Big Fat Surprise

Teicholz explodes fat bombs in Noakes ‘trial’

Apart from jumping the gun on a “guilty” verdict, the Health Professions Council of SA (HPCSA) has another big problem in its prosecution of scientist Prof Tim Noakes: all the evidence showing that low-fat diets increase the risk of heart disease.

If that were not bad enough, these diets also deprive infants and children of much-needed fats and other vital nutrients during their most formative years.

US investigative journalist Nina Teicholz presented this and other explosive evidence during her testimony as an expert witness for Noakes at the HPCSA’s fourth session of the hearing against him in Cape Town on October 25, 2016. In the first of a two-part series, here’s what she had to say. 

Why was her evidence such a body blow to the case against Noakes?

Well, the HPCSA has charged him with unprofessional conduct. That was for giving “unconventional advice to a breastfeeding mother on a social network (tweet) sic”. In that tweet, he said good first foods for babies are LCHF (low-carb, high-fat). In other words, he suggested meat, dairy and vegetables.

Noakes TeicholzTeicholz (left) showed that Noakes’ views on LCHF are very much evidence-based. Experts could consider his views unconventional in that they conflict with South Africa’s low-fat, high-carb dietary guidelines. However, they wouldn’t have considered his views unconventional in the least as recently as 1965, as Teicholz demonstrated. That was before the introduction of low-fat guidelines around the world.

Additionally problematic for the HPCSA is that Teicholz and another expert witness for Noakes, British obesity researcher gave evidence to show the guidelines are based on shaky science.

In other words, they are, for the most part, not evidence-based. That’s if you look at all the available evidence, not just the bits that suit a particular viewpoint.

HPCSA advocate Ajay Bhoopchand did try his best to critique Teicholz’s testimony. He suggested her evidence, which focused on the US dietary guidelines, wasn’t relevant in South Africa. He said SA’s dietary guidelines followed the World Health Organisation, not just the US.

Teicholz despatched that argument quickly. She showed how closely the SA’s dietary guidelines mirror the US guidelines.

So compelling was her evidence, that Teicholz left  Bhoopchand  stunned into uncharacteristic silence. He said he had no further questions. Chair of the HPCSA Professional Conduct Committee Pretoria advocate Joan Adams declared herself “stunned” at that. That was probably given Bhoopchand’s lengthy cross-examination of Harcombe the day before.

Critics like to dismiss Teicholz as “just a journalist”. Yet her meticulous, investigative journalism has been seismic. It has shaken the very foundation of the nutrition world. Bhoopchand wisely didn’t go there.

Teicholz studied both science and politics at Yale and Stanford Universities (her undergraduate degree is from Stanford, in American studies). In addition, she has a master’s in philosophy from Oxford University in the UK. She likes to say that her education in political science serves 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 told me.

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

Unusually for a  lay author, two top medical journals have reviewed her book. One is the American Journal of Clinical Nutrition (AJCN), a premier journal in the US.

It says of The Big Fat Surprise, “every nutritional science professional and all scientists should read (this book) as an example of how limited science can become federal policy”. The AJCN describes her book as a “historical treatise on scientific belief versus evidence”.

In The BMJ, former editor Dr Richard Smith is similarly expansive in its praise. In the course of a three-page review, Smith says the book “shook” him. He says Teicholz has 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”.

Still, it is a fascinating, forensic journey into nutrition science. It reveals the policy,  personalities, politics and influence of industry in the construction, implementation and maintenance of official dietary guidelines…..

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