UPDATE:Click here to see who and what went down at the hearing against Prof Tim Noakes in Cape Town on June 4.
By Marika Sboros
It’s the nutrition science equivalent of the Spanish Inquisition: the Health Professions Council of South Africa (HPCSA) ‘Banting for babies’ trial, as the hearing against dietary heretic Prof Tim Noakes has become known.
If the hearing in Cape Town on June 4 and 5 goes against him, Noakes, a medical doctor, University of Cape Town emeritus professor, and a scientist rated A1 by the National Research Foundation, could be struck off the roll.
Whether that will happen, is anybody’s guess right now. My guess is it won’t. My guess also is that the HPCSA is marshaling a host of orthodox forces that will go down fighting all the way to make sure it will happen.
It all started way back in February 2014 when Johannesburg dietitian Claire Strydom, president of the Association for Dietetics in SA (ADSA), reported Noakes to the Council for a single tweet advising a mother to wean her baby onto meat and veg.
You might not think that was such terrible advice for Noakes to give a mother, since he is both a medical doctor specialist in nutrition, and since Strydom and ADSA now claim always to have advised the same thing. So do dietitians, their associations and top medical and nutrition specialists worldwide.
It’s also the way babies have been raised in traditional societies worldwide for centuries, without any research showing any adverse effects whatsoever. (If you doubt it, just ask Canadian physician Dr Jay Wortman and the many others who have done extensive research into traditional diets.)
It makes the notion that ‘Banting’ (as low-carb, high-fat is known in SA), is potentially a ‘dangerous experiment’ – as registered dietician Lila Bruk is quoted as saying in a Health24 report – seem overly alarmist, if not downright ignorant in this scientific day and age.
You might also wonder at the legality and reasonableness of the HPCSA keeping this sword of Damocles hanging over Noakes’ head for close on 18 months for just one tweet, but that’s just one of many anomalies this case throws up.
I can’t tell you exactly why Strydom was so disturbed by Noakes’ tweet she felt the only avenue open to her was to report him to the HPCSA, or whether she reported him in her personal capacity from the start or as ADSA president, and whether she had a mandate to do so. After back and forth communication, , she confirmed in an email that she had laid the charge, but would “prefer” that I report that ADSA had laid it. I asked for clarification of “prefer”, but got none.
I also can’t tell you why the Council has decided to conduct this hearing at all, when so many top medical and nutrition specialists and scientists internationally (including some locally who prefer not to be quoted for obvious reasons) continue to express amazement and disbelief that it has.
The conspiracy of silence the HPCSA and ADSA have thrown up around this case hasn’t helped. It’s just another of the many disturbing anomalies.
Both have refused to answer most of a long list of questions I put to them, even those unrelated to the specific merits of the case. Both have stonewalled me throughout, citing the sub judice rule, yet anyone with half a legal brain knows it doesn’t apply in this case.
The most important public hearing ever (for those who eat food): Thu 4/6 at 10am, Southern Sun Newlands, Cape Town. http://t.co/0gv4IcEUxn
— Jan Vyjidak (@janvyjidak) June 2, 2015
Johannesburg attorney Neil Kirby, Werksmans health legal eagle, told me diplomatically in an email that he is “not aware of the application of the sub judice rule to matters before the HPCSA”. Every other lawyer I spoke to said the same thing.
The fact is the HPCSA is public body, not a court of law. It is constituted in terms of the Health Professions Act, national legislation, and consequently it is a public body as defined in the Promotion of Access to Information Act (PAIA). In desperation, I also requested information from the HPCSA according to my rights under the PAIA, but got precisely nowhere.
The HPCSA is supposed to exercise its powers openly, transparently, and accountably. So far, I haven’t seen any evidence of that. I couldn’t even get the Council to come clean on the exact wording of the charge against Noakes, and whether it was true, as has been suggested, that the charge would now cover giving “unconventional advice”.
Fiddling with wording of charges?
All I could get out of HPCSA communications manager Priscilla Sekhonyana in an email on May 20 (after my first email to the Council on April 21) was that: “Currently, HPCSA cannot provide the details of the charge/s as they have not yet been disclosed to the Professional Conduct Committee. However, on 4 &5 June 2015, the charges will be disclosed to the committee, whereby, Professor Tim Noakes will be expected to plead to the charge/s.”
One would think the Council’s Professional Conduct Committee would want to know well in advance what the charges are, particularly since Noakes must have been preparing for the hearing for at least three months.
And if anyone is fiddling about with the wording, or even thinking of making any substantial changes to charges at this late stage, it doesn’t augur well for the HPCSA’s ethics and competency – or a fair hearing for Noakes.
I asked Noakes’ Cape Town attorney, Adam Pike, of Pike Law, for comment on whether the HPCSA had supplied specifics of charges. He confirmed that it had, but declined to comment. He has clearly decided to say as little as possible, so as not to prejudice his client’s case in any way.
I’d say the HPCSA’s deafening silence and ADSA’s oddball antics are doing that all on its own.
I haven’t been able to find out from the council who will be on the panel hearing the charge/s against Noakes, who their “expert witnesses” are they have called to testify against him, whether the charge of unprofessional conduct covers “unconventional advice”, just what constitutes unconventional advice and whether the delivery method – Tweeting – comes into it as well.
In fact, I haven’t been able to find out much about this peculiar case, except that it is making South Africa the laughing stock of the scientific nutrition world.
From my vantage point, the signs are not auspicious that Noakes will get a fair hearing. In fact, it seems to me the HPCSA has already made up its mind on key issues surrounding the case.
— Derek Watts (@DerekWatts) May 31, 2015
One of those is the safety and efficacy of low-carb, high-fat (LCHF, AKA Banting) eating regimen Noakes now supports so vocally, and backed up by latest and most compelling scientific evidence.
The problem is the HPCSA is already on public record as warning the public against LCHF – in an unusual move in October 2012, the Council issued a statement by the chairwoman of its Professional Board for Dietetics and Nutrition Prof Edelweiss Wentzel-Viljoen . The statement didn’t mention Noakes by name, but expressed “concern” over the “controversial unhealthy diets that have been recommended in the media by individuals, who are not specialized in the dietetics and nutrition fields”. (The HPCSA was making it pretty clear who it believes should be handing out dietary advice to the public.)
If Wentzel-Viljoen did mean Noakes (he is after all well-known or infamous, depending on your point of view, as the pioneer of LCHF, and has been venomously attacked in the media ever since his turnaround in 2009 in favour of LCHF), she got her facts completely wrong about him not being specialized in dietetics and nutrition. That’s just one example of the dietetic world busily marshaling its forces against Noakes since Strydom laid the charge.
Here’s another: In July 2014, nutrition researchers at Stellenbosh University’s Centre for Evidence-Based HealthCare hastily cobbled together a meta-analysis of 19 studies, published in the online journal PLOS One, and concluded that it showed that low-carb diets were no better than “balanced diets” for weight loss. (International obesity researchers took a very different view of the study.) ADSA and the HPCSA issued a joint statement on the Centre’s research, along with the Nutrition Society of SA, and the Heart and Stroke Foundation of SA – unusual behaviour given that the complaint against Noakes had already been laid.
It looked suspiciously as if the ADSA and HPCSA were colluding and attempting to fortify their position in some way.
Silencing the messenger
As well, why would ADSA concern itself with discussing Noakes and his diet at their KZN meetings and subjecting themselves to a presentation on “Low-Carbohydrate, High Protein Diets: Long-term solution for weight loss and health” as early as March 2014? If they were genuninely interested in the topic, not in muzzling the messenger, they could just have invited Noakes to talk to them – or at the very least invited him on the same panel, in the interests of balanced nutrition information.
As a sports scientist for decades, Noakes’ specialty has always been a specialist in dietetics and nutrition. He has also been studying infant nutrition for the past four years, and will be bringing out a book soon, titled Raising Superheroes. Medical specialists, including a paediatrician, have already denounced it even before it is published. If that isn’t a sign of professional jealousy and territoriality, I don’t know what is.
There are many other key scientific questions the HPCSA appears to have answered for itself, in its rush (as I see it) to find Noakes guilty on a charge of unprofessional conduct, no matter how spurious.
One of those is the role of saturated fat and the diet-heart hypothesis.
Top nutrition bodies worldwide, including world’s largest dietitian and nutritionists association, the US-based Academy of Nutritionists and Dietitians (AND) of which ADSA is a member, recently declared (rather clumsily) that saturated fat should be “de-emphasised” as a nutrient of concern in the diet.
Fat not a health demon
In other words, it finally acknowledges that the science is currently all there (and actually has been all along, it was just ignored and hidden) to prove that saturated fat is not the health demon we’ve all been led to believe it is. That followed a US government dietary advisory group saying the same about cholesterol.
— Tim Noakes (@ProfTimNoakes) June 2, 2015
That’s a big problem not just for the HPCSA, but for all the powerful vested interests in the food and pharmaceutical industries ranged against Noakes. These are industries that have made fortunes from making low-fat, high-carb foods, and drugs to lower cholesterol, and clearly want to continue doing so.
The HPCSA also has to define low-carb, and decide how low a diet has to be before it deserves to be called low-carb. Good luck with that one.
And it has to decide on another of the most contentious topics in nutrition science today: whether carbohydrates really are an essential nutrient, when all the science is stacking up to say they are not. It’s no coincidence that these members of what I like to call the “CarboNostra” are all in bed with Big Food, and it is Big Food that so desperately wants to silence Noakes.
If the Council does strike Noakes off the roll, it will open up its own medical can of worms, given Noakes’ constitutional right to free speech, and the Council’s close ties with ADSA and Big Food, as recent posts in BizNews by Sonia Mountford have been pointing out.
And if you think the medical profession (including the dietetic industry) is above dirty tricks worthy of the most corrupt politicians, you might think again after this case.
It will be interesting to see if this really is a fight between Big Food and Big Pharma against Noakes, with the Council and ADSA as their proxies, as many experts are suggesting internationally, on and off social media.
You don’t have to be a nutrition rocket scientist or an economist or a medical or dietetic professional to work that out. All you have to do, as they say on Twitter, is #followthemoney.