Natural Born Heroes

CHAPTER 33

I was quite wrong. Sorry, everyone.

—DR. TIMOTHY NOAKES

I WAS FAMISHED by the time I met Dr. Noakes in the lobby of his Washington, D.C., hotel and figured we’d head straight out to eat. It was pushing 1 P.M., and Noakes had been stuck in a conference all morning discussing, among other things, his biggest professional mistake. We just had time for a hearty lunch before his flight back home to South Africa. But Noakes had other ideas.

“I won’t eat until tomorrow,” he said. “Or the next day.”

“You go two days without food?”

“Or more. Sometimes I’ve got to stop and think to remember my last meal.”

Looking at him, it’s hard to believe. At sixty-four, Noakes is tall and fit as a lumberjack, with the rangy look of the college rower he once was and the barely contained energy of a man whose mind is a constantly expanding to-do list. Everything about him seemed to demand constant refueling—his locked-in focus when listening, his Christmas-morning grin when amused, the unruly brown hair barely touched by time or a comb. It would all make sense, Noakes promised, when I heard his story. He suggested we grab coffee and get right to it. He had a lot to get off his chest.

“It’s really funny when you think how chance events occur,” he begins. In 2010, Noakes was finally reaching the end of a grim crusade. Back in 1981, he suspected joggers were being tricked into drinking themselves to death. Companies like Gatorade were pushing the idea that runners needed lots of fluids to avoid dehydration, and the race directors and running magazines who depend on sponsorship and advertising were quick to join the chorus. Suddenly, you could barely run a mile in a race without someone handing you a cup. Runners were told, “Drink until your eyeballs float,” and “Don’t just rely on thirst.”

But hang on; when did thirst suddenly become unreliable? For millions of years, it’s been fantastically effective. In fact, it’s one of the most important aspects of our evolutionary development: humans lived or died by their ability to lope long on hot days, and the reason we survived is that our bodies told us when and how much to drink. It was precisely because we’re resistant to dehydration that we could run other animals to death. “Humans evolved to be extremely adept long-distance runners with an unmatched ability to regulate their body temperatures when exercising in the heat,” Noakes knew. “And our brains developed the ability to delay the need to drink—a crucial adaptation if we were to chase after our potential meals in the midday heat when there was little water available and no time to stop the hunt to search for fluid.”

Noakes began checking the habits of runners from the pre-Gatorade era and discovered that old-school marathoners had no trouble going dry. “I only chew gum. I take no drink at all,” Matthew Maloney said after he set the marathon world record in 1908. Mike Gratton won the London Marathon in 1983 without a single sip, and Arthur Newton, the legendary ultrarunner and five-time Comrades champion, believed, “Even in the warmest English weather, a 26-mile run ought to be manageable with no more than a single drink or, at most, two.” To this day, the San people of the Kalahari can run up to seven hours in heat of 108º Fahrenheit on just a few swallows.

So now all of a sudden the American College of Sports Medicine, with major funding by its first platinum sponsor—Gatorade—was declaring, “Thirst may be an unreliable index of fluids needed during exercise”? Something else was fishy: the fifty-six-mile Comrades race never had a problem with dehydration and heat illness before it set up regular aid stations. “This paradox did not escape me,” Noakes points out. “How could ‘dehydration and heat illness’ have become a significant problem in marathon and ultramarathon running after frequent drinking had become the accepted norm?”

Nothing added up—least of all the corpses. When Noakes researched postrace body weights, he found something peculiar: elite runners pump out more sweat than the midpack plodders. If dehydration were truly a danger, how did the elites even make it to the finish line? Logically, the faster runners should be knocked off their feet. Instead, they’re stronger than everyone else in the field. And when Noakes went looking for all those marathoners who supposedly keeled over from too little to drink, he found …

None.

Not one. Ever. “There is not a single report in the medical literature of dehydration being a proven, direct cause of death in a marathon runner,” Noakes discovered.

But if you look at runners who had plenty to drink, that’s a different story. That’s where the bodies turn up. In the United States, three marathoners died on days that weren’t extraordinarily warm. In the UK, a fitness instructor in excellent shape and known for advising his own clients about hydration was dead soon after running the London Marathon. In the same race, a sports scientist with expertise in endurance conditioning became so delusional that she kept running in place while lying on a stretcher. Eight trekkers dropped into comas and never recovered while hiking the Kokoda Trail, a popular route for Australians on Papua New Guinea. For all of them, fluids weren’t just available—they were unavoidable, just as they were at the Houston Marathon in 2000 when dozens were rushed to the medical tent, even though drinks were handed out every single mile.

None of these people were fleeing for their lives. None of them were pursuing food across the savanna. So if they were slowly dying of thirst, why on earth didn’t they just pick up a cup? How could they be so blind to their own doom? Shipwreck victims survive on life rafts for weeks; how did these athletes die within a few hours?

Noakes was baffled. And then it hit him: they were drowning. Instead of too little to drink, they were dying from too much. They’d gulped so much fluid, they’d diluted their blood sodium concentration and caused their brains to swell. Water poisoning! Suddenly it all made sense. The Sports Drink Giants had been fantastically successful at tricking people into believing that, unlike every other creature on Earth, humans were too stupid to know when to drink. Cows and puppies and infants have it covered, but not you—no, you need to be told. The terrible irony was that by inventing a fake health scare, the Drink Giants had created a real one. They’d scared people into believing they were drinking too little, and fooled them into drinking too much. It was death by marketing.

Noakes found twelve confirmed deaths by water poisoning in sports events and thousands of close calls. “The ‘Science of Hydration’ is propaganda conceived by marketers who wished to turn a collection of kitchen chemicals into a multi-billion dollar industry,” Noakes declared. “To their credit, they succeeded. To their unending shame, they cost the lives of some of those they were pretending to protect.”

The scam was so outrageous, Noakes was sure it would explode as soon as it was revealed. Instead, he found himself battling the “Mafia of Science,” as he calls it: doctors and researchers funded by corporate war chests. The more Noakes insisted the Drink Giants were a lethal menace, the more the Drink Giants and their paid Ph.D.’s blasted the message that humans were frail creatures who couldn’t trust their own bodies. “Drink before you’re thirsty or you’ll just be playing catch-up,” the Gatorade camp insisted. “Drink before, during and after exercise.” When Asker Jeukendrup published a study that showed sports drinks are basically placebos—you can swish and spit and get the same benefit as if you’d swallowed—Gatorade knew just what to do: it hired him. As for Noakes—well, the Mafia of Science regretted that such a respected scientist was now just a mouthy crank. True, Noakes was possibly the world’s top authority on distance-running physiology, but his warnings about excess hydration were just “one man’s opinion,” as the director of the Gatorade Sports Science Institute sniffed, and “not representative of the comprehensive research that is available on the topic of hydration during exercise.”

Noakes persisted, gathering evidence from around the world for Waterlogged, his four-hundred-plus-page indictment of the sports-drink industry. On the night he wrote the last sentence, in December 2010, he went to bed thinking, Tomorrow, you’ve got to start running again. He’d been absorbed in work for too long. He hadn’t run a marathon in four years. He’d put on thirty pounds. And he was about to wake up to a sickening discovery:

His own advice about carbs was killing him.

. . .

It was that first run that opened his eyes. Noakes got up as planned and huffed out a few miles, hating every step. He felt fat and slow, as if he’d never run a step before. His father and brother had both died from diabetes, and Noakes knew from his thickening waist and increasing sluggishness that he was heading in the same direction. He’d always persuaded himself that running would keep his weight under control, but now the misery of starting all over again made him face the truth: it wasn’t going to work. It had never worked.

“In forty-one years of running I have learnt that the numerous benefits of exercise do not include any sustained effects on weight loss,” Noakes realized. Even during his peak of nearly twenty miles a day, back in the seventies, he’d lost only a few pounds and yo-yoed them right back on again. His medical training told him that exercise and calorie control should do the trick, but after four decades as a conscientious eater and athlete, he was living proof that his medical training was wrong. With his book out of the way and his genetic time bomb ticking, Noakes set out to find out what was going on.

He began digging into nutrition science with the same intensity with which he’d gone after drinks, examining the primary research behind the dietary guidelines. What he found made Noakes angry, then heart-sick. He’d been duped. Even worse: the whole time he’d been so self-righteous during his holy war with the Drink Giants, he’d been the instrument of something even deadlier. The food industry had pulled the same trick as the Drink Giants, and Noakes hadn’t only missed it; he’d endorsed it. For decades, he’d advocated a carbohydrate-rich diet. He was so influential, he’d been dubbed the High Priest of Carbo-Loading—and processed carbs, he now understood, were toxic.

“Skillful marketing has made carbohydrate consumption a religion among athletes,” he’d fume. “They believe that you cannot get energy from anywhere but carbs.” The same foods Noakes had assured people would make them stronger and faster were a slow-acting poison making them fatter, weaker, and more prone to heart attacks, strokes, diabetes, and dementia.

Privately, Noakes was anguished for another reason. It wasn’t well known, but Noakes’s father had made his fortune as a tobacco broker. In medical school autopsies, Noakes had seen firsthand the kind of horror his father’s profession wreaked on human bodies. He’d been troubled by Big Tobacco’s stealth efforts to increase addiction and market to minors, and it gnawed at him that every time his father cut a check to pay his school fees, it was at the cost of “the ill-health of those who smoked cigarettes containing the tobacco he exported.” In the end, Noakes’s father begged him to make amends. “Tim, I did not help enough people in my life,” his father told him. “You had better do so.”

Now Noakes discovered he’d been pushing something that was even more addictive and shopped even more shamelessly, especially to children. If he’d been more careful, if he’d been more skeptical about the mass production and marketing of processed carbs, he could have saved so many people—starting with his own brother and father. He wished he’d been aware of these four key pieces of evidence:

HUMAN HISTORY

It’s an inconvenient truth, but a truth nevertheless: animal fat made us who we are. When our ancestors first strayed from the African savanna, they weren’t following the harvest. They were following the herds. They went in search of meat, and wherever they found it, no matter how harsh the environment, they stayed. For over two million years, we lived on the meats and chewy roots we could hunt and gather. Eggs, fatty flesh, and cheeses were prized because they were rich in energy, easy to preserve, and such a steadily burning nutrient that a few ounces could sustain someone all day. When the ancient Greeks offered the fattiest cut of meat to the gods, it was a sacrifice; they gave up what they wanted most. Only very recently did we switch to farm-raised grains, and since then we’ve seen a decrease in average human height and a spike in obesity and nutrition-deficiency diseases. The worst explosion began in the 1980s, after the United States embarked on a disastrous experiment. From 1960 to 1980, obesity remained constant. But in 1977, the United States separated itself from every other government in history by vilifying meat and pushing grains, which were traditionally used to fatten cattle. Soon after, America’s obesity rate shot up and hasn’t stopped.

PLUMBING THEORY

America’s shift from proteins to grains was sparked by Ancel Keys, a biochemist from the University of Minnesota who made his name during World War II by inventing K-rations, the ready-to-eat meal for combat troops. Later, Keys was reading his local newspaper’s obituary column when he noticed an unusual number of rich Minnesotans were dropping dead of heart disease. One thing America had after the war that other nations lacked was plenty of red meat, so Keys developed a plausible-sounding theory: If you pour bacon grease down your sink, it will thicken inside your pipes and eventually clog them. Our arteries must work the same way, Keys assumed.

“Keys hypothesized that heart disease was mostly a nutritional disorder linked directly to the amount of fat in the diet,” one journalist explained. “High-fat foods raised cholesterol levels in the blood, which, in turn, increased the risk of clogged arteries and heart disease.” That also sounded right to Senator George McGovern, who’d experimented with the low-fat Pritikin Diet. McGovern very quickly gave up on low-fat himself, but just because he didn’t want to eat that way didn’t mean other people shouldn’t. McGovern would go on to become an extraordinarily influential voice in nutrition, serving as the United Nations’ first global envoy on world hunger and teaming with Senator Bob Dole to create a worldwide school lunch program.

So largely on the whim of one powerful senator, the fat-is-fatal theory was rammed through U.S. health agencies in 1977 and propelled along by governmental “food faddists who hold the public in thrall,” as Science magazine put it. Later, journalist Gary Taubes would reveal that Ancel Keys had built his argument on his “Seven Countries Study,” ignoring data from three times as many other countries that weakened his theory. Dead people were also a problem; if Keys was right, the new U.S. dietary recommendations should have caused heart disease to plummet. Instead it’s skyrocketed: in the twenty years after the fat warnings went into effect, medical procedures for heart disease quintupled from 1.2 million to 5.4 million a year.

INSULIN IS OZ

Whether you become fatter or skinnier, stronger or weaker, more alert or lethargic is largely influenced by insulin, the hormone that acts as your body’s warehouse foreman. When sugars and carbohydrates are converted to glucose and enter your bloodstream, your pancreas deploys insulin to figure out where to store it. Glucose is great when your body needs it; it fuels brain and muscle cells, and is converted into fat for future use. It also acts as tinder so your body can burn fat as fuel.

But here’s the catch: insulin evolved to handle complex carbs created by nature, like leafy greens, not simple carbs created by us, like cereal and bread. Simple carbs are absorbed too fast; your cells get their fill and the rest is turned into fat before your insulin has a chance to dissipate. The still-active insulin in your bloodstream goes looking for more sugar, which makes you feel hungry. So you chow another donut, starting the whole process all over again. Enough years of this abuse and your cells can become insulin resistant; they’re tired of being asked to absorb all this glucose, so they just stop responding. What then happens to all that glucose? It goes straight to fat.

That’s what killed Noakes’s father and brother: their system needed fuel it wasn’t getting, while storing fat it didn’t need.

FAT AS FUEL

But there’s a way out, Noakes discovered. Once you kick the carbohydrate habit, you can convert your body back into a fat burner. “If you’re fat-adapted,” Noakes posited, “then theoretically you should be able to source all your energy from fat metabolism, especially during very prolonged exercise, when the intensity of the activity is somewhat lower, so that there should not be any need to burn carbohydrates.”

Bruce Fordyce, the legendary South African ultramarathon champ, put it to the test. Like Noakes, Fordyce had packed on the pounds since his glory days. But once he stopped eating grains and sugars and adopted a high-fat, low-carb diet, Fordyce underwent a running renaissance. At age fifty-six, he beat his best-ever Comrades time by two hours and chopped five minutes off his 5K, improving from 7:20 a mile to 5:40—a tremendous achievement for any experienced athlete, let alone one pushing sixty.

Still, Fordyce’s self-experimentation is decades away from catching up with Dr. Fred Kummerow, a University of Illinois scientist who, since the 1950s, has taken the position that hardening of the arteries isn’t caused by LDL, the so-called bad cholesterol found in eggs, red meat, and cheese. If LDL were deadly, Kummerow asks, then how come half of all heart disease patients have normal or low LDL levels? Something else must have killed them, and Kummerow believes it’s exactly the food pushed by the U.S. government—polyunsaturated vegetable oils like soybean, corn, and sunflower.

“Cholesterol has nothing to do with heart disease, except if it’s oxidized,” Dr. Kummerow told the New York Times. And because soybean and corn oils are inherently unstable, they’re quick to oxidize under the high heat of frying or even normal digestion. Kummerow put his own body on the firing line; he eats LDL food daily, including red meat, eggs scrambled in butter, and a glass of whole milk every day. He’s one hundred years old, takes no meds, and runs his own university lab. Yes, you read that age correctly: one hundred.

When I met up with Noakes in D.C., he’d flown all the way from Cape Town for a one-day conference on “Innovations in Diabetes.” That morning, he’d tucked away a farmhand’s breakfast of eggs, sausage, and bacon. A meal like that will leave him satisfied all day, often longer. “I just don’t get hungry anymore,” he shrugged. “Sometimes I’ll feel my energy waning and realize I haven’t eaten in forty-eight hours.”

“So basically, we’re talking about Paleo?” I ask. The Paleo Diet is based on the premise that humans are healthiest when they follow the example of our Stone Age ancestors and eat grass-fed meats, wild-caught fish, vegetables, nuts, and seeds and stay away from rice, bread, pasta, and other grain-based foods from the agricultural age.

“Basically, yes,” Noakes replies, although for the sake of precision, he’d replace “Paleo” with “Banting”: Noakes can’t be scientifically certain about what early humans ate, but he knows exactly what was on the menu of an overweight London embalmer named William Banting. Back in the 1860s, Banting was England’s undertaker to the stars and so sought after that he was given the honor of building the coffin for the Duke of Wellington, one of Britain’s most beloved heroes. Banting’s success, however, was pushing him toward his own grave; he attended so many lavish funeral dinners that by age sixty-six he was “nearly spherical.” He was only five foot five, yet weighed over two hundred pounds and was so belly heavy he had to walk downstairs backwards and couldn’t tie his own shoes. Banting’s doctors prescribed every known treatment for obesity—diets, Turkish baths, heavy exercise, spa retreats, even systematic vomiting—but every pound he took off boomeranged right back on again. Oddly, Banting made a breakthrough only when he began going deaf. He went to see a hearing specialist named William Harvey, who decided Banting’s problem wasn’t his ears, but his waistline. Poor circulation was damaging his auditory canal, so in August, Banting began following Dr. Harvey’s eating instructions:

BREAKFAST: Five or six ounces of beef, mutton, kidneys, broiled fish, bacon, or cold meat of any kind, except pork. One small biscuit or one ounce of dry toast. A large cup of tea without milk or sugar.

LUNCH: Five or six ounces of any fish except salmon, any meat except pork, and any vegetable except potato. Any kind of poultry or game. One ounce of dry toast. Two or three classes of good claret, sherry, or Madeira.

DINNER: Three or four ounces of meat or fish, as for lunch. A glass of claret or two. Nightcap, if required.

So morning, noon, and night, Banting was feasting on roasts and fatty steaks with sides of buttery broccoli and washing it down with tasty wines, plus a snort of gin before bed. He was packing in the calories, too; Banting’s meals amounted to nearly three thousand calories a day, triple what most weight-loss diets allow. Yet even in his midsixties, when weight loss is most difficult, Banting trimmed off twenty pounds in the first five months. Within a year he’d reduced his weight by fifty pounds and his waist by twelve inches, and he remained trim the rest of his life.

“The Banting plan was the foundation of the Atkins diet in the 1970s,” Noakes explains. “We keep rediscovering these same fundamental principals of nutrition, then we forget them and start all over again.”

In 2012, the Los Angeles Lakers began following in Banting’s footsteps after a nutritionist consulting for the team became concerned about Dwight Howard, the superstar center nicknamed Superman for his Adonis abs and cannonball biceps. Howard was only twenty-seven years old and looked fantastic, with only 6 percent body fat, but there was something a little off about his hands. “It looked like he was wearing oven mitts,” the nutritionist would recall. “It reminded me of patients who have pre-diabetes and neurological problems because of how sugar impacts the nervous system.” A blood screening revealed Howard’s glucose level was “through the roof,” and a nutritional assessment found he was basically living on sugar: between candy, soda, and starches, he was downing the equivalent of twenty-four chocolate bars a day.

So the entire Lakers squad, including franchise player Kobe Bryant and seasoned veteran Steve Nash, joined Howard in a Banting-style meal makeover. “Not only are the Lakers unafraid of healthy fats, they practically freebase them,” one journalist noted. “The pre-game beverage of choice is something the players call ‘bullet-proof coffee’—coffee seasoned with two teaspoons of pastured butter and heavy, grass-fed cream.”

“I’ve seen great results from it from when I started doing it last year—watching your sugar intake, making sure you’re eating healthy fats,” Kobe Bryant was quoted. “You’ve got to find a balance in that system. It’s worked well for me.” Lakers forward Shawne Williams showed up twenty pounds overweight for training camp; by doubling his fat intake and cutting out sugar, he took off twenty-five. Now most Lakers meals are built around grass-fed beef, humanely raised pork, raw nuts, squeezepacks of hazelnut butter, kale chips, and grass-fed beef jerky. Dwight Howard even remained faithful after he was traded; when he arrived in Houston, Howard persuaded Rockets management to start Banting. “We had to make that change,” Rockets general manager Daryl Morey told a reporter, “and I should’ve pushed harder earlier.”

For Dr. Noakes, it’s been a three-year journey of scientific awakening and personal transformation. He’s back down to 175 pounds—same as he was in his twenties—and feels like an athlete again. Eight weeks after he stopped eating sugar and processed carbs, Noakes was in Stockholm for a conference. It was dark when he arrived and twenty-five degrees below freezing, but Noakes went on a five-mile run anyway. He slept a few hours, then got up and ran ten more. “A few weeks earlier, I could barely finish 5K,” he recalls. “I thought it was aging. But it was really carbohydrate intolerance. In two months, I lost eleven kilos. I turned it all around.”

We’ve been brainwashed into being repulsed by the mention of the word fat, Noakes says, but the real heart danger is sugar. It’s a corrosive that damages arterial walls, creating grooves that allow plaque to adhere. Which means the only real solution for cardiovascular disease and global obesity, Noakes feels, is pure scorched earth. “Ten companies produce 80 percent of processed foods in the world, and they’re creating billions and billions of dollars in profits by poisoning people,” he says. “I’d tax them out of existence. If you don’t take addictive foods out of the environment, you’ll never cure the addiction.”

Some of Noakes’s fellow scientists think he’s going too far. The Heart Association was quick to urge caution; the same day Noakes began advocating saturated fats, the Heart Association issued a warning that “the ‘Noakes Diet’ is dangerous.” It was an impressive performance, Noakes felt; cramming three mistakes into four words in one day isn’t easy. It’s not his, he argues, since it’s been the basis of human nutrition for more than two million years. It’s not a diet, because there are no portion or calorie restrictions. And how can it possibly be dangerous when humans have thrived on those very foods for most of our existence? If it were dangerous, we’d be extinct.

Rather than going too far, Noakes is furious with himself for starting so late. Back when he first began to suspect he’d been wrong about carbs, Noakes dug into the data on Ironman legend Mark Allen. Allen’s eating habits were well-documented. Noakes could find almost no starches or processed carbs in the mix. So how could Allen possibly scorch out a marathon in two hours and forty minutes, immediately after swimming nearly two and a half miles and biking one hundred and twelve? There was only one explanation. “I knew that he had to start the race without any sugar or glycogen in his muscles,” Noakes would say. “So he must’ve just been burning fat.”

“Phil Maffetone knew this years ago,” Noakes concluded. “Fat as fuel. It’s exactly what he was saying all the way back in the eighties. Imagine the difference if we’d just listened to him.”

Or knew where he was.