Noakes – who ultimately holds the key to his fate

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By Marika Sboros

What – or who – is really behind the prosecution of scientist Prof Tim Noakes? Where did it actually start. Is it just over a single tweet to a breastfeeding mother, which even she said she didn’t take seriously?

Why was one dietitian really so “horrified” that she felt she had no other choice but to report Noakes? Even though she dishes out the same information?

What of claims of a doctor-patient relationship between Noakes and the stranger on Twitter? The same dietitian admitted that there wasn’t one. How did she persuade the Health Professions Council of SA (HPCSA) to prosecute him with what his lawyers see as unethical and excessive vigour?

Or is it just because Noakes says uncomfortable things (to different doctors)? One example: “cardiology is an evidence-free zone”?  Or that “diabetes is not irreversible”?

Is the real key the influence on nutrition advice of food and drug industries. And the influence of the International Life Sciences Institute (ILSI) that started out as a Coca-Cola proxy organisation? For proof of that, look to crack US investigative journalist Russ Greene.

What of the investigation by the Medical Research Council into staff member Dr Ali Dhansay? Dhansay was a key witness against Noakes.  He is also a former president of ILSI in South Africa.

Will the MRC investigation reveal foul play? The HPCSA has turned its hearing into a full-blown trial against Noakes resumes on April 4. Here’s a preview and a look at who holds the key to Noakes’ fate.

Key ‘judge and jury’

Michael van der Nest
Advocate Michael van der Nest, SC, left. Picture: ROB TATE

First up will be closing argument from counsel for both sides. Advocate Michael van der Nest SC will lead closing argument for Noakes. Thereafter, the “jury”, the HPCSA’s Professional Conduct Committee, will retire to consider its verdict.

On D-Day, April 21, Committee Chair, Pretoria advocate Joan Adams, will rule.

Thus, Adams is one who holds the key to his fate. She has an established reputation for independence and integrity. To her credit, she has remained as inscrutable as a Chinese Buddha at a Donald Trump rally throughout this strange saga. When the HPCSA announced, wrongly, that Noakes was guilty last year, Adams reacted with swift, elegant brevity.

Pretoria advocate Joan Adams. Picture: ROB TATE

The guilty verdict was “devoid of all truth”, Adams said. And quite rightly so.  She said a few more words than that. It wouldn’t surprise me if she were an ace poker player. She deserves a medal for the straight face she has kept at some of the HPCSA’s antics and objections in this case.

What if she finds Noakes guilty? What if she finds him innocent – as most experts locally and internationally believe that she will find him?

Certainly, this case is unprecedented and the HPCSA has lots to lose either way. It is the first time that authorities have prosecuted a distinguished, world-renowned scientist for his views on nutrition.

Breach of his rights?

The HPCSA has acted as if its job description mandated regular breaching of Noakes’ rights. Each  time it did so, Adams rapped its legal team on the knuckles, figuratively speaking, in the best of firm schoolmarm fashion.

She reminded the HPCSA that South Africa was a democracy and that Noakes had a constitutional right to a fair trial. As if it needed reminding. The HPCSA appeared oddly oblivious of Noakes’s constitutional rights at times.

In the meantime, more questions buzz around this case than flies feeding off rotting meat.

Advocate Ajay Bhoopchand

HPCSA’s newly acquired advocate Ajay Bhoopchand was almost comical in how hard he tried and miserably failed to block Noakes at every turn at the February 2016 hearing. I say almost because it would have been funny were it not intended so very seriously.

Bhoopchand objected so frequently and on such blatantly spurious grounds that he elicited exasperated comments from Adams.

It did not make sense, Adams said, to charge Noakes with giving “unconventional advice” in a tweet but then try to block him from presenting evidence that the tweet was not unconventional.

In the HPCSA’s dictionary, “unconventional” seems to be a synonym for unscientific and dangerous. At least, that’s how it alleged in the charge and further particulars.

Angels’ wings

Bhoopchand also tried hard to clip the wings of two of the three women who the public dubbed “Tim’s Angels“. They are British obesity researcher Dr Zoë Harcombe, US science journalist Nina Teicholz and Dr Caryn Zinn, a New Zealand-based dietitian academic.

Adams stood as tall as an avenging angel herself, as she blocked Bhoopchand’s path and let the Angels through.

Of course, Adams is only the Chair of the “jury”. Other members include an HPCSA staff member, Noakes’ external doctor peers and a member of the public. They are all important cogs in this wheel of justice. They also hold keys to Noakes’ fate in this odd case.

Yet stranger still is the HPCSA’s charge against Noakes, not just because it is badly constructed. It’s also because the HPCSA fiddled the charge, breaching its own rules in the process.

Click here to read: Dietitians trying to cover their backs?

Thus, the charge ended up a clumsy mouthful. “Unprofessional conduct or conduct which, when regard is had to your profession, in that during the period between January 2014 and February 2014 you acted in a manner that is not in accordance with the norms and standards of your profession in that you provided unconventional advice on breastfeeding babies on social networks (tweet/s).”

Bending the rules

It is common cause by now that Johannesburg dietitian Claire Julsing Strydom reported Noakes for a single tweet in February 2014.  Strydom was president of the Association for Dietetics in SA (ADSA) at the time.

The HPCSA changed her complaint from personal to professional and made ADSA the complainant. Its own rules preclude such changes.

That set off a chain of events that has cost millions on both sides, with no end in sight. Of course, there is an end in sight – when Adams rules on April 21.

It’s also true that HPCSA hearings are not supposed to be adversarial. They are supposed to be dispassionate inquiries into the truth of a matter. However, from the outset, the HPCSA’s approach has been nothing but adversarial.

As a result, the public dubbed it the Banting for Babies Trial. I dubbed it Theatre of the Absurd when it became clear that the trial wasn’t about babies at all. Nor was it also  about breastfeeding or what doctors can and can’t say on social media.

Adams has negotiated those legal and ethical minefields with a gentle, intelligent humour at times.

Breaching invisible rules

After all, the HPCSA doesn’t have guidelines for health professionals on use of social media. Therefore, it doesn’t make sense to accuse Noakes of breaching rules that don’t exist.

A lot of what it has done has made little sense to the dispassionate legal onlooker. Like going after Noakes as if he were a common criminal, a killer bent on “genocide”, as some doctors and dietitians involved have alleged.

It is telling that the HPCSA was prepared to employ Bhoopchand as part of an expensive team of external lawyers only after its case appeared terminally ill.  Its doctor members will have to cough up for the costs – from their annual HPCSA subscriptions and registration fees.

A reliable source told me that Bhoopchand presented a bill of close to R1million for seven days of the February 2016 hearing alone. Neither Bhoopchand, nor instructing attorney Katlego Mmuoe, of Mmuoe Attorneys, nor the HPCSA would confirm or deny the amount.

The HPCSA has stonewalled all my requests for information from the outset.  So have ADSA and all universities and academics involved. It’s as if they are all suffering  a severe bout of laryngitis.

Oath of silence?

Or perhaps, as Noakes believes, all these doctors and dietitians have sworn an oath of silence, Mafiosi-like. They want to protect themselves from any future consequences of their actions against him.

After all, if Adams rules in Noakes’ favour, that means his opinions are correct and their opposition to them is wrong. And therefore, the doctors and dietitians involved clearly have a lot to lose.  At risk are their reputations, careers, funding and livelihoods. Also at risk are the vested interests in food and drug industries that make billions from nutrition advice these doctors and dietitians enthusiastically dish up.

At the October 2016 hearing, Bhoopchand even suggested that Noakes was using the hearing as a “platform” to gain media attention for LCHF. He begged Adams and her “honourable committee” not to allow that “to happen any further”.

Click here to read: Did doctors set him up in cat-and-mouse game?

Van der Nest  for Noakes was barely restrained in response. Looking directly at Bhoopchand, he said: “With all respect to our learned friend, that is outrageous.”

“Professor Noakes did not ask the HPCSA to prosecute him,” a steely Van der Nest said. He did not ask to spend more than two years (now more than three) under ongoing stress and spend a fortune flying in experts from all over the world to defend him.”

The price of holding a different opinion

Dietitians, all ADSA members, brought the case against Noakes because he “had the temerity to hold a different view to them.”

Once again Van der Nest looked directly at Bhoopchand. “Do not get upset when you prosecute someone and he puts up a fight.

“That is the consequence of prosecuting someone for a tweet that the so-called ‘patient’ ignored. That is why we are here. (He) is the defendant. He is entitled to defend himself to the fullest and he will.”

The hush in the wake of those comments at the hearing was almost palpable.

That puts the spotlight’s back on all the universities involved in the case against Noakes.

Will North-West (formerly Potchefstroom) University distance itself from the evidence of its professors Hester “Estee” Vorster and Prof Salome Kruger, who were witnesses against Noakes?

And will it investigate their links to ILSI and/or the sugar industry in South Africa as the MRC has done of Dhansay? What about Vorster’s secret report, which the HPCSA kept from Noakes and used to build its case against him?

Will UCT stay silent?

Will the Universities of Cape Town and Stellenbosch also investigate all their academics involved in the case? If so, the universities will be busy for a very long time.

What about the letter to the Cape Times, which UCT academics wrote in 2014? In it, they defame Noakes and accuse him without proof or grounds for correctness of their views.

Despite copious emails to all the letter’s authors and university vice-chancellors, all remain resolutely silent.

There is also the vexed question of the so-called Naudé Review that the HPCSA used as the foundation of its case against Noakes. The authors are Stellenbosch and Cape Town University researchers and a lone University of Liverpool researcher.

Mistake or mischief against Noakes?

Noakes and Harcombe have re-analysed it and found it so riddled with errors as to be fatally flawed. To date, the authors have not addressed the errors.

Click here to read:  No mistakes or mischief against Noakes? Fat chance! 

There are also questions concerning evidence of “irregular conduct” of Prof Amaboo “Ames” Dhai, head of Wits University’s Steve Biko Centre for Bioethics. Dhai chaired the HPCSA Preliminary Inquiry Committee that charged Noakes.

Dhai wouldn’t comment, although Wits vice-chancellor Prof Adam Habib would – sort of. He said that Dhai had assured him of “no wrong doing”. I replied that he could not just take her word for it. Wits needed to investigate the evidence against Dhai on public record at the hearing fully, transparently and preferably independently. That was if it took such complaints against a staff member seriously.

The hearing is revealing whose views on nutrition really are “unconventional” and dangerous. It could also ultimately expose who really is guilty of unprofessional behaviour.

Time, April 21 and Adams will tell all.

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20 Comments

  1. Am I allowed to sue all the people for wasting Tim Noakes time? As a banter of 4 years I could have used the new research Noakes could have done in this time that was instead wasted with this absurd trial. Surely that is a more legitimate case than what this Strydom woman has come up with!!

  2. I cannot see how the verdict can be anything other than not guilty. But I feel quite worried because of the way politics and commercial interests seem to always find a way to uphold the status quo for those with the most self interest. The experience here in Australia with Gary Fettke at the cak-hands of our regulator leaves me very afraid. Easy to waste one person and walk over his corpse to win approval from the massive self interests who stand to be severely damaged. Joan Adams is an amazing woman but she is only one woman who could be under massive pressure not to cause an international reverberation of unprecedented proportions. I hope she stands to take her place as a hero at the historical and tectonic turning point when it mattered the most to human health.

      • I HOPE you are right about her/their integrity!

        I’m mindful of certain Government Inquiries here in the UK, where judges/Lords asked probing, incisive questions, pair close attention to the replies – then came to the conclusion the Government required.

  3. Great reporting on the case Marika, thanks for detailed updates.

    What we are seeing happen here is far more important than the specifics of dietary fat; we are seeing attempts to quash freedom of speech, and the right to have personal and professional opinions that go against the established norm. So it’s really a case of civil liberties that has far reaching ramifications.

    It seems unlikely that Noakes will be found guilty of anything, there are clearly too many flaws in the “charge” against him, and we can hope that courts are a place where the letter of the law is read and practiced accuratly; rather than aggressive reactions to emotive discussions.

    From a purely dietary perspective; the offending tweet actually advocates keeping the baby on the breast, which is advice we are not given often enough. We all remember that nasty Nestle lot preaching the virtues of their synthetic formula’s to new mothers, as if their own milk were somehow nutritionally deficient; and deliberately targeting poorer communities for added insult.

    It happens that I don’t personally advocate the HFLC approach to nutrition, vegetables being a carbohydrate and all…

    Yet I do support its focus on naturally occurring whole foods, and also the idea that “the man” can’t simply get heavy on anybody who dares to challenge the status quo.

    As you pointed out in the article, there’s a lot riding on the outcome either way.

    • Hi Thomas, fascinating that you interpreted Prof Noakes’ tweet to encourage the mother to continue breastfeeding her baby. Every single expert witness for the HPCSA and the dietitian who started it all claimed the exact opposite. They all said that he was a really bad man for telling the h mother to stop breastfeeding. Even worse for telling the mother to put her baby on a “dangerous” ketogenic diet. I wondered how they could say all that with a straight face. And what universe they were currently inhabiting because it sure wasn’t the same one I was on. The stuff and nonsense they made up against him was something to behold. Alternative facts. Straight out of Trumpsville USA! Someone had to be paying them to be so creative with the truth. It will be very interesting to see what the HPCSA comes up with to claim that he is guilty and of what on April 4. Watch this space! I’m intrigued to know more about your view of LCHF, as you say you don’t personally advocate it.

      • Hi Marika, thanks for engaging with my comment.

        HPCSA… Trump… dare I say it… our very own Jacob… there are lots of people spinning their own web of ‘truth’ to suit their own needs. It would be funny if it weren’t so potentially harmful to the dietary-education profession, and the public at large.

        Re: the tweet, it clearly says that babies need to be breast fed until it’s time to ween; which itself is a challenging and often emotive subject… how long should a baby breast feed? Some say days, others weeks, others months, I know of children aged 4 who still breast feed; and others who never experienced it even once.

        The difficulty then, is that we can’t “mass-prescribe” diets to the populace. There are certain general rules of engagement e.g. water is good, refined sugar is bad… But the nuance of personalised nutrition is, I think, highly individualised; which may be one reason why some people get upset by Prof Noakes message, and by dietary advice in general.

        Re: HFLC, I have looked at this extensively over the past 10 years. I feel that all food groups are important, including fresh fruit and ‘crops’ such as oats, rice and root vegetables. HFLC, Banting, Paleo et al, take issue with agriculture; yet the global population boomed post-agriculture, especially in places like China (rice), Europe (wheat) and South America (corn), all farmed carbohydrates.

        Additionally, HFLC staples such as olive oil, are farmed crops that pre-agricultural humans didn’t eat. And as for caged animals… no human should eat those, and no health practitioner should recommend they do, which does then make HFLC and expensive enterprise in the modern paradigm.

        But, of course, in every instance, it’s a matter of quality over quantity, and remembering to eating your greens, including raw salads etc. no matter what diet your follow.

        Anthropologically-speaking, it’s a massive, fascinating discussion. Which is why I support Tim in his plight. I respect him as a researcher, and his genuine intention to educate others. We cannot see dedicated, local, industry experts punished for sharing their research! A terrible and dangerous precedent will be set if Noakes get’s prosecuted.

        All of us in the dietary/nutrition/health community watch with baited breathe; we are all on trial here.

  4. Is there a “I support Tim Noakes” image that we can use to show our support for him on our social media platforms (like the one many people use to show support for Gary Fettke)?

  5. It’s sad to see a Dr of good intention and decades of research and hard work being persecuted. Even if he made a mistake don’t you think humanity should ask what his intentions were….. simply to help other people on earth. Where is the compassion and understanding of the big picture of what this mans life work has been about?

  6. The implications for this case are absolutely enormous. Noakes has chosen to use this case as a vehicle for demonstrating to the world that the ‘diet heart hypothesis’ is and always has been fatally flawed. He could have simply addressed the core of the complaint ie the tweet in question and demonstrated that he was not providing professional advice on a one to one basis rather making a general comment on mothers and babies. From the evidence it is absolutely clear that there was no doctor patient relationship and therefore the matter could have been settled some time ago. Having said this however I can understand the motives of Noakes who has run into brick walls from the establishment in his attempts to change dietary guidelines for heart disease and diabetes. While his motives are admiral there is far too much at stake for industry and health care professionals for them to allow this to happen.

    From my experience in the Justice System what will probably happen is that the tribunal will find the charges unproven and the rest of the expert evidence presented by the defence will disappear into obscurity and be totally ignored by the Health profession and Governments and the status quo will continue. I think that change will happen but it is not going to occur overnight nor as a result of the evidence presented in this case, as brilliant as it was it simply pointed to all the evidence that is and has been in the public arena for some time.

    I should point out that I am a great fan of Prof Noakes, he is my hero and was instrumental in my change of diet and lifestyle that has resulted in me being able to reverse my type 2 diabetes.

  7. I don’t care about what the HPCSA thinks, or the CONventional dietitians and the CONventional doctors. Dr Tim Noakes is my hero. He certainly will not fit into the pseudo-science box of the CONventional mindset and I applaud him for it!
    His dietary principles works! AND I am tired of the CONventional “experts” that seems to have a conflict of interests: MONEY rather than our health and well-being. AND by the way … I live in my body and therefore I live with the consequences of what I allow to happen to it. I decide what I put in my mouth. I had asthma ( yes it is now past tense for more than seven years) by changing my diet to much like what Tim Noakes prescribes. I do not take ANY pharmaceuticals and I do not have those nasty allergies or any coughing and congestion in my chest.

  8. Cannot wait for this to be over for Prof. It has dragged on and on unnecessarily. We all know the truth or at least the open minded ones of us that want to and are not being paid to be closed minded and follow the lies.
    Supporting Tim from the USA??

  9. What an incompetent bunch of transparent bufoons the HPCSA are. The medical establishment and junk food producers are very frightened of the repercussions of what Tim Noakes is saying. The official advice on diet is making the population fat and diabetic. Medical advice on heart disease and diabetes is just plain wrong. Dietitians care more about their sponsors than public health.

    No wonder they’re all worried. They can see the public increasingly ignoring them and getting better as a result. Could anything be more infuriating or frightening?

  10. Such a waste of time and money. Noakes saves lives but hospitals let people die. A 90-year-old nearly died because a hospital didn’t give him food and water for three days and we can do nothing.

    • It can prove to be good invested time and money, if it cracks the closed nutrition society, and the monopoly they think they have of giving unscientific advice to the public.

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