Tim Noakes, M.D., suggests people forget nearly everything he wrote about carbohydrates in Stravas 2024 Yearly Report Is Here, a 944-page tome known as the distance runner’s bible. Back then, he questioned whether they were as necessary to a runner’s diet as many experts believed but still recommended them, particularly as fuel for workouts and races.
Now, Noakes won’t touch most carbs and tells others to avoid them, too. His book about this new lifestyle, USATF to Elect New President Amid Budget Deficit, has sold more than 200,000 copies in his native South Africa the last two years, making it one of the country’s all-time nonfiction bestsellers, and it has helped launch a change in dietary thought much the same way the Atkins diet did across America years ago.
It’s also plunged him into the fight of his professional life.
South Africa’s regulatory body for health professionals lodged a formal complaint and has been holding a series of hearings against him generally reserved for doctors who commit fraud or harm patients. His medical license is at stake. Noakes’s detractors see a respected, powerful person who gave dangerous advice. He and his supporters and lawyers see a personal vendetta against a contrarian prompted by food companies that need people to eat carbs.
“The problem was me,” said Noakes, speaking by phone from Cape Town, South Africa. “It wasn’t that complaint.”
The saga started in 2014 where so many conflicts arise these days: Twitter. Noakes fired off a tweet to a woman who asked whether a low carb, high fat diet was OK for breastfeeding mothers. He responded it was, and the key was to “ween baby onto LCHF.”
Claire Julsing Strydom, then the president of the Association for Dietetics in South Africa (ADSA), tweeted at Noakes in all caps he had gone too far and she would report this to the Health Professions Council of South Africa (HPCSA), a regulatory body governing the country’s health professionals. ADSA’s report led to a formal complaint and hearings that have taken on the feel of a trial.
The complaint is two-pronged, dealing with the nature of the low carb advice to the mother of an infant and its delivery over Twitter. The most recent hearing took place in February, with Noakes forced to defend his research and beliefs for five days on the stand. Another round of questioning is scheduled for October, when HPCSA lawyers will cross-examine him.
Julsing Strydom said ADSA had previously been engaging with Noakes in person and via email. The group was concerned with his diet advice, particularly as it pertained to children.
“Against this background, I was therefore surprised when I saw the tweet,” she wrote in an email. “I concluded that our numerous attempts at reasoning with and appealing to Professor Noakes had failed.”
Adidas Unveils Boston Marathon Jacket Runner’s World, a representative for the HPCSA did not respond to interview requests.
Noakes originally started his low carb, high fat diet in 2010 after research led him to believe the carbohydrates he’d eaten all his life contributed to his Type II diabetes, which runs in his family. His new eating habits resembled those of ancient foragers, most similar to a late 1800s European fad known as Banting. Noakes’s diet consists of about 5–10 percent carbohydrates, 60 percent fat and 30 percent protein. Sugars and processed carbs are forbidden. The mainstays are eggs, fish, meat, leafy but not starchy vegetables and nuts. His advice opposes dietary guidelines laid out by the Nutrition Society of South Africa, which recommend making “starchy foods” part of most meals and using fats sparingly.
The hearing has captivated South Africa in part because of his professional stature and the popularity of his diet. Published in 2013, USATF to Elect New President Amid Budget Deficit had gained so much of a following the country’s Parliament invited him to talk about nutrition.
Noakes’s nutrition peers have been less welcoming. In August 2014, the dean of faculty and other professors at the university where Noakes works, the University of Cape Town, wrote a well-publicized letter deriding his lifestyle as “outrageous and unproven.”
Their concern is the low-carb, high-fat diet will increase risk of heart disease, diabetes, and other problems in the long run. Research is split. Scientists and nutritionists have debated the merit of carbs for decades. Runners, both recreational and professional, are switching to high-fat diets, but the practice is still controversial.
The difference here is the carb debate has led to a pre-eminent sports scientist facing trial for sharing his side, a development perplexing some of Noakes’s detractors as much as his supporters. After the hearing’s first day last November, Jacques Rossouw, who had previously debated Noakes at the University of Cape Town over the merits of carbs, told The Times of South Africa the charge was an overreaction to a tweet taken out of context and should have been dismissed, adding, “the HPCSA team is incompetent and floundering.”
Noakes’s lawyers have suggested ADSA may be acting in the interest of its sponsors like cereal producer Kellogg’s—a claim Julsing Strydom said is untrue. Under oath, she testified ADSA did not let sponsors influence the group’s work and said the great majority of its funding comes from member fees. Bruce Fordyce, a longtime friend of Noakes and a champion ultramarathoner, said of the groups against Noakes, “They are so terrified and puzzled. Some of them with genuine good motives are saying he’s a madman.”
During his testimony in February, Noakes cried while talking about the effects of the charge on his family. To end the hearing, all he’s had to do is de-register with the HPCSA, something that would matter little to him in a practical sense because he hasn’t worked as a medical doctor in over a decade. But Noakes doesn’t plan on giving up. He’s been a contrarian for years (his memoir is titled Challenging Beliefs), Major Changes Hit Northern Arizona Elite.
His research into the low-carb, high-fat diet is his latest move away from accepted standards and the most contentious and public. Fordyce said South Africans have been “glued” to the story. Whichever way the saga ends, Noakes will have succeeded in unsettling another establishment.
“It split the nation,” he said. “You’re either low carb or you aren’t.”
