Evolution and Carbohydrates in Our Diet and Exercise with Professor Tim Noakes

Welcome‌ ‌to‌ ‌Pushing‌ ‌the‌ ‌Limits,‌ ‌the‌ ‌show‌ ‌that‌ ‌helps‌ ‌you‌ ‌reach‌ ‌your‌ ‌full‌ ‌potential,‌ ‌with‌ ‌your‌ ‌host‌ ‌
Lisa‌ ‌Tamati,‌ ‌brought‌ ‌to‌ ‌you‌ ‌by‌ ‌‌lisatamati.com‌.‌ 

Lisa Tamati: Hey everyone, welcome back to Pushing the Limits. Today, I have another fantastic professor for you. This one is an expert in everything running. He is someone that— I studied the Bible — the running Bible, the Lore of Running years and years ago. Professor Tim Noakes is a guest from South Africa. 

Now, Professor Noakes has published over more than 750 scientific books and articles. He's been cited more than 21,000 times in scientific literature. He has, of course, been the author of the Lore of Running, now, the Lore of Nutrition. He's rated as an A1 scientist by the National Research Foundation of South Africa. He's won numerous awards over the years. An incredible runner, an incredible scientist, and a man of straight-talking. He says it like it is, and he tells the truth. 

He is really a brave and courageous soul. I do hope you enjoy this interview with Professor Noakes. Some of the stuff we get into is quite deep. With his personal take on things, my personal take on things, do your own research. Understand this is for information and educational purposes only. I hope you enjoy this interview with Professor Noakes. He really is amazing. 

Before we head over, just want to remind you about the epigenetics program. If you are wanting help with understanding your genetics, and how to optimise those genes, and make sure that you get the best out of your genes that you inherited from mom and dad, putting them in the right environment to get the best out of them which we talked a little bit about in this episode as well — then head over to lisatamati.com and hit the “Work with Us” button, and you'll see our Peak Epigenetics Programme there. 

You'll also see our online run training system there. You'll also see my speaking services, my books — everything else is on the website at lisatamati.com. Of course, you can listen to this great podcast on there as well. Right, over to the show now with Professor Tim Noakes. 

Well, hi everyone and welcome back to Pushing the Limits. Today, I have one of my longtime heroes, role models — just an amazing professor that I am just so stoked to be interviewing today. So Professor Tim Noakes, welcome to the show. It's absolutely fantastic to have you here. I'm such an admirer. I'm fangirling a little bit.

Your book, The Lore of Running, which is just one of many books that you've written and it's basically the Bible of running. I've read that many times when I was a younger athlete. You're just an incredible person with an incredible knowledge and experience. It's fantastic to have you here today. Thanks for being here with me. 

Professor Tim Noakes: Thanks, Lisa. Lovely to talk to you. I look forward to the next hour or so. It's going to be really exciting. Thank you for having me.
Lisa: It is going to be really exciting. So Professor Noakes, for those who don't know your incredible history in which — I don't know what rock people might have been living under. But can you just give them a little bit of a synopsis of your career — your incredible career?

Tim: Lisa, I was very fortunate that I went into medical school in 1969. It was really the start of the exercise sciences. Before that, the sports sciences weren't very strongly sports science-related. It was still the old stuff, and the new ideas hadn't come in yet. I started up the ground level. Within a year of starting medical school, I decided I preferred sports science and sports medicine. 

So I went through my career as a doctor, trained as a doctor only interested in sports medicine — everything I interpreted according to sports medicine. I, then, went out into research for five or six years that got my PhD in medicine. Then, I started sports science and sports medicine in South Africa, and then started doing research. 

During that time, you refer to Lore of Running, I started writing regularly because a friend of mine said, ‘You should write for the public.’ I realised that to be successful, I needed this public on my side. I started writing. In 1981, I'd finished enough. I thought I've got a book. Then, I sat down and I said, ‘Actually, I don't have a book.’ Then, in 1985, I've published the Lore of Running the first edition, and then it's been revised four times, and I'm just about to start the fifth revision of that. 

I became very well known as the sort of guru on running. I ran many marathons and ultramarathons during that time. The only problem was, I was giving the wrong dietary advice. I was telling athletes. For them, it’s to eat lots of carbohydrates. That's great if you're healthy. But if you're unhealthy like I became — I became insulin resistant, developed type 2 diabetes. It's the wrong advice. 

Fortunately, 11 years ago, I saw the light and I realised that my health was deteriorating. I changed my diet, and then I became persona non grata in South African medicine. My university cancelled me. They actively acted to get rid of me. I lost all my funding — which was amazing because I was telling the truth — which I still do. I just tell the truth. 

Then, the Health Professions Council took action against me for being unprofessional for promoting this diet. We went to court for four years — 28 days in court. I gave evidence for nine days, cross-examined for three of those days. Eventually, 113 null — we completely flattened the new authorities. The reason was we used the science. They didn't bother about science. 

What I learned, then, is that the authorities have no interest whatsoever in science. They try to block you and cancel you on the basis that we don't like you because you're saying the wrong stuff. They have no interest in the science — that the science never gets out. It's just propaganda that is popular that… We presented 7,000 pages of documented science. They presented 10 pages — one paper — which we then prove was probably fraudulent.

Lisa: This was about the low-carb, high-fat — that you'd change from telling athletes to eat lots of carbs. I remember all the pasta parties that I went to prior to marathons. Everyone was into their pasta. We've all evolved over the time to realise, ‘Hang on a minute. This isn't working like it shouldn't be when you're young and —’ 

And we all sort of developed in this time and changed our point of view, and the science has developed. Because your history was interesting. You have a family history of type 2 diabetes, and you were heading down that same track. That's actually what woke you up, isn't it?

Tim: Now, exactly. My dad died 10 years after diagnosis. I've been well over 10 years with my diagnosis, and I'm doing really well. You don't die of diabetes, you die of its management — or its mismanagement. That's what happened to my father. Sadly, I was part of that mismanagement because I didn't understand. I just thought carbs are good for you. 

If you're diabetic, you need carbs — and that's the last thing you need. Part of my goal in the next, as the number of years I've got left, is to just keep driving the story that diabetes is a disease of choice — it's a behaviour choice. It's very difficult to get that message out in medicine because medicine doesn't want that. They don't want choices. You just take pills and that's it. That is the wrong advice.

Lisa: Was it also because… When you change from the high carb — the cereals, and the oatmeal, and the bread, and the pastas, and the things — were, are you going against the food industry? What was the reason behind it, and why they attacked you so hard out?

Tim: Absolutely. The funny thing is that main funding, then, came from a medical insurance company in South Africa. I was the poster boy for their high carbohydrate, grain-based diet. Then, I read an article in one of their magazines which they stupidly published. I said, ‘Against The Grain’. That was the title.

I mean, I didn't know. I'd only been doing it for five months. I just knew it was helping me. I immediately lost all the funding there. But there was much worse than that. I'm sure you've also known that I wrote the book Waterlogged which is about overdrinking. 

Lisa: Yes, I want to talk about that.

Tim: That's where I really upset the sports drink industry, particularly Pepsi Cola because that's their product. I’m aware that they wanted to shut me up. But ultimately, when the trial came along, the main opponents to me — the prosecution witnesses — had connections to an organisation called the International Life Sciences Institute. That is a front for the food industry. 

The food industry was indirectly involved in my trial. In fact, that’s more than indirectly. They control the dietary guidelines in New Zealand, and Australia, and in South Africa — completely control them. They control it through the people, the professors who run the major departments of nutrition. The person who was the chief prosecution witness was the head of nutrition at one of the universities. She's been an ILSI fan and president for decades. So it was very clear that was the linkage. She either realised that she had no basis in science and we exposed her in the trial terribly. She was just completely ignorant.

Lisa: But you must have gone through hell. Like as a professor, someone who spent years dedicated to their profession and the pursuit of good science to be discredited in this way or taken to court and put through the wringer, basically, for telling the truth. Now, in 2021, the low-carb, high-fat diet has a lot more adoption — still not in mainstream, still not fad part of the food pyramid for God's sake. If anybody follows that they're in trouble. 

But it is shifting slowly. It's a bit like the electric car revolution. I think they would have had electric cars decades ago, but it was stopped by the auto industry. They always want to stop what's going to cut off the money supply. We have to understand that there is a driver of the way things are run. I'm seeing this in my own life with my mum. 

Everybody who knows my podcast knows my story with my mum. She had an aneurysm six years ago, was left with massive brain damage, and we were told she would never do anything again and never have any quality of life — put a ‘Do Not Resuscitate’ order on her and all of that sort of carry on. 

I absolutely, as an athlete, as an ultra marathon athlete, I know that people have always told me, ‘You can't do that.’ It's impossible to run the distances that I did run. I've never listened to the people that told me I can. I spent the next — now six years later — dedicated to finding answers from people that could help me. The ketone, ketosis and ketone diets was a big part of it — hyperbaric oxygen therapy, intravenous vitamin C —a whole lot of things were a part of that therapy back. 

To cut a long story short, my mom came back to full health, and full power of opportunity, and full driver's licence — like a miracle, like coming from a baby state, like being a baby to being a fully functioning woman. This happened when she was 74 years old — not a young person. I know that hyperbaric for example, which is a powerful therapy will never, ever see the light of day, really, because there's no money behind it. There's no, there's no big driving force to do the clinical research. 

When you understand to see this in a personal experience, you start to understand some of the things that are at play. How did you deal with the psychological pressure of being put through such a long, arduous — I mean, they must want you to just jump off a cliff, really, don't they?

Tim: That's really right there. They want you to commit suicide. That's the whole focus and it's called ‘academic mobbing’. Eventually, some people do quit, and they do commit suicide. That was always a risk, but these people don't consider it because they're basically psychopathic. 

They have no interest in anyone who did — what happened to me was done by professors of medicine, and deans of medicine, and it was just not one university, it was about four or five in South Africa. 

That's the tragedy. Psychopaths get to the top — and they only get to the top because they're psychopathic. They have no concern for you or the patients or anything, and they just pretend. I think that's the reason why I got out of medicine. I got out of medicine after a one-year internship.

Then, I went into research and science because I thought that's much more, I’m better equipped for doing that. But it was partly because of this toxic environment that you're in. It's got more toxic, much more toxic.  

Lisa: Way toxic at the moment. Why is this academic seems to be really, really brutal? I mean, people from the outside around in academia would think that doctors and scientists are the most civilised people because they're the most educated and well-educated people. Surely they're all very similar, civilised and above reproach. We have this image of doctors and people that are in the medical profession as being saints. 

Unfortunately, there are some brilliant — I mean, there are some brilliant doctors, don't get me wrong. There’s some lovely, compassionate, amazing human beings and amazing surgeons, and so on and so forth. But it's not true for the entire academic or medical professions. There are people who have ulterior motives, and they're minding their own nests and things like that. 

Tim: The profession is brutal, the training is brutal. I mean, we used to work 110 hours a week and didn't sleep at night, and you have to treat patients. That's brutal. Then, it doesn't get any easier. By the time you're in the mid-30s, you've got huge debts and it's very difficult get out of those debts. You just have to work harder and harder. I think it destroys your family life where it can. It's a very, very difficult profession. I feel compassion for the doctors who are stuck in it because they're really struggling.

Lisa: It is putting everything on the line sometimes for their beliefs. Let's dive into a little bit to — what is a good diet? Because we have vegetarians, we have vegans, we have people on ketosis, we have people who are carnivores — we have all sorts of people and they all have very, very strong opinions. They all have some good points and some negative points. 

What is for you a healthy human diet? Does such a thing exist? Or does it depend on your genetics and your background? What are some general guidelines that we can follow to be healthy?

Tim: I think the general rule is you must eat the evolutionary diet — the diet that humans adapted for. I was very fortunate to be putting together a textbook on low carbs for The Noakes Foundation. I wrote a chapter — not that I was a premier author — with Bendory, Mick Bendory, who's a genius from Jerusalem, from Israel who's done some amazing studies of what is the original diet, and he showed that humans hunted the fattest animals they could find. That was the goal. It was biggest, fattest animals. 

Once those fat animals disappeared, then we were in real trouble. Then, we had to adopt agriculture. Then, became the problem. But if you read the books as you would have like  — Weston Price, it's very clear the traditional populations like the Maori in New Zealand, and in Australia — the Aborigines, that they were unbelievably healthy. They were amongst the healthiest, most attractive, most powerful humans on Earth on the planet. 

They were unbelievable. They had none of the diseases, and particularly — there was no cancer amongst those populations. Cancer is purely a nutritional disease. Now, I never heard that at medical school, and you still will never hear it at medical schools. The answer is we’ve got to go back to eat what the Maoris were eating, or the Australian Aborigines. That's what they were eating — fish and other foods from the land. Those are the foods that really keep you healthy. I would conclude that animal produce is essential. 

Now, there are vegetarians and vegans who live reasonably healthily. But it's difficult, and it's probably quite an expensive diet. The problem with vegetarian diets, it also allows you to eat sugar — and that's a killer. These highly refined foods are the disaster. The simple advice is, you need to eat real foods that are not processed, and mainly from an animal-based origin. That's what I would say. 

Of course, that will make vegans and vegetarians very angry, but that's the way it is. If they choose to eat that, that’s fine. But generally, that is more sort of a religious, spiritual belief — and that's fantastic. They may get benefit from the spiritual beliefs that they have. But on talking simple biology, it's very clear animal-based foods are the best for you.

Lisa: This is the thing, if we can separate the ethical argument from the actual, what do we evolve to eat? How is our digestive tract different? For example, I heard you speak on one podcast about — I think it was the gorillas and how they turn their vegetables or the plant-based stuff differently than our digestive systems work. 

How have we evolved from a digestive point of view? Why is it good for us to have a relatively high-fat diet in some meats in there, and not too much carbs? I mean, we all understand — I think anybody who's a little bit aware, is aware that we're eating far too much sugar and far too many carbs. 

As a general rule, why are we so addicted to those? Why do we chase them so hard? When you eat a piece of chocolate, the whole thing's gone. It is very addictive… I've struggled with that one. I know what it's like. From an evolutionary point given our digestion — and from that perspective, what's going on there and how do we evolve?

Tim: Well, if you go back far enough, like three or four million years, it's very clear that it was animal produce that made us human, and we weren't eating high carbohydrate diets. It's true, if you look at some hunter-gatherer populations today, they do eat quite a lot of carbohydrates. But that's only because there's no animals available. They had to evolve to adapt to that, and they probably evolved appropriately. 

But for many of us — and I come from the north of England. That's where my parents come from. It was covered with ice for the last 10,000 years, and they weren't growing wheat, and grains, and things — and they weren't eating strawberries. They were eating sheep, and lamb and those sorts of things. They were eating animal-based high-fat diets. 

For myself, it's very difficult to adapt within a few thousand years to a high grain diet. The grains have come probably 18,000 years ago, and the populations in the Middle East that eat high carbohydrate diets are probably quite well-adapted because they had 18,000 years. But for the rest of us, we haven't. We were very much closer to animal-based foods. Now you ask, ‘What's the difference?’ 

But if you take a gorilla, they've got this huge pendulous abdomen and people think ‘Oh they’re fat.’ No, that's not — that's the large bowel. They've got this huge colon because the food that they’re eating, they can't digest it. They have to have bacteria in the gut, which then break it down. They break the cellulose, which is a carbohydrate, into saturated fat. That's the key. They're eating a high saturated fat diet. They're not fat. It's because they've got this huge gut.

When humans evolved to become hunters, we could get rid of that huge gut because we didn't need it. We were getting the saturated fat directly from the animals so we didn't need to produce the saturated fat ourselves. Immediately, we could reduce the length of our guts, and particularly the large bowel was much shorter. We still got quite a large, small bowel, which is where we digest animal foods. But we've got a very small, large bowel. 

That's how we've evolved. It's very clear. We’re designed to eat animal produce, which is digestive in the small bowel. That's how we’ve evolved, and that allowed us to get our hips to narrow that allowed us to start running because our knees came closer together. We could run more effectively, and then we became better hunters — and that then helped us evolve further. 

Lisa: I was involved years ago when I was doing my ultramarathons. We tried to get a worldwide series off the ground called Run The Planet. It was looking at tribal groups all around the world that did super long-distance running. We actually ended up doing the pilot, we did a reenactment of an Aboriginal man who has run turned 250 kilometres, and it was documented across the Australian Outback, near Alice Springs. 

We did it that show… We didn't end up getting the funding for the entire series, unfortunately, because it would have been fascinating. We had plans to go and visit all the hunter-gatherer places around the world that had done that sort of persistence hunting. It was so fascinating.

But I truly believe that humans used to run or walk — not just running, but longer distances every day. It was a part of who we are. I was always promoting running and so on as a good sport. I've tempered they're a little bit now that I understand more about my own genetics, and I've studied genetics and epigenetics — it's part of what I do. 

I understand now that, actually, my ultramarathoning was actually against working against my own genetics. I'm more suited to shorter, sharper, high-intensity sort of workouts that are of shorter duration. I have a very easily inflamed cardiovascular system and I can overwhelm with oxidative stress very quickly. Didn't understand all of that when I was doing ultra marathons, but now I do. But I do still believe that humans need to be moving every day, all day. We're very much meant to be physical beings. What is your take on all of that? 

Is ultramarathoning — because a lot of people listen to us are ultramarathoners or marathoners. What is your take on — is it a good thing to be doing long-distance running or long-distance endurance-based athletics? Is it still your belief after having done many, many yourself?

Tim: Lisa, it's very difficult as the author of Lore of Running. There in the book, it says, “You can't run enough. You must run more, and more, and more. You'll never get arthritis. Well, now that I'm in my 70s and I look around at the guys that have been running into their 70s. It's clear that it's not a sustainable activity. That's very clear. 

If you've been running all your life, by the age of 70, it'll be very, very few who are still able to run as they once did. I think if you look at the Olympic marathon runners who I described in that book as being my heroes, they're not in such great shape now. It's not — maybe their cardiovascular health, but the orthopaedic problems that they have. 

One of my great friends who is well-written about in the book, he's really struggling with bilateral knee arthritis and he's about six years younger than me. I agree with you that from an orthopaedic standpoint, it's not ideal, and it’s not what you want to do for 30 or 40 years,

Lisa: I would suggest also that from a hormonal perspective, and certainly genetics comes into this. Some people are more suited. I mean obviously, the Kenyans and the Ethiopians are made to run longer distances, and probably the Moria. There’s a genetic component. But when I was doing ultra marathons — and I've said this a number of times on the podcast. 

At one point, I did a run right through New Zealand where I ran 2250 kilometres in 42 days — so 52 marathons and 42 days, and I put on weight. I got fatter, and I was burning in excess of 10,000—12,000 calories a day, and I was nowhere eating anywhere near that. But I got fatter, I got inflammation, I got hormone problems, infertility over the course of that time. I had to rethink. 

When I did my own genetics, and understood and studied genetics, I actually stopped doing ultras. I did start doing shorter, high-intensity workouts. Most of my workouts are done and dusted within an hour. I do a lot of strength work and yoga, and things like that to balance things out. I feel a ton healthier — just day and night healthier. I can manage my weight much better. I was fatter when I was running the distances. Did you find weight control the more difficult when you're doing a longer distance running?

Tim: In my case, it was definitely the carbohydrates. That was my problem. As soon as I removed them, I got thin again. But I'm absolutely doing what you're doing. I joined CrossFit three years ago, and it's been magic for me. It's been really, really astonishing. It's interesting how I got there. I was invited by the person who started CrossFit — Greg Glassman — because he read Waterlogged. 

It's interesting, CrossFit was also targeted by the same people who are targeting me, targeted CrossFit because it was a threat to them for various reasons. There was a paper published in which it was clearly fraudulent. He knew it is fraudulent because he read it. He said that these things don't happen in CrossFit. He challenged — he took the authors to court, plus the journal, and he also included all the people who supposedly were injured in the trial. They've got — say, 20 people. 

He said, ‘I want to see all 20 of those people in court. If they were injured, I want them to, in front, of the judge to say they were injured.’ Eventually, I realised it was completely fraudulent that made up these injuries. He won the case and it's still ongoing because he's got the losses because he lost the contract with the US military as a result of that paper. That has got to be sorted out. 

Anyway, he said, ‘You’re the only person I know who is an author that took on the industry in Waterlogged.’ He got it, he got interested. I got to talk to the CrossFit people. Then, eventually, I decided I better go and try CrossFit. I ran into one session where I did — I mean, I couldn't even do a proper press up. I do press up against the wall after. But I couldn't walk for a week. 

Lisa: Don’t go too hard. You can’t go too hard.

Tim: After I’ve almost done nothing, I said, ‘Well, I'm more stiff than when I ran the Comrades Marathon of 90 kilometres. I've loved every minute of it. Exactly like you, I do an hour to twice a week, and it's 40 minutes — it’s really hard but really, really odd. Then, I can complement that with some running, but that's what I need. I've bulked up. I've put on five kilograms of muscle at the age of 72. I'm lifting weights that I could never even considered when I was younger.

Lisa: This is the other thing. Running is very catabolic. When you're 20, that's fine, you can keep your muscle. But when you're over 40, ‘I've got some serious good guns now because I did do that weights, and it's very important to me to maintain my muscle mass, and that helps me manage my weight.’ And all the other stuff that would otherwise…

Tim: The other thing that you will have is flexibility — which at 72 you'll see everyone's fixed. They can't move. I've got these back muscles which are astonishing. So they protect my spine.

Lisa: Back issues. I had four crushed discs — like nothing there. When I was running, they would say, ‘Oh, you're going to have to have a spinal surgery, and fuse everything.’ My career was over, blah, blah, blah. I was having spasms 10 times a day. Then, I started doing CrossFit and I worked my way up. Now, I've been years without a single spasm and I do not have back pain, and I have a very, very strong core. I work on the core and I maintain it because the back injury is still there but I don't have any issues.

You know what I love about you is that you're not afraid to say, ‘Hey, what I was teaching 20 years ago isn't quite right because I've done a lot of science since then, and I've actually worked some stuff out and I've experimented on myself. I've changed.’ I've definitely — I've changed my tune on many, many things. That's the sign of someone who's humble enough to, I think, realise that there's more out there to learn, and we can never stop learning. It's really, really important that we do that.

But running for the psychological, and the goals, and the tenacity, and the mental toughness, and all of that sort of stuff. I'm still — it's made me who I am for sure, 

Tim: If we hadn't been runners, we wouldn't be doing in the gym now. That's the other thing. By the way, I am rewriting the Lore of Running, as I said. The first few chapters now are debunking all the myths. The problem in Lore of Running was that it has so much science in it initially. The guys have advised me, they said, ‘Well, you're going to have to rewrite it.’ But I said, ‘But how can I leave stuff out? It's so good.’ 

I just said, ‘I'm starting completely anew. The first thing is, I'm debunking all the stories.’ But let me tell you in the last month, I've been writing an article on, ‘Should you be eating carbohydrates or fats during exercise or before exercise?’ I've discovered another thing — which of course, I never understood. The only reason you need carbohydrates is to keep your blood glucose normal. That is the sole reason. You do not really need it for muscle glycogen use, and so on. 

I've been through all the historical studies, and they all show that if you take a group and exercise them — let's say for three hours or two hours — of course, their muscle glycogen drops. But the only way you can get you performance be enhanced is to prevent the blood glucose from falling. Every time, at exhaustion, they may have low glycogen, but they always have low blood glucose. 

The blood glucose acts in the brain to prevent you exercising more because it's obvious. You've got to regulate your glucose because there's so little — it’s only five grams in the bloodstream. You can be burning three or four grams a minute. Now, you must have an incredible control to prevent that from happening. The only way you can do it is to make sure you don't allow the muscles to do too much work and to deplete your blood glucose levels. 

It's so obvious. This whole debate about what you should eat in marathon running is simple. Just don't become hypoglycemic. Whatever you do — if you need carbs to do that, that's fine. If you need to do a high-fat diet to do it, that's fine. But just don't allow your blood glucose to fall.

Lisa: What's your take on being in ketosis or being a keto-adapted athlete? I had Professor Grant Schofield on the podcast recently, and he's another top man that wrote What the Fat? — and some other books. He’s run into trouble as well as you. He has athletes, like top-level athletes, where he said he has adapted them over a period of weeks, obviously, to get into ketosis and to get them stable and stuff. 

But then their performance goes up. Now, I look back in my career — doing things like running or things like that, and think, ‘Gosh, if I had been fat-adapted, what difference would that have made to my performance?’ Because you hit the wall like 10 times and something like that.

Tim: Exactly. Now, that's the whole point. The whole point is that you mustn’t allow your blood glucose to fall. Ketosis does that brilliantly because it also provides a different fuel to the ketones. I mean, it's amazing. I've just this very minute being working on a paper, reading a paper. 

This is an amazing paper. This is published in 2003 — Association between fatigue and failure to preserve cerebral energy turnover during prolonged exercise. These guys knew it. They studied people, they studied their brain metabolism and exhaustion. Now, who would do that? They’ve got to have a cannula in this vein up here and in the artery, and then they can measure what's being used by the brain. They show once your blood glucose falls, your brain just stops working properly. 

My point was the ketones that you tried — the brain tries to use the ketones but it's not adapted, so it doesn't work. If you are keto-adapted over months, I'm sure under the same circumstances, your glucose drops. The brain just says, ‘No, that's fine. I’ll burn the ketones.’ I think that benefit of ketosis, it prevents hypoglycemia — as we said, the bumps. You can't get them anymore. You don't need as much glucose, or even if you need any glucose.

Lisa: I wonder if you have the exogenous ketones. I'm taking exogenous ketones now, and I'm not on a full keto diet at all. But that alone is helping me be more metabolically flexible. It's teaching my body to use carbs sometimes, and then ketones other times, and teaching my body to do that. 

I had Professor Dom D'Agostino on the show, whose keto — it was good. It’s just amazing sharing all his knowledge around that. Just on the ketones too for brains and for cancer. Unfortunately, my mom, who I just mentioned before came back from this aneurysm has now got lymphoma, and had a brain tumour — and we've had the brain tumour removed. We're now fighting cancer. The first thing I went to was diet. 

I already had her on a relatively good diet. But from the point that I knew that she had a tumour, we went — for starters, I just did vegetables while I cleaned out and worked out what pathways were at play and what way to do it. Now, she's on a ketone diet. She's only — exogenous ketones plus a small amount of fish, and meat, and vegetables, basically greens. 

She's doing very well. The doctors went to the haematologist yesterday, and he said, ‘Looking at you on paper, I would have thought I would be seeing someone who's like near the end.’ She looks all perky, and happy, and amazing. I think that's one part of my strategy is the metabolic approach to cancer because cancer loves sugar. Cancer also loves glutamine, sometimes, depending on your types of cancer. I've been studying hard all the metabolic pathways. What's your take on this low-carb, high-fat for preventing cancer?

Tim: I've no question it prevents. I think because as we've said — when we change the diet, that cancer becomes a contributor. The underlying factor for cancer is glucose, insulin resistance. Insulin resistance underlies most of the cancers. It's a lifetime of a high carbohydrate diet, and people are insulin resistant. I put fructose right up front there as well as a big factor in cancer.

Lisa: Fructose — we think is healthy. We think fruit… I think a little bit of fruit when you're eating the whole fruit, and not juicing or anything like that — if you're an active person, you can probably get away with a few strawberries and a few blueberries, and things like that. But it's a very dangerous area because people believe that — 

I used to think that grapes were great healthy food, but I need a kilo at the time, and I wonder why I've got problems with my weight. I did not understand. Those are fruits, isn't it? It’s healthy. Fruits are very, very problematic one. Cancer, for preventing cancer… I mean, there's other aspects — of course, toxins and viruses, and things that can enter into the mix as well. Certainly, it’s not a simple thing. 

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We've talked about a little bit about running, and your passion for running, and your knowledge. I mean, your book, Lore of Running, was my Bible. In there, you talked about the central governor. Is that one part that you were rewriting or not? Because I really caught on to that thing. 

Because when I was doing ultramarathons, my brain would prohibit me from using my muscles. I'd be like this little robot that I couldn't get my muscles to work. I’m going to reach the same point. Is that still part of your theory?

Tim: You know what's so interesting is that I came across the central governor in about 1996, 1997. That's when I first started describing it and I realised this is the truth. I included it in Lore of Running knowing that — because I wanted to put a stake in the ground saying, ‘Okay, this is the theory and you got it from me.’ 

But that caused me huge problems. It was reviewed by one of the leading exercise physiologists in the world. He just said ‘This is bunkum. This whole central governor theory is nonsense.’ It was so funny because the book was up for an award, and he almost kurbash that award. But he didn't like me, and he was one of those guys who can't change his mind. The central governor will be central because it is absolutely true.

Lisa: Oh, good! I'm glad. I believe that I’ve been reaching that for 20 years.

Tim: As part of the mythology, the dogmas that I throw out is the older — the reductionist idea — that you can reduce exercise performance to lactate in glycogen. It's unbelievably stupid that conclusion. The reason it's taught is because exercise physiologists have to be able to sell something. 

What they can sell is, ‘We can test your oxygen use.’ Then, come to laboratory and we'll tell you whether you've got lots of oxygen — you can use lots of oxygen or not, VO2 Max, and that'll tell us whether you're a good athlete or not. Well, I can tell you whether you’re a good athlete or not just by telling me what your times are at different distances. You don't even need to come to the laboratory.

Then, the other thing is we've got to measure your glycogen in the muscle because that'll tell us whether you've got enough carbohydrate stored — and that, as I said, was nonsensical because the only glucose fuel store that's important in the body is the five grams that's in the bloodstream. That’s all that’s important. There is that important. All you have to do is take enough carbs to make sure that you keep those five grams in the bloodstream.

Lisa: The central governor — the whole principle, when you reach a certain… I adopted in doing super long ultramarathons, and walking is part of my strategy to push out the time until my body would start to just shut down. It takes massive mental strength to overwhelm — it's like a survival instinct. 

Say that your body is going, ‘Sit the frick down. We've got to stop moving.’ And you're like, ‘No, no! I'm going to move anyway.’ This is war going on up there. That sort of resonated with me because that's very true. I've felt it 100 times on my body or more in seeing the selection. But it's very much a mental thing that you actually just want to stop, and you're having to overcome that. 

Tim: I'll come back to that. But I was going to tell you a story which I should have about the carbs. One of my great friends is Bruce Fordyce. We convinced him, sorry… He convinced us that carbohydrates were essential — ultramarathon running, and we developed a product together with him and it's called FRN Leppin, and so on. F is his name, and N is my name. 

Anyway, he converted to the low carbs about eight years ago. Then, he went to ran the New York City Marathon under three hours at age 56. He's running completely reversed. He said ‘Tim, if I'd eaten this high-fat diet, I would around 20 minutes fast in the Comrades Marathon.’ He held the record that lasted for 20 years. But he’s not the only one. 

Dave Scott, who is one of the greatest ultramen athletes of all time — Ironman athletes of all time — who really started the move towards ultradistance events. It was his running and competing in the Ironman that stimulated the world's interest in the Ironman. Anyway, he wrote to me about four years ago and says, ‘Tim, I've just read your book and I changed my diet.’ And he said ‘I wish I'd been eating this diet all my life.’ I asked him, ‘What would have happened?’ He said, ‘I would have been an hour faster’.

Lisa: It does make you wonder right now when you're older and you think, ‘Oh, Gosh! If I had just known that and just done that, what could I have achieved?’ Would have been fantastic.

Tim: He also said that, ‘I will not allow any of my athletes.’ He trains a lot of athletes, ‘I will not allow any of them to eat a high carbohydrate diet.’ Because he says, ‘You can't survive on it. You can do it for four or five years at the top level where you're training six hours a day. But soon enough, it catches up with you.’

Lisa: Great. Your book, Waterlogged — hypernatremia is a thing that… Most people believe they have to drink tons all the time. This is when you're doing long-distance racing. What's wrong with that theory, and what's hyponatremia for those who don't know? I've had it many times.

Tim: Hyponatremia is a drop in your blood sodium levels. Then, normally, like glucose, sodium is tightly regulated. It's homeostatically regulated, so you have all these feedback systems and feed-forward systems. The brain is involved in telling you how much to drink, and then it controls the hormone release, which determines how much sodium you lose in your urine and in your sweat. Then, it'll tell you to take in more sodium if you’re sodium deficient. 

These mechanisms evolved over millions of years. They’re unbelievable. We could never construct an animal with those controls. They’re too refined. When we come to the glucose story, the key in glucose is you don't want the muscles to use too much, so you have to slow down when your blood glucose falls. What happens in hyponatremia is it happens a bit late. You start to slow down — too late. It doesn't tell you to stop drinking. That's part of the problem. 

What happens is you overdrink and your blood sodium levels fall, fall, fall, fall, fall. Eventually, your brain swells because the water can't exist in the bloodstream anymore. It's got to go out into the cells. Your brain swells — because you've got a rigid skull, the brain can only swell a certain amount before the pressure rises. Once the pressure rises, the blood flow into the brain is reduced. When that happens, you stop breathing — so you die from stopping breathing. 

We identified the problem in 1981. We described what was the cause by 1991. We absolutely determined flawless research either because these people drank too much during these exercises. We were able to confirm that they have a genetic defect as well that they oversecrete a hormone that prevents them from losing the sodium in the water. 

That, again, comes back to the point. You won't get hyponatremia if your system is homeostatically working properly. You’ll just pass the urine out and you'll stop drinking. Your body will realise, ‘I don't need to drink all this water.’ In these people for some reason, that homeostatic mechanism is damaged because they're oversecreting this hormone which they shouldn't be. 

They oversecrete antidiuretic hormone, so they don't pass urine. They're drinking at great length while they're running the marathon and they're not passing urine. Then, they heard from Gatorade saying, ‘You must drink 1.2 litres or 40 ounces of fluid every hour.’ What happened — 

I predicted that the first case would be a female marathon runner in America. It's exactly as it happened. Why female — because they’re smaller and they follow instructions. But they may also be more likely to have this condition where they oversecrete this hormone antidiuretic hormone. Predictably, that's what happens. 

We had a number of deaths. Unfortunately, in South Africa, we would have had an epidemic in The Comrades marathon if we had followed those guidelines — drink 1.2 litres per hour for 10 or 11 hours — we would have literally have had thousands of people and hundreds dying from this condition. But fortunately, we were able to stop that and the authorities listened — but reluctantly I must add. 

We told them this, ‘Listen, you don't need seconding stations every mile in a race for 90 kilometres, for 56 miles. You don't need it.’ They still kept them, but they managed to say, ‘Listen, you don't need to drink at each of them each station and you should only drink to thirst.’ 

Again, it's the same old story — we evolved, we’ve got the mechanisms. You don't need to be told when to drink, your body will tell you when to drink. You just drink to thirst, and that's absolutely what is the case. You drink to thirst and you'll be fine. If you drink not out of thirst, you're at risk of developing this condition.

Lisa: What about the argument that by the time you're thirsty, it's too late. You're actually dehydrated because dehydration is a problem too — like we put for some runners. Or, if you're taking your sodiums and your electrolyte tablets, or your electrolyte drinks, are you balancing out there?

Tim: You don't need to, your body will do it for you. If you just take water, you will retain sodium. We always have a sodium excess. It's essentially impossible to get a sodium deficit. Each day, each of us eat more salt than we need. The next day, we got to get rid of it. When you start your marathon, your body's saying, ‘Actually, I've got too much salt on board from yesterday. I'm trying to get rid of it.’ And they'll say, ‘Oh, thank goodness. You're helping me by you sweating out some sodium. That's great. I don't have to pass that much sodium in urine.’ 

That's how the system works. If you take sodium during exercise, as we should, you just pass it during the exercise. What you were reflecting is Gatorade’s influence on thinking of runners. Firstly, dehydration is not a medical condition. It is purely that your blood volume has reduced slightly. That's what dehydration is. It has no effects at all. It is true that if you don't drink, and you get thirsty, and you get seriously thirsty — and you don't drink to replace it, you will get into trouble. 

The only people who really get into trouble from dehydration are the people who are lost in the desert for two or three days. They get kidney failure. That’s true. But they are profoundly thirsty and they want to drink. If you’re not thirsty, your body's saying, ‘It's fine — this level of dehydration.’ We studied Haile Gebrselassie with a group from Glasgow. When he set his world record, he lost five kilograms in the race.

Now, just take Haile Gebrselassie weighs 50 kilograms, and you reduce his weight to 45 kilograms for the last 10 kilometres of the race — it's going to have to help his performance. Absolutely will help you. But the physiologist… Because we have to be able to tell you what to do and you must do this, and you must take your carbohydrates — they didn't listen, they didn't look at the total picture. 

Let's take Haile Gebrselassie and make him run. We put their five-kilogram weight on his body for the last 10 kilometres and see how fast he runs. I can guarantee you… But physiologists don't think like that because sometimes they just try to reduce everything, ‘Oh, if you get dehydrated, it's going to affect performance.’ No, no, no — performance is determined by a host of factors. Most importantly, as you said, it's your brain, and your psyche, and your desire...

Lisa: I actually did a crossing over the Libyan desert back in my youth when I was crazy. It was illegal and it was across a military bad zone. We only had two litres of water a day in a 40-degree temperature sort of thing, and we had 35-kilo backpacks. There, I was dehydrated. There, I had trouble after seven days. Massive problems with the kidneys and was lucky to survive that one to be fair. But otherwise, it's not quite as easy as you think — this hyponatremia versus dehydration. It's a little bit complicated. 

Professor Noakes, thank you so much for your insights. Thank you for sticking to your guns and always speaking the truth, and developing, and evolving, and changing the things that you have to change as you go along in life. That's what we should all be doing — and for being brave and courageous, and telling us what's actually in the science because it's really, really important.

Tim: It's been a fabulous pleasure. Thank you. It's been a wonderful hour. Thank you so much, Lisa. I've enjoyed every second of it and I wish you success in the future.

That's it this week for Pushing The Limits. Be sure to write, review and share with your friends and head over and visit Lisa and her team at lisatamati.com