NOAKES TRIAL: RECKONING DAY FOR FEROCIOUS ‘FABLE’?
By Marika Sboros
There’s something absolutely “fabulous” about the ferocity with which the Health Professions Council of South Africa (HPCSA) has prosecuted Prof Tim Noakes. Not fabulous in the informal sense of “very good” – as in a “fabulous holiday” or “fabulous riches”.
I mean the Oxford dictionary’s formal definition of fabulous as “extraordinary”, especially “extraordinarily large”. Most of all, fabulous as having “no basis in reality”. In other words, something mythical, the stuff of fables.
For more than three years now, the HPCSA has waged a titanic battle against Noakes over the tiniest of provocations. It began with a single tweet he made in February 2014. In it, he said that good first foods for infant weaning are LCHF (low-carbohydrate, high-fat).
Thus, April 21, 2017, has become the day of reckoning for a ferocious scientific fable.
The HPCSA has reacted in extraordinary ways in conducting its case. It has pulled patients out of a hat. It has made witnesses appear and disappear at the drop of the same hat. The HPCSA has demanded evidence from Noakes that his tweet won’t kill infants and adults on a genocidal scale. Noakes obliged with the evidence – over 40 hours, with 1163 slides and 5093 pages, citing 354 publications and/or materials. When he gave the evidence, the HPCSA turned a jaundiced, bleary eye.
Noakes obliged with the evidence – over 40 hours, with 1163 slides and 5093 pages, citing 354 publications and/or materials. When he gave the evidence, the HPCSA turned a jaundiced, bleary eye.
Perhaps the most fabulous thing about this saga really is the HPCSA’s response to the science for LCHF. Their lawyers tried arguing that Noakes’ evidence is all irrelevant. They presented a single, flawed study purporting to debunk LCHF.
Noakes’ legal team argued that there’s a far more likely reason why the HPCSA has ignored the evidence for LCHF: It cannot answer the science.
Thus, April 21 has become its day of reckoning. On that day, the “judge” in this case, the HPCSA’s Professional Conduct Committee, will rule. Committee chair, Pretoria counsel Joan Adams will read the ruling. The Committee will decide whether Noakes is guilty as charged of “unprofessional conduct for giving “unconventional advice on a social network”.
In two days of legal argument on April 4 and 5, 2017, HPCSA counsel Dr Ajay Bhoopchand argued that the case is about infant nutrition only. Therefore, most of the evidence for the defence is irrelevant because it is on adult nutrition only. That turned out to be magical thinking.
Counsel for Noakes, Michael van der Nest (SC) and Dr Ravin “Rocky” Ramdass, argued that the case is about adult, not infant, nutrition. After all, the HPCSA’s own Preliminary Committee of Inquiry based the decision to charge Noakes in September 2014 on evidence on adult nutrition only.
It also based the charge on a secret report it commissioned from North-West University nutrition professor Hester “Estee” Vorster in June 2014. That secret report is on adult, not infant, nutrition. In her report, Vorster refers to the flawed Stellenbosch (Naudé) Review. That review is on adult nutrition.
Vorster also refers in her report to Noakes’ “high-profile” as a “celebrity” scientist. The dietitian who started the whole case against him, Claire Julsing Strydom, said much the same thing. In her letter of complaint, she urges the HPCSA “to please take urgent action” against Noakes as he is a “celebrity” in South Africa.
Strydom also says that Noakes’ tweet is “especially dangerous” for infants and can “potentially be life- threatening”.

The team: left to right, Michael Van der Nest SC, Prof Tim Noakes, advocate Dr Ravin “Rocky” Ramdass and instructing attorney Adam Pike of Pike Law.
In her evidence, Strydom conceded that she had “may have over-reacted” to Noakes’ tweet. A second HPCSA expert witness, North-West University nutrition professor Salome Kruger agreed that LCHF is “probably not harmful”.
Thus, Van der Nest argued that Strydom launched the complaint against Noakes on a whim. He said that the case is not just the prosecution of an eminent scientist for his views. It is also a persecution. Van der Nest uses the word deliberately. It is not a Freudian slip.
He argued that Strydom is little more than a “disgruntled dietitian”. She and other health professionals have gone after Noakes because they don’t like what he says. They also don’t like the fact that the public seems to listen more to him than to them. “Miraculously”, they managed to get the HPCSA to do their bidding, Van der Nest said.
“The case was never about Noakes’ conduct as a medical doctor,” he argued. After all, Noakes hasn’t practised clinical medicine for more than 16 years now. “Somehow a scientific disagreement resulted in a vigorous prosecution of someone who no longer even practises as a medical doctor,” Van der Nest said.
Noakes called three experts: Dr Zoë Harcombe, US science journalist Nina Teicholz and New Zealand-based Dr Caryn Zinn.
In his arguments, Ramdass showed direct relevance of all the evidence for the defence. He also undermined the bedrock of the HPCSA’s case against Noakes: South Africa’s official dietary guidelines. These guidelines are wrong in material respects, Ramdass argued. They are also industry-led. They promote low-fat, high-carbohydrate conventional thinking for weight loss and health without any science to back it up.
Click here to read: DID DISGRUNTLED DIETITIANS SET HIM UP?
The guidelines are “umbilically linked” to the US Dietary Guidelines on the causes of coronary heart disease, Ramdass said. They are based on the “diet-heart hypothesis” that saturated fat causes heart disease. Ramdass showed that Noakes presented uncontested research that there is no evidence for the hypothesis. Teicholz also showed that low-fat diets increase the risk of heart disease. Conversely, Noakes and his experts showed that a high-fat intake reduces that risk by decreasing insulin resistance
Ramdass also referred to Vorster’s many conflicts of interest. Vorster wrote the guidelines. She also wrote the recommendation for infants older than six months, children and adults to “make starchy foods the basis of most meals”. Noakes and his experts showed that there is no science for that advice.
Vorster gave evidence on how she came to make that recommendation. It was remarkable, though probably not as intended. She said that she based it on what foods poor communities eat and can afford. In the case of rural South African communities, that is “mielie pap”. Mielie pap is a traditional porridge or polenta made from ground corn. In other words, Vorster said that she based the advice on economics, not science and not safety.
Click here to read: WHO REALLY DISHES UP DANGEROUS ADVICE?
Noakes and his experts showed that Vorster’s advice is both unscientific and dangerous. They showed that for anyone at risk of insulin resistance, starchy foods are a significant health risk. They also showed that weaning babies onto mielie pap and other cereals and grains has contributed to the obesity epidemics among South Africans of all ages.
Therefore, it was not so much what Noakes said in his tweet as what he did not say that got him into trouble. He did not say that parents should wean children on to baby cereals.
Conservative estimates are that legal costs for both sides are around R10 million. (That’s around $756,000.) This case has raised many awkward questions. One is why the HPCSA, a statutory body, has spent so much time, money and resources arguing for dietitians against Noakes. And why it automatically assumes that Noakes is wrong and the dietitians are right.
Van der Nest and Ramdass have argued that the HPCSA has not proved any of the pillars of its case. Therefore, it has no case and the “judge” must rule that Noakes is innocent. Bhoopchand argued that the HPCA has proved its case “on the balance of probability. Therefore, the “judge” must rule that he is guilty.
April 21, 2017 will reveal who has the stronger argument – or whose political scientific pull is stronger.
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- Graphic courtesy of the Noakes Foundation.
Right up to the wire! Finally I can unclench my buttocks.
Marika, huge thanks for the outstanding coverage, I bet your fingers are worn down to stumps from all the tweeting!
It wasn’t until Professor Feinman pointed it out a while back that I realised despite all the coverage of the trial in Twitter and the Blogosphere there has been next to no mainstream reporting.
Now the verdict is finally in, do you think this is likely to change? Hint: can you digest and summarise enough for an article to be syndicated?
Now off to celebrate with lamb chops, asparagus, butter and red wine.
If ADSA’s press statement after the verdict is anything to go by, nothing will change! Bad habits clearly die hard.
Great piece. As someone following the case from the UK where the dietary establishment is still firmly supporting low fat although not (yet?) prosecuting dissenters, two more general points strike me.
It puts a big question mark over the notion of evidence based medicine. For years the medical establishment has claimed to occupy the scientific high ground. Anyone claiming that diet and life style can help to prevent or treat a disorder has been dismissed as a fraud/quack because their claims were not evidence based. Evidence-based here is synonymous with large randomised controlled trials which are intrinsically difficult and very expensive to do on diet. The trial has shown that not only is the establishment lacking in good evidence for its own claims but, perhaps even more damagingly unscientific, that it is capable of deliberately ignoring contrary evidence for years.
Secondly what is striking about the LC approach is that it seems to offer a new and effective approach to to a number of conditions. This in turn has led to a grassroots revolution in the UK with over 150 – and rising – GPs who are actively investigating and using the low carb approach specifically to treat diabetic patients. Assuming evidence of benefit continues to come in, the notion that doctors in general can safely and effectively treat patients with lifestyle disorders with virtually no knowledge of nutrition is going to change. The impact of this on the conventional idea that the only way to “fight” the likes of cancer, Alzheimer’s, diabetes and obesity with ever more expensive drugs will also have to be questioned.
All from a tweet!
Regardless of the outcome, I hope Prof Noakes will consider taking those behind this witch hunt, including the HPCSA, to a proper court of law where this farce will be torn to shreds and he will most certainly be awarded damages. Thanks for your excellent articles, and also for exposing how vested business interests can corruptly manipulate a so-called professional watchdog body to serve their interests at the expense of those of the public.
My thoughts are with Professor Noakes on this important day. I am grateful for progress he made helping others, despite his opposition. Win, lose or draw he has my enduring support.
Check out @t2d66’s Tweet: https://twitter.com/t2d66/status/855236610157232128?s=09
Totally agree with you! I also had to do with Prof Noakes years ago regarding running and found him a person of immense logic and integrity. I have also found the HPCSA pathetic and wonder why I am paying yearly fees for no service redendered on their part. Apart from wasting our money on lame legal wars.
Not quilty- may the truth prevail.
Thanks as always for the information. All things being equal Dr Noakes should romp home on this one, but we know that things are pretty twisted and skewed in the world of dietary religion so I’m not holding out too much hope. If he is found against there should be a huge outpouring of anger and ridicule against the vested interests and status quo.
I intend to be part of that voice win or lose!!
It’s the SA medical Mafia versus an honest Scientist. Their often scurrilous behavior is to be deplored.
I can only hope that the case is decided by the facts and the science, not vested interests and threatened professionals. The reputation of dietitians is generally poor and this hearing has time and again shown why they have so little credibility. Their insecurity and growing irrelevance has driven this case.
Vorster’s stupid advice to wean infants onto mielie pap is a betrayal of her duty. It’s not her job to say, you can only afford rubbish, so we’ll tell you it’s okay. What about South Africans who can afford better? Should they still get bad advice to comfort them as they become fat and diabetic? You start with science-based advice and then try to get everyone as near as possible. Tim Noakes has exposed this nonsense and that’s why they’ve sought to shut him up.
It’s disgusting that someone who has devoted their life to sports medicine in South Africa, could be persecuted in this massive costly and wasteful witchunt. I consulted Prof Noakes about 20 years ago and he is brilliant and someone of immense integrity. Clearly the HPCSA are trying to divert attention from what a pathetic organization they have become
I look forward to hearing the verdict, “Not Guilty”!
I will regard it as good birthday reading for me tomorrow when I read that sense has prevailed and he is declared wholly innocent.
What a wonderful summary of events. Thank you. I have my fingers crossed, hoping that the decision tomorrow goes the right way.
May the truth set them free!
Even more “fabulous” will be a guilty verdict – one that will surely have hundreds of thousands of LCHF followers up in arms and HPCSA will have great difficulty in proving that this will be and unbiased, predetermined verdict since erroneously leaking out the verdict at the completion of the trial last year…
Well I’ll bet you are upset that the right verdict was delivered and proved once and for all how vindictive Big Pharma and Big Business is when their profits are threatened. Nothing to do with their sham and lies about caring for people’s health! Just ravenous wolves feeding on a gullible public!
This fiasco fits so well in our Trumped up world of Zuma Logic and Mugabesque rhetoric. An embarrassment to the already embarrassed world of (mostly) pseudo-scientific dietitians – they that suck on the hind teat of mediocre medical science, whilst led, often unknowingly, by the amorphous, multi-trillion dollar carbohydrate industry.
We could feel sorry for Tim Noakes but that would be to feel sorry for someone who is successfully pursuing and teaching truth. It would be like feeling sorry for Ben Goldacre rather than vitamin pill salesman Matthias Rath.
No, we should never forget that Trump, and to a far less enthralling extent, Claire Julsing Strydom, were sent by Momus (god of satire) for our entertainment. They’re dangerous pawns, of course, but some kind of risk is integral to all fine comedy.
Despite many poor lines and buckets of awful acting it is for us to sit back and enjoy the final act in this peculiar farce.
I’m keeping my fingers crossed. Although Professor Noakes is innocent beyond a doubt and has proven it beyond a doubt, for some reason I have doubts that HPCSA will let the facts get in the way of their judgement. Marika, some of what you’ve written about Joan Adams gives me some hope. (And thank you for your fabulous, in the “very good!” sense, coverage of the trial.) I do hope they do the right thing. If nothing else, this has introduced many, many more people to Professor Noakes and to Banting/LCHF – not something, I’m sure, that HPCSA intended. One of those pesky “side-effects.”
I am not a legal expert but from reading your excellent article, Prof. Noakes and his defence team provided the courts: “RCT’s, Intervention/laboratory trials, Meta analyses, observational studies etc. etc. etc.” and all the HPCSA can provide is: “the balance of probability”. The Dieticians are still going on about “evidence based practices” and obesity and diet related diseases are in epidemic proportions . Go figure …
I agree