Noakes: globally, doctors call on HPCSA to stop prosecuting him


By Marika Sboros

Leading doctors and scientists in the US, Canada and Australia have signed an open letter to the Health Professions Council of South Africa. They want the HPCSA to stop prosecuting scientist Prof Tim Noakes for allegedly tweeting “unconventional advice” that was not evidence-based.

They provide evidence to show that his tweet was evidence-based and thus not unconventional.

Among the signatories is Australian cricket team physician Dr Peter Brukner. Brukner is a professor of sports science at La Trobe University.

Others include leading US, Canadian and Australian endocrinologists, obesity specialists, obstetricians and gynaecologists, oncologists, orthopaedic surgeons, anatomical pathologists, nephrologists, internal medicine specialists, anaesthetists, psychiatrists and researchers.

They have disseminated the letter as a petition. At last count there were more than 9000 signatures. (Editor’s note: the number is now above 11,000.) Many of those are doctors, other health professionals and scientists.

Judge and jury

The HPCSA effectively acts as judge and jury when holding hearings against its members. It is now as appealing its own committee’s comprehensive not guilty verdict for Noakes. That was in April 2017 on a charge of unprofessional conduct. The appeal takes place at its Pretoria offices from February 21 to 23, 2018.

The HPCSA has objected to a request by Noakes’s lawyers to introduce new evidence. It shows that dietitians from the Association for Dietetics in South Africa (ADSA) had inside help from the HPCSA to set him up.

Prof Alastair Millar

Another signatory is South African paediatric surgeon Prof Alastair Millar, who  calls the HPCSA’s case against Noakes ” madness and wasteful. It makes one ashamed to be listed on the HPCSA register as a medical practitioner.”

It beggars belief that the HPCSA has the “audacity” to spend R10m on trying to rubbish the opinion of one of its own. This opinion,  by all scientific evidence’ was “sound dietary advice”, Millar says.

That’s especially significant given the obesity epidemic that is “obvious for all to see, every day all around us”, he says.

Millar hopes for “sense to prevail”. He also hopes that HPCSA Chair Dr T K S Letlape and Vice Chair Dr R L Morar will “be persuaded to halt this madness and wasteful expenditure”.

A driver of the petition is Dr Sarah Hallberg, Medical Director, at Indiana University Health Arnett. She is also Virta Health Medical Director.

Ethics under scrutiny

Dr Sarah Hallberg

Hallberg was lead author of a peer-reviewed Virta study that  Diabetes Review published recently.  It is a one-year trial showing that a low-carbohydrate, ketogenic diet puts 61% of patients with type 2 diabetes into remission.

The petition letter notes “many disturbing ethical issues” in the HPCSA’s treatment of Noakes. However, it focuses on the charge that Noakes’s  tweet  was “unconventional advice”

In it, he said that good first foods for infant weaning are LCHF (low-carb, high-fat). The HPCSA claimed that this was unconventional because it was “not evidence-based”. And because it conflicted with South Africa’s dietary guidelines for infants and adults.

As a result, the HPCSA claimed that the tweet was “dangerous”.

Where’s the real danger?

The petition letter states that Noakes’s tweet is, in fact, evidence-based. All signatories acknowledge this fact.

They present a large body of scientific evidence with references for LCHF diets. They say that researchers have now tested low-carbohydrate diets in more than 70 clinical trials on nearly 7,000 people. These include a wide variety of sick and well populations.

Thirty-two of these studies have lasted at least six months and six trials went on for two years. “That’s enough time to demonstrate the lack of any negative side effects,” the letter’s authors say. And in virtually every case, the lower-carb, higher-fat diets did as well or better than competing diets.

Therefore, the cumulative evidence shows that low-carb diets are “safe and effective for combating obesity“. These diets are also highly promising for the treatment of type 2 diabetes. And they improve most cardiovascular risk factors, the authors say.

Moreover, the best-available data from the US government shows that in 1965, Americans ate 39% of calories as carbohydrates and 41% as fat. These percentages are what nutrition researchers now consider to be within the realm of a “low-carbohydrate, high-fat” diet.

Consequently, all Americans, including infants (the population Noakes’s tweet addresses) were formerly on the sort of diet that he favours.

“This was, of course, before the epidemics of obesity and diabetes from which so many nations suffer today,” the petition authors say.

LCHF aligns with SA’s paediatric guidelines

They note that LCHF aligns closely with South Africa’s paediatric guidelines. (Editor’s note: All the HPCSA’s expert witnesses against Noakes conceded that fact in their evidence.)

The guidelines currently advise: “From 6 months of age give your baby meat, chicken, fish, or egg every day as often as possible. Give your baby dark green leafy vegetables and orange coloured vegetables and fruit every day.”

Noakesand the petition authors have noted that advice is “entirely consistent with a low-carbohydrate, higher fat diet”.

As well, results from the PURE study that The Lancet published recentlysupports Noakes’s advice. PURE is the largest-ever and only truly global epidemiological study. It shows that populations with the highest-fat and lowest carbohydrate consumption had the lowest rates of total mortality

Taken together, these findings “firmly support” the information Noakes tweeted, the letter’s authors say. Further, “virtually no rigorous clinical trial data exist to contradict this body of evidence”.

Thus, from a scientific perspective, the evidence overwhelmingly supports a diet low in carbohydrates and high in fat as “evidence-based”.

The US-based Nutrition Coalition has supported the petition.

  • I am co-author with Prof Tim Noakes of Lore of Nutrition, Challenging Conventional Dietary Beliefs (Penguin 2017). I am contributing author to Healthy Eating, The BIG Mistake by Dr Verner Wheelock (Columbus 2018)
  • Follow me on Twitter @MarikaSboros
  • Like my Facebook page




  1. Big thanks as usual for your tweeting throughout the trial.

    I read through from beginning to end yesterday. Meanwhile Trump was wittering on on the TV news in the background. I started to get paranoid that someone had slipped me some bad acid and I had entered an alternative reality.

    Seriously though I cannot comprehend the prosecution, especially Bhoopchand, believing that they had any semblance of credibility compared to the defence. A one-legged man in an a$$-kicking contest comes to mind. Maybe all the carbs have addled their brains

  2. At 92 and fellow medical graduate of UCT I attend Gym every day and follow much of his advice
    I totally disagree with HPCA’s vendetta against Tim Noakes

  3. Tim you are our hero and role model. According to your advice, a large number of people have got significant blood data normalized. In my case, to a position similar to that I had 40 years ago. I really feel so much younger as well

  4. good luck Tim, your a champion, you are being unjustly tried…for what???…..for helping people! and exposing the dietery bullshit we have been “force fed” for years.
    all the best mate, you have a lot of support

  5. When LCHF is finally “approved” following the stupidity of the HPCSA that will surely be revealed for everyone to see, I just hope that the media will be truthful and resist all attempts to buy it off.

  6. From my Swedish perspective I see just pure and rampant madness going on in the SA medical world. They will be the laughing stock of the world if they continue.

    We had a similar case with a prominent dietitian accusing our LCHF pioneer Dr. Annika Dahlqvist in 2005 for giving LCHF advice to her diabetic patients. She was scrutinized by the medical boards for her advice during three years and meanwhile lost her job. In 2008 she was though cleared and could keep her licens and got her job back.

    As consequence LCHF was then also approved as a treatment for obese and diabetic patients.

    By the way, the T2D of my own wife was put on complete remission on LCHF without medication 10 years ago.

  7. Good luck, Professor Noakes. Your ‘Diabetes Unpacked’ book made me realise that there was an alternative to the low-fat diets which signally failed for me over decades. I started low carb healthy fat eating in October 2017 and, to date, have lost 33 pounds in weight, all the bloat, have more energy, am glowing with good health, according to my friends and family. Thank you for making my life and my diet a pleasure! Pamela Pollin, UK

  8. If those wonderful people at the HPCSA succeed in rigging another hearing and find Tim Noakes guilty, do they think they can put the low-carb genie back in the bottle? Will people who are slimmer and healthier after adopting the low-carb way of eating, suddenly rush out and buy cereals for breakfast and pasta for tea? Will they stop telling their friends about their success?

    What does the HPCSA hope to achieve, except further public ridicule? Could it be that the HPCSA is secretly in charge of making people aware of Professor Noakes’ work? Or was everyone in this deluded organisation appointed by South Africa’s last president and they haven’t yet smelt the coffee?

    It seems that South Africa’s courts will be the place where all the evidence is heard in public and the HPCSA is finally torn to shreds.

  9. Good luck Prof Noakes. If these idiots wish to see further evidence, all they need to do is come see my life over the past three years. How’s that for a long term study? I am now 57 and lost 34kg. Much healthier all-round. Now to find a dead cert solution for sciatica…

  10. The only rational (?) explanations I can conjure up is:”they”have judged the embarrassment of another windmill-tilt… will be less than (someone’s) loss of “face” by accepting their OWN umpire’s decision. Or, and with apologies to that cynical comment on bad newspaper reportage… “Never let the facts get in the way of a Good Vendetta…” You’d think that with their last Epic Fail experience with “judgement”, they’d even give the word a wide berth…

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