Summary of Prof Noakes’ “Baby Banting” Trial

Claire Strydom, former president of the Association of Dietetics in South Africa (ASDA), lodged a complaint against Prof Noakes for a tweet he made in February 2014, in which he said that low carb high fat foods were good first foods for babies.

According to the HPCSA, he acted in a manner not in accordance with the norms and standards of the profession, by providing "unconventional advice on breast feeding babies".

The hearing against Prof Tim Noakes by the Health Professions Council of South Africa (HPCSA) resumed on Monday 23 November. You can read a summary of the first few days here.

Prof Noakes could easily have made the hearing disappear by deregistering as a medical doctor and the council would no longer have had jurisdiction over him.

"I don’t have to be here. I don’t practice medicine. I gave it up 15 years ago. But I believe that South Africans have to hear the truth. I have incurred enormous costs, but I believe so strongly that this message needs to get out. That’s why I am here." Prof Noakes

Prof stated that he alone would incur the costs of the trial and not the Noakes Foundation, but fortunately a significant portion of his legal team graciously donated their time pro-bono.

"I am indebted to my legal team for their generosity that will make a robust defence possible in this case. They believe, as do I, that this is a watershed case for both South Africa, and indeed the world, and which cannot be approached in a haphazard way with inadequate planning and resources." Prof Noakes

It is estimated that the hearing has cost HPCSA over R1 million, which SA taxpayers are said to be responsible for.

On day one

of the trial, the HPCSA tried, and failed, to prevent the Noakes’ legal team from presenting evidence by video link. The reason the team had to seek evidence outside of South Africa was because no South African specialists came forward, through apparent fear of what might happen to them.

Claire Strydom then tried to present evidence that the Noakes’ team hadn’t seen and began to give expert instead of factual testimony.

On day two

, Claire Strydom continued with her testimony, but kept straying into expert territory, instead of sticking to the facts. During the cross-examination, "Julsing-Strydom said she didn't believe the Banting advocate should be struck from the health professions roll for giving unconventional advice" and she admitted to over-reacting "when she sent a tweet about how horrified she was by Noakes’ advice to a breastfeeding mother."

Many Banting advocates showed their support for Prof Noakes at the trial, and other influential people, from around the world, did too.

"It is a travesty that he needs to sit here and defend himself. Before I started the low carb, high fat (LCHF) lifestyle, I was overweight and pre-diabetic. Today I am healthier than I have ever been. He saved my life."

Amanda Youngleson, said she came to support Noakes because his diet had saved her life.

"Professor Noakes said if I didn’t drop my carbohydrates down to about 25g of carbs, I could end up on kidney dialysis and get diabetes. So for the last three and a half years, I followed the high fat/low carb diet. I’ve regained my health."

On day three

, evidence went missing including three files from panel members, and Caryn Zinn’s CV, which was sent six months ago.

Chair Joan Adams criticised HPCSA for wasting time and money and stated that the case would cost council at least R1 million. Michael van der Nest placed on record that Prof Noakes’ legal team was working pro-bono.

HPCSA’s expert witness, retired Professor Este Vorster, has a BSc in Home Economics, but no formal qualifications in dietetics, is not a registered dietitian, hasn’t consulted patients and hasn’t studied LCHF. She has however conducted extensive research into dietary guidelines. Vorster’s scientific rating is B1, Prof Noakes is A1 – 3 levels above her. An A1 rated scientist is one of the best in the world, which Vorster agreed to. It was also discovered that she hadn’t bought or read the Real Meal Revolution. It was disputed whether or not Vorster qualifies as an expert witness.

Michael van der Nest asked that Prof Cunnane be interviewed the next day at 2pm because HPCSA was running over time. Mapholisa did not agree to it.

"A tweet of only 140 characters is too short to give complete advice that will be usable and safe, expert witness Professor Este Vorster said during a hearing against Professor Tim Noakes on Wednesday."

"Vorster’s expertise on ethics on doctor-patient relationships, social media and the low carb high fat diet has been tested during cross examination at the hearing today.

She stated Noakes’s interaction with Pippa Leenstra on Twitter is similar to a doctor giving medical advice to a patient therefore he acted irresponsibly by giving unconventional advice.

But Noakes’s lawyer Ravin Ramdass dismissed her testimony, saying she was not a doctor and could therefore not comment on the matter.

Ramdass has also disputed her knowledge of social media, saying she never used her Twitter account.

He added she had never done clinical studies on the Banting diet and therefore cannot directly comment on it.

Vorster has agreed to all the points raised by Ramdass."

Day four

cross examination of Prof Este Vorster by Adv Dr Ravin Ramdass continued.

Ramdass stated that there was no evidence to show that LCHF was harmful. Vorster retorted that if she had time she would compile a list. He said that she had had 6 months and hadn’t found anything during that time.

Ramdass set the scene for the food industry influence on official dietary guidelines in South Africa. Kelloggs was one of the sponsors of 2003 guidelines that promotde grains and the sugar industry sponsored Vorster’s research.

Vorster agreed that a higher fat diet was optimal for infants up to 24 months. Ramdass stated that there was increasing evidence that consumption of gluten-containing grains could cause a variety of health problems, which Vorster agreed to. "I’d say avoid sugar, and highly processed cereals, but not starchy foods"

Next witness for HPCSA was Prof Salome Kruger. Nutrition Prof, pharmacist, RD, on board of Cambridge Health Nutrition journal. Co-author of report compiling dietary guidelines in SA.

"Under intense cross-examination from Noakes’s legal representative, advocate Ravin Ramdass, Kruger conceded that there was no evidence that proved the LCHF diet was harmful. She also said she hadn’t seen any evidence to suggest it was superior either.

Ramdass also suggested that her report was not only written in haste, but was based on assumptions and not facts.

Kruger admitted to writing the report under pressure and said she based the report on her experience as a mother and the information that was available at the time." Kruger ended off by saying, "Professor Noakes won’t kill anyone. He is a good person."

Kruger said that Prof Noakes had no qualifications to give the mother advice because he was had experience in sports nutrition and not nutrition itself. Kruger also said that babies should have breast milk up to six months and it was asked why she assumed Prof Noakes meant the baby should be weaned onto LCHF foods before that time.

Tweets from day four:

Hearing adjourned early as expert witness Prof Muhammad Dhansay had a death in the family.

On day five

, Prof Muhammad Dhansay was on the stand. He has a diploma in child health and two decades of experience in child health and paediatrics.

Tweets from day five:

After cross examination of Dhansay ended, HPCSA said they wanted to call another witness, but wouldn’t say who. Prof Noakes’ team became annoyed because the HPCSA had already had five days of the trial and only seven were set aside for it.

On day six

Stellenbosch University Prof Willy Pienaar was supposed to provide evidence on ethics, but he was only called as a witness on Friday (day five), according to HPCSA, because the Noakes’ team criticised Prof Salome Kruger as not being an expert on ethics. Van der Nest was having none of it and called it "ambush evidence". Van der Nest also explained in length how unfairly he felt Prof Noakes and his team had been treated throughout the hearing.

Tweets from day six:

The HPCSA were expected to call five witnesses, but by day five only four had testified. On day six only witnesses from the complainant had been heard. As a result of numerous delays and the fact that the HPCSA saw fit to call as many witnesses as they wanted, the hearing is now due to continue in February next year.

For more insight into the trial visit here and here.

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