Noakes made the point that breastmilk is ketogenic, despite having a moderate carbohydrate content. “There is something in breastmilk that increases ketosis and we have never been able to reproduce that in standard milk that is provided to babies,” he said. Humans fed breastmilk and moderate carbohydrates would still be producing “lots of ketones for the brain”, he said.

Bhoopchand pounced and asked Noakes if had any science to back up that view. Noakes smiled and said yes and he had presented it. He reminded Bhoopchand that the HPCSA’s own witness, paediatrician Dr Mohammed Dhansay, had confirmed that breastmilk was ketogenic.