Teicholz explodes fat bombs during Noakes trial

Nina Teicholz
US investigative journalist Nina Teicholz with Prof Tim Noakes

By Marika Sboros

The Health Professions Council of SA (HPCSA) has faced its fair share of obstacles in its road to prosecuting scientist Prof Tim Noakes. For example, major obstacle was research showing that negative effects of conventional dietary advice on adults but also on infants in their most formative years.

US investigative journalist Nina Teicholz was an expert witness for Noakes at the HPCSA’s fourth session of the hearing against him in Cape Town on October 25, 2016. She gave explosive testimony, as this first of a two-part series shows.

Why was her evidence so explosive? Well, for starters, the HPCSA has charged Noakes with unprofessional conduct for giving “unconventional advice to a breastfeeding mother on a social network (Twitter)”. That was for a single tweet in February 2014.

Noakes tweeted that good first foods for babies are LCHF (low-carb, high-fat). In other words, he suggested meat, fish, chicken, eggs, dairy food and vegetables.

In her evidence, Teicholz showed that Noakes’ tweeted opinion was actually evidence-based. Therefore, it was not “unconventional” and “dangerous” scientifically, as the HPCSA was alleging.

Experts could consider his views unconventional in that they conflicted with South Africa’s low-fat, high-carb dietary guidelines these days, Teicholz said. However, they wouldn’t have considered his views unconventional as recently as 1965, as she demonstrated.

A big, fat surprise!

Big Fat SurpriseIn her testimony, Teicholz drew heavily from her book, The Big Fat Surprise. It’s a seminal, unique work published in 2014. It is also the fruits of 10 years’ research into what one wouldn’t ordinarily think of as a murky world: nutrition science.

Unusually for a lay author, Teicholz has had reviews of her book in top medical journals. The American Journal of Clinical Nutrition (AJCN), a premier journal in the US, has said of The Big Fat Surprise that “every nutritional science professional and all scientists should read (it) as an example of how limited science can become federal policy”.

The AJCN described her book as a “historical treatise on scientific belief versus evidence”.

In The BMJ, former editor Dr Richard Smith was similarly expansive. In a three-page review, Smith said that the book “shook” him. Teicholz had done “a remarkable job in analysing the weak science, strong personalities and vested interests in political expediency”.

The Economist named The Big Fat Surprise the Number 1 science book of 2014 and called it a “nutrition thriller”.  Teicholz joked that that’s  “probably an oxymoron”.

Murky world of nutrition science

Still, her book is a detailed and fascinating, forensic journey into the murky world of nutrition science. It reveals the policy, personalities, politics and influence of industry in the construction, implementation and maintenance of official dietary guidelines. It is often an ugly picture.

In the book, Teicholz analyses the last 50 years of nutrition policy in the US. This is particularly as it relates to dietary fat and cholesterol. She also looks in depth at the current influential US dietary guidelines the government introduced in 1980. And how the guidelines lacked robust science to back them up.

Teicholz showed how, in the ensuing years, most countries, including the UK and South Africa, have followed the US model.

In her evidence, Teicholz looked at the science to support the guidelines’ low-fat, high-carb recommendations when the US first introduced them. She showed that top scientists knew that there was evidence to the contrary. They simply ignored or suppressed the evidence for decades.

The consequences for public health have been nothing short of tragic, she told the hearing. Teicholz said that the US guidelines have been a major contributor to the pandemics of obesity, diabetes and heart disease.

As an aside, the US Dietary Guidelines Advisory Committee now warns that low-fat diets actually cause atherogenic dyslipidaemia. In other words, low-fat raises the risk of heart disease. Few writers, other than Teicholz, have picked that up.

Just as shocking, Teicholz told the Noakes hearing that official dietary advice deprived infants and children of vital dietary fats needed to absorb vitamins and other nutrients during their most formative years.

More than ‘just a journalist’

The sub-text of her evidence throughout was that the same applied to South Africa’s dietary guidelines.

Critics of Teicholz have often tried to dismiss her as “just a journalist”. Bhoopchand wisely didn’t go there. After all, Teicholz has an impeccable academic pedigree. She studied science and politics at Yale and Stanford Universities (her undergraduate degree is from Stanford, in American studies). She also has a master’s in philosophy from Oxford University in the UK.

Teicholz has told me that her education in political science had served her as well as her courses in science.

“Unfortunately, the story of nutrition policy over the past 50 years is just as much about politics as science, perhaps even more so,” she said.

Click here to read: HPCSA case against Noakes falling apart at the seams 

Teicholz told the hearing how her nutrition journey began: with an investigation into trans fats for Gourmet, a food magazine, in 2004. Consequently, this assignment introduced her to the “world of fat”.

“Fat is what we obsess most about in nutrition,” Teicholz said, “how much fat to eat, what fat, good fat, bad fat, low-fat, non-fat.”

Have we ‘got it all wrong’?

Her research into transfat quickly threw up an intriguing possibility. It is that everything we thought we knew about dietary fat “is completely wrong”. And that US  nutrition policy had probably gone “completely upside down and backwards as to what we should be eating”.

Teicholz is not given to sweeping statements. She is thoroughly grounded in the scientific method. One of the many strengths of her book is her dogged, critical, independent approach to research. She did not rely on summary statements or review papers. Instead, she went back to all the original papers, sometimes back to the original data.

In many cases, scientists tried to hide their data – some of it published in foreign language publications. Teicholz hunted those down too and got someone to translate the studies professionally.

She interviewed hundreds of scientists, most of them top in their fields in the US and internationally. Some interview subjects said in hushed tones that they “couldn’t talk about fat”. They slammed the phone down. Teicholz wrote that she had found that unsettling and that she felt at times as if she were  “investigating the mob”.

The analogy was not lost on Noakes and his lawyers.

Shaky pillar

In her trial testimony, Teicholz covered the work of US physiologist Ancel Benjamin Keys who studied the influence of diet on health. Keys believed strong that dietary fat caused heart disease. He called his belief the diet-heart hypothesis that became a pillar of US dietary guidelines.

Teicholz showed how his belief still lies at the heart of dietary guidelines across the globe today.

Teicholz also described how, in the 1960s in the US, the only group telling people how to eat and what lifestyle habits to have to avoid a heart attack was the American Heart Association (AHA).  The AHA did so firmly under the guidance of Keys.

In 1961, the AHA began advising men not to eat saturated fat and dietary cholesterol. This was the very first official advice anywhere in the world telling people to avoid saturated fat and cholesterol to prevent heart attacks, Teicholz said. “This was where it was all born,” she said.

And from there, as she showed, it spread globally and reached South Africa’s shores.



  1. The HPCSA are not fit for purpose – period.
    Ancel Keys is an utter disgrace!
    Prof Tim Noakes is a super hero!
    Nina Teicholz rocks!

  2. They slipped that in quietly:

    “… the US Dietary Guidelines Advisory Committee now warns low-fat diets cause atherogenic dyslipidaemia. In other words, it raises the risk of heart disease. Few other than Teicholz have picked that up.”


    I think that’s called “covering your back”. The USDA obviously fears the current (high carb/ low fat) paradigm – for which it has been in large part responsible – is going to break down sooner rather than later. When it does there could be some tough questions asked and some public investigation of it all – senatorial committees and whatnot.

    • Yes. There seems to be an awful lot of covering of exposed backs going on in this strange saga. Most odd is Association for Dietetics in SA (ADSA) president Maryke Gallagher’s latest claim in a communication with members during the latest session of the HPCSA hearing against Prof Tim Noakes: that neither ADSA not former president Claire Julsing Strydom ever lodged a complaint against Prof Noakes. Gallager keeps insisting that ADSA and Strydom only asked the HPCSA a question (she calls it a “query”) and were simply “seeking guidance” from the HPCSA. Yet Strydom’s evidence in chief and the HPCSA’s own actions tell a very different story. I’ve written about these anomalies in https://foodmed.net/2016/10/28/noakes-trial-dietitians-trying-cover-their-backs-lchf/

      • Hmm … you published the content of Ms. Styrdom’s tweet (responding to Prof. Noakes’s “controversial” one) here recently. I’d say its tone was triumphalist down to the use of upper-case text. It had I’ve got you now written all over it. CaptainCaps-lock may be backing away now, but I really don’t buy that.

        My sense is that while the dieticians’ lobby was fully awake to the commercial advantages of the low fat/ high carb paradigm (namely sponsorship) it pretty much assumed that paradigm was well-founded. So interest and duty seemed to coincide nicely.

        I’d be surprised if they’re not becoming aware by now that the current paradigm is, in fact, a house of cards. I suspect the same is true of Mr. Boopchand – who I think you said had some medical background. I doubt he’s really questioned the assumptions that background would have bequeathed to him. I also doubt he’s paid much attention to the work of Zoe Harcombe or Nina Teicholz before, although he should have done. Reading between the lines, Zoe’s testimony probably shook him up a little, and Nina’s has undermined his beliefs to the point where he’s not sure how to respond.

        I think it’s clear that *the* big problem in medicine, and dietetics, is, as Prof. Noakes says, insulin resistance. Now depending on the individual that might be turned round by:

        (a) a low carb diet;
        (b) swapping out refined carbs in favour of unrefined carbs;
        (c) a ketogenic diet;
        (d) intermittent fasting;
        (e) block fasting (c.f. Dr. Fung’s work);
        (f) better sleep;
        (g) any other factor known or as yet unknown that impacts upon IR;
        (h) some combination of the above.

        But, however you cut it, insulin resistance is a HUGE issue – and one that the dietitians, and the medical profession, with some honourable exceptiona, has largely missed. This, of course, includes most cardiologists – and even diabetologists.

        It’s the elephant in the room. That so many people, many of them well-qualified, have no understood what’s going on around them is surprisingly – no, rather it’s simply astounding. It’s a fact, though.

        • HPCSA advocate Ajay Bhoopchand is a medical doctor, or perhaps was. He declined to say whether or not he has kept up his registration with the HPCSA. Prof Noakes’ advocate Dr Ravin ‘Rocky’ Ramdass is also a medical doctor. He had no problem telling me he has kept up his registration. The difference between the two “sides” in this case is remarkable: one side is thoroughly open. The other isn’t. Nor are ADSA and Claire Julsing Strydom. Their reticence doesn’t reflect well or inspire any confidence in the little they do say.

      • So, the dietitians didn’t make a complaint? Are they really stupid enough to think anyone will buy that? I doubt Tim Noakes, or his friends, will stay quiet on the issue. The ADSA doesn’t seem to possess anyone with a smidgeon of judgment. Every action they take makes them look undignified and foolish. An acknowledgement that this whole business was a mistake would be a sensible step for them, but they’re far too dim to see that a credible exit strategy is required. A bit of humble pie is better than looking continually foolish and unprincipled.

        • It takes courage and big heart to admit you got it wrong. It may be a triumph of hope over experience, but I live ever in hope that sanity and common decency will prevail.

  3. Excellent summary. Teicholz and Harcombe have shown the fabrications and agendas behind the low-fat diet. It’s amazing how relatively easy it was to put this nonsense into the system, yet how difficult it is to remove and go back to sanity. Of course, huge vested interests have grown up behind it.

    It always makes me laugh when they criticise Teicholz for “just being a journalist.” What they mean is “someone who disagrees with us”. If someone of her credibility agreed with the dietitians, they’d praise her to the skies. This journalist has done more for public health than all the world’s nutritionists put together. They have one subject to get right and almost all of them get it wrong. I greatly respect those few independently-minded ones who are actually helping people to achieve good health.

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