Is breakfast a have-to?

Higher carb breakfast
Quinoa, nuts and apples

There are new, interesting studies about whether eating breakfast is a better health option or improves weight loss.  No surprise… we’ve been following a bunch of half-logical assumptions as fact and repeating them so much that everyone believes them.  There are a lot of examples of this in nutrition; remember these:

“Margarine is healthy.”  gets declared over and over again as your arteries drown in their artificial sludge.

“Low fat is healthy” is cut and paste from one magazine advertisement to another  as low fat diets and bad fats starve your brain of food and your hormones of their building blocks.

“Sweeteners are the healthy option.” That’s a real marketing coup.  How did we ever buy into the concept that the more artificial a food is, the better it is for us?

So, what is proven with good science rather than repeated from bad assumptions?

Breakfast and your health

The answer is completely individual and depends on your health and personal choices.

  Weight loss


There is no difference in metabolism between people who eat breakfast or those who skip.  In other words, eating breakfast doesn’t kick-start your metabolism and doesn’t make you burn more energy in the day.


Your energy peaks at different times if you eat breakfast or extend your fast.  If you eat early, your energy peaks in the morning.  If you skip breakfast, it peaks in the afternoon and evening.

Blood glucose / Appetite Control

If you skip eating in the morning, your blood glucose levels might be a bit unstable in the late afternoon.  That’s something you want to avoid.  There are ways to manage it, but if you are diabetic, have metabolic syndrome or if you’re not generally healthy, eating breakfast might be best for you.  Spikes in blood sugar cause energy and appetite spikes too which are bad in general, but also make losing weight difficult.


Exercise while you’re still fasting does mean you burn fat rather than other energy sources, so it’s useful if you want to burn fat stores. BUT fasting exercise is tough going on your chemistry if you are stressed.  It’s more important to protect your health than to burn fat faster.

Other Health Factors


Nothing.  There’s nothing yet to support what eating or fasting does to your concentration (mental energy), so that’s something you have to test for yourself.

Colon Health

If you’re in good health, then skipping breakfast at least once or twice a week can be a best practice.  It gives your colon long enough to clean out properly and then your good bacteria have a chance to heal and repair it.  We have lengthened our day with our electrical lifestyle: artificial light and lots of devices keep us busy longer, which means we eat over a longer period.  That shortens the time available to our colons for this maintenance and housekeeping routine.

Asparagus, roast tomatoes and egg

Breakfast foods of choice

A small study shows that an egg and beef breakfast makes you feel fuller than a lower protein one.  That might be because of the quality of the carbohydrates used in the study.  Test these options for yourself and compare these to your normal breakfast:

  • Poached egg on spinach or asparagus
  • Baked mushrooms and feta
  • Whole oats, cooked the night before with added protein powder, reheated
  • Shakshuka – eggs poached in a tomato-chili sauce
  • Quinoa porridge with nuts, berries and a milk of choice
Cereal breakfast
Cereal breakfast

Your worst choices for breakfast are prepared cereals, even the high fibre kind.  Rather eat whole foods and ensure a good balance of protein in your meal.  How you balance meals and fat in the rest of the meal depends on whether you eat high or low fat.  The quality of whatever you eat is really important because you need the best fuel for your energy and concentration.

How to skip breakfast if you don’t usually

If you normally eat breakfast and want to skip it for a while, but maintain your energy, rather build up slowly.  Extend your breakfast time hour by hour.  Eat when you’re properly hungry rather than just eating from habit.

If you do have an afternoon energy dip or hunger pangs, you can try to manage that with a higher fat or protein balance for lunch.  If that doesn’t help, then possibly have your sugar checked out.  Or is your body in stress-overdrive that means this isn’t the right choice for you?  Work with a therapist or coach if you don’t have an easy fix for your energy.

Breakfast best practice?

  • Eat breakfast if you are stressed or work in a stressful position as a protection for your own chemistry.
  • If you skip breakfast and struggle with an energy dip or hunger pangs in the late afternoon, manage your blood sugar.
  • Otherwise do what works best for your own energy and concentration.

An Eye on Medical Marijuana

An eye on medical marijuanaThis innocuous-looking plant is amongst the most contentious on our planet thanks to a history of abuse.  Strangely, in the US it’s used more by the ageing populations than by the youth.  That could be because the marijuana friendly Woodstock-hippies are now that age.  It’s more likely because there are more people in the older generations who are suffering with severe, debilitating medical illnesses.  More people suffering who are prepared to try herbs because pills don’t have all their answers and they’re reaching for something more.

Although marijuana is being legalised more and more world-wide, South Africa is only at the beginning phases of the legal process.  A recent court case declared that the laws should be rewritten to support personal use, but the government have taken it on appeal.  It isn’t legal unless you have a very specific medical certificate obtained from a duly authorised doctor.

The result is that people who are desperate for relief from extreme pain, nausea relief in chemo, certain Parkinsons symptoms etc then turn to questionable sources with varying results.  Cannabis provides proven assistance, and used responsibly can offer  relief for debilitating symptoms. I argue for controlled medical use because there is real need and scientific proof of efficacy.

Cannabis: marijuana versus hemp

Cannabis IndicaMarijuana and hemp are all strains of the same plant, but with different chemical components. How they are grown, the parts of the plant harvested and the timing of harvesting all affect chemical content and stability, so hemp is generally not allowed to be cultivated any more than marijuana is.  Hemp is the ‘legal’ version in terms of products, but unfortunately medically  it’s very much cannabis light.  It has less than a tenth of the active ingredients that marijuana does.  However, hemp does have some active components and is legal, so it’s worth testing for your specific symptoms.  Buy from a reputable health shop, but shop around first and ask for the percentage of CBD in it.  Buy from wherever has the highest Cannabidiol (CBD) content.  As with food, the reaction to hemp is individual and you need to test dosage.

Active ingredients of cannabis

There are four groups of active ingredients that have medicinal value for us.  The best known is Tetrahydrocannabinol (THC).  THC is the psychoactive component, so it’s what gives you the high.  Woodstockers and their hippy friends  have done us a dirty because plants have been increasingly bred for more of a high, so for higher THC levels.  That means there’s less of the other, equally important chemicals.

Cannabidiol (CBD) is the other major component.  Part of its function is to regulate the psychoactive THC.  CBD has important medical benefits of its own, but it also stops THC from over-stimulating the user.  Where THC has been bred to be over-present in the plant, there is a far greater likelihood that the person using that products will experience anxiety as the CBD isn’t there in sufficient quantity to keep it in check.

Other important medicinal components in the plant are terpenes and flavonoids.  Applied topically, cannabis is an anti-inflammatory and is said to resolve sunburn overnight, but that might have more to do with the terpenes and flavonoids than the other components.

These four medicinal components all serve different functions, but together and in tandem, they make this an important medicinal plant that provides a multitude of benefits, and more so if we don’t mess with the plant.

Quality sources count

And this is the first strike against buying on the black market or from recreational vendors.  You need to know that the source of your product is an old-fashioned cannabis plant with a high CBD content, otherwise it will have less medicinal effect and might cause anxiety, even a panic attack.  Second strike is that the manufacturing process of the oil must be clinically precise to maintain the active components.  It is unsettling at least to have a severe medical condition and use something that reacts one way on your symptoms the first time and another the second.  You can’t afford that confusion when you already have other, very real problems.

What your bodies does with the marijuana?

This is the interesting part – it couldn’t do anything if we didn’t have receptors for it.  We have CB1 and CB2 receptors.  We even produce some of our own CBD ourselves, without any help from 5-leafed plants.  They’re spread throughout our body – in our brains, our kidneys, our liver, heart, lungs, pancreas and immune system.  That means we have a purpose and need for these chemicals.  It also means we have to be careful none of these normal functions are messed with.  The physical management comes in not overdosing and over-utilising those receptors, so the suggestion from practitioners who use it in medical practise in the US is to start with the smallest dose possible and build up in little steps until you achieve efficacy, then stop there.

Our own cannabinoid system seems to be part of a signalling system for our own cells, particularly for nerve cells.  If you overdose on external cannabinoid products, you clog up those receptors and they can’t do their day job.  That could have long-term implications for you that could worsen symptoms, hence the medical advice to keep doses as low as possible.

How to use cannabis medicinally

Medical scientists prefer prescribing a daily pill as the most stable, measured way of taking cannabis.  They can carefully control the balance of the chemicals and amount taken and compare it with the results.  If I wanted to manage symptoms for an individual rather than gather repeatable, publishable data, pills would not be my first choice.  They rely on a digestive system that is already probably compromised if there is a serious illness.  The amount of the THC you absorb is also directly dependent on how much fat you eat because it needs the fat for absorption.  Pills, eating baked products or drinking tea also pass through the liver and convert some of the chemicals to other forms, potentially creating a more intense effect.  These options take longer to be felt, but the effect lasts for five to six hours.  The pill lasts for a day.

Drops of oil or tincture under the tongue are more bio-available because they bypass the digestion process, but the product must be from a reputable laboratory that produces exactly the same balance and quality time after time.  It also should be pure as this system bypasses your normal protective mechanisms and absorbs directly via your mucosa in your mouth straight into your blood stream.  It’s effects are quickly felt and dosage is three times daily.

Vaporising has not proven to be as effective as other methods of delivery.

Smoking marijuana has you feeling the effects faster, but for a shorter period, only one to two hours.  Smoking marijuana causes more lung damage than smoking tobacco, but is not associated with lung cancer like normal tobacco smoke.  The heat of the smoke might be what damages your lungs.  If so, using a water pipe would cool the smoke and the damage might be minimised. Practically I don’t see that marijuana would produce more smoke-heat than tobacco, so I think that the damage to the lungs must be chemical.  Personally, I would never recommend it as an option.

Dangers of marijuana

Like all things chemical, there are positives and negatives.  Higher THC brands can produce anxiety, panic attacks or even psychosis.  For some particularly susceptible people, this might even happen with a high CBD variety.  It will pass, but that’s scant comfort to the person experiencing the side-effect.

The other problem is that it stimulates melatonin production and so can make you sleepy in the daytime and not at night.  This is a transitory side-effect and should pass in a month or so.  In the meantime, consider medicating at night.

Call of support for radical medical transformation

Cannabis can bring some measure of relief to people suffering from conditions that medicine has been unable to relieve.  It’s a herb that should be available for responsible use.  Reform attitudes, minds and laws to add it to the medical doctors arsenal of tools to bring relief to their patients and for pharmacists to make available.


IBS?  Pitfalls and Paths of the FODMAP Diet

If you have severe IBS symptoms, then a FODMAP diet could be the answer for you.  It eliminates winds, bloating and cramping by severely restricting the ‘sugars’ that ferment in your gut and cause these symptoms.

It’s a therapeutic diet, not one meant for standard health improvement because it excludes too many healthy foods.  Changing to a FODMAP diet is something you do if you have a very real problem.  If you’re one of the people who suffering with serious IBS, it’s a lifesaver, or at the very least a social rescue.

FODMAP diet overview

How the FODMAP diet works

If certain types of sugar, short chain carbohydrates, don’t get properly absorbed in your small intestine, they can reach your large intestine where they ferment and they become food for bacteria.  These bacteria eat them and give off gas.  Between your food fermenting and the bacteria’s gassy emissions, you now know where your gas comes from. Sometimes the gas is smelly, sometimes it isn’t, and that is a clue to what bugs are overgrown.

If you don’t eat the foods that can ferment or feed your bugs, then the gas and other symptoms aren’t produced.


FODMAP pros and cons

Pros are felt almost immediately.  Being gas and pain free is a relief that makes the strict eating worthwhile initially.

Cons are felt over the long term.  It’s a very restrictive diet and the food you eat is plain and simple, which does get boring.  Like all clean eating, it takes a lot of planning and can make you high-maintenance when socialising.  The big problem is that a diet this restrictive could result in nutritional deficiencies, so it’s probably best to ensure you take a good quality multivitamin and mineral.   Careful though because they can also exacerbate your IBS symptoms.


FODMAP and socialising

The impact of having severe IBS, particularly the smelly gas kind, cannot be understood by someone who hasn’t experienced it.  I haven’t, but I’ve lived in close proximity to someone who had it, so my understanding grew.  She’d had part of her colon removed which was the reason for her digestive difficulties. I’m not sure what was worse for her, the pain of the cramps, the discomfort of the bloating, or having a house that smelt so bad from her bug-fumes that she was embarrassed to allow anyone in.  She burnt candles, sprayed air freshener and nothing helped.  She drifted outside for long periods on cold winter nights to ‘express’ her gas and habitually refused to participate in family outings.

Then there was the diarrhea – when it hit, it hit.  She had no choice, she had to rush to a toilet immediately.  Everything had to be planned to avoid potential embarrassment.  What did she do if she had to go shopping and needed the toilet?  What happened if she eventually agreed to go out to a meal and there was someone in the toilet when it hit? What happened …? Life shrank to her access to toilets and eventually narrowed even more to what was happening hour to hour with her bowels.  They became her world and conversation eventually shrank to the same.  It’s a life with very few pleasures.

Twenty years after her symptoms started, Monash published the FODMAP diet.  It took a couple of years to filter through to us as a solution for her, but once it did, we changed her diet.  It made a huge difference.  For the first time she was truly symptom free, with none of the bloating she suffered from so long as we were completely rigid with every single ingredient that went into the food.  That’s not as simple as it sounds when you’re cooking for a family and she’s one of five, not the only one.


What I’m really getting at here is that I understand the difficulties of living on a FODMAP diet, but

How to socialise on FODMAP?
I don’t want my FODMAP diet to damage my social life.

I also understand the restrictions of not doing so or the price you pay for ‘cheating’.  My suggestion is that you control your environment from the beginning to manage these potentials issues.  Tell your social circle you’re on a medical diet for an extended period but you don’t want to miss out on your friends and family because of it. Ask them to please still invite you, but you’ll bring your own food.  If they tell you their menu, you can bring along something similar.  Make them understand that as people they count more than the food at their party.


If they want to understand more, refer them to the MONASH site, being a university diet it has credibility that will save you explanations.

By doing this you repackage your high-maintenance lifestyle in a low-maintenance way.

Social pitfalls

I don’t even have IBS myself, but just shopping and cooking for someone who else me semi-obsessive.  The consequences of getting it wrong are real, this isn’t a fad diet.  It became too big a part of what I was speaking about all the time, my own conversation started becoming limited.  If you have IBS and are living the symptoms and the diet, you are more susceptible to being obsessed that I ever was.  Make rules for yourself up front about how avoiding anything more than the most general or practical comments about your eating lifestyle in public unless asked.


Support for a FODMAP diet

It’s a well-researched diet, but is still relatively new in the blogosphere, so there isn’t a lot of interesting support like tons of great recipe sites for it yet.

FODMAP forever or is there life after FODMAP?

Eating a FODMAP diet is the key to managing your symptoms, not the key to actually healing your gut.  If you have physical damage, you might not be able to heal much, but you still want to be the best you can so that you can be a little more flexible in what you eat.  Healing means rebalancing gut bacteria and is both an art and a science.  It’s a combination of understanding how to kill off unwanted, overgrown bacteria, how to add in bacteria that is more useful, and the science of knowing what those bacteria are.  It’s best to work with a therapist who understands the microbiome to do that.

You can do other things to support a healthy balance of bacteria, and it’s in lifestyle choices.  You should exercise, get eight hours of sleep at night, go into nature and touch the rocks and the plants, and read up about supporting your skin and mouth microbiome as the entry-points into your body.  Those will all support any healing you undertake.  Lets get real though, if you’re fodmapping, you’re doing a lot more cooking and planning around food than others, so take on these projects in baby steps.  Be kind to yourself.

This quote is used a lot, but there’s a good reason for it:

Making healthy food fun again
Making healthy food fun again



“Let food be thy medicine and medicine be thy food.”



Noakes 1: Bullies 0

Act 1 of this sad health melodrama

I feel unexpectedly strongly about the Noakes verdict.  David vs Goliath, evidence vs dogma, and a victory for the individual versus the gang of bullies.

Celebrating Noakes eating HC naartjies
Eating high carb naartjies and celebrating the Noakes victory

So I’m sitting here eating my high carb naartjie and celebrating the Noakes team victory!   I don’t know anyone involved in the HPCSA-Noakes hearing and  I only believe in LCHF as a therapeutic tool, not as a first-stop, but lets face it, the way they treated him sucked!

With his win in the hearing, arrogance, doublespeak and self-righteousness lost, but at a huge cost to him and to the reputation of his accusers?


How it all started

I’m not going to go through all the tweets again that lead to this debacle.  Here’s the summary:

Noakes has been passionate about his hobby-horse LCHF for a while, everyone knows it.  A mother on Twitter simultaneously asked him and another ardent low carb proponent a question about a mother’s diet whilst breastfeeding.  Surprise – the low-carb proponents gave a pro low carb answer.  Even more of a surprise, on Twitter the answer had limited detail. Why did the mother even ask the question when she basically already knew what the answer would be from the people she chose to pose her question to?  Why did she ask on Twitter if she wanted a detailed answer?  The answer to this, it seems, is worth millions, even though that mother made her own choices to follow anther path and never laid a complaint.

Enter the Bullies…     

They were prissy, opinionated and arrogant.  They were going to teach this A1 graded research scientist a lesson simply because they didn’t believe his research could be true if they disagreed.  Did they think he got overnight dementia and threw his world-class-top-ranking-research-scientist rating that he had spent years achieving out of the window on a whim?  Whatever they thought, they behaved like bullies, and waded in shouting (on Twitter, in CAPS), publicly trashing him and his views,  and doing so, completely in contravention of their professional code of conduct:

Clare Julsing Strydom’s tweets to Prof Tim Noakes – suitably blurry

People don’t automatically earn respect, but he has spent years at the forefront of research.  You don’t think there’s something in his achievements that deserve at least a respectful approach, or a professional forum for criticism?  Is our Academia going the route of our parliament, where the loudest voices must be the right ones?

The tragicomedy unfolds

  1. The HPCSA charged him from a file of secret information and reports that they had no intention of ever sharing with him until the Chair of the Committee hearing shamed them into doing so.  They produced ‘secret’ witnesses.  I think it’s fair to call them ‘The Bullies”.
  2. In mid-process, against good legal practice, the HPCSA changed the complainant from Ms Clare Julsing-Strydom to the dietitian’s association (ADSA).
  3. The ADSA then enlightened us in a news articles that they have nothing personal against Professor Noakes: they merely wanted clarity of how to use social media professional and they wanted to protect innocent little babies with their ‘query’. It wasn’t a direct disciplinary charge now, just an innocent little query. Am I the only one wondering why not just ASK THE HPCSA FOR GUIDELINES?  Or ask Prof Noakes to reply to a published, peer-reviewed scientific study in a public forum if you’re honest and admit you didn’t like the content of what he’s saying.  In other words, choose a professional response.

Below is Julsing Strydom’s “not-personal” query-complaint against Prof Noakes.


ADSA on their high horse vs Noakes
The ADSA, represented by Clare Julsing Strydom, conservatively perched side-saddle on it’s high horse.

“To whom it may concern

“I would like to file a report against Prof Tim Noakes. He is giving incorrect medical (medical nutrition therapy) (sic) on Twitter that is not evidence based. I have attached the tweet where Prof Noakes advises a breastfeeding mother to wean her baby onto a low carbohydrate high-fat diet.”

“I urge HPCSA to please take urgent action against this type of misconduct as prof (sic) Noakes is a ‘celebrity’in South Africa and the public does not have the knowledge to understand that the information he is advocating is not evidence based – it is especially dangerous to give this advice for infants and can potentially be life-threatening. I await your response.

Kind regards,

Claire Julsing Strydom”


Cue fluttering eyelashes: “It wasn’t personal”

Now that Noakes has been found not guilty, with no recognition of the hurt and harm done to him, the ADSA (Gallagher) writes the following article again on Health24:

I doubt that Noakes has experienced it quite that way. At least further on in this article they admit that it’s a complaint against him and no longer try to soft-soap it.  I see there’s been a statement published by the ADSA since the Not Guilty verdict, saying that they didn’t expect it to go this far, but that it wasn’t their choice that it followed this path, it was the HPCSA’s process.  Somehow, with all the effort to get a dietitian on the panel, I don’t quite buy that they were passive bystanders in the process, completely without influence.  They also say it went this far because it couldn’t be resolved in the normal process, but again, with the attitude they showed, how could they have expected to be met with conciliation.  They don’t mention anywhere that they tried to initiate conciliation.  The HPCSA also didn’t manage the case as aggressively as they did because they were trying to find a meeting of minds.

The ADSA still does not say is that they will read Professor Noakes’s research cases, even though the Advocate Chairing the HPCSA hearing, Adv Joan Adams did maintain there was “logic” to it.  The ADSA rather go to lengths to defend their current stance.  I find that sad.  As professionals they should robustly research, read, engage with and critically analyse ALL relevant research.  They don’t have to change their approach if the scientific evidence doesn’t pass critical scientific evaluation.

Being this blinkered and ignoring research because it doesn’t match their guidelines is an indictment on their profession and the South African training institutions that have fostered this mindset.

Back to the ADSA’s statement … they do say mud was slung on both sides and it was.  I also don’t completely buy Prof Noakes’s side, much as it seems I support him a hundred percent.  The difference is I’d try a meeting of grounds with respect before I attacked him in public.  I also won’t assume I’m right until I’ve read his scientific reviews point by point and assessed my belief system against them if I were going to argue with him.  However, this post isn’t about the content of what he said or the manner in which it was said, this is about the process and the disrespect and procedural unfairness it was riddled with from the start.

Setting up the boxing ring

Who can blame a man aggressively backed into a corner for fighting?  I certainly don’t.  Communications  strategy 101: you set up the environment to ensure you achieve the result you want.  You attack, they fight.  One has to assume that, despite all contradictory statements, conflict was what was sought, consciously or not.  When a bully attacks you, you can either stand and fight or run away and face it again another day.  Professor Noakes was never going to run!  And in the circumstances, how could they possibly expect him to initiate conciliation!?!

Noakes vs ADSA – HPCSA: Opponents don’t reconcile in a boxing ring

 Follow the Money

What really gets to me is the price of this whole escapade.  Of course there is a huge emotional price that the Professor has paid:

* the enormous damage of grossly belittling a giant of a man on the cusp of his retirement,

*  the hurt he has dealt with in being declared a pariah by Academia

*  and much more I haven’t even thought of.

Let’s ignore that though, not because it’s unimportant, but because it’s unquantifiable. Let’s look at the actual rand value of this hearing.  According to media reports, it cost the HPCSA R10 MILLION – did I shout that?  I’ll do it again: TEN MILLION RAND!  And that’s without Noakes’ Team’s costs, which apparently amounted to R2 million.

Given the R130 BILLION that the HPCSA collected last year in membership fees, the ten million rand they frittered away in a poorly managed process according to legal and governance practices is perfectly acceptable to them.  But how will any but the most well-off doctor manage to get justice in that system where their professional council is prepared to throw this kind of money at annihilating a single career and reputation. Maybe understandable if lives had been lost and more were at stake, but that doesn’t cut it here.  And that is the crux of my anger.  It’s the David and Goliath issue:  how would my GP have been able to defend herself in this process? She would never have been able to afford it.


Change of the balance of power with the Not Guilty  verdict for Noakes

Noakes vs ADSA-HPCSA: A shift in who’s holding the power?Thanks to his reputation, Professor Noakes had a legal team who were prepared to defend him pro bono – Pike Law.   Their presence balanced the odds.  So they won, but they haven’t been paid for it and the HPCSA who lost have been paid.  Unfair, but can that change?

It might, because now, as the victors, there’s potentially room for either the Pike Law legal team or Professor Noakes to seek financial redress for a patently unfair process, but from whom?  The HPCSA, Clare Julsing Strydom and the ADSA are all potential targets.


Any emotional attempt at reparation?

The ADSA dancing around their culpability in the Noakes vs ADSA-HPCSA complaint

Clare Julsing Strydom admitted under cross-questioning that she might have over-reacted, but she never apologised for her unprofessional slagging-off of Professor Noakes.  The ADSA tried to do ballerina twirls on top of their fairy-tale white-washed horse – but no admission or apology from them either.  And Professor Noakes? He still, unsurprisingly, is passionately promoting his diet-philosophy.  But let’s be fair, he hauled out mountains of evidence in the hearing for it.  Who from the ADSA was there to hear them with a scientifically open mind – there was only nominal representation?  Do you suppose anyone read the research after hours?

Isn’t it time the two sides at least started sharing and courtesy-reading peer-reviewed PubMed articles?  And I don’t only mean the ones that they agree with before they read them.

Bottom line, despite Professor Noakes’ Not Guilty  verdict, this process has been a travesty and a blight on South’s Africa’s professional procedures and ethics.  I’m not even sure that the Bullies get how huge the international following for this has been and the concomitant embarrassment.


Act 2 Part 1 of this sad health melodrama

The HPCSA is again taking up the cudgels against dangerous Noakes.  Clearly losing face didn’t sit well with them and they need to make sure it doesn’t happen again.  They’ve chosen the ground and the fighters. In other words they have chosen the committee and the terms of the appeal.  Noakes has no chance, so let’s add the likely outcome here:

Noakes 1: Bullies 1   Fair fight?  – None

And the sorority -clique-dieticians?  Still sitting holier than though, denying any culpability and persisting in their prissy pettiness.  Is the Noakes-Sboros side better?  not really.  It’s become personal, but they are the victims here.  Noakes has been hit personally, of course he’ll take it personally, and he’s not going to stop fighting, so …

It will move onto a fairer battleground – the South African Courts.  And they are fair.

Act 3 Noakes escalates to fair ground, the legal system

May justice prevail!  You’ll notice I don’t say may Noakes prevail because I truly do want fair justice, a win for health.

And, in and ideal world, the court would insist that the HPCSA gets real grievance procedures, fair processes and stops wasting our money because at the end of the day the doctors charge us to cover their insurance.

Disclaimer:  All the information sourced for this article was sourced from twitter or the internet.  It assumes that you are not an idiot and will read multiple views in this information age, as the eloquent and time-savvy Advocate Joan Adams declared.


How Exercise for Health and Weight Loss Differs

Exercise for health and weigh-loss differ
Exercise for health and weigh-loss differ

Exercise for health and weight loss – they’re different!

Energy in, energy out, right?  Wrong!  As we’re learning with everything, it isn’t the quantity, but the quality. That goes for both food and exercise.

You don’t need exercise just to lose weight, you need it to keep your muscles working in good condition, especially as you age.  Your metabolism needs you to exercise, your heart needs it, your lungs need it, your lymph system needs it, your mood needs it. It’s critical to your health and immunity.  Whether you exercise and how you exercise will influence how you age and probably how you die.

First a reminder that the ‘No pain no gain’ philosophy should stay buried in the 80s.  It isn’t useful or healthy.  You need to build your muscles up slowly in measured steps because as they grow, your transport system of veins and capillaries need to develop with them to feed the new tissue.  Be kind to your body and give your muscles fair time to develop their support system.


What is healthy exercise?

Most exercise is healthy, but the real benefit comes from a combination of exercises.  Your body is a complex network of systems, and you need to exercise to support all the systems, not just one or two.

Weight-bearing exercise

Weight-bearing exercise


Weight-bearing exercise builds and maintains your bone health and has a slight aerobic effect.  If you do no other exercise for your old age, do this.



Aerobic Exercise

Aerobic exercise


Aerobic exercise is important for your heart and circulation.  It gets your blood pumping, oxygen flowing and increases your yummy feel-good hormones.  Walking hard and swimming or cycling are excellent options as they are gentler on your joints.



Stretching Exercise

Stretching exerciseStretching exercise as you wake up is a best practice.  It activates your lymph drainage system and ‘wakes up’ your hormones in a good way.  Combine that with stretching workouts like pilates once or twice a week and you develop a muscle infrastructure that protects your bone structure and joints.  Yoga adds a calming dimension to your routine and is indispensable for someone who is stressed or has insomnia or mental health issues.  Weekly yoga sessions should be part of your routine if you’re aiming at optimal health.  Stretching generally maintains your flexibility, and the breathing exercises in yoga assist with hormone rebalancing, so that you can handle stress better.


Bouncing exercise


Bouncing is excellent for lymph drainage and therefore immunity.  10 minutes of gentle bouncing on a trampoline with your feet not leaving the trampoline will stimulate the action of your lymph system.





Weight loss – what’s the best way to get there?

Once you’ve built up your fitness to a level that can sustain it, Tabata produces above-average results in a short time of very high intensity exercise.

Tabata consists of 8 sets of 20 seconds each of any exercise of your choice, followed by a 10 second break.  You do as many reps of the exercise as you can in those 20 seconds, really pushing yourself, and resting for no more than 10 seconds between sets.  In four minutes of Tabata your body gets the benefits of a full cardio workout, so replacing a full workout with a Tabata workout once or twice a week is beneficial from a timing, fitness and weight loss point of view, but it isn’t for newbies – you need to be in good shape to do it.  There are Tabata apps to guide your timing.

What is unhealthy exercise?

Anything that hurts your joints or muscles is a no-no.  Listen to your body’s messages.  You can push, but never to the point of pain.  The only time you should work through pain in exercise is when you are in medical therapy for a diagnosed condition and you are under professional supervision.

Also avoid exercising too frequently. You need two or three off days a week for your muscles to recover from weight-bearing or aerobic exercise.


Nutritional tips for sustained energy

A tablespoon of MCT oil 20 minutes before you exercise will give you an energy boost to sustain you through a workout.  But be careful because taking it too late in the day could cause insomnia.

Eat real foods in their natural form for optimal health

Eat real foods in their natural form for optimal health

Nutritional tips to aid recovery

Heavy exercise induces slight tears in your muscles that re-heal as the muscles build.   In this process chemicals are expressed and converted, so you benefit if you have all the nutritional building blocks your muscles need to repair the damage these tears cause.

L-glutamine taken after exercise will help muscle recovery

Vitamin C, resveratrol and curcumin are antioxidants that help mop up the free radical byproducts (supplements are okay, but stress real food, especially uncooked vegetables or fruit for Vitamin C).

A good natural protein will help the muscles grow and recover.

Gelatine provides collagen building blocks for joints and muscles.  You can add gelatine to any warm drinks, soups and stews.

Replace ordinary salt with pink Himalayan salt.  It has a far broader mineral base than Table Salt which you will need to replace minerals that are lost in perspiration.

If exercise is fun, it’s more sustainable, so have fun!

If exercise is fun, it’s more sustainable, so have fun!

Soya – Good or Bad? Quick Guide

Raw soya beansSoya (aka edamame in it’s raw form) is hugely controversial, so here are some ways to navigate the web of soya-curiosities.  Use this to filter what you read about soya and to choose what you eat.


When is soya healthy?

If you are Asian (from Asia) and eating soya, then you are probably eating fermented soya like miso.  Population studies indicate that that is healthy for you.

If you are adapted to a western diet, then the soya products you eat are more likely to be processed soya like sausages, schnitzels etc which are made from unfermented soya. Tofu and soya milk are also usually unfermented, but you can make or source fermented products.  Unless your soya is fermented according to the old-style recipes where the fermentation has time to properly alter the chemical structure of the soya, it’s probably mostly bad for you.

Fermenting breaks down the phytic acid in the beans which binds with nutrients to stop you absorbing them.  In other words, it’s an anti-nutrient.

Soya is a phyto-estrogen, a plant estrogen, so if you eat a lot of it have your doctor regularly check your hormone levels to avoid problems.  Some people are more sensitive to the estrogenic effects.

And what if you are eating fermented soya?

Studies show that people on a western diet are better adapted to getting similar health benefits from seeds as traditional Asian-diet populations get from soya, probably because their gut bacteria have adapted.  Miso and tempeh are habitually fermented and so are good choices.


Miso soup
Miso soup

How to choose

How does this help me understand all the conflicting information and take the good from it?

  1. It helps you break down the studies:

If something is tested on an Asian population and you are on a western diet, you can’t extrapolate their results to yourself. Asian populations have a low incidence of breast cancer on soya, but western-dieters have a correlation with soya diet and incidence of breast cancer.

Any commercially processed product is less healthy, and processed soya is no different. Check the source of the food in any quoted study to help put the results in context.


 2.  And it helps you make better choices:

If you want to eat soya, choose fermented options and non-commercially processed ones. Fermenting is also a form of processing, but it breaks down the anti-nutrients in the soya and makes it more digestible.  If you’re used to a Western diet and don’t want to ferment your soya, sprout it.  Sprouts are jam-packed with goodness.

Don’t make soya a staple dietary choice (never make any food a staple, rather aim for variety).

If you use non-dairy milk options, then try to develop a wide variety of milk sources for your needs, including nuts and oats rather than using a blanket soya-replacement option.

Sprouted beans
Sprouted beans

To Gluten or Not To Gluten?

Gluten containing wheat bread Voices get raised and ‘facts’ get bandied about with more self-righteous indignation than logic or research.  Every magazine has contradictory information and almost everyone has their own gluten-religion, some of it is based on resistance to change, some on ease of access, but much of it is based on memories of comfort and love.

My grandfather was a baker.  I grew up at his knee, kneading and knocking down the yeasty dough, shaping my own bread roll into an impractically intricate shape as he expertly produced his baker’s dozen in the same time, so I understand the emotional attraction of fresh, airy gluten-filled bread better than most.  Does that make it good for me?  Unfortunately no.  What feeds my soul with nostalgic memories isn’t as good for other, more physical parts of me, but that doesn’t mean the same is true to the same degree for you.

In this post I’m going to try to break down the gluten argument to explain why you might choose one way and someone else might choose another.  It’ll be a very high level overview of the science behind gluten’s biological effects, but it will give you a framework for further research if you’re more of an information junkie.

Hopefully when all the conflicting information that confuses us is logically organised, gluten discussions can be more useful and less preachy.


Understanding gluten

Intolerance to gluten falls into a spectrum of degrees of negative response:

  1. Celiac disease

Celiac’s are hugely intolerant to gluten.  They cannot afford even cross-contamination from a board or knife used to cut something that had gluten in it.  If they are exposed to gluten, their reactions are extreme and serious.  Celiac disease is usually diagnosed via an intestinal biopsy and blood and genetic tests.

  1. Wheat Allergy / Gluten Allergy

People who are allergic to wheat or gluten intolerant generally have an immediate, measurable reaction to it like a rash or difficulty breathing.  An intestinal biopsy is not necessary to diagnose it as there is a definitive IgE blood test to diagnose it.

  1. Non-coeliac gluten sensitivity (NCGS)

This is the most hotly debated one, mainly because there is no blood test for gluten sensitivity.  It is the underlying reaction that builds up over time, so you don’t suddenly go red, swell up and stop breathing, and your skin doesn’t break out in hives on contact. In other words, there are no obvious, immediate symptoms to prove you’re gluten sensitive.  An intestinal biopsy can be done to confirm gluten-related damage, but that is invasive and unnecessary if an elimination diet can give you the same answer to “Can I tolerate gluten or not?”  They are now starting to determining biomarkers that do prove NCGS, but it’s still in the early stages of being studies and defined.

Wheat field


  1. Other passengers in the gluten grain

There are other chemicals on and in grains containing gluten that can also be responsible for the IBS-type symptoms experienced when eaten.  These would include fertilisers, pesticides or complex sugars called FODMAPS.  You might not be strictly gluten intolerant, but intolerant to one of those ingredients.  This means that you might be unable to eat gluten grains and assume you’re gluten-sensitive, but you might actually have a pesticide or FODMAP sensitivity. You still have to avoid the gluten containing grains to avoid a continuation of your symptoms, but just not because of the gluten itself.

I was always of the practical philosophy of Whats in a name? A rose by any other name would smell as fair, but studies have proved me wrong.  You should follow the various biopsy, blood test and elimination paths to determine exactly where your problem lies.  If the underlying problem is an underlying auto-immune issue, your doctor needs to know that and your health management will be different.  There’ll be more about that in a later post.

A rose by any other name would smell as fair


  1. Better food choices

Often, when eliminating gluten, people become more conscious of the power and purpose of nutrition and start eating more whole foods, which could lead to a sense of well-being that could be falsely attributed to being gluten free.  Flour in general, whether or not it contains gluten, is not a best choice as about 80% of its nutritive value is lost in the milling process. Replacing flour with vegetables would immediately give your body more of the building blocks it needs to process your fuel-compounds, so you will also automatically feel better.  Your blood glucose will also in most cases be more balanced which will give you more energy and you will feel you are coping better overall.

Whole foods are the best food choice


  Whole foods are the best food choice .




Four basic gluten facts

  1. Gluten is a protein found in wheat and rye grains, and is generally used in the processing of oats.
  2. The gluten protein consists of two other proteins, glutenin and gliadin. It is possible to react to one and not the other, but a celiac reacts to both, and even often to other proteins with a similar structure.
  3. Gluten stimulates the production of a hormone called zonulin in your gut and your brain. Zonulin opens ‘doors’, more correctly known as tight junctions in both the intestine and the brain, allowing the contents to leak into neighbouring tissue and the blood stream.  Obviously your brain could be less protected from pathogens, metals etc if zonulin relaxes the tight junctions of the blood brain barrier. As your brain doesn’t have the detoxifying processes that the rest of your body does, that is a worry.
  4. Gluten creates a toxic response and a detoxifying waterfall. Most people can cope with the tight junctions allowing leakage and their body cleans it out through various detoxifying processes. Your body always has to process some side-effect toxins if you eat gluten because of this, so it isn’t a best choice food.  If your body is already dealing with other toxic load, it will have a harder time eliminating the additional toxins.
Crossroads – should I or shouldn’t I?


How do I choose if I eat gluten or not?

 Better health?

If you have a reaction to gluten grains, then ignore what the media says in half their articles and take their advice from the other half: avoid gluten because avoiding it can’t harm you and eating it does.  It’s your body, you know it best and you don’t have to justify that to anyone.

If you don’t react, but just want to up your game and make better choices, then I would suggest that you mostly avoid gluten and concentrate on better, whole foods.

BUT!  If you are replacing gluten with a lot of other refined products, you haven’t really treated your body to much of an improvement.  Then it might be best to stay with gluten of a better quality and eat the fermented, sourdough options that break down more easily in your colon.

Weight loss?

If you’re eating gluten-free products to lose weight, you’re on the wrong path.  You’d be better advised to eat at a good balance of micro and macro-nutrients and address lifestyle factors like stress, sleep and exercise to achieve that.

Personal choices your own truth

 I personally can eat gluten, but it definitely affects my mental and digestive performance so I don’t eat it often.

If my teenage daughter eats it, even unknowingly, she physically looks like she’s swallowed lead: her shoulders hang, her body moves like its being held back and she judges herself and the world around her from a difficult place.  We don’t have to ask if she ate gluten that day, the result is visually measurable.   That’s her truth, and it’s based on her body’s response.  I respect that because to tell her she isn’t experiencing what she is because science hasn’t devised a test to confirm it yet is disrespectful and closed-minded.  She’s clearly NCGS, but we’ve chosen to do the biopsy when she’s a little older in the hopes that the tests are more efficient then and hopefully less invasive.  In the meantime she completely avoids gluten as a trigger to autoimmunity.

You have your own gluten-reality and you have the right to choose what you want to, whether it’s based on physical or chemical responses, practical issues or philosophy.  Trust your body, tune in to it, and do what will give you the best results.  Just don’t assume your answer is also your child’s answer or your neighbour’s answer.  We’re all different.  We have to accept that there is no one-size-fits-all in nutrition, so don’t crusade because something works for you – it’s important to keep your friends even if they can eat crusty baguettes and you can’t.

Individuality – nutrition’s new frontier

Even if we come from the same pod and look the same, we aren’t.

We’re all individual – and that’s medicine and nutrition’s exciting new frontier.

It’s terrifying because your reality isn’t the same as anyone else’s, it’s liberating because what you feel is real and no-one else can tell you differently, it’s frustrating because your therapists have to get to know and understand you, so on some level you’ll always be a guinea-pig.

Healthiest Ways to Cook Food

This is an on-going debate.  We don’t like giving up our preconceptions or our pleasures, so we resist some answers.  But facts stay facts – see if you can trip me up on the science behind mine. (How’s that for confidence.)

Have I slipped on latest research? Be fair – it must be peer reviewed and recent.

The best type of cooking is steaming.  You retain the most nutrients because you don’t lose nutrients into the water like you do when you boil food.  You also don’t have as many carcinogenic chemicals developing as you do in long or fast cooking.  The good news is that you never have to eat boiled liver again because it isn’t really that healthy.

Microwave cooking has a bad reputation with limited proof.  Recent studies again show that it doesn’t kill off any more nutrients than normal cooking does.  It does agitate the molecules harder and faster than normal cooking, but that hasn’t been related to any negative results yet.  I do presume that it probably does kill off any beneficial bacteria, but I doubt many of those survive steaming either.  Of course the machine itself has to be well-maintained to be safe, but that’s a different discussion.

Cooking food quickly at high temperatures or for too long causes chemical reactions in the food that are carcinogenic.  That means that fried and grilled food isn’t good for you, eat it in moderation.

Poached eggs on salmon salad

What practical results can you take from this?

* Poach or boil eggs rather than frying.

* Pre-prepare meat in the microwave rather than only grilling it to cut down its exposure to heat.

* Turn what you’re cooking often if you are grilling or frying so that the heat stays as gentle as possible on both sides.

* And the hardest for me to accept … don’t make gravies from the bits left in the bottom of the pan, particularly not if some of the bits are charred.

Should you cook your vegetables or not?  Who’s right? The people who cook or the Raw Foodies?  The answer, typically, is completely individual – it’s dependent on both the specific food-type and your digestive system.  A rule of thumb is that the more processed a food is, the more nutrients it loses.  Vitamin C is practically destroyed by heat but other nutrients are more heat stable and some like lycopene benefit from longer cooking.

Some people need to have their food cooked to assist with their digestion, others thrive on raw foods.  In general aim for some cooked and some raw every day to get the best of both?   It’s best to experiment with what works for you, but don’t be inflexible.  Our bodies change with time, and you need to change with it to do what’s best for you rather than blindly following a philosophy.

Note that cooking foods with a high anti-nutrient value like lectins or oxalates is different.  There are tricks to negating the negatives effects of the anti-nutrients in your preparation and cooking techniques, but that’s for anther time.

Grilled meat: sear the outside, cook the inside more slowly. Preferably don’t eat the seared bits.

I’ve heard from informed sources that if you’re grilling meat it’s best to quickly sear the outside and then cook it more slowly once sealed.  The seared outside bits are carcinogenic and should be avoided. The inside retains flavour and juices due to the searing, but is less carcinogenic.   See, I said you wouldn’t like it but it makes sense.  I don’t have scientific research for this one, just logic.