By Marika Sboros
When the Kafkaesque trial of world-renowned South African scientist Prof Tim Noakes resumes in Cape Town in October 2016, two heavyweight international expert witnesses will testify for him: Cambridge University graduate Dr Zoë Harcombe, a British public health nutritionist, and US science writer Nina Teicholz.
The country’s regulatory body, the Health Professions Council of SA, has charged Noakes with unprofessional conduct for his views on diet. Here’s what you can look forward to in this strange scientific saga that has garnered worldwide attention:
Harcombe has a doctorate in the evidence base for official dietary guidelines. Her doctoral thesis was: An examination of the randomised controlled trial and epidemiological evidence for the introduction of dietary fat recommendations in 1977 and 1983: A systematic review and meta-analysis.
She received a letter of commendation following the Ph D award.
Harcombe has been an independent board member, a member of the remuneration and HR committees for the University of Wales, Institute Cardiff, now Cardiff Metropolitan University, and an independent board member for the National Health Service in Wales.
She is author of best-selling books that include The Obesity Epidemic: What caused it? How can we stop it? (2010).
Teicholz is author of the international bestseller, The Big Fat Surprise. The book is regarded as a seminal contribution to the understanding of nutrition and disease, as well the politics of nutrition science. The American Journal of Clinical Nutrition said it should be required reading by all health professionals, doctors, and scientists.The Economist named it the number #1 science book of 2014. It was on that year’s “Best Book” lists for the Wall Street Journal and Forbes, among others.
It was the basis for a now-iconic cover story in Time. Both the American Journal of Clinical Nutrition and the BMJ have reviewed it favourably.
Stanford University graduate Teicholz is the first journalist elected to Phi Tau Sigma, the elite US honour society for food scientists. The Canadian Senate invited her to give a full hour of expert testimony in 2014, and by the US Department of Agriculture in 2016 to give testimony on how to improve nutrition policy.
Teicholz’s article in The BMJ on the dietary guidelines was the one of the most-viewed stories in the journal last year. It was influential in informing questions in a Congressional hearing on the US dietary guidelines in 2015.
Both Harcombe and Teicholz are clearly well-placed to know just what research doctors and dietitians routinely ignore in SA and worldwide.
So what’s this case really all about:
The Health Professions Council of SA (HPCSA) has charged Noakes with “unprofessional conduct for allegedly giving “unconventional advice on a social network (Twitter)”.
That was for a couple of tweets Noakes made in response to a request for information from a breastfeeding mother. Noakes told the mother that good first foods for infant weaning are low-carb, high-fat (LCHF). In other words, he was suggesting meat, dairy and vegetable.
Ironically, that’s the same advice the Johannesburg dietitian, Claire Julsing Strydom, who reported him to the HPCSA, now gives. Strydom was president of the Association for Dietetics in SA (ADSA) when she reported Noakes in her personal capacity (later changed to say that ADSA was the complainant). ADSA also gives the same nutrition advice.
That is just some of the Kafkaesque aspects of this peculiar saga that has come to be called the “Banting for Babies Trial”, also the “Nutrition Trial of the 21st Century.”
What has become clear is that this is not just a trial of a famous scientist. Noakes has one of the highest scientific ratings in the world (A1 by the National Research Foundation) for his expertise, both in nutrition and in sports science. He is also a medical doctor, with an academic doctorate in medicine and one in science. He has a doctorate honouris causa, to boot.
The hearing is really a battle of attrition. The theatre of war is the venue at Belmont Square, Rondebosch. The prize is the control of nutrition science.
The ultimate finding of this trial could determine how best to treat and prevent a host of serious disease that are epidemic worldwide: obesity, diabetes, heart disease, cancer and even dementia. Dementia is becoming so prevalent these days that doctors are calling it type 3 diabetes because of its documented links with diet.
At stake, is the “business” of cardiologists, who prescribe statins, and perhaps, the liability of doctors prescribing them.
Dietitians don’t seem to want Noakes – or any other doctor – giving dietary advice. They seem to think they should enjoy that monopoly. They seem to be of the view that their degree confers some kind of omni-“science” when it comes to evidence-based dietary advice.
Click here to read: NOAKES EXPOSED: THE REAL BEEF DIETITIANS HAVE WITH HIM!
They can probably be forgiven for thinking this way. Many doctors collude with dietitians by deferring to them for dietary advice for their patients.
Doctors, particularly cardiologists, don’t want Noakes giving advice that strays into their “territory”. Noakes gives cardiologists heart palpitations when he declares – and rightly so – that the diet-heart hypothesis is disproven. He has endocrinologists foaming at the mouth when he says diabetes is not the chronic, irreversible condition they keep insisting it is.
He leaves a sour taste in doctors’ and dietitians’ mouths when he says there’s solid evidence to show people can lose fortunes of weight quickly and safely, simply by eating LCHF foods.
At heart, as Noakes has noted, “everyone is entitled to their own opinion but no one is entitled to their own set of facts”.
The HPCSA’s expert witnesses so far have appeared intent on – and content with – not letting the facts get in the way of their considered opinions.
Harcombe and Teicholz will likely continue the demolition job Noakes’ legal “dream team” started on all the expert witnesses the HPCSA called so far.
The experts have included NorthWest (formerly Potchefstroom) University nutrition professors Este Vorster (now retired) and Salome Kruger, and a paediatrics researcher Muhammed Ali Dhansay now with the Medical Research Council.
The HPCSA tried hard – and failed miserably – to plug those holes with one last “expert witness” again on ethics called at the very last minute of the November hearing. That was retired Stellenbosch University psychiatry professor Willie Pienaar. Pienaar has a master’s degree in medical ethics and occasionally lectures on the topic.
At the resumption of the hearing in February 2016, Pienaar did a lot of chest-beating (literally). He repeatedly expressed grave concern “for my profession” if doctors were allowed to give information on Twitter and other social media. (Like all the expert witnesses, Pienaar admitted to having little or no knowledge of the dynamics of the popular social network).
Were Pienaar’s evidence not meant seriously, it would have been comical at times. He appeared so biased against both Noakes and LCHF, an increasingly exasperated Van der Nest responded dismissively: “Professor, your petticoat (of bias) is showing.”
Expert witnesses are supposed to assist courts of law, or tribunals such as the one convened by the HPCSA by assisting non expert members of the tribunal come to an opinion in circumstances where the members of the tribunal do not have expertise.
All the HPCSA witnesses strayed far beyond that remit. Part of the problem has been witnesses who are not medically trained doctors (in Vorster’s and Kruger’s case) and who appear to be not particularly well-trained scientists. They appeared at times ignorant of first principles of biology, chemistry, physics and endocrinology. In the case of Dhansay, his research output is far from significant.
Noakes finally gave his evidence-in-chief at the February hearing. He took close to 40 hours, over 4000 pages and 900 slides to show why his views on LCHF are, in fact, evidence-based.
He demonstrated that much of scientific literature that supports his views, are either misinterpreted by orthodoxy, or simply ignored.
His legal team points out that his views are based in science. Thus, it follows that his views cannot be seen as unconventional, particularly in scientific terms.
When the hearing resumes in Cape Town on October 17, the HPCSA’s legal team will attempt to cross-examine him. Watch this space. I’ll be tweeting live again.
- Main image: Prof Tim Noakes at the February 2016 hearing: ROB TATE
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