By Marika Sboros
The Australian Health Practitioner Regulation Agency (AHPRA) has banned orthopaedic surgeon Dr Gary Fettke from giving nutrition advice. It has done so after a two-year “investigation” into Fettke’s qualifications.
Overnight they’ve turned him into “Australia’s Tim Noakes”. Elements of this case mirror the Health Professions Council of South Africa (HPCSA) case against Prof Tim Noakes, a world-renowned scientist and medical doctor. There are differences, but both the AHPRA and the HPCSA cases open up a medical Pandora’s box. Both go to the heart of what it means to be a real “doctor of medicine”, and who is best qualified to give nutrition advice.
Both these cases boil down to a medical and dietetic battle for territory. In both cases, the regulatory agencies take up cudgels on one side of that battle. They support powerful vested interests propping up the territories.
The only real surprise is that the AHPRA has taken so long to act against Fettke.
Fettke, apart from being a practising orthopaedic surgeon and senior lecturer to medical students at the University of Tasmania, has been researching nutrition for more than a decade now. As an orthopaedic surgeon, he has had a longstanding interest in the preventative aspects of health outcomes, particularly before operating on patients.
Many are obese and diabetic and come to him with weight-related issues, with joint pathology and arthritis. Outcomes he has achieved for patients have been remarkable.
Fettke’s extensive knowledge of nutrition is also because he is a cancer survivor. He had orthodox treatment then started researching options. That led him to adopt a specific dietary lifestyle (which he calls low-carb, healthy fat, including saturated).
He is not against orthodox treatment for cancer. He simply believes that the right diet ups the odds of long-term survival for cancer patients. He advocates for the metabolic model of cancer and an integrative approach to treatment that includes nutrition. In so doing, Fettke goes up against powerful vested interests in the pharmaceutical and medical industries.
Spotlight on: CANCER THERAPY OF THE FUTURE? ALREADY HERE, SAYS FETTKE!
The AHPRA has conducted its “investigation” against Fettke behind closed doors. He doesn’t even know who complained to the AHPRA about him.
The HPCSA on the other hand has had to conduct its case against Noakes in the full glare of the public. It hasn’t disclosed all evidence against him.
However, Noakes does at least know who started the ball rolling against him in 2014: Johannesburg dietitian Claire Julsing Strydom, then president of the Association for Dietetics in SA (ADSA).
ADSA is the South African counterpart of the Dietitians Association of Australia (DAA). Both are voluntary bodies and hugely influential in setting public health policy relating to diet and nutrition. Both support the status quo.
The DAA even expelled dietitian Jennifer Elliot for going against its high-carb, low-fat (HCLF) advice. She is an advocate of low-carb, high-fat (LCHF) to treat and prevent serious disease. (More on that in upcoming posts. Watch this space.)
The AHPRA has gone to great lengths to suggest its case against Fettke is not about LCHF. Or as Fettke practises and calls it, low-carb, healthy fat. It has told Fettke not to “provide specific advice or recommendations on the subject of nutrition and how it relates to the management of diabetes or the treatment and/or prevention of cancer”.
The HPCSA case against Noakes centres around giving “unconventional advice on a social network” (Twitter). That was for two tweets in which Noakes said good first foods for infant weaning are LCHF. In other words, meat and veg, according to LCHF theory.
The HPCSA has tried hard – and failed miserably – to create the impression that its case is not about the science for LCHF; that it isn’t going for him because he won’t support conventional nutrition advice based on high-carb, low-fat (HCLF) and the vested interests behind it; that there are not careers and reputations that will fall if LCHF becomes mainstream.
Fettke is also founder and mentor of the team at Nutrition for Life located in Launceston and Hobart providing nutritional care around Tasmania and Australia. He has launched social media, grassroots campaigns against excessive sugar and processed food consumption in the Australian diet.
Therein probably lie some of the main drivers of the AHPRA action against him.
Orthodox medicine is premised on the pharmaceutical model of disease. It makes no room for food as medicine even when it pays lip service to the notion.
For dietetics to survive as a profession, the public needs to believe that dietitians’ degrees confer on them omniscience by osmosis on optimum nutrition to treat or prevent life-threatening disease. Both the DAA and ADSA work hard to create that impression (as a DAA post on Facebook, shown right, shows).
Yet the effects on health of people who followed conventional dietary advice for decades are there for all to see: pandemics of obesity, diabetes, heart disease and cancer.
At heart, the AHPRA in acting against Fettke pays no heed to the ancient Chinese proverb: “He that takes medicine and neglects diet wastes the skill of the physician.”
Like Noakes, Fettke is learning about the perils of challenging orthodoxy. If Voltaire were around he would probably say to Noakes and Fettke: “It is dangerous to be right in matters on which the established authorities are wrong.”
However, if the AHPRA hopes to be able to muzzle Fettke, the opposite is likely to happen. In Noakes’ case, the HPCSA and ADSA have handed him on a platter an international platform for dissemination of his ideas. They have boosted his international profile.
The same will happen with Fettke. It’s part of the law of unintended consequences on social media.
Of course, that doesn’t mean it’s going to be plain sailing. In 1985, the US National Academy of Sciences published a report on the lack of adequate nutrition education in US medical schools. Experts considered it a “landmark” report. It was US-focused but pointed to a global phenomenon that exists tody.
Just how parlous the state of nutrition in medical education in the US was at the time showed in the report authors’ recommendation: a minimum of 25 hours of nutrition instruction. Taken over the six years doctors average as medical students, it’s not exactly an onerous burden on those who compile the curriculum.
A study published in Academic Medicine, the journal of the Association of Medical Colleges in 2010, shows just how seriously those who run medical schools have taken that recommendation on board: mostly not at all. (Click here to read the full text of Nutrition Education in U.S. Medical Schools: Latest Update of a National Survey.)
US physician Dr Pauline Chen writes in her column for the New York Times in 2010: “Between the growing list of diet-related diseases and a burgeoning obesity epidemic, the most important public health measure for any of us to take may well be watching what we eat.
“But few doctors are prepared to effectively spearhead or even help in those efforts.”
Noakes gets to the heart of the matter when he says: “Medicine no longer cures. It just creates customers for pharmaceutical industries.”
Experts point to a broken scientific research model that contributes to propping up dogma and the status quo and forgets about patients.
US Prof Richard Feinman is scathing about the AHPRA action. “Doctors don’t study nutrition. Nutritionists don’t study medicine. Neither study science,” says Feinman, who is professor of cell biology at SUNY (State University of New York).
Feinman says Fettke doesn’t have the credentials precisely because “there are no credentials”.
What is the likely outcome of the AHPRA action unless that brute action ever happens? Anybody’s guess at this stage. I’m ever the optimist.
My guess is that through brute force, Thomas Eddison’s prophetic words will prevail: “The doctor of the future will no longer treat the human frame with drugs, but rather will cure and prevent disease with nutrition.”
Fettke is considering his options. In the meantime, he has handed over the nutrition baton to wife, Belinda. She spearheads Nutrition for Life he founded, and the qualified registered dietitians who make up its staff.
Here’s some of what Belinda had to say on Facebook in announcing the AHPRA action against her husband. Click here to read it in full on the No Fructose Facebook page:
By Belinda Fettke
Who can actually give nutritional advice? There has been an AHPRA investigation into my husband, Dr Gary Fettke’s, qualifications to give nutritional advice and speak on the science of what we eat and its central role in our health. This investigation has been going on for over two years. The AHPRA is proposing a “caution”.
Gary will be questioning the proposed “caution”. Until there is a final finding from AHPRA he will have to abide by the law to maintain his professional registration.
The Medical Board of Tasmania under the umbrella of the AHPRA have advised him: ”In particular that he does not provide specific advice or recommendations on the subject of nutrition and how it relates to the management of diabetes or the treatment and/or prevention of cancer.”
Gary is not allowed to comment on nutrition in preventative health, nor in management of chronic illness on any social media platform. Gary cannot discuss nutrition with his patients in any clinical setting. That’s regardless of any undue stress on joints before replacement, inflammation, or even diabetes complications requiring amputation.
Gary is not allowed to speak at any public or professional meetings that involve the discussion of nutrition.
That will be difficult as he sees benefits every working day for his patients that adopt better eating habits.
It is IMPORTANT to note: Gary has NOT BEEN CAUTIONED on what he has been advocating with regards to LCHF – Low Carbohydrate Healthy Fat living – nor in lowering carbohydrate intake in diabetes management; or on what he advocates with regards to the central role of nutrition in health.
By qualification to comment, I have none. My previous work as a registered nurse is unlikely to give me any expertise. But like so many people living the LCHF life, I have seen the benefits in myself. And those around me for many others who have decided to choose health.
If you are interested in helping me continue to question the science, promote the role that Low Carb Healthy Fat principles play in both the management and the prevention of disease, please join me as the voice of No Fructose.