Tim Noakes

Last updated

Tim Noakes
Dr. Tim Noakes at West Point 13 Nov 09.JPG
Tim Noakes at West Point in 2009
Timothy David Noakes

1949 (age 7374)
Nationality South African
Alma mater University of Cape Town
Diocesan College
Known for Central governor Theory of Fatigue
Hyponatremia research
The "Noakes Diet"
Scientific career
Fields Exercise physiology
Institutions University of Cape Town

Timothy David Noakes (born 1949) is a South African scientist, and an emeritus professor in the Division of Exercise Science and Sports Medicine at the University of Cape Town.


He has run more than 70 marathons and ultramarathons, [1] and is the author of several books on exercise and diet. He is known for his work in sports science and for his support of a low-carbohydrate, high-fat (LCHF, Banting) diet, as set out in his books The Real Meal Revolution and Lore of Nutrition: Challenging Conventional Dietary Beliefs.


Noakes was born in Salisbury, Southern Rhodesia (today Harare, Zimbabwe) in 1949 as the son of a third-generation tobacco exporter [2] and moved to South Africa at the age of five. [3] As a young boy his main sporting interest was cricket. Noakes attended boarding school at Monterey Preparatory School in Constantia, Cape Town. [3] One year was spent as a foreign exchange student at Huntington Park High School in Huntington Park, California. Prep school was followed by Diocesan College, from which he matriculated in 1966. [4] He has earned an MBChB (1974), MD (1981), and DSc (Med) (2002).


In 1980 Noakes was tasked to start a sports science course at the University of Cape Town. Noakes went on to head the Medical Research Council-funded Bioenergetics of Exercise Research Unit, which was later changed to the MRC/UCT Research Unit for Exercise Science and Sports Medicine. [5]

In the early 1990s Noakes co-founded the Sports Science Institute of South Africa, [6] with former South African rugby player Morne du Plessis.

He is a leading researcher on the condition now known as exercise-associated hyponatremia (EAH). [7] He first recognised this condition in a female runner during the 1984 Comrades Marathon, and published his findings in 1985 in the journal Medicine and Science in Sports and Exercise. Noakes wrote the consensus statement for the 1st International Exercise-Associated Hyponatremia Consensus Development Conference in Cape Town in May 2005.

In 1996 Noakes published his theory of the "central governor". [8] The theory proposed that fatigue is a "protective emotion" rather than a physiological state. [9]

Noakes served on the selection panel for the International Olympic Committee’s Science Prize between 1995 and 2002. [4] Noakes is a fellow of the American College of Sports Medicine.

In 2005 he undertook a series of experiments in the Arctic and Antarctic on South African (British-born) swimmer Lewis Gordon Pugh to understand human capability in extreme cold. He discovered that Pugh had the ability to raise his core body temperature before entering the water in anticipation of the cold and coined the phrase 'anticipatory thermo-genesis' to describe it. [10] [11] In 2007, Noakes was the expedition doctor for Pugh's one kilometre swim at the Geographic North Pole. [12]

The Noakes Diet

Noakes has characterised mainstream dietary advice, which emphasizes carbohydrate consumption, as "genocide", [13] and instead advocates a low-carbohydrate, high-fat (LCHF) diet — a variation of the low-carbohydrate diet — often referred to in South Africa as the "Noakes Diet" (or, less commonly, the "Banting" diet). Noakes founded the Noakes Foundation in 2012 to help promote the diet, [14] which is described in detail in Noakes's 2014 book The Real Meal Revolution. [15] Noakes' father died from diabetes. [8] Noakes believes his father's diet was instrumental in his decline, [8] so following his own diagnosis with diabetes, Noakes changed his diet to a LCHF diet. He also reversed the carbohydrate-loading advice he had given previously to athletes, and which had featured extensively in his book Lore of Running. [8] He has cited the effects of diabetes on his father and his father's life regrets as important motivation for his efforts to promulgate his dietary advice. [2]

Despite following his diet, Noakes's fasting glucose levels barely budged, and he started taking the diabetes management drug metformin and dietary supplements to control the condition. He now describes himself as "cured" as long as he follows this regimen. [8]

Registered dietician Megan Pentz-Kluyts said that omitting food groups, as Noakes's diet does, is the hallmark of fad diets not backed up by scientific evidence. [16] After members of the Parliament of South Africa expressed support for his diet, fellow faculty members at the University of Cape Town accused him of making “outrageous, unproven claims about disease prevention” in an open letter they sent to the Cape Times. Wim de Villiers, dean of the faculty, accused Noakes of having no real scientific evidence to back up his assertions. [17]

In February 2014 a registered dietician complained to the Health Professions Council of South Africa (HPCSA) that Noakes tweeted to a mother that she should wean her baby onto low-carbohydrate, high-fat foods, which he described as real foods. The HPCSA held a hearing about the allegation against Noakes over the next few years. Controversially, on 28 October 2016, the HPSCA incorrectly released a statement announcing that Noakes had been found guilty of misconduct, namely "giving unconventional advice over social media". In a second press release issued over three hours later, the HPSCA apologised for the mistake. [18] Noakes was cleared of misconduct in April 2017. [19] [20] The HPSCA lost its appeal in June 2018 and the appeal committee dismissed the HPSCA's case by unanimous decision. [21] Noakes commented: "Acquitted on all counts, twice, by two different judging panels". [21]

Noakes co-wrote the 2017 book Lore of Nutrition with journalist Marika Sboros. [22] In it Noakes describes his conversion to LCHF dieting, and writes that in his view the lipid hypothesis is the "biggest mistake in modern medicine". He details his struggles with the medical establishment. [22] Paediatrician Alastair McAlpine criticised Noakes's Lore of Nutrition book as "bad science" in a review, [22] to which Noakes responded. [23]

Clinical dietitian Ingrid Schloss, citing a 2018 study, [24] pointed out that no significant differences were found between low-fat and low-carb diets, and suggested that instead of the "fundamentalism" of the Noakes diet, people should be encouraged to reduce added sugar and refined grains; choose more whole foods, and include a wide variety of vegetables. [25]

Other controversies over public statements

In August 2014, Noakes tweeted: "Dishonest science. Proven link between autism and early immunisation covered up?". [26] The tweet included a link to a video from disgraced ex-doctor and anti-vaccine activist Andrew Wakefield, in which Wakefield was repeating the conspiracy theory that the CDC is covering-up a link between vaccination and autism. [26] Subsequently asked directly on Twitter if he thought there was a connection between the MMR vaccine and autism, Noakes responded: “Have no opinion. Focus of video was on wilful distortion of science and importance of whistleblowers. How did you miss it?” [26]

In a 2021 opinion piece published by News24 Eduard Grebe, an epidemiologist and infectious disease specialist, wrote that Noakes had "a long history of making misleading and false claims", including support for the false claim that MMR vaccines can cause autism and claiming that hydroxychloroquine was an effective treatment for COVID-19. [27]

Awards and achievements

In 1996 he was honoured by the American College of Sports Medicine when he was asked to present the J.B. Wolfe Memorial Lecture, the college's keynote address at its annual meeting. In 2002 he was awarded a Doctorate in Science (DSc). In 2002 Noakes was awarded the International Cannes Grand Prix Award for Research in Medicine and Water, for his work on Exercise-associated hyponatremia (EAH). In 2004 Runner's World (USA) included this work as one of the 40 most important "persons or events" in the sport of running in the past 40 years. In 2008 he was elected an honorary fellow of the Faculty of Sports and Exercise Medicine (UK), the first foreigner to be so recognised. In that year he also received the Order of Mapungubwe (Silver), from the President of South Africa for his "excellent contribution in the field of sports and the science of physical exercise". In 2011 Noakes was awarded an honorary doctorate by the Vrije Universiteit Amsterdam, Netherlands. [28] In 2012 he received the Lifetime Achievement Award from South Africa's National Research Foundation for his contribution to sports science research. In 2014 the Southern Africa Association for the Advancement of Science (S2A3) awarded Noakes their prestigious South Africa Medal (gold) for his outstanding contributions to sport physiology. [29]

Selected publications

Noakes has written several books detailing his research in sports science and nutrition. A selected bibliography is given below.

Related Research Articles

Dieting is the practice of eating food in a regulated way to decrease, maintain, or increase body weight, or to prevent and treat diseases such as diabetes and obesity. As weight loss depends on calorie intake, different kinds of calorie-reduced diets, such as those emphasising particular macronutrients, have been shown to be no more effective than one another. As weight regain is common, diet success is best predicted by long-term adherence. Regardless, the outcome of a diet can vary widely depending on the individual.

<span class="mw-page-title-main">Ketosis</span> Using body fats as fuel instead of carbohydrates

Ketosis is a metabolic state characterized by elevated levels of ketone bodies in the blood or urine. Physiological ketosis is a normal response to low glucose availability, such as low-carbohydrate diets or fasting, that provides an additional energy source for the brain in the form of ketones. In physiological ketosis, ketones in the blood are elevated above baseline levels, but the body's acid–base homeostasis is maintained. This contrasts with ketoacidosis, an uncontrolled production of ketones that occurs in pathologic states and causes a metabolic acidosis, which is a medical emergency. Ketoacidosis is most commonly the result of complete insulin deficiency in type 1 diabetes or late-stage type 2 diabetes. Ketone levels can be measured in blood, urine or breath and are generally between 0.5 and 3.0 millimolar (mM) in physiological ketosis, while ketoacidosis may cause blood concentrations greater than 10 mM.

<span class="mw-page-title-main">Sports drink</span> Oral electrolytic infusion

Sports drinks, also known as electrolyte drinks, are functional beverages whose stated purpose is to help athletes replace water, electrolytes, and energy before, during and especially after training or competition. There are many perceived benefits and questions pertaining to the efficacy of use for sports and fitness performance.

<span class="mw-page-title-main">Carbohydrate loading</span> Dietic strategy in preparation for athletic endurance events

Carbohydrate loading, commonly referred to as carb-loading, or carbo-loading, is a strategy used by endurance athletes, such as marathoners and triathletes, to maximize the storage of glycogen in the muscles and liver.

<span class="mw-page-title-main">Fad diet</span> Popular diet with claims not supported by science

A fad diet is a diet that is popular, generally only for a short time, similar to fads in fashion, without being a standard dietary recommendation, and often making pseudoscientific or unreasonable claims for fast weight loss or health improvements. Fad diets are usually not supported by clinical research and their health recommendations are not peer-reviewed, thus they often make unsubstantiated statements about health and disease.

<span class="mw-page-title-main">Low-carbohydrate diet</span> Diets restricting carbohydrate consumption

Low-carbohydrate diets restrict carbohydrate consumption relative to the average diet. Foods high in carbohydrates are limited, and replaced with foods containing a higher percentage of fat and protein, as well as low carbohydrate foods.

<span class="mw-page-title-main">William Banting</span> English undertaker and populariser of a weight loss diet

William Banting was a notable English undertaker. Formerly obese, he is also known for being the first to popularise a weight loss diet based on limiting the intake of carbohydrates, especially those of a starchy or sugary nature. He undertook his dietary changes at the suggestion of Soho Square physician William Harvey, who in turn had learned of this type of diet, but in the context of diabetes management, from attending lectures in Paris by Claude Bernard.

Bodybuilding supplements are dietary supplements commonly used by those involved in bodybuilding, weightlifting, mixed martial arts, and athletics for the purpose of facilitating an increase in lean body mass. Bodybuilding supplements may contain ingredients that are advertised to increase a person's muscle, body weight, athletic performance, and decrease a person's percent body fat for desired muscle definition. Among the most widely used are high protein drinks, pre-workout blends, branched-chain amino acids (BCAA), glutamine, arginine, essential fatty acids, creatine, HMB, whey protein, ZMA, and weight loss products. Supplements are sold either as single ingredient preparations or in the form of "stacks" – proprietary blends of various supplements marketed as offering synergistic advantages.

<span class="mw-page-title-main">Sports nutrition</span> Study and practice of nutrition to improve performance

Sports nutrition is the study and practice of nutrition and diet with regards to improving anyone's athletic performance. Nutrition is an important part of many sports training regimens, being popular in strength sports and endurance sports. Sports nutrition focuses its studies on the type, as well as the quantity of fluids and food taken by an athlete. In addition, it deals with the consumption of nutrients such as vitamins, minerals, supplements and organic substances that include carbohydrates, proteins and fats.

A diabetic diet is a diet that is used by people with diabetes mellitus or high blood sugar to minimize symptoms and dangerous complications of long-term elevations in blood sugar.

Jacques Rossouw is a South African-born physician and epidemiologist. He retired as head of the Women's Health Initiative, and is based in Washington, D.C.

<span class="mw-page-title-main">Gary Taubes</span> Science writer, born 1956

Gary Taubes is an American journalist, writer, and low-carbohydrate / high-fat (LCHF) diet advocate. His central claim is that carbohydrates, especially sugar and high-fructose corn syrup, overstimulate the secretion of insulin, causing the body to store fat in fat cells and the liver, and that it is primarily a high level of dietary carbohydrate consumption that accounts for obesity and other metabolic syndrome conditions. He is the author of Nobel Dreams (1987); Bad Science: The Short Life and Weird Times of Cold Fusion (1993); Good Calories, Bad Calories (2007), titled The Diet Delusion (2008) in the UK and Australia; Why We Get Fat: And What to Do About It (2010); The Case Against Sugar (2016); and The Case for Keto: Rethinking Weight Control and the Science and Practice of Low-Carb/High-Fat Eating (2020). Taubes's work often goes against accepted scientific, governmental, and popular tenets such as that obesity is caused by eating too much and exercising too little and that excessive consumption of fat, especially saturated fat in animal products, leads to cardiovascular disease.

<span class="mw-page-title-main">Western pattern diet</span> Modern dietary pattern

The Western pattern diet is a modern dietary pattern that is generally characterized by high intakes of pre-packaged foods, refined grains, red meat, processed meat, high-sugar drinks, candy and sweets, fried foods, industrially produced animal products, butter and other high-fat dairy products, eggs, potatoes, corn, and low intakes of fruits, vegetables, whole grains, pasture-raised animal products, fish, nuts, and seeds.

<span class="mw-page-title-main">Central governor</span> Brain process

The central governor is a proposed process in the brain that regulates exercise in regard to a neurally calculated safe exertion by the body. In particular, physical activity is controlled so that its intensity cannot threaten the body’s homeostasis by causing anoxic damage to the heart muscle. The central governor limits exercise by reducing the neural recruitment of muscle fibers. This reduced recruitment causes the sensation of fatigue. The existence of a central governor was suggested to explain fatigue after prolonged strenuous exercise in long-distance running and other endurance sports, but its ideas could also apply to other causes of exertion-induced fatigue.

The South Beach Diet is a popular fad diet developed by Arthur Agatston and promoted in a best-selling 2003 book. It emphasizes eating food with a low glycemic index, and categorizes carbohydrates and fats as "good" or "bad". Like other fad diets, it may have elements which are generally recognized as sensible, but it promises benefits not backed by supporting evidence or sound science.

Ronald M. Krauss is an American professor of pediatrics, medical researcher and low-carbohydrate diet advocate. He studies genetic, dietary, and hormonal effects on plasma lipoproteins and coronary disease risk.

Exercise-associated hyponatremia (EAH) is a fluid-electrolyte disorder caused by a decrease in sodium levels (hyponatremia) during or up to 24 hours after prolonged physical activity. This disorder can develop when marathon runners or endurance event athletes drink more fluid, usually water or sports drinks, than their kidneys can excrete. This excess water can severely dilute the level of sodium in the blood needed for organs, especially the brain, to function properly.

Fred Pescatore is a Manhattan-based author and internist who specializes in nutrition. He is best known as the author of the bestselling children's health book Feed Your Kids Well (1998) and The Hamptons Diet (2004).

<span class="mw-page-title-main">Andreas Eenfeldt</span> Swedish doctor

Andreas Eenfeldt is a Swedish doctor specializing in family medicine. He is an advocate for low-carbohydrate high-fat diets and has criticized the saturated fat guidelines. Eenfeldt was born in 1972 and graduated from medical school at Uppsala University. A few years later, he started DietDoctor.com, a website focused on low-carbohydrate diets. He became a public figure in a heated debate over the merits of the diet.

<span class="mw-page-title-main">Jim Mann (scientist)</span> New Zealand nutritionist and endocrinologist

Sir Joel Ivor Mann, generally known as Jim Mann, is a New Zealand nutritionist and endocrinologist. He is professor in human nutrition and medicine at the University of Otago and consultant physician (endocrinology) at Dunedin Hospital. He has researched the role of lipids and carbohydrates in coronary heart disease, diabetes, and obesity, as well as the relationship between obesity and cancer. He was knighted in the 2022 New Year Honours.


  1. "RA024 Dr. Tim Noakes: A Lifetime of Running and Research".
  2. 1 2 "Tim Noakes: Nutritional Fascism and the "Twitter Trial"".
  3. 1 2 "How Tim wants you to train". Archived from the original on 14 June 2011.
  4. 1 2 3 Official Site, SA Government. "Timothy David Noakes (1949 – ) The Order of Mapungubwe". The Presidency. Retrieved 31 May 2023.
  5. MRC/UCT Research Unit for Exercise Science and Sports Medicine Archived 24 December 2012 at archive.today
  6. Sports Science Institute of South Africa
  7. Speedy, DB; Noakes TD; Schneider C (2001). "Exercise-associated Hyponatremia: A review". Emerg Med. 13 (1): 17–27. doi:10.1046/j.1442-2026.2001.00173.x. PMID   11476407 . Retrieved 6 January 2014.
  8. 1 2 3 4 5 Gifford, Bill (9 December 2016). "The Silencing of a Low-Carb Rebel". Outside Online. Retrieved 1 June 2023.
  9. Hutchinson, Alex. (12 December 2014). "What Is Fatigue?", The New Yorker . Retrieved 23 January 2019.
  10. "Pugh will be the guinea pig", (2 March 2006). News24 . Retrieved 24 January 2019.
  11. Knott, Jonathan (29 November 2013). "Dipping my toe into cold-water swimming", The Guardian . Retrieved 24 January 2019.
  12. Cramb, Auslan. (16 July 2007) "North Pole swimmer's unique body heat trick", The Telegraph . Retrieved 24 January 2019.
  13. Child K (16 October 2017). "Noakes calls traditional food pyramid 'genocide'". Sunday Times. South Africa.
  14. "Professor Tim Noakes: Challenging conventional dietary guidelines" . Retrieved 31 May 2023.
  15. Whiting, Kate (12 August 2015). "The Real Meal Revolution". Press and Journal. Retrieved 3 June 2023.
  16. Health, Mens (17 February 2012). "The Tim Noakes Diet". Men's Health. Retrieved 28 May 2023.
  17. Villette, Francesca (25 August 2014). "UCT doctors slam Noakes". Cape Times.
  18. Etheridge, Jenna. "No ruling from Tim Noakes hearing, matter adjourned until April 2017". Mail & Guardian. Retrieved 25 April 2017.
  19. Digital, TMG. "Tim Noakes cleared of misconduct over 'baby Banting' tweet". Times LIVE. Retrieved 25 April 2017.
  20. "Noakes cleared of misconduct. Full HPCSA judgment". Medical Brief. 26 April 2017. Retrieved 5 May 2017.
  21. 1 2 "Noakes clears final hurdle, not guilty says HPCSA appeal committee". News24. 9 June 2018. Retrieved 14 August 2023.
  22. 1 2 3 McAlpine A (10 January 2018). "Less lore and more science, please, Prof Noakes". Medical Brief.
  23. "Noakes: 'A litany of specious comments and errors'". Juta MedicalBrief. 24 January 2018. Retrieved 27 May 2023.
  24. Gardner CD, Trepanowski JF, Del Gobbo LC, Hauser ME, Rigdon J, Ioannidis JPA; et al. (2018). "Effect of Low-Fat vs Low-Carbohydrate Diet on 12-Month Weight Loss in Overweight Adults and the Association With Genotype Pattern or Insulin Secretion: The DIETFITS Randomized Clinical Trial". JAMA. 319 (7): 667–679. doi:10.1001/jama.2018.0245. PMC   5839290 . PMID   29466592.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  25. "'End the vilification of the dietetic profession' - dietician". Juta MedicalBrief. 28 February 2018. Retrieved 31 May 2023.
  26. 1 2 3 Geffen N (27 August 2014). "Tim Noakes and the responsibility of experts". GroundUp.
  27. "Tim Noakes and BizNews are spreading dangerous falsehoods". News24 (Opinion). 6 June 2021.
  28. "Honorary doctorates". VU University: Research. Vrije Universiteit Amsterdam. Retrieved 23 February 2016.
  29. Plug, C. (2015). "The 2014 South Africa Medal (gold): Awarded to Professor Timothy Noakes", Rudolf Marloth Brochure 2015: 1–3.
  30. Noakes, Tim. 2003. The Lore of Running. (4th edition) Oxford University Press ISBN   0-87322-959-2
  31. Noakes, Timothy, 1949- (2012). Challenging beliefs : memoirs of a career. Vlismas, Michael. (New ed.). Cape Town: Zebra Press. ISBN   9781770224599. OCLC   785373938.{{cite book}}: CS1 maint: multiple names: authors list (link)
  32. Noakes, Timothy, 1949- (22 January 2018). Lore of nutrition : challenging conventional dietary beliefs. Sboros, Marika. Cape Town. ISBN   9781776092611. OCLC   1013165315.{{cite book}}: CS1 maint: location missing publisher (link) CS1 maint: multiple names: authors list (link)
  33. Noakes, Timothy, 1949- (2019). Real Food On Trial: How the diet dictators tried to destroy a top scientist. Sboros, Marika. Cape Town. ISBN   978-1907797651.{{cite book}}: CS1 maint: location missing publisher (link) CS1 maint: multiple names: authors list (link)