Diabetes is a medical condition in which glucose levels in the bloodstream are higher (hyperglycaemia) than normal, as measured with fasting bloods, a glucose tolerance test or HbA1c test. The body usually uses insulin to lower glucose levels by increasing the ability of cells to take up the excess glucose from the bloodstream. In some cases not enough insulin is produced (type 1 diabetes), but in the majority of cases the body does produce more than enough glucose, but cells do not respond adequately to the insulin signal (type 2 diabetes). In both cases glucose levels build up in the bloodstream.

Insulin resistance occurs when the body’s cells (especially those in the muscle, liver and fat) do not adequately respond to the stimulation of insulin to induce the uptake of glucose to the cells. Insulin also plays a role in inhibiting the production of glucose from the liver. When both these actions of insulin are inadequate (insulin resistance), glucose levels rise in the bloodstream.

Common signs and symptoms of early diabetes include fatigue, increased thirst, weight loss, frequent infections, lack of interest and concentration, blurred vision, vomiting and stomach pains, increased hunger, frequent urination, tingling and numbness in hands and feet. We recommend medical tests to properly diagnose diabetes and do not recommend or condone self-diagnosis.

When following a diet low in carbohydrates and high in fat you can expect the following changes: stabilizing of glucose levels, lowering of Triglcerides, raising HDL (cholesterol levels may reduce, stay the same or go up in some people), normalised blood pressure levels, weight loss and decreased hunger.

The Noakes Foundation, its researchers, directors, affiliates and partners recommends seeking medical advice from a registered doctor before changing the doses of your prescription medicine in any way.

Some people experience discomfort during the first few days of eating a typical LCHF diet due to their bodies adapting to the decreased amounts of high-carbohydrate foods and increased high-fat foods consumed. This is normal as your metabolism is adjusting the way it fuels your body.

I have had this query from many people who have recognised the benefits of LCHF, but are not fully fat-adapted and so they generally benefit by taking some carbohydrate during prolonged exercise. There appear to be two types of athletes eating this diet – those who adapt fully and who do not need to take any carbohydrates during prolonged exercise – Bruce Fordyce is one of them – and athletes who do very well up to a certain distance and then unravel.

You may be one of those athletes who need to take a little bit of carbohydrate both before and during prolonged exercise. Some find that if they increase their carbohydrate intake to 150-200 g the day before the races, and if they take some carbohydrates during races, they perform better.

So my advice is that you should just increase your carbohydrate a little bit the day before your races and take some carbohydrate during races – perhaps take 25 g of carbohydrate per hour after the first 20 km. That should be enough. After the race, you need to get back to your low carb eating.

Is your lack of energy only temporary? If so, it might signify the removal of an addictive food like sugar or refined carbs that gives an addictive rush when eaten. This should get better with time. If this condition is not temporary, and is present even after 4-6 weeks, then the athlete is not likely to benefit in the long term and more carbs should be introduced. However, there is never a reason to eat more than 200 g carbs per day, even if you are cycling or running great distances. The excess that is not used during exercise is simply burned at rest when you could be burning fats.

Note that it is important to remember to differentiate performance from health. Carbs may improve performance in some, but at the long term cost of ill-health as it happened to Sir Steven Redgrave who developed type 2 diabetes (T2DM) despite 20 years of world-class competition and winning 5 Olympic gold medals in consecutive Olympic Games.

The question of what one should eat during prolonged exercise if you’re following this diet is one that I receive very frequently. My experience is that there appear to be two responses to athletes on this diet as far as their performance and their need for carbohydrate before and during exercise is concerned.

The one group becomes very well adapted to fat burning and are able to burn so much fat during exercise that they do not need to ingest carbohydrate at all during exercise. Instead, if they feel the need to eat during exercise (which I don’t think is necessary unless the activity lasts more than about 4 hours), they simply eat the same foods during exercise that they would normally snack on during the day. This might be high fat protein foods like nuts, biltong (jerky or even better, pemmican), cheese, bacon (fried), milk, etc. In time someone will produce pemmican, which was the original food for endurance performance (and for soldiers fighting wars) right up to the Second World War when it was replaced (at least in the USA) by the sugary (Keys) Rations, which contained processed carbohydrates and little fat.

The other group finds that they are not able to perform as well on the low carb diet unless they add some carbohydrate before and during exercise. So they find that ingesting 100-200 g of carbs during the last 24 hours before the race and taking in some carbs during the race (up to about 25 g/hr) maximises their performance. This can come from a sports drink or a GU product or from high carb foods like bananas.

My advice is that it is much more convenient to eat only fat and protein during exercise and not to be dependent on a continuous supply of carbs (as is necessary in those who are carb-adapted/dependent) and so this is the outcome one should aim for. But if it is not possible, then go the limited carbs route. The key, however, is to experiment with the two different options and to decide what works best for you.

It is very difficult to be a LCHF vegetarian since the vegetarian diet will still be high in carbohydrate and low in protein and fat. In order to Bant you’ll need to eat more of the fatty foods we prescribe – nuts, avocado, coconut oil, eggs, cheese, and other dairy. It would also be helpful if you could eat fish, as this will ensure that you have an excellent diet. My advice is therefore to increase your fat intake and try to get in more animal protein from fish and eggs – you will be in great shape!

Here are a couple of possible explanations. First, you may have lost fat and replaced it with some muscle. Has your waist measurement decreased? If not, then this explanation does not work. Second, to lose weight you need to reduce your calorie intake. This usually happens spontaneously in those who respond well to this diet. If you are not losing weight, you are still eating more calories than your body requires. Even though you’re eating relatively little, it may be that your body has adapted to require very few calories to sustain it. If this is the case, you actively have to reduce your calorie consumption in order to lose more weight. In other words, you need to learn to restrict your portions.

I have reduced my calorie consumption by up to 40%, largely because I’ve lost my appetite on the high-fat moderate-protein LCHF diet and I only eat highly nutritious, energy-dense foods. But I also think that there is an element of conscious control in that I consciously aim to eat less now than I would have in the past. My advice is to eat a very big breakfast and learn not to eat lunch, then only snack in the afternoon and eat a light dinner. In other words, you don’t need to eat three meals a day and, in my view, you want to rather eat large meals infrequently. I think you’ll find that that will accelerate your weight loss.

Finally, some women find that if they cut dairy from their eating and drinking, they do better. Perhaps give that a go. Some women have found that intermittent fasting helps, either a meal a day, or a day a week. This is certainly something to explore on an individual basis and has been utilized by Dr Jason Fung quite successfully amongst his patients.

The evidence is that the average response of the blood (LDL or total) cholesterol concentration to an increased fat intake (in the absence of a high carbohydrate diet), measured in thousands of patients, is no change. Yet we know that values do go up in some subjects. So, in an equal number of patients, the value must go down, which most people would consider to be good. So how can an “unhealthy” diet produce changes that are either very unhealthy or very healthy? It does not make immediate sense, so we need to dig a bit deeper.

There are 2 models for how heart disease develops – the cholesterol theory and the insulin theory. The cholesterol theory holds that cholesterol in the blood rises when one eats a high fat diet and this clogs the arteries causing heart attack. The treatment is therefore simple – remove all fat from the diet.

According to this theory, the only factors in your blood which you need to worry about are either your total or your LDL-cholesterol concentrations – anything that makes either one go up is bad, and anything that causes either to go down is good. Statin drugs reduce both and are therefore good, as is a low fat diet. The only trouble is that even the most religiously followed low fat diet will drop the total cholesterol by a homeopathic amount (about 0,2 mmol/L), which would be too little to make any difference even if cholesterol was the true cause of arterial “clogging”.

The insulin theory holds the opposite – that it is the consistently elevated blood insulin levels, caused by carbohydrate in the diet, that produce the series of conditions we recognise as Metabolic Syndrome (MS), which in turn causes heart disease. Individuals with insulin resistance (IR) are at an especially high risk, and are likely to develop MS when following a high carbohydrate diet.

The cholesterol theory of heart disease has never been proven. The best evidence that the science behind this theory is “junk” can be found in Nina Teicholtz’s new book, The Big Fat Surprise. It seems that we have been seriously misled by bad scientists, industry, and politics to accept a theory for which there is no good evidence. Then there is an entire $40 million per year industry – the cholesterol lowering (statin) industry – that seeks to ensure that we continue to accept this unproven theory without question.

Affiliates associated with The Foundation are Banting Blvd. Probyo, MojoMe, Nutriseed and Heba Pap currently. The expansion of our community education programme, Eat Better South Africa!, is supported by the monthly contributions of our affiliates. These supporters share the philosophy of The Noakes Foundation and show their support in using our affiliate stamp. The criteria and process of becoming an affiliate is described in the next question.

Companies may benefit from sponsoring our community education and research projects, which can give them the opportunity to show affiliation using our community outreach logo.

Before companies can affiliate with us, our manager follows an in-depth ratifying process for checking that companies comply with these criteria. A company

• Should not influence the direction or outcome of scientific research in an unethical manner (i.e. we would not partner with a large beverage and soft drink company, since it probably actively manipulates global nutritional research to emphasise exercise as the optimal solution against metabolic syndrome. We believe funding research into the effects of reducing and eliminating sugary drink consumption would prove more beneficial, particularly for the health of such beverage manufacturer’s insulin-resistant drinkers.);
• That is aligned with the objects and purposes of The Foundation or is committed to the achievement of such an alignment;
• That has, as one of its priorities, the improvement of the lives of the members of broader society and is committed to ethical business practices; and

If the company adheres to these principles, a “corporate character test” is done. This consists of an appropriate due diligence exercise and in the course of our manager’s interaction with the prospective associate or affiliate. Prof Noakes is its scientific author and this business is committed to ensuring that its services adhere to the Banting Diet.

The Noakes Foundation does not endorse any product associated with the Banting or LCHF lifestyle or ‘The Banting Diet’. The Foundation has, however, partnered with selected companies. Please see Question 1. The Noakes Foundation will not form affiliations with beverages or food goods that are sweet in flavour currently, even if the items are listed as ‘green list’ items on the LCHF lifestyle.

The Noakes Foundation and Prof Tim Noakes do not endorse any products affiliated with the Banting or LCHF lifestyle. This is part of both Prof Noakes and The Foundation’s aims to protect Prof Noakes’ research legacy and dignity.

‘The BantingDiet’ had gained colloquial currency and in many cases has been used to differentiate healthier offerings from their sugary rivals. However, a few opportunists have abused Prof Noakes’ name or ‘The Tim Noakes Diet’ in promoting red list foods whose consumption would completely undermine the efficacy of a low-carbohydrate lifestyle. In response, The Noakes Foundation registered both ‘The Tim Noakes Diet’ and variations of Professor Tim Noakes’ as trademarks. These registrations enable our legal team to tackle commercial opportunists who misrepresent the ethos informing a low-carbohydrate lifestyle.

Please notify us of potential trademark infringements by contacting us via The Noakes Foundation website or Facebook page. Our preference is to reach an amicable solution with infringes. However, where repeat offenses occur, we will seek recourse through our lawyers, Pike Law.

• You can sign your staff up or personally complete the training and be a part of the Banting Elite platform, donating anywhere from 5% to 100% of your profits to The Noakes Foundation.
• You can fund and run an in-house Eat Better South Africa programme with your staff. Click here to read about one of our successful in-house programmes.
• You can fund a community near you or your company to do the Eat Better South Africa programme.
• You can donate money from your CSI budget to The Noakes Foundation, which is a registered Public Benefit Organisation (PBO).

• Prof Tim Noakes
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All directors, executive nor non-executive, volunteer their time and are not paid for their contribution to the board. Executive directors are not paid for any work they do. Where non-executive directors perform work for The Noakes Foundation, this is done in a context where competitive quotes are sought by our administration and the service providers that offer the best value are approved by the executive. Further, the financial accounts of The Noakes Foundation will be made publicly available on www.thenoakesfoundation.org. Any payments to directors and management will be listed as separate line items.

Eat Better South Africa! is a community intervention programme aimed at supporting people from lower income areas to get better by eating better. Men and women from these areas sign up to a 7 week course where they learn about the LCHF lifestyle, how to bant on a budget, sugar addiction, and the benefits of a LCHF lifestyle on high cholesterol, blood pressure, diabetes and insulin resistance.

Every week the groups meet at a central place in the community to listen to a short educational presentation by a guest speaker, share their experiences, have their blood pressure, cholesterol and insulin levels tested and weight loss tracked.

The first intervention was implemented in the Ocean View community and since then the programme has reached other Cape Town communities including Delft, Villiersdorp, Observatory and Lavender Hill.

Visit our Eat Better South Africa! Facebook page to learn more.

Make a difference by donating to the Eat Better South Africa! campaign by making a donation. You can also contact us to find out more about other ways to contribute, support a new community or fund a corporate in house staff intervention.

The Noakes Foundation supports research excellence and diversity in both its research teams and participants. Our foundation’s priority is funding ground-breaking nutritional research that makes a difference to the lives of all South Africans.

Low-carbohydrate eating can be misperceived as a “rich man’s solution” pioneered by affluent white, male researchers. However, we believe that this lifestyle can be affordable for almost all South African citizens, and understanding its adoption should be driven by demographically-representative, local research teams.

South Africa presents an ideal site for living research that tests both propositions through securing research funding into what the outcomes of low-carbohydrate approaches are compared to the mainstream alternatives. To support thriving scientific research in South Africa, we aim to provide opportunities for scientists from previously disadvantaged communities to do research into under-served communities. This will enable us to better describe the opportunities and challenges that the adoption of low-carbohydrate eating presents for the broadest population.

If you can help us improve the diversity of our organisation through; requesting project funds for your research or becoming a funder or ambassador for The Noakes Foundation, please contact us.

Our Eat Better South Africa! programme takes the LCHF lifestyle to previously disadvantaged communities in South Africa.

The Noakes Foundation accepts cash donations to be deposited. Donations can be made online at http://www.thenoakesfoundation.org/donate using either Visa or MasterCard credit cards.

Electronic fund transfer donations to The Noakes Foundation can be deposited into the following bank account:

Bank: Standard Bank

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Branch Number: 025309 (if overseas require an 8 digit number then use 02530917)

Branch Address: Shop 23a, Constantia Courtyard, Constantia Main Road, Constantia, Cape Town, Western Province, 7800

Account Number: 271624914

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The Noakes Foundation is registered as a Public Benefit Organization (PBO) in terms of section 30(3) of the Income Tax Act No 58 of 1962, therefore any contributions will have a tax benefit for businesses. A PBO is an organization that has the sole objective of providing one or more public benefit activities in a non profit manner as defined by the Minister. The public benefit activity that The Foundation provides is in the healthcare category.

PBO Number available on request

There are many reasons why modern clinical research is costly. The salary for research scientists can be high due to their extensive education and advanced training, specialized job skills, and previous experience. Research supplies, materials and equipment can be expensive. The Diabetes reversal trial that The Noakes Foundation is funding with several medical doctors and an in house dietician will cost in excess of ZAR 10 million and will take about four years to complete. We are looking for 80% of this funding still. The programme commenced in January 2016.

The Noakes Foundation is open to increase the diversity of projects shortlisted in its research pipeline for funding. In particular, we are keen to work with other South African universities as a co-funder for projects that support this aim while developing research excellence.

Prospective partners should contact us with their proposed project well in advance of when they require support. This kind of process can take up to a year to secure funding for your project.

All research question are proposed by Prof Tim Noakes and a panel of scientists and research directors. Projects that can possibly answer these questions are set by the research team and shortlisted for funding on an annual basis. Funding is ratified at The Noakes Foundation’s board meeting.

The Noakes Foundation has created a comprehensive set of blood tests that you can do to pinpoint the various factors which affect your health, both before or while Banting. Take this list to your preferred Blood Test Centre and choose from either The Minimum, The Ideal or The All Inclusive to identify health factors that need improving. By doing these tests you can track your progress throughout your Banting journey.