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Thursday, June 11, 2015

Ancestral Health Dishonesty ~ Professor Tim Noakes Style!

It's hard to believe that Tim Noakes actually gave the presentation in the embedded YouTube video over two years ago.   It's even more difficult to believe that anyone has taken him seriously since.  

For the topic of this post, one needs only devote ~ 6 minutes to listening to Noakes read to you about human evolution and how Ancel Keys destroyed the world.  This begins at roughly 3 min 36 seconds.   If you can't tolerate the video, or simply wish to follow along with a written form, the South African Journal of Clinical Nutrition has dramatically lowered their standards and published Noakes' heavily fortified "transcript" (at least 25 references date to after the 2012 delivery of this speech) without any peer review.  His references, regardless of date, are enlightening, so I'm glad they were provided, however the journal should put a heavy disclaimer directly in/on the paper in question (and fix the oversight that allowed the peer reviewed "stamp" to appear on it). 

Diminuitive Australopithecus

Noakes begins by introducing us to our vegetarian ancestors:
Our human ancestors evolved from the tiny Australopithecus africanus (~ 1 m tall, weighing 30 kg) to the substantially taller and heavier modern Homo sapiens over a period of 3.5 million years. This change occurred as hominins became more successful at increasing the quality of the foods they ate, changing from a predominantly vegetarian diet to one containing an increasing amount of animal fat and protein.1-3
1. Cordain L, Miller JB, Eaton SB, et al. Plant-animal subsistence ratios and macronutrient energy estimations in worldwide hunter-gatherer diets. Am J Clin Nutr. 2000;71(3):682-692.

2. Boyd Eaton S, Konner M. Paleolithic nutrition: a consideration of its nature and current implications. New Eng J Med. 1985;312(5):283-289.
3. Konner M, Eaton SB. Paleolithic nutrition: twenty-five years later. Nutr Clin Pract. 2010;25(6):594-602.
I'm not sure what the height of our ancestors really has to do with this, after all there are small carnivores and large herbivores, but mostly I find his references to be interesting.   Cordain is a discussion -- as the title clearly states -- of the diets of modern hunter-gatherer diets.  The author's assertion that these diets are probably our best clue to what our paleolithic ancestors consumed, has been transformed into some ridiculous "fact" that this is how they did eat.   Importantly to this discussion, the first reference does not discuss our evolutionary ancestors.  Next up the original "paleo diet" NEJM paper, the Eaton & Konner paper, that started it all.  This one does discuss human evolution through Homo habilus and Homo erectus, stresses a shift towards more animal hunting and higher protein intake, etc.  But Noakes' distillation from this reference would be a stretch -- I'll come back to that as we segue into the next great leap of Noakes.  

This leaves us with the quarter-century retrospective paper by the same authors.  In this paper we find:
Some analyses in the past decade have suggested that we underestimated the proportion of meat in HG diets.[10-12] This is of substantial potential importance in estimating the intake of total fat, protein, carbohydrate, and fiber in those diets. However, this position has not gone unchallenged.[13] It is clear that ancestral human diets derive from higher primate diets that were overwhelmingly plant based,[14] supplemented by insects and (in some species) a small amount of animal flesh. Fossil evidence shows that this pattern continued to be true of early bipedal hominids (between 6 and 2 million years ago [mya]),[15] with a likely particular emphasis on underground storage organs (USOs; tubers)[16] and on large protected nuts and seeds.[17] Reliance on animal flesh increased substantially after 2 mya with the evolution of Homo habilis and especially Homo erectus, a species clearly capable of hunting large game, an ability shared by modern humans. However, much evidence points to continued significant (if not predominant) dependence on plant foods.
Reference 17 is a direct reference to the diet of Australopithecus.  Taken together, however, none of these three semi-redundant references delve very deeply into the actual diet of the paleolithic.  Furthermore, there's a focus on protein -- NOT fat -- and that nagging reminder about the value of plant foods that goes all but ignored and their wording is somewhat dismissive of plants in this article.  

As mentioned previously, the 1985 Eaton & Konner paper that started it all does go into some detail as to the evolution of human diets.  There is a curious almost obsession with size (height in particular) as the ultimate arbiter of species fitness ... but this obsession is coupled with meat consumption and protein.  See the screen cap right.  So big-game hunting became the rage and then what -- this "fully developed while the human population was still small in relation to the biomass of available fauna".  In other words, this was -- as appears to be a pattern repeated around the globe -- a blink of the eyes in evolutionary terms.  Animal protein consumption leads to bigger, better, faster, stronger, smarter (?) humans who hunt their food supply to extinction or levels unable to sustain their populations.  Even then, note the qualifiers:  

"In some areas during this time meat probably provided over 50 per cent of the diet".  
This somehow translates to humans the globe over became super-intelligent carnivores until Ancel Keys came along.  Noakes REALLY hates A. Ben!   How about the next line of the paper though?  
"But because of overhunting, climate changes, and population growth, the period shortly before the inception of agriculture and animal husbandry was marked by a shift away from big game hunting and toward a broader spectrum of subsistence activities."
So even before agriculture, humans were shifting away from hunting.  Note, I didn't say they stopped hunting.  But the unidirectional way in which human diets are portrayed to have changed over time and region is clearly a misdirection!   The remainder of the paragraph is screenshot at right.  Note:
"tools that are useful for processing plant foods, such as grindstones, mortars, and pestles."
Before agriculture folks.  Humans were shifting back to more plants and fewer animals, likely (note the qualifier) due to the fact that the increased demands of larger populations of super-big super-humans depleted the very thing some presume made them that way.  Deliberate efforts to raise plants for food seem to predate those to raise animals for food, and also seem to be more universally evidenced around the globe (in all but the most plant-inhospitable environments).

Before moving on, I cannot help but mention that the "paleo diet" from Noakes' references is anything but #LCHF.  From this other reference by the main authors we note that until very recently, the paleo diet was considered MCLFHP.   Even the highest fat versions that have come to fruition in the clinical literature top out around 40% fat.  This, folks, is still shy of the bare minimum in high fat circles (even 50% is inadequate for most advocates, 60% minimum and on up from there!).  

Completing Noakes' first paragraph on human dietary history we have:

The greater consumption of meat occurred as early hominins became the most effective persistence hunters on the planet, able to run large antelope to their exhaustion within 4-6 hours in extreme heat.[4-6] The discovery of fire and the development of cooking[7] approximately 1.8 million years ago increased the energy delivery from meat, roots and shoots, reducing the time humans spent chewing their food.  Stone-tipped throwing spears were added approximately 500 000 years ago,[8] further increasing our human ancestors’ ability to capture large, fatfilled animals, including elephants,[9] and in Africa, rhinoceros and hippopotamus.
We've already touched on those larger animals, but I've always been intrigued by this "human outrunning their prey to exhaustion" theory that I first came across reading Noakes' book.  I won't copy all of the references, but here are the ones for this idea
4. Heinrich B. Endurance predator. In: Sands RR, Sands LR, editors. The anthropology of sport and human movement. Maryland: Lexington Books, 2010; p. 95-101.

5. Noakes TD. Thermoregulation and hydrating stategies in human evolution. In: Sands RR, Sands LR, editors. The anthropology of sport and human movement. Maryland: Lexington Books, 2010; p. 103-141.
6. Sands RR. Homo cursor: running into the pleistocene. In: Sands RR, Sands LR, editors.  The anthropology of sport and human movement. Maryland: Lexington Books, 2010; p. 143-181.
These appear to be three chapters in the same book on the bipedal locomotion, running, etc.  The idea to me that as humans developed intelligence they would resort to trying to outrun much faster animals to the point of the animals exhausting themselves and dying of exhaustion just doesn't fit for me.  I realize this is supposition on my part.  What say you?  Is there evidence of this hunting strategy?  I know there are records of the !Kung San walking for miles at a clip on gathering trips (and hunting excursions as well) but 4 hour runs to nab an antelope?   Please help me get what I'm not seeing there!!  

In any case, Noakes neglects to mention the shift away from big game hunting described by Eaton & Konner before moving on.

Across the Globe and Forward to the 1800s ...

We now move on to the Plains Indians as portrayed by George Catlin in the 1830s.  I kid you not.  From Australopithecus to unnamed hominids to the Plains Indians of North America it is!  From the Noakes "transcript"
By the mid 1800s, the Plains Indians of North America, who existed on a diet of bison and little else, were the tallest[10] and perhaps the healthiest of all the peoples then populating the earth. In the 1830s, Catlin[11] travelled west of the Mississippi River, and painted hundreds of Plains Indians, including Black Dog and Tal-lee, two Osage warriors, who ate mostly buffalo meat and were both over 1.98 m tall. The arrival of  avaricious Europeans , disconnected from the land, foretold the massacre of 60 million bison and the demise of the Plains Indians’ health. Forced to eat the standard American diet, the modern descendants of the Plains Indians are now among the least healthy populations in North America.[12]  Annually, millions of dollars of public monies are spent trying to “discover” why these first peoples of North America are so unhealthy. Genius is not required to solve that particular riddle.
Genius is not required to obtain a reasonably accurate record of the wide-ranging diets of the numerous culturally unique tribes of humans in North America.  Clearly Noakes is not interested in an honest portrayal that doesn't fit his agenda.   I'm not going to rehash all of the buffalo stuff, except to say that even when buffalo were abundant, not every tribe hunted them and they were an erratic and unreliable food source.   See my post HERE (including comments by Melanie and Stella), that contains other pertinent links regarding buffalo specifically, and Ancestral Health Dishonesty ~ Phinney, the Osage and more Buffalo Feces!    
It is rather ironic, nay dripping with irony, to see a white European-descended Zimbabwe-born South African speak of "avaricious Europeans" ruining the native diet of what we are led to presume is all pre-contact inhabitants of the continent.   A hundred years ago, European researchers in the African colonies were going on about the inferior nature of the mostly vegetarian diets they encountered (or at least highly plant-based) when it was their avaricious conquest that caused various changes in the presumed "primative" diets to begin with.   

Before I move on, I'm aghast at the fact that Noakes would extrapolate from the diary of an artist as he did.  Phinney just goes on about the disproportionate appearing heads (the tall dudes in the NBA don't look like these guys to me) ... but Noakes takes it to a whole new level by claiming they were the tallest men on earth, and *probably* the healthiest people ever!  Congratulations SAJCN!!   By abdicating any peer review, you've now given clout to this load of unsubstantiated bunk.   In Catlin's own words:
"The Osages may justly be said to be the tallest race of men in North America, either of red or white skins ..."
And of Black Dog:
"This dignitary, who is blind in the left eye, is one of the most conspicuous characters in all this country, rendered so by his huge size (standing in height and in girth, above all of his tribe), as well as by his extraordinary life. The Black Dog is familiarly known to all the officers of the army, as well as to Traders and all other white men, who have traversed these regions, and I believe, admired and respected by most of them.

His height, I think, is seven feet; and his limbs full and rather fat, making his bulk formidable, and weighing, perhaps, some 250 or 300 pounds. ...
There is no mention of the cause of his partial blindness, Catlin didn't actually even measure anyone, and his limbs "fat"  -- not muscular, hefty, sturdy, stout, or whatever more flattering term for a limbs of a large man.  No, the term he used was FAT.  But you see, Noakes didn't research the Osage or Native American history, he got his dietary tales from Stephen Phinney.    

There's a reason I didn't gloss over this part, because there was mention of the "Paleoindians" in the "New World" in Eaton and Konner's 1985 paper.  This screenshot picks up where the last one from that paper left off.  Note the mention of a pattern repeating itself in North America, however the decline in big-game hunting occurred "in the period just before European contact".   

As I've discussed, the buffalo hunters were perhaps a small blip on the dietary radar screen, although clearly hunting was part of the food system for most if not all of the tribes indigenous to this continent.  Even had the white man not deliberately helped wipe out the buffalo, it may have only been a matter of another hundred years or so before hunting with horses and guns did.   But Noakes would have you believe what he wants you to, even if his sources tell another story entirely.

Back To Africa!

Our dietary journey brings us back to Africa now, the southern tip of the continent.   Noakes writes:
Xhosa- and Zulu-speaking South Africans experienced a not dissimilar fate.  In 1896, the Rhinderpest virus decimated the cattle herds of East and South Africa, forcing our indigenous peoples to migrate to the cities, where they first encountered the standard American diet of highly processed foods, white flour, refined carbohydrates, sugar and processed “vegetable” (actually seed) oils. There was an epidemic increase in obesity and diabetes within 20 years.[13-15] Other immigrant populations have shown an identical response.[16,17] 

Ummm ... Remind me just which non-natives occupied South Africa again.  So Rhinderpest wiped out the cattle -- and game! -- in more than just South Africa.  Indeed but the rest of Noakes' failure to mention a thing about colonialism and its role in transforming -- largely for the worse -- the continent of Africa is apalling.   To nonchalantly blame Rhinderpest and none of the sociopolitical wranglings of colonial authorities demonstrates a serious disconnect in this man.  (An interesting resource).  Furthermore, he fails to acknowledge how such a singular cause may have altered Masai history/diet differently than it did others.  And even furthermore, he ignores the *different* agricultural/gathering histories of precolonial cultures.

In any case, many of the problems to this day in South Africa and the region are the result of relentless European efforts to transform the economies of the colonies and their peoples.   This was LONG before anyone had even coined the term Standard American Diet, and in those days, the reliance on flour and sugar provisions during disasters like Rhinderpest were not the doing of Americans and Ancel Keys.    I also think Noakes needs to do a little brushing up on his math, because let's say 1900 + 20 = 1920s and the citations he uses for the epidemic rise in obesity and diabetes date to the 1960s.  Indeed the full excerpt including immigrant populations should be attributed to references 13-15, all by the same author.  

13. Campbell GD. Diabetes in Asians and Africans in and around Durban. S Afr Med J. 1963;37:1195-1208.

14. Campbell GD. Incidence of diabetes mellitus in one district of Basutoland. S Afr Med J.  1960;34:332.
15. Campbell GD, Batchelor EL, Goldberg MD. Sugar intake and diabetes. Diabetes. 1967;16(1):62-63.
I can't find anything but citations for these references, but it's highly unlikely that Asians first encountered carbs in South Africa in the late 50s or early 60s.

Northward to Israel!

As mentioned in the last section, the narrative moves again, this time north to Israel with references 16-18.  
The increase in diabetes and ischaemic heart disease in Yemenite Jews settling in Israel is associated with an increased intake of dietary sugar and polyunsaturated, not saturated, fat, the so-called Israeli Paradox.18
The relevance of this to the evolution of the human diet escapes me, as does pinning it on that damned American Ancel Keys.  But I include it here to demonstrate just how disjointed Noakes' argument is.   Given as there is a rich archeological record in southern Africa dating back well into the paleolithic, one wonders why he didn't just stay "at home" and chronicle the dietary changes in the region over time.  My guess is that he might have had to do a bit of "original" research (as in locate and read for himself from amongst the copious literature) and such an endeavor would more than likely have produced more inconvenient truths countering his agenda than those supporting it.   Why bother when you can mindlessly repeat the false tales of others ...

It's All A. Ben's Fault Anyway ...

So there you have it, human dietary history according to Tim Noakes.  Millions of years of fatty big game hunting followed by European avirice in the New World and a disease-promoted alteration in the way of life in southern Africa.  Eh ... and we'll throw in the Israelis for good measure.  All of which led Ancel Keys to do his supposed bad deeds beginning in the 1950s.  So here we are today with a medicated diabetic on a mission to change the world by:
  • Promoting a diet that has never been consumed by any culture ever
  • Promoting a diet that has failed to reverse his disease
  • Misrepresenting his own references
  • Misrepresenting human history, and basically
  • Lying through his teeth half the time if he even can make any sense at all  


There's a virtual goldmine of debunking to be had at every turn with Noakes and his "facts".   My guess is that if I'm lucky, I get to point out a few more of them before his hearing on his advice for feeding helpless infants.  

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