By Marika Sboros
“We made no mistakes and no mischief in our study debunking Banting and Prof Tim Noakes,” say South African scientists. They don’t use those exact words. However, that’s the gist of their letter, which the SAMJ has just published. It relates to the Naudé Review in PLoS One in June/July 2014 by Stellenbosch and Cape Town University researchers.
Noakes and British obesity researcher Dr Zoë Harcombe published their analysis of it in the SAMJ in December 2016. They found major errors. Therefore, they concluded, the review findings are “not robust”. That’s scientific speak for wrong. Noakes and Harcombe don’t use the words “scientific fraud” – yet. Instead, they diplomatically ask: “Mistake or mischief?” However, if the errors were not honest mistakes, then mischief is a euphemism. So, are these academics giving “alternative facts” to try to silence Noakes? Why should you (or anyone) believe the Naudé authors when they say there was no monkey business against Noakes? Because they say so?
As a journalist, I don’t take anyone’s say-so at face value. Especially given the seminal role the review played in the HPCSA’s case against Noakes. That gives the authors a significant, vested interest in fudging whether there was any “mischief”. At the very least, until the Health Professions Council of SA (HPCSA) case against Noakes is over. (Scroll down for links to all the studies.)
Unless you’ve been inhabiting another planet, you’ll know that the HPCSA has charged Noakes with unprofessional conduct for a single tweet to a breastfeeding mother in February 2014. Three years later, the case is still dragging on.
It resumes in Cape Town on April 3 and 4, 2017 for legal argument from both sides. The Chair of the Professional Conduct Committee hearing the charge against Noakes Pretoria advocate Joan Adams, will rule on April 21, 2017.
The Naudé Review is named after lead author, Dr Celeste Naudé, a nutrition academic at Stellenbosch University. Her co-authors include Stellenbosch dean of Faculty of Health Sciences Prof Jimmy Volmink, UCT associate professor of nutrition Marjanne Senekal and a Liverpool School of Tropical Medicine researcher, Prof Paul Garne. They seem to be hoping that their SAMJ response puts the scientific dispute to bed. If that’s the case, that’s a fond hope.
Like the horse and carriage, the Naudé Review and the HPCSA trial go so well together, it’s as if destiny had a hand. However, there’s a murky background to the Naudé Review. It does not reflect well on the authors or their universities. The deafening silence from the vice-chancellors of the universities to the claim of “mischief” speaks volumes. It also speaks about the claims of mischief other academics involved in the HPCSA case, including at Wits University, may have got up to against Noakes.
Click here to read: Proof that SA scientists tried to smear him?
In the SAMJ letter, the authors create the impression they have addressed all the errors, which Noakes and Harcombe have identified. They haven’t – at least not from my reading. And if I’m right, then they have either made more “honest mistakes” or more “mischief”. (I won’t mention the “f” word, for now.)
Just one example: the authors say that they “used data from intention-to-treat analyses (and only if not reported … used data from per-protocol analyses)”. They also say that they “did not report values the wrong way around”. Even with my glasses on, I still see their numbers as the wrong way around.
For the rest, I don’t see any rebutting of errors. However, that could just be because I’m a lay person.
Naudé et al also insist that they studied low-carb diets. However, as Harcombe has pointed out, they did not. That’s likely the result of their well-documented support for industry-led, high-carb, low-fat dietary guidelines. They seem chronically unable to understand what a low-carb diet is and is not.
The authors suggest that Noakes and Harcombe have themselves erred and “show lack of understanding of current methods in evidence synthesis”. I’d say that’s highly unlikely.
After all, the National Research Foundation recently renewed Noakes’s A1 rating as a scientist, making him one of the few in the world with that rating. In other words, Noakes is an acknowledged world authority in his research fields: both sports science and nutrition.
Harcombe, who recently completed her Ph D, is a specialist in nutrition and obesity research. She also happens to be an independent researcher. I’ve only ever known her to look at all the research, not just the bits that suit her point of view.
The Naudé reviewers say that they “welcome scrutiny and comments”. They say that having considered (Noakes and Harcombe’s criticisms) “carefully”, they “stand by” their review results. They “also report that in overweight and obese adults randomised to low-carbohydrate or iso-energetic balanced diets, there is probably little or no clinically important difference in average changes in cardiovascular risk factors for up to two years”.
They appear stuck in a scientific sequel to the hit movie, Groundhog Day. They appear, as a contact on Twitter has reflected, to be giving “alternative facts”.
Thus, the Naudé Review authors probably mean their letter as a distraction. They probably hope that it is only the discerning reader they won’t distract from what Noakes and Harcombe say in their analysis of the review.
Click here to read: ILSI ‘queenpins’ trying to nail him?
Why would they hope that? My guess is for the same reason that anti-Noakes media hailed the study in 2014 as “debunking Banting” and discrediting Noakes. Yet the Naudé Review never even mentioned Banting or Noakes. The authors never bothered to correct the impressions.
It’s likely the same reason that a mainstream media report on the SAMJ letter also immediately trumpeted it as giving Noakes a “fat lip” in the “Banting wars”. Where that headline comes from is anyone’s guess. Again, the authors remain silent.
But there’s a real reason that the Naudé Review authors may be unwilling – or unable – to admit to any mischief. Their study was sweet scientific music to the ears of Health Professions Council of SA (HPCSA). The HPCSA has used it as the pillar of its case against Noakes.
That’s not just my opinion. It’s straight from a dietitian “horse’s” mouth, so to speak – Johannesburg dietitian Claire Julsing Strydom herself. Strydom set off the “Nutrition Trial of the 21st Century”, as the public has dubbed the HPCSA case against Noakes, by lodging a complaint against Noakes.
In her evidence at the November 2015 trial session, Strydom had special words to say about the Naudé Review. Those words may come back to haunt her. She probably didn’t mean to hint of an orchestrated campaign against Noakes.
Strydom said that she and “many big organisations” were waiting for the Naudé Review. Why were they waiting? To make public statements about Noakes and LCHF diets, she said. Who were those organisations? Strydom never said. And Noakes and his legal team may have missed a trick in not asking.
Still, you didn’t have to look far to find who they were. Some pretty big organisations responded quickly to the review in the media in 2014. Among them were the HPCSA, the Heart and Stroke Foundation of SA and, of course, the Association for Dietetics in SA (ADSA). Strydom was ADSA president at the time.
And of course, Naudé Review author, UCT nutrition professor Marjanne Senekal, went on to become a consultant to the HPCSA in its ongoing quest to nail Noakes.
The review featured frequently in evidence by expert witnesses against Noakes. One was North-West University nutrition professor Hester “Estee” Vorster. She did so in a secret report the HPCSA Preliminary Committee of Inquiry commissioned in July 2014. I say “secret” because the Committee didn’t bother to let Noakes see Vorster’s report before charging him, despite their legal obligation to do so.
In it, Vorster refers to the Naudé Review before it was published the very next month.
That report was part of evidence in the HPCSA trial against him, which his legal team undermined with embarrassing ease. At least I’d be embarrassed if I were those scientists. They seem to have a very high threshold for scientific embarrassment.
Interestingly, ADSA morphed into the complainant in the HPCSA case against Noakes. Initial correspondence shows that Strydom complained in her personal capacity, not as ADSA president. However, that’s a whole ‘nother story for ‘nother time. Suffice to say, it was just one of many “irregularities” and breaches of HPCSA regulations and Noakes’s rights that are typical of this trial. It’s one reason that Adams rapped the HPCSA on its knuckles. She said that the hearing was not the set of Ally McBeal or Petrocelli.
Interestingly, the first response from Naudé Review authors was to ignore my emailed requests for comment. Instead, they sent a statement to a Cape Town newspaper a few weeks later. In it, they said that Harcombe had conceded in her evidence for Noakes at the October 2016 hearing session that she was wrong about their study. I don’t know if Senekal told them that (she isn’t saying) as she was consulting at the hearing. However, it’s simply not true. All her colleagues have to do to find that out is read the trial transcript.
Don’t take my word for what this latest foray against Noakes. Read the three articles below and make up your own minds:
- Low-Carbohydrate versus Isoenergetic Balanced Diets for Reducing Weight and Cardiovascular Risk: A Systematic Review and Meta-Analysis
- The universities of Stellenbosch/Cape Town low-carbohydrate diet review: Mistake or mischief?
- Reliable systematic review of low-carbohydrate diets shows similar weight-loss effects compared with balanced diets and no cardiovascular risk benefits: Response to methodological criticisms
- I have emailed Noakes and Harcombe for comment. They say that they will comment at an appropriate time. I have emailed all the Naudé Review authors for comment. So far, none has replied. All those mentioned in Foodmed.net articles have right of reply.