Boston Marathon 2013: Live splits, projections and commentary

Our thoughts are with everyone affected by the tragic events at the Boston Marathon

The 2013 Boston Marathon has been marred by tragic and senseless acts of violence.  Below you will find our race report, which is written live and in real-time during the elite men's and women's races.  During that event, we used terms that are normal for use during sporting events, but which have, in the light of the later tragedy, become insensitive and entirely inappropriate.  We would like to emphasize that this post was written many hours before the tragedy, and we regret the delivery of the post by email and circulation. We have edited the below to remove those words that now may be deemed insensitive.

Our hearts and thoughts go out to the many runners, supporters, the BAA and other race and city of Boston personnel who were affected by this act of violenceA historical event has been marred by the actions of the perpetrators, but we are fully confident that the spirit of the race and the marathon will continue to unite and inspire us.

Boston 2013: Splits, projections and in-race commentary

Welcome to our coverage of the 2013 Boston Marathon.

Below you'll find splits and thoughts as the races unfolded.  They were won by Ethiopia's Lelisa Desisa (2:10:22) and Kenya's Rita Jeptoo (2:26:25).  Both were tactical and overall quite slow, with dramatic changes in the second half.  Enjoy the race as it happened!

Ross

Men's Race

Additional thoughts:

From 15km to 20km, the men have resembled a training group on an easy running day. The field is entirely African, with the Ethiopians most prominent at the front. Gebremariam and Lilesa are their big dangers, but Merga is also in the group of nine.  So too are all the favored Kenyans.

At 20km, the elite field has swelled because of the comparatively easy running.  The pace really has dropped and allowed those athletes back in.  This is building to an huge surge from 20 to 30km as the hills hit the field.

At 24km, Watson of Canada is leading, and the pace has been lifted as a result.  The halfway split is slow, however, and projects a 2:09:48, and so we can expect a huge second half.  As with the women, look for a massive negative split.  I'd predict a second half in the range of 63 min, and a 2:07 to win today.  Micah Kogo, making his marathon debut, is the 10km specialist and must be enjoying the way the race has developed.

Just before 30km, the men's race has been shaken up dramatically.  We have helicopter shots of it so we don't know what is happening...typical.  It is being reported that Dixon Chumba of Kenya who has done the damange.  At the bottom of the hills, 11 men were together, and it has been thinned to two.  Chumba and Desisa of Ethiopia are clear.  The field is fragmented behind, but the hills may help keep them in contact.

The group has in fact reformed, at 30km, and we have six men together, with Merga just off the back. That 5km segment from 25km to 30km, taking in the Newton Hills, was covered in 15:28, but the damage was really, at least from the helicopter shot, done in about 1km.

The men have once again settled into a pretty conservative pace.  The group of six are not attacking one another anymore.  The final 5km will be dramatic.  They really have been jogging for much of the race.  We are so used to seeing paced efforts, it's almost funny to watch the shut down as they build to that surge.  I just hope they show the attacks because they will be incredibly aggressive.

The 5km split from 30 to 35km were covered in 15:59, incredibly slow.  Anyone bet that the final 5km could well be done in under 14 minutes?

Yes, as expected, we have missed the start of the surges in the men's race.  Well done Boston Marathon TV production, excellent decision to finally get rid of the split screen at the very moment that one of the race's decisive surges came.  Outstanding.

And of course, we will now wait to see all the top 10 women come in while a good men's race happens somewhere on the streets of Boston.  And people wonder about the waning popularity of road running...

Right, back on it.  At 40km, there are three men together.  Gebremariam, Desisa and Kogo.  The two favorites and the debutant with the most recent track pedigree.  No attacks among the three in the last five minutes.  I'm surprised that the field has been narrowed to only three at this pace, which really is slow (2:10 projected).

Desisa has it.  A break with less than one kilometer to go first shed Kogo and then Gebremariam as they turned left into the final straight.  Kogo recovered to get second, with Gebremariam in a cramping third place.  The winning time was 2:10:21, slow for a relatively cool day given what we have become accustomed to seeing, but a refreshing tactical race.

Women's Race

Additional thoughts:

At 20km, Caballero of Colombia is well clear of the chase pack.  The commentators seem to think that her lead is potentially decisive.  I'm not sure if they are trying to hype it up for the viewers, but it's very obvious that the pack have permitted her the lead.  The pace from 15km to 20km has not even increased, which tells that the gap is there because the elite women don't care to keep it down and are clearly not interested.  The break is clearly under control.  Commentary is missing a good race.

Now Ana Felix of Portugal has assumed the lead.  Similarly, she is only there by "permission" of the elite who I would expect will run the second half in between 70 and 71 minutes.  Any lead less than about 4 minutes at this stage is not enough.  Projected winning time at this stage is 2:28 but the race will be won in 2:25, and the winner will come from the chase pack.

Ana Felix's lead continues to grow, with 12km to run it is about 1 minute.  The elite field have yet to show any desire to attack one another, perhaps waiting for the hills to end.  Her lead with 10km to run will about one minute, and one would expect the top women, attacking one another, to cover that in around 33 to 34 minutes.  Can Felix run a 34 and win?  Time will tell.  Strange that none of the chasing women have shown intent.

Felix's gap is dropping.  With 7km to go it is just over 1 minute.  Major intrigue, the elite field requires 10 seconds per kilometer to make the catch.  The last 5km for Felix was slower (17:42, so 3:32/km), but it did include Heartbreak Hill.  The real action is behind, where Jeptoo has taken the lead and is driving hard.  As I expected, once the elite women woke from their slumber, the gap could fall dramatically.  You can expect 3:15 to 3:20 for the elites, and so Felix's 3:32/km will not be enough.

With 5km to go, it's pretty clear that the catch will happen.  The gap has been cut by almost a minute in the last 4 or 5 km.

Jeptoo has won the race between 35km and 40km with some impressive running.  Having assumed the lead, she stretched it out and dropped first Cherop and then Hailu of Ethiopia.  Her lead is growing all the time, thanks to a 16:56 last 5km.

The Kenyan success genetic controversy

Kenyan success: Genes, method and controversies

Earlier today, I tweeted two articles of interest tackling the question of whether Kenya's incredible distance running success is genetic or training-related.

The first article, from the Atlantic, takes the genetic view, while the response from a Kenyan paper is quite offended at the suggestion, and attributes their success to method, which includes the usual combination of training, altitude, system, etc.  I won't summarize the articles here, but would encourage you to have a read on what is quite a controversial topic.

I recall this controversy from a year or two ago, when I wrote some articles about innate ability.  Then, my specific purpose was to address the fallacy that anyone could become a champion with 10,000 hours of practice, and the discussion moved into one of genetic factors that predispose individuals to success in sport (or activities like chess and darts, for that matter).

I received some fairly angry emails, I think from Kenyan readers, who take offense at the suggestion that their runners may have some genetic advantage as long-distance runners.  I think much of this controversy comes from the all too typical error that people make when they polarize a debate into an "either/or" situation, and fail to recognize how complex factors must interact with one another.  In my opinion, the issue is pretty straight-forward, and I've not really fully understood why it evokes such hostile responses.  My brief take on this issue is below.

Upcoming review - more on the science of the genes and why studies have thus far failed to find "the gene"

While I'm on the subject, I will soon have a review article published in the British Journal of Sports Medicine on this very subject.  It was invited by the journal as a follow up to a review I had published last year, called "What makes champions? A review of the relative contribution of genes and training to sporting success".

On that occasion, I co-wrote with Prof Malcolm Collins, a geneticist, and we tried to explain the essential role of BOTH genes and training on ultimate sporting success.  The 10,000 hour concept holds little water when evaluated scientifically, but is a nice way to get people fired up to train more.  Similarly, genetics cannot explain sporting success entirely.  To disregard either is to provide a false explanation and the ultimate conclusion is that training should be defined as the realization of genetic potential.  Alone, each is insufficient, and it is the right training applied to the optimal genotype  that produces world champion caliber performance.

For this latest review article, I was asked to delve more deeply into the issue, and the question of Kenyan running is just too intriguing to pass up.  So, I teamed up with Prof Collins again, and this time added another colleague, Dr Jordan Santos, who did his PhD studying North African and Spanish elite runners, and is now looking into East African running physiology.

We wrote a paper that has just been accepted, and once it is available, I will certainly describe it in more detail and send out links for those who are interested.  The paper describes the current science of the genes in East Africans, and we explain why those studies have thus far failed to find the performance gene.  It is a technical and conceptual failure, one where the research has, in our opinion, looked in the wrong place for the wrong thing.  We propose a theory for Kenyan success that IS genetic, but which is not unique to Kenya, and which does not in any way exclude the method and system they can rightly credit with their success.  More on that soon.

Today, briefly, and since it is topical thanks to the above-linked articles, this is a summary of that review paper, which represents our thinking based on where the science of this matter stands today:

Unlikely a unique gene

• First, and perhaps most important, if you are looking for a specific gene or gene variant that Kenyans possess, and which no other athletes have, then you may be be looking for a long, long time.  It is improbable that a) a single gene variant will explain something as complex as running physiology, and b) only one population in group in the world will possess this unique variant.  That said, until the entire genome is understood, it remains possible that a variant or combination of gene variants unique to a population in East Africa is the 1% difference between a 2:04 marathon and the 2:06 we see from elsewhere.  But it is unlikely, in my estimation.
  
  
  
• Instead, if there is a genetic basis for performance, it will be polygenic (think hundreds, if not thousands of genes), which exist in the optimal combination for an individual to be predisposed for sporting success.  Crucial to realize is that this individual could be found anywhere in the world.  Among the billions of people in it, there will be individuals with this 'endurance favored genotype' in every population.  There may be more in some populations than others, but chances are that a genetic advantage is NOT unique to one population only.  Therefore, Kenyans are not likely to be unique or possess unique genes.  This does not mean there is not genetic advantage, however.
  
  For instance, if we take the very simplified view that Kenyans are great runners because they have longer legs, shorter torsos and skinny calf muscles (this is part of the explanation put forward), then I guarantee that there are thousands of adults in the USA, UK and here in South Africa with that same structure and hence advantage.  It is not unique to Kenya.  However, this does not mean that genes do not contribute, as I shall explain shortly.
  
  
  
• Once a collection of factors are identified, they must be exposed to the optimal environment in order to be "expressed".  And I'm not talking gene expression here (though this is part of it, literally).  I'm talking more about the ability to identify, nurture and then develop whatever innate ability is there.  In the absence of the right environment - the coach, the competition, the system, the culture - any genetic advantages will never be identified or realized.  Therefore, a method or a system is just as crucial as genes

It may be about prevalence, not presence

• Now, where this leaves one is with a combination model, that says that genes ARE important, but so is the application of training and hard work to them.  If now one looks at the Kenyan population, there are only two possible theories available:
• Kenyans have exactly the same probability as the rest of the world's athletes of becoming elite, but the difference is in the system.  This is the theory of the second article I linked to earlier.
• Kenyans have the same types of genes, nothing unique sets Kenya apart, but...the prevalence of these favorable genetic factors is greater in this population.  The result is that the same system applied to 100 people in Kenya and 100 people in say, the UK, will produce a different result, because the "raw material" is different in the different populations.  There may be a greater probability of discovering champions in Kenya, not because of the presence of a gene variant, but rather its prevalence among the population
  
  
  
• Differentiating between these options requires large scale genome wide association studies on huge numbers of the respective populations.  It comes with many strings attached - the interpretation of genetic differences across ethnic groups is fraught with difficulty.  It is impossible at this stage to conclusively link a particular gene variants, or even a panel of gene variants, to performance, though some breakthroughs have been made.  For instance, it was recently found that individuals who had 19 or more of a panel of 21 SNP (single nucleotide polymorphisms) were high responders to training, wherease individuals who had 9 or fewer of these 21 SNPs were poor responders.  I think it's fair to say that Olympic champion runners would come from the first group, and thus possess 19 or more of these identified SNPs.
  
  That's the approach that will further unlock understanding of the genetic basis for performance.  If I had to commit to a hypothesis, it would be this:  
• Within the Kenyan population, and specifically, the Nandi sub-tribe of the Kalenjin tribe (this group, incidentally, makes up 3% of the Kenyan population, but make up almost half of their great international runners), there will be a higher prevalence of favorable gene variants or genotypes than in a population from another country.
• The result is that the application of the same training stimuli, plus the environmental factors and culture, will result is a greater emergence of international caliber runners from this population.  For every 100 people, there exists a greater probability that an elite athlete will emerge from the Kenyan population than a similarly aged population in say, Australia or America
• On top of this, add the fact that the environment in Kenya (and East Africa) is uniquely suited to distance running.  The people, the culture of running, the history of success, the altitude, diet, economic factors and 'system' ensure that in Kenya, the training environment is unlike any other in the world.  This is why so many athletes go to Kenya to train - their system is 'best of breed'
  
  
  
• So, when you combine this training environment to a theorized prevalence model for genetic advantage, it is not difficult to see the origin of statistics that are so often quoted to support the Kenyan dominance - 20 of 25 Boston champions, 7 of 8 London champions and the top 25 times in the marathon world two years ago.  These are the result of BOTH genetic and training related factors, but it is unlikely to be a unique gene that is found only in Kenya.  The rest of the world therefore is not destined to be beaten (as Galen Rupp and a number of Americans have shown), but they have to work a lot harder on a system-wide level to identify those athletes with the potential to be competitive, and to expose them to the right environment (without a host of other distractions, which arguably compromise the success of runners).
  
  Think of the mining analogy - there are some places in the world where you can pick valuable metals off the ground.  In others, you have to prospect, consult geologists, and invest heavily to dig deep into the earth's crust to extract those valuable materials.  Kenya may just be, genetically speaking, the richest natural source of talent.  But they also mine it more effectively, and that combination is the secret to success.
  
  
  
• Finally, I do not see any genetic argument in any way undermining the achievement of a nation like Kenya.  To suggest that they have some advantage is not to say that they have done any less to earn their champions and medals.  I think this is the root of the controversy, and it's a pity because it comes from a polarization attitude that seems to believe that if you have one, you don't need the other.  When I am watching Boston, or Rotterdam, or London, over the next week, I will be in awe of men running 2:05 and women running 2:20, not because they are genetically superior in any way, and not because they train hard, but because they have it all, and they're maximizing natural and hard earned talent.  That's worth celebrating.  And understanding.

Of course, this is all just hypothesis generating thought.  The studies will come in time, and perhaps we will one day discover a unique gene in East Africans, and another in West Africans or Jamaicans that makes them such amazing sprinters.  Or perhaps we'll discover no differences at all.  Regardless, I can't see how either extreme position (it's all genes, or it's all training) is defendable.  It must be, as I've now written often, the realization of genetic potential through training that produces those great performances.

Thoughts welcome!

Ross

The thyroid medication debate: Is it doping? Brief thoughts

Does the use of thyroid stimulating hormones in athletes cross a doping boundary?


Early today, I tweeted a link to a really thought-provoking investigative piece from the Wall Street Journal.  It describes a USA-based doctor, Jeffrey Brown, who treats a number of athletes for hypothyroidism, which he describes as a condition that afflicts endurance athletes as a result of their high training volumes and intensity.  It's an excellent article, and well worth a read before you read on.

Without going into every single intriguing question raised by the article (there are many - the validity of his claim that hypothyroidism is common among athletes is questioned, as is the performance benefit of the drug), I thought I'd share some very brief thoughts on it below.  This is, as always, a first word on a debate and I welcome thoughts and comments below!

Brief comment

When reading about the medical use of drugs in athletes, the most obvious and impulsive parallel to draw is asthma, for which athletes can get TUEs (therapeutic use exemptions) to use steroid-containing inhalers to restore "normal" function and compete fairly.  It's been suggested that within the athletic population, the prevalence of asthma is higher than in a typical sample, and that's not a triumph over adversity, it's more likely the manoeuvring of athletes within the grey areas of doping control!  The same is true for some other drugs - Armstrong's corticosteroid TUE in 1999 comes to mind.  Lionel Messi and HGH as a child is another.

With thyroid hormones, however, I feel that the situation is subtly different, because the allegation (in the WSJ article, anyway) is that it's the training that causes the condition to begin with.  That's not the case for asthma, which is an existing condition, admittedly worsened by intense exercise, but not a direct consequence of exercise participation and training.

In effect then, in the case of hypothyroidism, the athlete requires the medication because they behave as an athlete - they train hard.  They generate the condition, and the drug permits harder training, and that to me does cross the line of fairness.  I see no distinction between this and the use of testosterone or other hormones to ensure that recovery is optimized.  Similarly, blood doping or other methods to manipulate blood could be justified as means to help the body recover from the arduous training required to compete as an elite athlete.  After all, the chronic effects of a three-week stage race like the Vuelta Espana on hormones are known - for instance, testosterone and cortisol decrease significantly - this is the result of the stress of competition.  These changes could arguably be treated, with valid and credible physiological benefits, by the administration of drugs.  I do not see the difference between this situation and the use of any other medication that directly stimulates hormone production by the body.

Of course, this introduces a slippery slope, one that those of you well versed in the doping debate will be onto right away.  If these types of interventions are banned, then why not similar interventions that improve recovery, including diet?  This is where the debate gets progressively greyer, and in lecturing students today, it came up as a very important question.  It's not a leap of logic to go from a position that allows some things to allowing everything, or vice-versa - if you can't use X, then you shouldn't be allowed to use Y.

I have no definitive answer on this, only an opinion.  That is the opinion that part of becoming a world-class athlete is the ability to respond to high training volumes.  In an almost "Darwinian" manner, training is the stress that sorts out the fittest from the fitter (the fit and unfit have long ago been filtered out by performance level and lack of, for want of a better word, talent!).

Therefore, if an athlete is subjected to a training load X and intensity Y, their ability to respond to that load with improved physiology and performance, without breaking down sick, overtrained and injured, is crucial for their ultimate performance level.  If they cannot adapt, and break down, they become sick and overtrained, and fail to reach the same levels as the responders.  The athletes who require medical assistance that nudges their hormones levels up to restore them to levels typical of a non-training individual are benefitting from an unnatural practice that DIRECTLY changes hormone levels.

Of course, I must stress that the aetiology and presence of the hypothyroidism introduced in the WSJ article (link below for more) is debatable to begin with, but it would seem to me to be part of the giant complex puzzle that goes into producing an elite athlete.  It's also debatable whether the administration of thyroid stimulating drugs benefits performance.  One IOC source quoted in the WSJ piece claims that it is more likely to inhibit than enhance performance, and so clearly studies are required.  Studies are also required to understand if it is harmful.  However, in principle, I cannot see how the prescription of synthetic thyroid hormones to help athletes cope with training differs from the administration of steroids and blood-manipulating drugs and methods that are already on the list of banned substances and practices.

I'm sure there will be widely differing opinions, and I welcome them all.  I'm certainly well aware of the "hypocritical" position one can adopt when saying one practice should be banned but not another.  Indeed, we've had the debate about the legalization of drugs in sport many times right here.  This is yet another grey area in that debate.  Your thoughts are welcome.

For a start, the thoughts shared here by Letsrun.com's Weldon Johnson are interesting, well framed and include quotes from inside the sport of athletics.  They also discuss why thyroid hormones may benefit performance, as well as safety.  I echo these sentiments, and further discussion is certainly required

Ross

Late addition:  

In posting on our Facebook page, the following occurred to me, so I'm sharing it below.  Related to the above, but to add a dimension from an old subject - females and testosterone.  It's about what we are born with, to some extent.  Some are just luckier than others!

Here's that post:

One final thought on the thyroid hormone issue, and I have to raise the ghosts of female/gender issues in sport. There are some "conditions", which are not really conditions, but rather normal variations in hormones that preclude certain individuals from succeeding in sport. For instance, a study by Cook et al showed clearly that female athletes with higher testosterone levels were elite, and those with lower levels were not (link in comments section below)

Such is life - you have it, or you don't. In some instances, those who have it become elite, those who do not, well, they become enthusiasts. Now, I am totally sympathetic to the fact that there are individuals who genuinely are affected by hormone imbalances. Hypothyroidism is real. As is hypogonadism in males, and a variety of other conditions.

But when it comes to elite sport, there's a certain element of luck in the genetic "lottery" that determines who becomes elite and who does not. I could, for instance, reasonably argue, that aspects of my physiology are inferior (compared to say, Usain Bolt's) and that the appropriate intervention by a doctor with some questionable ethical standards is all I need to join the ranks of the elite. In reality, it doesn't work this way, but I illustrate a point, which is to say that biological variation is part of what we celebrate when we crown an Olympic gold medalist!

And part of biological variation is the baseline physiology, as well as the adaptation to training, and the 'hardware' we take into an athletic career.  That is refined by training, but only when the training response is positive - that, in turn, is part of the physiology.  Some individuals cannot achieve the same success without medication and that to me puts this practice over the line of fairness.

Now, ideally, we will develop a way to clearly identify whether a person has developed hypothyroidism because of a genuine medical condition, or whether it is training related. As I've said in the article, when it's training related, I cannot see how the use of synthetic hormones can be justified. And given that this ideal situation is unlikely to exist, as much as I want to see a solution for all, I cannot. And thus, thyroid hormones should, in my opinion, be banned, unless it can be clearly shown that they have no performance benefit (which it can't because if they allow training in a fatigued individual, then the comparison must be with an athlete not training, and that's a clear performance benefit).

Ross

The low-carb, high fat diet debate and deviant thinking

The low-carb high fat diet debate: Three videos, and thoughts on polarized views and 'deviant' thinking

One of the hot topics in exercise science and diet is the low-carb, high-fat diet concept, now backed vocally by Prof Tim Noakes in South Africa.  In December, he and Prof Jacques Roussouw debated the dietary guidelines with respect to cholesterol and its impact on heart disease, and a video of that debate can be found below.  The low-carb diet echoes other topical issues in exercise science, perhaps most notably barefoot running, in that it polarizes opinions between two opposing camps.  It then strays into 'rules' and over-simplifications, which are arguably incorrect.  Here's how to 'pole-spot' and embrace complexity, along with the low-carb debate

- Ross Tucker

In the course of a debate on doping and cycling a few years ago, a certain well-known exercise physiologist who had tested and defended Lance Armstrong publicly dismissed Jonathan and I as "newly-minted scientists".  True, of course, since we had both obtained our qualifications within four years of him writing those words.

He intended it as disrespectful at the time, suggesting ours was an opinion not worth listening to because we did not have 300 years of experience (and about as many conflicts of interests, I'd add) behind us.  I always viewed "newness" as a distinct advantage, because it brings with it some aspect of novelty, a new way of approaching an old problem.  That's often lacking in science and in many areas of life (coaches, managers, I'm looking at you!), and as I've evolved from newly minted to (recently?) minted, I've come to recognize that progress usually comes from forcing a novel view.  

Deviant thinking and innovation

I recently spoke to a group of financial consultants about the lessons I have learned about high performance teams from my involvement with sports teams and athletes, and one thing that I tried to re-inforce, in business and in sport, is that progress is the result of so-called deviant thinking.  By "deviant", I mean that person who pushes back against convention, who asks the apparently ridiculous questions and forces others to rethink their positions of comfort.  Deviants make us anxious, but they also drive innovation.

If we are allowed to drift along with the current, we never challenge paradigms.  Jonathan and I were both fortunate that our post-graduate training was overseen by Prof Tim Noakes, who is not newly minted but has retained the capacity to challenge current beliefs.  He is a scientific "deviant", in the most complimentary sense of the word.  In so doing, he has driven a change in perceptions around fluid intake and dehydration during exercise, and also has contributed to our understanding of fatigue and the role the brain plays in performance regulation.  These topics were, respectively, the subject of Jonathan and my PhDs, and so we have inherited this desire to push back against convention, hence the existence of, and many of the approaches and articles on, this website.

The low-carb high-fat diet debate

The latest area of Noakes' interest is diet.  Specifically, he is a vocal proponent against carbohydrates and processed food, arguing for a high fat, low carb diet.  In South Africa, it is impossible to give a presentation on exercise and health without some member of the public asking about Noakes' dietary views and their implications for exercise, weight loss and health.

However, it is not a topic whose specific content and details I am comfortable dealing with.  I am not an endocrinologist, nor a cardiologist, nor a dietician.  I understand the basics, but in the same way that my driver's license does not entitle me to tell Michael Schumacher, Sebastian Vettel or Jimmie Johnson how to drive, I would not presume to educate or correct the experts on diet and cardiology - I might ask them a few pointed questions, of course, and challenge their thinking, but there's a line that I wouldn't cross in terms of dictating to them.  I have not dealt with people struggling to lose weight, and have not encountered the very real, practical challenges they face.  I do not have a lifetime of expertise evaluating research studies on heart disease, though I can appreciate how many 'holes' exist in current thinking.  Nor have I devoted any length of time to evaluating the respective sides of this particular debate.

And so I won't delve into specifics, at least not now.  However, in order to make the debate as widely accessible as possible, which is important, I want to share with you three videos.  They are taken from the University of Cape Town's Centenary Debate, held last year in December, where Prof Tim Noakes and Prof Jacques Roussouw debated various aspects of the high fat diet.  The focus is very much on cholesterol and its links with heart disease.  The videos are long, but worth watching when you have the time.  I'd love your feedback, your thoughts on who "won" the debate and what it means for our understanding.  Those videos are at the bottom of this post.  

Thoughts on scientific concepts and complexity

But first, my view on this whole debate, without delving into the specifics.  My biggest "objection" as it were, is not to the content of the debate, but rather the manner and justification for each side's respective positions.  Below is part of a presentation I gave to the public last year, and in it, I mention two examples of how scientific progress and application to the public can be undermined by the natural, human desire to simplify the message and adopt a polarized view of what are actually very complex concepts.  (Click here if you are reading this in an email)

The first is the 10,000 hour concept for expert performance - a great theory, wonderful to motivate parents and young athletes about the value of training, but a pretty useless theory in practice - in sport, it hardly ever applies.  The second is barefoot running, which has been taken and transformed into a cure for everything without any evidence.  

Polarized science, rules and a wildly swinging pendulum

The result of these kinds of debates is a polarized science, one where the pendulum swings wildly from one extreme to the other.  We go from "Practice is the only thing" to "Genes are the only thing" and back.  Or from "Barefoot running will prevent all injuries" to "Barefoot running is a fast-track plan for physical therapists".  Neither is true as a "rule", though within any population, there will be those who succeed at the extremes, and those who fail.  That of course introduces a huge confirmation bias, because every success story is held up as "proof".  It also leads to cherry-picking, because anything not supporting the pole has to be ignored.  Those who advocate for those polarized positions must recognize that they are pulling everyone to the sides, where they may not belong. 

The same is true for diet and metabolism.  The reality is that we are dealing with complexity in physiology that can't be explained by one theory, and an obesity problem that does not have one solution.  Biological complexity dictates that what works for one will not work for another, and that's what coaches figure out very early with athletes, and dieticians learn empirically with clients.  The idea that shoes are bad is just as wrong as the idea that shoes are essential, because in any population, either could be true for some people.  These kinds of over-simplifications are damaging because they polarize understanding in a way that benefits few, introducing dogma that is then disseminated to the detriment of many.  And that is the point I make in the presentation above.

So, how is this relevant to diet?  Well, the same things I see from the barefoot debate appear to be happening in the dietary debate.  Conventional wisdom is challenged, and rapidly leads to the formation of two opposing camps, whose idealism is so at odds that the poor people in the middle, who are ultimately the "end users" of the information, are caught in a figurative stretching rack, being pulled in opposite directions by 'extremists'.  If it is difficult for experts to agree, then imagine how complex it becomes for those in the middle.

The problems at the poles

Science is never black and white.  It's one of the first lessons I learned, and have relearned weekly since.  Does dehydration impair performance and health? Is fatigue the result of chemicals in the muscle?  Is barefoot running safer?  Does cholesterol lead to heart disease?  There is no such thing as a straight-forward answer to any of these questions, and so a single extreme view is invariably wrong.  

It then becomes more about "how" the message is communicated, and not "what" is being said.  That is, the content of the deviant view almost always has value - the barefoot running concept, for example, may be incredibly helpful to many runners and I would strongly support that everyone take something from it.  On the other hand, there may be people who simply cannot succeed barefoot.   

What then tends to happen is that the polarized camps become almost obnoxious about their view, blaming everything but their view for the obvious failure to succeed 100% of the time.  If you are injured running barefoot, it's your fault, for instance, and its advocates seem to show no awareness that they are making exactly the same mistake as they accuse shoe companies of making before them.  It is that aspect of the debate that is most off-putting, and I find the same true in the carbohydrate debate.  The justification for a given position becomes more and more 'radical', and eventually, it is based on anecdotes, resembling a series of TV infomercials promising "more".  

Polarization also introduces a risk of weak scientific interpretation, and I've seen examples recently where an association study is dismissed as weak and unreliable when it suggests that carbs are important, only for the same type of association studies to be used as "proof" when they support the desired viewpoint a day later.

Ultimately, there is without doubt truth in any deviant view, but there is also a problem with the idea that the scientific pendulum should swing all the way from its current position to an entirely new one.  With respect to the carbohydrate debate, there is no question that Noakes has, like those advocating for it before him, contributed to many success stories and positive changes as a result of diet.  And by opening up the kind of debate you see below, he has potentially created enough "scientific anxiety" that it will stimulate a whole new area of research that will ultimately help advance our understanding of how INDIVIDUALS respond to different macro-nutrients, and hopefully reduce the obesity epidemic we face.

But in all this, and in debates about shoes vs barefoot running, and talent vs training, and methods of training and so on, don't feel compelled to pull the pendulum to the other extreme - remember, that's what you're suggesting others have done wrongly before!  There's no such thing as "we were 100% wrong before".  We just weren't 100% right, and it's the contribution of deviants who help us see that.  But stay away from the poles.

UCT Centenary Debate: the cholesterol debate

Right, so below is the debate.  It's one long video, divided into three chapters:

1. Prof Tim Noakes introduces his theory (35:43)
2. Prof Jacques Roussouw responds (43:21)
3. Questions and discussion with the audience (51:05, but probably the most interesting aspect)

To compliment the video, you may also want to view the presentations (it's not filmed very well, have to say):

View Prof Noakes' presentation
View Prof Roussouw's presentation

Feel free to comment and share your views.  Again, I'm not going into specifics, it just isn't my place and feels disrespectful to people who arguably know more than I do about this, but gladly debate the manner of the debate and the way ideas are communicated!

Ross