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SAMJ: South African Medical Journal

On-line version ISSN 2078-5135
Print version ISSN 0256-9574

SAMJ, S. Afr. med. j. vol.104 n.1 Cape Town Jan. 2014




'A new dietary paradigm?' - prove it



R Kapp

Family physician, Goodwood, Cape Town, South Africa.



To the Editor: While I respect Prof. Noakes' passionate search for a much-needed nutritional nirvana, I wish to mention some of my objections to his article in the November issue of the SAMJ.[1]

While conceding his study's limitations, he could have added a few more: patients generally exaggerate their actual weight loss; no attempt was made to verify these alleged clinical successes by consulting any patient's clinician; there is no indication that these patients were indeed following the 'Noakes diet'.

Furthermore, these case studies are no more dramatic than the stories of patients we as clinicians experience on a regular basis: people who have experienced significant weight loss as a result of other diets, including the prudent diet. Unlike Noakes' short-term study, these patients bear testimony to long-term successful weight loss.

More alarmingly, I am amazed that the mighty Discovery Health -one of Prof. Noakes' sponsors - is suddenly too out-of-pocket to fund a randomised control trial (RCT) needed to prove Noakes' hypothesis.

In conclusion, I challenge Prof. Tim Noakes to do the ethical thing: conduct the necessary RCT to prove his hypothesis. Failing which, he should stop using this debate as a platform from which to openly criticise his colleagues and confuse the public.


1. Noakes TD. Low-carbohydrate and high-fat intake can manage obesity and associated conditions: Occasional survey. S Afr Med J 2013;103(11):826-830. []        [ Links ]

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