Nick Norwitz: an athletic diet?

by Mani Malagón · Published September 29, 2020 · Updated January 6, 2023

The Metabolic Multiplier team would like to welcome Nick Norwitz aboard. Nick is a great combination of a brilliant mind with a caring heart. His roots are in South Africa and his growth has been fueled by athletic competition—from high school endurance athletics to becoming the youngest time-qualified competitor for the 2014 Boston Marathon. Nick completed completed his Doctor of Philosophy (Ph.D.) at Oxford University. Currently, Nick is pursuing a medical degree at Harvard Medical School. He’s passionate about “Food as Medicine” because his health and illness have revolved around nutritional choices. Let’s meet Nick.

Nick Norwiz raises money for charity by doing hand pushups. — When Nick was 14, he endeavored to break his high school’s push-up record of 72. As a freshman, he did 240 push-ups in a single set. The next year, he broke his own record, doing 344 pushups in one straight set, lasting 18 minutes, and used the effort to raise $2,000 for a South African charity, Ikamva Labantu. By the end of high school, Nick had the Massachusetts state record of 427 consecutive push-ups. By this time, Nick had also won his division in 7 half marathons and one marathon, and was the youngest time qualifier for the 2014 Boston Marathon.

Nicholas Norwitz MD PHD Keto diet Osteoporosis Ulcerative Colitis Inflammatory Bowel Disease — When Nick was 14, he endeavored to break his high school’s push-up record of 72. As a freshman, he did 240 push-ups in a single set. The next year, he broke his own record, doing 344 pushups in one straight set, lasting 18 minutes, and used the effort to raise $2,000 for a South African charity, Ikamva Labantu. By the end of high school, Nick had the Massachusetts state record of 427 consecutive push-ups. By this time, Nick had also won his division in 7 half marathons and one marathon, and was the youngest time qualifier for the 2014 Boston Marathon.

You can watch young Nick in high school pushing the limits: Nick Norwitz Crushes Push Up Record: The Body Achieves What the Mind Believes, Patch, accessed 29.9.2020

Nick uses sugar & carbs as fuel

If you recall, there was a time when Dr. Tim Noakes advocated carbohydrate loading in his Lore of Running before he had to face his own diabetes. In a similar fashion, Nick based his athletic prowess on a “healthy” low-fat diet consisting of large portions of fruits, starches, and supplements. But, in his own words, “as healthy as it seemed to me at the time, the human body wasn’t built to eat dates, Jif™ peanut butter, and energy bars.” He held to the popular notion that exercise conferred protection against dietary indiscretions. He was unaware that his lithe body was not just performing at its limits, but was metabolically unsound. As he puts it,

I did not realize that underneath my hood was not a well-oiled engine, but a weak metabolic candle burning at both ends.
Nick Norwitz

Norwitz goes from hoping to lead the pack to hobbling on crutches

Then in February 2014, after becoming the youngest qualifier for the Boston Marathon, the unexpected happened: a stress fracture in his right leg! Nick’s determination and grit came to the fore and he completed the Boston Marathon on a pair of metal crutches. But physical and mental courage were not enough to prevent his body from further disintegration. By age 20, Nick had suffered eight different bone fractures and the diagnosis of osteoporosis (T-score = -3.3).

The subject had no history of fractures until age 18, a year into a career in competitive distance running. As he continued to run over the following 2 years, his mileage threshold to fracture steadily and rapidly decreased until he was diagnosed with severe osteoporosis.
Norwitz, N. G., Mota, A. S., Misra, M., & Ackerman, K. E. (2019). LRP5, Bone Density, and Mechanical Stress: A Case Report and Literature Review. Front Endocrinol (Lausanne), 10, 184. https://doi.org/10.3389/fendo.2019.00184

Years of lab tests and medical workups by multiple doctors finally revealed that Nick’s disease was due to an interaction between his genetics and lifestyle, including his “good” (in reality bad), nutrition.

Damaged bones & leaky gut in Nick’s young body

Physical deterioration and a decline of Nick’s health continued apace when he was diagnosed at age 22 with ulcerative colitis, an inflammatory bowel disease (IBD). “Nobody really knows what causes IBD,” says Nick.

However, we do know that IBD is associated with a

messed-up gut microbiome and Westernized diets.
Nick Norwitz (added emphasis)

The Norwitz heart starts to fade

Nick’s condition was not improving. In fact, his overall health was spiraling downward. Despite the continual failure of the prescribed nutritional intervention, it was the only advice given. That prescription was to “follow the nutritional advice set forward by the standard healthy eating guidelines.” Then Nick was hospitalized for three days with bradycardia of not just a few beats below the 60 beats per minute (BPM) diagnostic cut-point, but an alarming heart rate in the 20s! As he languished in torpor, it seemed that medical and nutritional approaches to heal his failing body were as listless as he.

Nick’s shot in the dark: a ketogenic diet

The search for a lifestyle that would eliminate his body’s inflammation and put his colitis into remission continued for two years. Nick tried eleven different diets recommended by well-meaning healthcare providers. None worked. In desperation, he finally took the advice of a contrarian doctor, Dr. Vyvyane Loh, and adopted a high-fat, low-carb ketogenic diet.

It was so counter to what I ‘knew’ to be healthy. At that point, though, I had no expectations, therefore I also had nothing to lose. The effect was incredible. Within a week my colitis symptoms were better, my inflammation lab markers had dropped to their lowest ever, and I was more energized and happier than I had felt in years! Eventually I stopped my medications for colitis and the disease has remained in remission.
Nick Norwitz (added emphasis)

Podcast You cured what?! Ep. 13, Ulcerative Colitis, Osteoporosis

Evidence based dietary guidelines

As Nick delves deeper into bio-energetics and nutrition he reminds himself: “My personal experience with keto made me take a hard look at the scientific literature on nutrition. The fact that the best evidence did not support standard guidelines suprised me.” But he also notes that a ketogenic diet is not a cure-all silver-bullet. “I want to be clear,” Nick asserts, “my first run at a ketogenic diet did not transform me into the pinnacle of health. While I was better, better isn’t optimal.”

Incidentally, changes in his serum lipids that would be considered adverse by current standards were noted. A more critical analysis of his lipid profile suggests that the changes he experienced may not be dangerous and may, at least with regard to several parameters, represent improvements.
Norwitz, N. G., & Loh, V. (2020). A Standard Lipid Panel Is Insufficient for the Care of a Patient on a High-Fat, Low-Carbohydrate Ketogenic Diet. Frontiers in medicine, 7, 97-97. https://doi.org/10.3389/fmed.2020.00097 (added emphasis)

Nick’s N = 1 experimentation

“I became greedy for optimal health. By experimenting on myself, I’ve been able to asymptomatically creep towards what is optimal for my personal biology.”
If he had one piece of advice to share about nutrition it would be:

I am increasingly impressed by how much remains to be learned and revised about nutrition and by how potent food is as a medical tool. I know nutrition can be confusing when there is so much different advice out there. But it’s also a worthwhile personal journey.
Nick Norwitz (added emphasis)

What’s Nick up to now?

While completing his Oxford doctorate (Ph.D.), Nick published twelve papers related to metabolism and health; worked on developing a nutrition tracking application to facilitate nutrition science research; started teaching “Food as Medicine” as a Harvard Medical School elective; and, co-authored a science-based keto cookbook for release 9 March 2021.

In July 2021, Nick started his medical studies at Harvard Medical School.