Tim Noakes on trial: Daily updates from South Africa

***UPDATE: On Friday 28 October, the HPCSA released a statement which “incorrectly stated” Noakes had been found guilty of professional misconduct. This statement has since been retracted.

The “Nutrition Trial of the 21st Century” resumed this week as Professor Tim Noakes continues to answer a charge of unprofessional conduct made by the Health Professionals Council of South Africa (HSPCA).

What began as a tweet way back in February 2014 has evolved into a three-year on-off trial that has highlighted the politics of food and thrusted the low-carb diet into mainstream news coverage.

Noakes, a world-renowned South African scientist, is being charged for “giving unconventional advice on a social network (Twitter)”.

He is accused of acting unprofessionally by advising Pippa Leenstra to wean her baby onto a low-carb, high-fat (LCHF) diet. Noakes said on Twitter: “Baby doesn’t eat the dairy and cauliflower. Just very healthy high fat breast milk. Key is to wean baby on LCHF.”

Noakes, the author of The Real Meal Revolution, which advocates the benefits of a low-carb diet, has argued that he was trying to discourage the mother from feeding highly-processed breakfast cereals to her child.

The trial began, after much delay, in November 2015. It then resumed in February 2016. And now, nearly three years after the tweet that started it all, Noakes is once again facing the HSPCA this week in what is expected to be the final chapter of this saga.

We’ve been keeping a watchful eye over proceedings; here are some of the key developments so far in Cape Town.

MONDAY 17 OCTOBER:

The HPCSA’s legal team objected to three expert witnesses giving evidence. These witnesses are UK nutritionist Dr Zoe Harcombe, US science journalist Nina Teicholz and New Zealand-based dietitian academic Dr Caryn Zinn. All three are low-carb experts and have been dubbed “Tim’s Angels” by Noakes supporters.

Committee chairman advocate Joan Adams dismissed the HPCSA’s objections, confirming the witnesses would be called to testify over the next eight days. Noakes was then able to stand to present his evidence in chief.

Noakes presented research he co-authored which found that the number of study participants suffering from metabolic syndrome dropped from 58 per cent to 19 per cent after six months of them being on a LCHF diet.

He told the committee: “The high-carbohydrate diet they were eating (before) was the cause of their metabolic syndrome. This is an irreversible condition, and we reversed it, by putting people on a diet we are told is dangerous.”

Noakes added he thought it was strange that the complaint against him had not been from Leenstra, but Claire Julsing-Strydom, a past president of the Association for Dietetics in South Africa (ADSA).

“I would argue the reason she complained was because of the effect of the publication of The Real Meal Revolution. The complaint was lodged three months after its publication. What fired up the complainant was that we wrote a book and she took exception to that book. I provided an opinion on weaning and not breast-feeding. I am being charged for something I did not say,” he said.

TUESDAY 18 OCTOBER:

Noakes continued giving evidence, stressing his advice was conventional, and that the low-carb diet is “completely compatible with the South African dietary guidelines”.

He also said that he never discouraged Leenstra from breastfeeding – in his book, he encourages mothers to breastfeed their children until the age of two – but conceded he did not know the answer to her question if dairy and cauliflower caused wind in babies. Noakes reiterated that he had been encouraging Leenstra to wean her child onto “real”, healthy LCHF foods and not grains, and while he is not a specialist in paediatrics or dietetics, he is an expert in nutrition.

WEDNESDAY 19 OCTOBER:

Noakes, an A1 rated scientist, is forced to defend his qualifications as he is cross-examined by Health Professions Council of SA (HPCSA) advocate Ajay Bhoopchand.

“I have an obsessive compulsive nature to find answers,” said Noakes. “I am highly critical of myself and judge myself against top in the world. I look for information. I want to be the world’s best LCHF expert.”

Noakes added his “educated ignorance” means he did not realise the science behind the effectiveness of a LCHF diet has always been there, and the “scales fell from his eyes” when he immersed himself into studying it before becoming a leading expert in the field.

THURSDAY 20 OCTOBER:

Noakes makes two significant statements; the first of which is that all published research literature on nutrition is funded by industry and is profoundly biased. Noakes said: “For 33 years, I couldn’t see my bias. I like to think I am an extremely ethical person, but I couldn’t see it.”

He then went on to say how the hearing has cost him and the HPCSA millions of rands (South African currency), even though he “did not harm anyone”, adding he “was not dealt a fair hand”. He believes he has been targeted because of his celebrity status and stated again that the LCHF diet is not dangerous.

Noakes also revealed that his foundation has been working in lower income communities in a bid to make the LCHF diet more affordable to those of lower socioeconomic status.

FRIDAY 21 OCTOBER:

Harcombe began giving evidence late in the day, albeit for 45 minutes. But she was able to make an impact. She pointed out how low-fat diet guidelines introduced in the UK in 1983 – which South Africa follows – are based on poor science, and debunked the “diet-heart hypothesis” that saturated fat causes heart disease, saying there is no evidence to support this.

MONDAY 24 OCTOBER:

Harcombe continued her evidence, in which she fiercely refuted HPSCA claims that a low-carb diet is not beneficial.

She highlighted data confirming the worldwide obesity epidemic started around the time that low-fat diet guidelines were introduced. Moreover, she challenged the “Naude Review” (also known as the “Stellenbosch Review”); an analysis of 19 studies published by the PLoS (Public Library of Science) One journal in 2014, of which Dr Celeste Naudé of Stellenbosch University’s Centre for Evidence-based Healthcare was the lead author.

Harcombe said the study was personal, unprofessional, flawed and used to discredit Noakes, adding that a press release on the report called Noakes a “celebrity scientist” to debunk him.

“To claim Banting was debunked was absurd, impactful and potentially harmful,” said Harcombe. Harcombe and Noakes have written a paper refuting the Naude report, which has been peer-reviewed and will be published.

TUESDAY 25 OCTOBER:

Teicholz was on the stand and built on Harcombe’s point from Monday: even though people are sticking to the dietary food guidelines, they are not losing weight this way.

Teicholz added that the only way of overcoming the obesity and diabetes epidemic would be for people to start eating like they did in 1965, before carbohydrate-based dietary guidelines were introduced.

WEDNESDAY 26 OCTOBER:

A dramatic last day of proceedings saw Zinn, the last of Noakes’s expert witnesses, give evidence. Zinn further advocated the benefits of LCHF diet, adding that no harm would come to babies whose mothers were on a low-carb, high-fat diet.

“I think from several perspectives, it is a better way of eating. You just have to look at our current health status, you can look at the percentage of our population that has insulin resistance and also at what has happened since our high carb, low-fat dietary guidelines were introduced in 1977,” said Zinn.

Another advocate of Noakes, Michael van der Nest, was allowed to read out a letter addressed to the ADSA, in which he asked if Julsing-Strydom had lodged her complaint against Noakes in a private capacity or on behalf of ADSA. Van der Next also asked why neither the ADSA nor Julsing-Strydom had attended the hearing when Noakes was on the stand.

The defence rested its case. The HPCSA is expected to hand down judgment on April 4 2017.

Picture: Runner’s World

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Jack Woodfield

Jack is Deputy Editor of Diabetes.co.uk and the award-winning Low Carb Program. He works hard, plays fair and sleeps whenever possible. He also has type 1 diabetes, doesn't mind being called a "diabetic", and once won a talent show for dancing to Dario G’s 1997 hit “Sunchyme”.

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