.

But Noakes has since then been heckled in court by witnesses including expert witness for the HPCSA, Professor Esté Vorster.

Do the South African dietary guidelines recommend Banting for infants?

After the Twitter advice last year Noakes is reported to have said that “the choice between health and ill health begins with our infants as soon as they are weaned.” Noakes continues to push the opinion that children should not be weaned on high sugar; high carbohydrate cereals as an infant’s taste is conditioned by early exposure to “non-foods” and that meat and liver are the best sources of iron which is much better than iron-fortified cereals.

However, according to the recent Paediatric Food Based Dietary Guidelines for South Africa you should only give breast milk and no other liquids for the first six months of life. And from six months it is advised that you give your child meat, fish, chicken, eggs and vegetables as often as possible.

Furthermore, it is advised that you give your child dark leafy greens and orange coloured vegetables and fruits every day. Some experts also advise that you should increase the amount of food you give and avoid feeding your baby sugar, coffee, teas and high-fat salty snacks, and make starchy food part of most meals. Apparently, this guideline did not include any advice for babies to follow a Banting diet.

As a matter of fact in a recent report, data from the South African National Health and nutrition survey indicates that under nutrition among children is high, with the prevalence of stunting sitting at 27% of children under three. About six percent of children under 14 are underweight and on the flipside, 19% of children are overweight and so steps must be taken to improve childhood nutrition.

Is Banting safe for everyone?

Although Noakes maintains that the Banting diet is safe for everyone, there is not enough clinical evidence to prove a LCHF diet is beneficial for all adults and children. As the debate on Banting diet rages on and on, David Sanders professor at the University of Western Cape School of public health reportedly said that the country’s real nutrition problems are high rates of low birth weight and that steps must be taken to improve childhood nutrition.

Sanders agrees that Saturated Fats are a lot less dangerous than previously thought but he is sceptical of the long term effects of diets high in animal fats. Sanders believes that maternal and child nutrition should be improved as suboptimal nutrition in a mother can result in a low birth weight in babies. Low birth weight is correlated to poor infant health which is associated with the majority of infant deaths.

What are the implications?

Clearly, Noakes’ arguments do not provide evidence about the appropriateness of the LCHF diet for weaning infants and young children. However, nutritionists have expressed concern about the exclusion of certain food groups from a child’s diet, as this could increase the risk of nutrient deficiency which may in turn lead to illness.

Maintaining a child’s health and wellness is an expensive endeavour, so it is crucial for you to have the right information when dealing with issues pertaining to their health. That way you won’t spend money unnecessarily on medications and hospitalisation in the event that your children fall ill.

*Before placing your baby or child on a diet, consult a qualified medical professional to discuss the matter in depth. A diet that works for your friend’s baby might not work for yours, and therefore individual consultation is vital.