QUESTION: Are you familiar with any literature relating to canine blood types?

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ANSWER: Canine blood groups were initially defined in the mid-1950s, but they are very complicated compared to us simpler humans!

There are eight different designations (1. 1, 1.2, 3, 4, 5, 6, 7) within this system, which is currently open-ended. DEA 7 is like human blood group A, of the ABO system, although other DEA antigens have A type qualities as well (1), and anti-B is a common antibody in dogs (2) and their are differences in the reaction of certain species of canines to DEA specific lectins (3).

Over 13 canine blood groups have been described. Eight DEA (Dog Erythrocyte Antigen) types are recognized as international standards. Naturally occurring antibody is found against DEA 3, 5, and 7. DEA 1.1 and 1.2 antibody-antigen interactions result in acute hemolytic transfusion reactions. DEA 3, 5, and 7 antibody-antigen interaction in vivo results in permanent red blood cell sequestration and loss in 3 to 5 days. DEA 4 antibody-antigen interactions produce no effect on red blood cell survival in vivo. A dog possessing DEA 4 and no other antigen is considered a "universal" donors.

Well, if dogs are often type A, shopuld they be vegetarians?

Probably not.

First of all, canine DEA antigens are not located anywhere near their human counterparts, and so will not influence physiological functions through gene linkage. Second, although some canine antigens are A-like, they are much more fucosylated than the human counterparts, imparting more O-like antigenicity than would be found in humans.



1. Symons M, Bell K. Anim Genet 1991;22(3):227-35 Expansion of the canine A blood group system.

2. Symons M, Bell K. Anim Genet 1992;23(6):509-15 Canine blood groups: description of 20 specificities.

3. Andrews GA, Chavey PS, Smith JE. Res Vet Sci 1992 Nov;53(3):315-9 Reactivity of lichen lectins with blood typed canine erythrocytes.

STUDY: A genetic study of vitamin D deficiency rickets: 2-sex differences and ABO typing.

JOURNAL: J Egypt Public Health Assoc 1992;67(1-2):213-22

AUTHORS: el-Kholy MS, Abdel Mageed FY, Farid FA.

ABSTRACT: In a further attempt to study the role of genetics in vitamin D deficiency rickets, 400 rachitic infants randomly chosen and aged from 6 months to 2 years (14.3 +/- 3.5 months) were investigated for sex differences and ABO typing. A significant (P < 0.001) predominance of the male sex was found, sex ratio being 1.43. Blood group A was significantly (P < 0.001) associated with rachitic patients whether males or females. Alkaline phosphatase values were significantly (P < 0.01) higher in male infants 91% of them had levels above 30 K.A. units, while the corresponding percentage of girls was 72%. This indicates that the disease is more severe among males. The study gives added support for the belief that there is a genetic factor in nutritional rickets.

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COMMENTARY: As with several other studies highlighted this week on Ask Dr. D'Adamo, ABO blood type genetics seem to be heavily intertwined with the difference sin the sex ratio. In this case, rickets (a bone softening disease that is the result of vitamin D defficiency) blood group A and males. I find this interesting in light of my own results in large scale studies on personality analysis inventory (Myers-Briggs) and ABO blood group. My studies show a correlation of high significance (like the study above, P < 0.001) with extroversion and blood group O, but only in women. Also, there was a identical correlation of blood group A and introversion, but in this case only in men.

STUDY: The effect of quercetin on apoptosis and necrosis induction in human colon adenocarcinoma cell line LS180.

JOURNAL: Folia Histochem Cytobiol 2001;39(2):217-8

AUTHORS: Pawlikowska-Pawlega B, Jakubowicz-Gil J, Rzymowska J, Gawron A.

ABSTRACT: Quercetin is a very common flavonoid widely distributed in many plants. The flavonoid intake has been linked to the prevention of some human diseases including cancer. Quercetin inhibits heat shock protein expression and in this way triggers apoptosis of tumor cells. The present study was designed to investigate whether quercetin exerts cytotoxic activity against human colon adenocarcinoma cells. The studies have shown that quercetin alone and in combination with the heat shock can induce apoptosis and necrosis in vitro in human colon adenocarcinoma cells (LS 180). Relationships between heat shock proteins and quercetin in this phenomenon are discussed.

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COMMENTARY: Apotosis is a term used to describe programmed cell death. In essence what distinguishes normal cells for cancer cells is the fact that normal cells maintain the ability to destroy themselves if a mutation is produced during reproduction, whereas cancer cells lose this function and become essentially immortal. This study indicates the quercetin may help re-induce the ability of cancer cells to resume the apotosis function. Quercetin has been investigated in a number of animal models and human cancer cell lines, and has been found to have antiproliferative effects. It may also increase the effectiveness of chemotherapeutic agents. More clinically-oriented research needs to be done in this area to discover effective dosage ranges and protocols.

STUDY: Inhibition of natural killer and interleukin 2-activated natural killer cell cytotoxicity by monosaccharides and lectins.

JOURNAL: Mikrobiyol Bul 1987 Oct;21(4):245-50

AUTHORS: Imir T, Bankhurst AD.

ABSTRACT: Natural Killer (called NK) cells are specialized cells of the immune sytem which act predominantly to protect us against viruses, parasites and malignancies. Some dietary lectins have an NK Cell lowering activity while others have no activity on NK cell activity, and there are even a few lectins (not usually found in the diet) which have an ability to increase NK cell activity. The effect of lectins on NK cells can be both directly or indirectly modulated. Many lectins can influence NK cell activity directly by binding to the carbohydrate chains contained on these immune cells.

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COMMENTARY: Critics of the lectin hypothesis in ER4YT have suggested that lectins are unimportant and either get destroyed by digestive secretions or in some other way are not absorbed. Had these critics taken a moment to review the scientific literature on lectins, they would soon realize that no controversy exists. Lectins are absorbed and do reach your systemic circulation. But lectins do not even have to reach your NK cells to impact them negatively. High lectin diets generate polyamines in your digestive tract (protein breakdown products) and polyamines themselves reduce NK cell activity. High lectin diets also disrupt your intestinal flora (the balance of good and bad bacteria in your digestive tract) and an imbalanced flora also results in decreased NK cell activity. Many of the foods people eat on a daily basis contain lectins (see ER4YT) and many of the most commonly consumed lectins can dramatically decrease NK cell function.

QUESTION: How can lectins penetrate the gut? I asked my Doctor and he claimed that they are too large a sized molecule to penetrate the intestines. Is he correct?

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ANSWER: Your Doctor is incorrect, however this is a common misconception. There are now numerous studies clearly showing that dietary lectins can penetrate the intestinal linings and deposit systemically in the body.

In one recent study, lectins from wheat germ (Triticum aestivum) and thorn apple (Datura stramonium) included in the diet of test animals reduced the digestibility and utilization of dietary proteins and stunted the growth of rats, with wheat germ lectin being the most damaging. In this study, the researchers were quite clear that these lectins had been bound and actively transported (endocytosed) across the intestinal membrane. All three lectins were growth factors for the gut and interfered with its metabolism and function to varying degrees.

Here are the authors in their own words:

"Furthermore, an appreciable portion of the absorbed wheat germ lectin was transported across the gut wall into the systemic circulation, where it was deposited in the walls of the blood and lymphatic vessels."



Pusztai A, Ewen SW, Grant G, Brown DS, Stewart JC, Peumans WJ, Van Damme EJ, Bardocz S Antinutritive effects of wheat-germ agglutinin and other N-acetylglucosamine-specific lectins. Br J Nutr 1993 Jul;70(1):313-21

QUESTION: I have taken your blood type quiz several times and conclude that there is a "trick question." I think it is about who discovered the ABO blood groups. Was it Landsteiner or Jansky?

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ANSWER: Jan Jansky, born in 1873, graduated in the Medicine Faculty of the Carolina University of the Prague, specializing in Neurology and Psychiatry.

Dr. Jan Jansky dedicated himself to the investigations of laboratory, with the aim of clarifying a relationship between the mental upheavals and the composition of the blood. He analyzed more than three thousand samples of the blood of its patients.

The doctor wanted to find out if the serum of the psychotic patients, especially schizophrenic, differs by its coagulation characteristics from the one from the normal people. Interestingly, this was proved with more sophisticated methods almost a sentury later (1). With the coagulation of the blood, Dr. Jan Jansky established in 1907 four blood groups that nowadays we call A, B, O and AB.

With his discovery it made possible to make the transfusions without the danger that the patient died when receiving the blood of an inadequate donor. The Dr. Jansky published its discovery in the titled work "Hematologic Studies in Mental patients". In 1921 it accepted the definition of the blood groups established by the Dr. Jansky the Association of the North American doctors.

Dr. Jan Jansky passed away of a cardiac disease before turning the 50 years of age, as a result of ailments undergone in trenches of World War I. Jansky knew in life neither glory nor great honors and is only now being recognized as the true discoverer of the blood groups.



1. Dintenfass L, Zador I. Blood rheology in patients with depressive and schizoid anxiety. Biorheology. 1976 Feb;13(1):33-6.

QUESTION:

I am a nutrition student studying to be a R.D., and I have thoroughly enjoyed reading your book, "Eat Right For Your Type". I am 26 years old and I have O type blood. I have been seeing a doctor, who practices natural medicine, for a year now for several medical problems. I have very low cholesterol(130) and eat between 2 and 4 eggs per day. As long as I eat eggs my cholesterol stays around 160, otherwise it drops down to 130 or below. Why are eggs not recommended since they do not contain lactose? Should I cut back on the amount I eat? Also, my WBC count is too low and I have been treating it with Echinacea and Goldenseal. What do you think of these herbs for O type with low WBC?

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ANSWER:

Eggs are an acceptable protein source for type O, so there should be not reason to not enjoy them as an easy breakfast item. Echinacea is not recommended for type O as it can sometimes aggravate their propensity to inflammation. This is through Echinacea's effect on the enzyme hyaurondidase. Golden seal (Hydrastis canadensis) is generally not recommended for oral use. It can disturb the bacterial flora in the intestines and aggravate low blood sugar problems. Topically, or as a mouthwash for sore throat it is fine. In my practice we use the larch polysaccharide ARA6 for this type of situation.

STUDY: Long-term vegetarian diet and bone mineral density in postmenopausal Taiwanese women.

JOURNAL: Calcif Tissue Int 1997 Mar;60(3):245-9

AUTHORS: Chiu JF, Lan SJ, Yang CY, Wang PW, Yao WJ, Su LH, Hsieh CC.

ABSTRACT: This study examined bone density among postmenopausal Buddhist nuns and female religious followers of Buddhism in southern Taiwan and related the measurements to subjects characteristics including age, body mass, physical activity, nutrient intake, and vegetarian practice. A total of 258 postmenopausal Taiwanese vegetarian women participated in the study. Lumbar spine and femoral neck bone mineral density (BMD) were measured using dual-photon absorptimetry. BMD measurements were analyzed first as quantitative outcomes in multiple regression analyses and next as indicators of osteopenia status in logistic regression analyses. Among the independent variables examined, age inversely and body mass index positively correlated with both the spine and femoral neck BMD measurements. They were also significant predictors of the osteopenia status. Energy intake from protein was a significant correlate of lumbar spine BMD only. Other nutrients, including calcium and energy intake from nonprotein sources, did not correlate significantly with the two bone density parameters. Long-term practitioners of vegan vegetarian were found to be at a higher risk of exceeding lumbar spine fracture threshold (adjusted odds ratio = 2.48, 95% confidence interval = 1.03-5.96) and of being classified as having osteopenia of the femoral neck (3.94, 1.21-12.82). Identification of effective nutrition supplements may be necessary to improve BMD levels and to reduce the risk of osteoporosis among long-term female vegetarians.

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COMMENTARY: Undoubtedly if the reviewers had blood grouped the study's participants, they would have found that the majority of the vegan nuns who had lost the most bone were blood group O, since calcium absorption is more dependant in this blood group on the actions of enzymes in the intestines that are activated by protein and fat. Even type A's could benefit from a mineral supplement, especially if it were formulated with a small amount of vitamin A, which turns on the intestinal enzymes in this blood group.

QUESTION:

Please explain the differences between the A blood types (A1, A2..). I am A2 positive. Am I closer to O? Like where in geographical history did A2 appear and why? And is our diet exactly the same as the other A's. Thanks.

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ANSWER:

There are indeed more "subtypes" of group A than any of the other blood types, excepting of course AB, who can have variations of A (A1B, A2 as well. There are probably over 20 recognized variants of type A. Interestingly, most are found in Africa and probably represent admixtures of the Semitic type A gene pool reacting to local parasites. These include A1, A2, Ax and A-Bantu, though about 95% of all type As are A1, which is the variant I wrote about in ER4YT as "agriculturalists".

Of the minor forms of type A, only A2 is of any practical importance. From population studies it appears to have been an early mutation, or perhaps even the original type A. We know that A2 is found in an inordinately high percentage among the so-called "brown-eyed Laplanders." These are a fairly ancient people, who appear to have headed north to Scandinavia from the area around present-day Armenia, the point at which the A mutation had first originally developed in large numbers .

Type A2 has most of the attributes of A1, but according to some paleoserologists (in particular the anthropologist Kelso and the physician-epidemiologist Mourant) may have represented an offshoot retaining some of the tolerance for fat largely lost by the more common A1. Perhaps this represented an adaptation to fish or game, since the area is not suitable for agriculture, though there is no reported differences between A1 and A2 in either intestinal enzyme or stomach acid secretion. There is however a distinct increase in the occurence of type A2 in certain forms of leukemia. There appear to be some differences with between the A1 and A2 subtypes with regard to succeptibility to certain fungal lectins.

A2 is distinguished clinically by the use of a lectin from the plant Dolichos biflora which agglutinates type A1 but not type A2 cells. Practically, since A1 is transfusable into A2 and vice versa, they can for all practical purposes be considered equivalent, but you might see if you feel any benefit from increasing the amount of seafood in your diet, though I would still advise restricting foods which are listed as avoids for type A.

QUESTION: What are your thoughts on the level of devotion to blood type in Japanese society? They market soft drinks and condoms according to blood type! Do you think Americans will ever go so far?

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ANSWER: The first reference I could find linking blood type to personality in Japan was written in 1927. It appeared to be a study of the psychological attributes of Japanese schoolchildren. But as with the Japanese, nothing is ever simple! Not only did the study show that Type A children had higher IQs, it also managed to prove that Type B children defecate more than others! This is my problem with most of the Japanese research into blood types; it tends to be a hodgepodge of some science, some pop psychology, and a whole lot of baloney. Whereas I now think the Japanese did have some valid starting points with regards to blood type and personality, they tended to look at personality as an almost robotic-like concept, which most people find reprehensible. There is much more free choice involved in the type of person you are, than would be programmed by your blood type.

What is more interesting to me is not how people will function while they're healthy, but rather how the neurochemistry of a person will function under stressful circumstances. In a state of mental or physical stress, a person will tend to fall more into type. For example, we talked about the fact that Type A tends to secrete larger amounts of cortisol under stress -- this has been reported in several studies. High levels of cortisol have bad effects on the immune system. Perhaps this explains the statistically significant difference between Type A and the other types with regards to the rates of cancer. Curiously, several studies from Australia also proved that Type A tends to have thicker blood when under stress than the other blood types, which may help account for their higher rates of heart disease. With Type O, the name of the game is dopamine, which is, believe it or not, a chemical, the control of which is regulated by a gene that sits virtually right underneath the gene for ABO blood type. With Type B, another gene close to the ABO blood type gene regulates the metabolism of nitrous oxide, which research shows is involved in the mind-body connection.

A lot of this neurochemical response to stress that is different from one type to another has nothing to do with the physical expression of blood type. It has rather to do with the genetic expression of blood type. This is probably why so many health professionals scoff at the notion of blood type regulating anything. They can only harken back to what they were taught about the physiology of blood type, but do not have knowledge that it controls a wide range of genetic information.

STUDY: Social psychological factors of interest in lay personality theories: why is ABO blood-typing popular?

JOURNAL: Shinrigaku Kenkyu 2000 Dec;71(5):361-369

AUTHORS: Nagata Y.

ABSTRACT: We hypothesized that one of the reasons that not a few Japanese are interested in lay personality theories of ABO blood-typing and similar unsupported beliefs on human nature, was unsatisfied needs of having clear collective and personal identities. To test the hypothesis, we asked 149 married women, 34 to 62 years of age, to describe themselves as in self introduction to strangers, and then separately indicate the degree of interest in lay personality theories. We then counted the number of references to personal/private aspects (an index of personal identity) and the number to social groups whose membership was known to be exclusive and limited (an index of collective one). Results showed that those who were high on both indices were less interested in lay theories than those low on one or both of personal and collective indices.

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COMMENTARY: As anyone who has read my books can determine, I am not much of a fan of the belief seen in certain societies, such as Japan, that there is a well-defined 'blood type personality.' However, there is considerable evidence that ABO blood group does have some influence on major neurochemical mediators, such as platelet MAO, dopamine and cortisol.

However, this article makes such basic assumption about the nature of personality theory as to render itself useless. First, it assumes that people interested in personality theory are 'unsatisified' with their identity; and to prove that the study focuses on married women, which (I can only hypothesize) the author feels are a prime group for such analysis. No structuring as to IQ, socio-economic group or education level are made. The measures of 'collective identity' (participation in social groups known to be limited and exclusive) or 'personal identity' (comments on personal/ private life) are ruefully simplistic.

We need well-designed studies, looking at neuro-psychiatric parameters that can be scientifically measured, not fuzzy groupings based on characterizations of the believing public.

QUESTION: Is it true that by eating a number of almonds each day would give sufficient calcium without having to resort to taking calcium supplements?

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ANSWER: How much calcium do we need? The reccommended level of calcium for adults age 19 through 50 years is 1000 milligrams per day. An intake of 1200 milligrams of calcium per day is recommended for those age 51 years and older. In other countries, calcium recommendations are lower, as low as 600 milligrams daily for adults.

Other factors which increase the risk of osteoporosis include small frame size, female gender, aging, heredity, cigarette smoking, excessive alcohol, Caucasian or Oriental race, steroid use, early menopause, prolonged immobilization, and inadequate vitamin D.

Here is alist of plant foods and their relative calcium content. In most cicumstances eating a plant based diet will tend to provide, at best, marginal amounts of calcium:



Soy or ricemilk, commercial, 8 ounces 150-500

Collard greens, cooked 1 cup 357

Blackstrap molasses 2 Tbsp 342

Tofu, processed with calcium sulfate* 4 ounces 200-330

Calcium-fortified orange juice 8 ounces 300

Commercial soy yogurt, plain 6 ounces 250

Turnip greens, cooked 1 cup 249

Tofu, processed with nigari 4 ounces 80-230

Kale, cooked 1 cup 179

Okra, cooked 1 cup 176

Soybeans, cooked 1 cup 175

Sesame seeds 2 Tbsp 160

Bok choy, cooked 1 cup 158

Tempeh 1 cup 154

Mustard greens, cooked 1 cup 152

Figs, dried or fresh 5 medium 135

Tahini 2 Tbsp 128

Almonds 1/4 cup 97

Broccoli, cooked 1 cup 94

Almond butter 2 Tbsp 86

Soymilk, commercial, plain 8 ounces 80



I've developed ABO specific calcium supplements derived from a type of sea calcium of high purity and bioavailability. It is only found in one location in the ocean off the Beara Peninsula, in South Western Ireland, it grows for around five years in the crystal clear, pollution free Atlantic waters, absorbing minerals and nutrients from the sea. The seaweed then dies and falls to the ocean bed, where it becomes calcified. Local tidal patterns conspire to wash and gather it into one deep bed, the location of which is known to only a few people.

Look for these Phytocal in the NAP catalog.

QUESTION:

I am a type A with chronic sinusitis. I have had sinus surgery twice and would like to avoid having to do it again. I have used the herb "Collinsonia" as you recommended in your book with good results. However, I have been able to find no information about the herb on either the internet or your message board. Is it safe? How does it work?

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ANSWER:

I have found Collinsonia (stoneroot) to be of great reliability in assisting to stabilize the lining on the sinus cavities and to minimize the build-up of excess mucus in the sinus cavities and throat, particularly in types A and AB. It is a form of botanical support for individuals experiencing chronic build-up of nasal, pharyngeal, or stomach catarrh

Specific Indications:

Collinsonia has traditionally been employed for passive venous engorgement and relaxation: Sense of constriction, with irritation and pain in the orifices of the body. It has been variously described as an astringent, alterative, diuretic,stimulant, tonic, etc., all of which little describes the drug. Its effect,whether on the rectum, pharynx, or other vascular area, is to overcome unduecongestion with the accompanying irritation, pain and fullness, and bring abouta natural action. Dr. E. Mather, Detroit, says that it acts similarly to penthorum on the pharynx; on the urinary organs, relaxing the ureters, increasing urinary excretion, diminishing irritability of the bladder and facilitating passage of calculi. Collinsonia seems to act both as a tonic and antispasmodic, the first use being frequently exemplified. It shows its power as an antispasmodic in the painful constrictions and spasms of the sphincter accompanying hemorrhoids, fistulas, ulcers, fissures, etc., about the rectum, even in operations in this region; also in gastralgia and vesical tenesmus. It quiets irritation of the pneumogastric and of parts supplied by it. The two great uses to which it has been put in the past, are chronic pharyngitis and laryngitis--minister's sore throat--and hemorrhoids. Limiting the remedy to these diseases alone, will give it sufficient honors. In the first it is given in doses of ten to twenty drops in syrup; in the latter, slightly smaller doses combined with Hamamelis.

The remedy nearly always cures if administered sufficiently long, and in recent cases but a few days are needed. If given in conjunction with operations for hemorrhoids, it materially assists in relieving the pain and hastening the cure."Remember it in any wrong of the venous capillary system".--Lloyd's Bulletin.

Collinsonia acts as a kindly, soothing tonic to the stomach and portal circulation. It is highly recommended in catarrhal gastritis. It is also said to lessen the appetite for alcoholic drinks."--Ellingwood's Therapeutist, Volume 8, No. 12, December, 1914

Though best suited to types A and AB, Collinsonia is safe for all blood types.

QUESTION: Does any one blood type have a history of longevity superior to the others?

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ANSWER: This question has not been looked at with any degree of exactitude, but two studies did show a slight increase in life span for those individuals who were type O (over type A). Whether this is the result of any genetic link or simply the result of the fact that the modern hi-fat diet, hi-stress lifestyle is inherently more poisonous to type A over type O has not been determined. In any case, the studies are on small numbers of people and have not been replicated.

One older study looking at different rates of longevity between different nationalities saw the rate as being influenced by the percentage of type A in the population. They stated that:

"Innumerable influences of various types can cause diseases, primarily the high incidence of certain tumors in old age, climatic influences, overeating and malnutrition, and furthermore abuse of coffee, tea, tobacco and alcohol, medicines and insufficient movement. It can be assumed that wherever blood group A is prevailing the genes of blood group A constitute a factor. The impact of the blood group genes varies as a function of the underlying disease, the effectiveness of the exogenic factors and the general constitution of the individual patient."(1)

Another study of Italian dentists showed a higher incidence of type O among those who lived beyond 75. (2)

Remember that these are populations that have done no interventions such as diet or lifestyle modification. By following ER4YT, most type A's can be expected to better the odds considerably.



1. Kinner B, Sauer I, Ries W. [Preconditions for attaining advanced old age]. ZFA 1981;36(2):111-6

2. Sturgen P, Beller S, Bates E. Related Articles Study of blood group factors in longevity. J Gerontol. 1969 Jan;24(1):90-4.

QUESTION:

I was curious as to why you did not include yoga as an exercise option for Type O blood types? Some styles of yoga (such as Ashtanga or Viniyoga) can be aerobic and physically challenging. I am a Type O and I have practiced yoga for two years and I have found it highly beneficial.

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ANSWER:

Yoga is a great form of exercise for anyone who is willing to devote sufficient time to master it. However, in type O it is not the preferred method of blunting the chemical effects of stress, as it is for type A.

Elevated catecholamines (adrenaline and nor-adrenaline) are more characteristic of type O's when under stress and for this vigorous exercise is preferred. Also, yoga is insufficient for type O's to maintain active tissue mass (the tissue in our body that is metabolically active). However yoga is effective at lowering cortisol (a stress hormone) which is generally a type A stress response.

So, should O's avoid yoga? No, if it is part of an exercise regimen that included sufficient cardio and some resistance training. Then yoga can be practiced by type O's as well.

QUESTION: I'm type O. My dermatologist tells me I have melasma, dark spots on my face. Is there anything that you can recommend?

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ANSWER: Melasma is a common acquired increase of pigmentation that occurs exclusively in sun-exposed areas. Brownish in color, it is exacerbated by sun exposure, pregnancy, oral contraceptives, and certain anti-epilepsy drugs. Melasma is reasonably common, especially in women of child-bearing age. However, up to 10% of cases have been reported in males. While all races are affected, there is a prominence among Latinos and Asians. Melasma is more apparent during and after periods of sun exposure and less obvious in winter months, when sun exposure is lacking. Melasma presents itself in one of the three usually symmetrical facial patterns. The most common is a centrofacial pattern involving the cheeks, forehead, upper lip, nose, and chin. Less common are the malar pattern, involving the cheeks and nose, and the mandibular pattern, involving the ramus of the mandible (the side of the cheeks and jawline). Melasma also occurs on the forearms, but this is rare.

Melasma has been considered to arise from pregnancy, oral contraceptives, endocrine dysfunction, genetic factors, medications, nutritional deficiency, hepatic dysfunction, and other factors. The majority of cases appear related to pregnancy or oral contraceptives.

There is a syndrome named Congenital Generalized Lipodystrophy (CGL) characterzied by marked insulin resistance, high blood triglycerides and melasma -which interestingly enough has the gene for its origin at 9q34, exactly the same site as the gene for ABO blood type. (1)

There is some thought that nutrient deficiencies may give rise to melasma, so from a supplement standpoint, a good multivitamin, with sizeable levels of the B complex is probably a pretty good idea. Since insulin resistance is linked to melasma (2) it is great that you will be following the low-lectin type O diet

Most of the time melasma will slowly resolve following childbirth or upon discontinued use of oral contraceptives. If not, bleaching agents (mandelic acid is one), retinoic acid (Retin A) and religious use of sun block will often help.



1. Garg A, Wilson R, Barnes R, Arioglu E, Zaidi Z, Gurakan F, Kocak N, O'Rahilly S, Taylor SI, Patel SB, Bowcock AM. A gene for congenital generalized lipodystrophy maps to human chromosome 9q34. J Clin Endocrinol Metab 1999 Sep;84(9):3390-4

2. Jaffiol C, Rouard M, Macari F, Lautier C, Ait el Mkadem S, Mechaly I, Brun JF, Renard E, Cros G, Bringer J, Grigorescu F. [Insulin resistance: from clinical diagnosis to molecular genetics. Implications in diabetes mellitus]. Bull Acad Natl Med. 1999;183(9):1761-75; discussion 1775-7.

QUESTION: How do you answer your critics when they say that lectins are destroyed during cooking or in the digestive tract?

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ANSWER: How would you regard a critic who ignored, or was too lazy to make themselves aware of, the huge amount of data to the contrary?



" The lectins studied all have the potential to affect colonic cancer growth in vivo. Many dietary lectins are resistant to digestion and may have important effects in vivo but the definition of their role in human colonic cancer biology must take into account the variability in lectin response."

Gut 1997 Feb;40(2):253-61 In vitro influence of Phaseolus vulgaris, Griffonia simplicifolia, concanavalin A, wheat germ, and peanut agglutinins on HCT-15, LoVo, and SW837 human colorectal cancer cell growth. Kiss R, Camby I, Duckworth C, De Decker R, Salmon I, Pasteels JL, Danguy A, Yeaton P

"Most lectins in our diet are resistant to breakdown during gut passage and are bound and endocytosed by epithelial cells. These lectins are powerful exogenous growth factors for the small intestine, can induce dramatic shifts in its bacterial flora and interfere with its hormone secretion."

Eur J Clin Nutr 1993 Oct;47(10):691-9 Dietary lectins are metabolic signals for the gut and modulate immune and hormone functions. Pusztai A

"The possible systemic influences of absorbed saccharides at loci remote from the gut are considered in terms of inhibition of dietary and endogenous lectins, inhibition of bacterial attachment, and alteration of leukocyte homing behaviour. Finally, possible means by which dietary carbohydrates might modify various specific diseases are considered. It is probable that dietary carbohydrates can alter the equilibria between lectins, secretory IgA and micro-organisms in the alimentary canal, and this consideration could be exploited to promote health. The possible effects of dietary saccharides on allergy/oral tolerance or on recognition events at gut-remote sites warrant further investigation."

Eur J Nutr 1999 Jun;38(3):107-17 Immunological aspects of the potential role of dietary carbohydrates and lectins in human health. Kilpatrick DC

QUESTION: I'm an A+ (non-secretor), my wife is a B+ (secretor) and our daughter is a B- (secretor status unknown). Just curious about: (1) how our daughter's RH factor could come out different? (2) does the above imply that none of us (in particular my wife and daughter) are able to give blood to each other in an emergency? (3) does secretor status play a significant role in blood tranfusions?

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ANSWER:

1. Rhesus type is determined much like ABO, with the phenotype (physical characteristic) determined by genotype (genetic combination). Genotype is usually in the form of alleles ('variations', if you will). The gene locus for Rh blood type has two alleles; one from each parent. In this blood typing system the Rh+ allele is dominant to the Rh- allele. Thus any combination of two alleles other than Rh-/Rh- will make a person Rh+. My suspicion is that both you and you wife are Rh+/Rh- (so-called 'heterozygous') Your child no doubt received a Rh- allele from you, and an Rh- allele from you wife; there is a 25% chance of this occurring.

2. Rh- blood can be transfused into Rh+ individuals. Thus, your B+ wife can receive blood from your B- daughter.

3. Since secretor status does not code for any opposing antibodies (non-secretors do not make 'anti-secretor antiobodies') it does not influence transfusion.

QUESTION: My salesman husband is too laid back on the diet. How can I put back the spark of aggression needed to sell without taking him off the diet?

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ANSWER: Although one would question whether aggression is a quality one would wish to engender in another person, perhaps it is time for your husband to ponder a change in vocation?

In general, type O's can do with a dose of anger management skills. In published studies it appears that blood group O individuals tend to be more impacted by 'type A behavior' in particular when it comes to male heart attack patients. (1)

My advice is to make sure that your husband gets adequate aerobic physical activity and perhaps try taking a B-vitamin supplement so as to maximize his protein metabolism.



(1) Neumann JK, Chi DS, Arbogast BW, Kostrzewa RM, Harvill LM. Relationship between blood groups and behavior patterns in men who have had myocardial infarction. South Med J. 1991 Feb;84(2):214-8.

QUESTION: Have you read (fill in the name here)'s criticism of your book in (fill in the name of the magazine or website)? How do you respond?

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ANSWER: I'm not using this forum to respond to criticisms of my theory. You can read a few responses to them by myself and others at this address.

As far as I can tell, we've yet to see a criticism of the book which has been based on any faulty science on my part. Most of the time these reviews are just full of personal opinions such as 'I have never heard anything about lectins.' or my favorite, 'It is nonsense.'

This is just disinformation.

Many of the criticisms are from sources who have their own interests to defend.

For example,

My advocacy of soy for blood type A gets slammed by the 'paleolithic' diet people.

My recommendation of high protein for the type O's gets the 'goat' of many vegan nutritionists.

The one-size-fits-all diet people (like the ADA's food pyramid) slam me for having specific recommendations which are not across the board.

The 'metabolic typing' people feel that blood type doesn't go far enough to individualize people's diets.

The truth be told, every type of diet can be found to fit one section of the population (this is really just common sense). Some health recommendations do work in everyone (smoking, for example, really is bad for you). Other types metabolic profiling are scientifically unsound (no backing in the literature) and very expensive.

Our work with blood type allows for the appreciation of individual biochemical variance, but with the use of reliable scientific markers that have as their basis reliability and a complete genetic understanding of the scientific underpinings.

QUESTION: I want to try your diet so I asked my doctor about my bloodtype. I had blood type "D" and undergroup "little C". So which of the diets I should follow?

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ANSWER: These markers are part of the Rh system (the 'negative/positive' part of how blood type is generally expressed). They will not tell you about your ABO type, which is what the diet is predicated on. Perhaps you should investigate purchasing a home typing test from North American Pharmacal.

The Rh blood group system was discovered independently in 1939 by Philip Levine and R.E. Stetson and in 1940 by Karl Landsteiner and A.S. Weiner. There are 5 antigens in this group: C, D, E, c, e. These antigens occur in complementary pairs with the same name but different case. Complementary antigens never occur in the same person. In other words, if a person has C they won't have c, and vice-versa. No d antigen has ever been found but the notation d is used to denote the absence of D.



The most important is D. The first, and most common one, called Rh1 (also Rho or D). Rh1 causes the most severe immune reaction and is the primary determinant of the Rh trait. All Rh antigens apparently are produced by three sets of closely linked genes that are located near the end of the short arm on chromosome 1.

Although the Rh-negative trait is rare in most parts of the world, it occurs in about 15 percent of Caucasians in Europe, Canada, and the United States. The trait's highest incidence is among the Basques of the Pyrenees (from 25 to 35 percent), and the Berbers of Africa and the Bedouins of the Sinai Peninsula (from 18 to 30 percent).

QUESTION:

I am a Type A who has just discovered your book. I am looking forward to beginning the Type A diet and exercise plan! My question is: what can you suggest (other than the guidelines for Type A already in the book) for panic disorder and anxiety attacks. In the past I have been prescribed Xanax and/or anti-depressants, but want to find a more natural therapy for this aggravating problem. I suspect that beginning the yoga exercise and stress reduction techniques will help, but are there any particular supplements or herbs/phytochemicals that might help with this disorder? I am a 45-year old woman just beginning to experience symptoms and signs of menopause too and would welcome any comments or suggestions on that subject as well. Thank you for caring about others' health and thank you in advance for any help or suggestions you might have for my particular concerns.

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ANSWER:

The yoga technique of "alternate nostril breathing" would be an excellent adjunct to the type A diet. Both help lower cortisol, an important stress hormone manufactured more commonly by type A than by the other types. Alternate nostril breathing just requires that you close one nostril with the finger, breath in with the open nostril, change positions, and breathe out with the other. Do this 15-20 times, then reverse thr procedure. Studies have shown this to be valuable in balanceing out the sympathetic and parasympathetic nervous systems, an important cause of panic type attacks.

QUESTION: My two children aged 3 and 5 are both on the bloodtype diet. Their health is good but still they get the necessary infections. As I don't want to give them regular medicines I use Echinacea and homeopathy. Could you recommend some supplements, children vitamins specific for their bloodgroup B. I suppose I can't give them any of the recommmended herbs or supplements for B as they are much too young. Thank you for your time.

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ANSWER: I have found that young children (my own included) benefit from the use of elderberry as a general preventive against flu and other viruses. This may be even more important in children who are blood group B, since that blood group is more prone to low viral resistance. A great-tasting product that is very effective is NAP's Proberry 3 syrup.

Another easy-to-use product which can help to prevent infections typically seen as children return to the classroom is larch arabinogalactan. Larch is a milder immune modulator, similar in action to echinacea, but usable by all blood groups and possessing additional beneficial effects on the intestines. NAP's ARA6 is the only arabinogalactan product available using pharmaceutical grade larch: all others use the cruder food grade.

Both compounds are safe and equally usable by any blood group.

QUESTION: First of all many thanks for sharing your blood type knowledge and food guidelines with the public. Your ER4YT book is a life saver! My husband is a type O, had heart by-pass surgery and in spite of medication (Lipitor), he could not get his cholesterol down below 210; 3 months on your diet and he lost 36 pounds and lowered his cholesterol to 154! And the eating patterns were comfortable. I am a type A and have lost 43 pounds very comfortably. However, I do have a problem with osteoporosis (I am 60 years old and this was just diagnosed). I am currently taking 900 mg of calcium lactate & 450 mg magnesium (I was taking 1200 mg of calcium but had to decrease the dose because of runny bowels). So I would appreciate any suggestions you have about foods and supplements for this condition. Many thanks for your help and consideration and running this great website!

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ANSWER: I would recommend that you investigate a specific mineral supplement designed to enhance bone health for type A individuals called Phytocal A.

The calcium for this formula is derived from the small red seaweed called "Maerl" found only in the isolated areas off the pristine coast of Northwest Ireland. Of all sources of calcium Maerl has one of the lowest levels of undesirable contaminants. Its superior buffering capacity allows Maerl-based calcium to maintain very high rates of absorption despite the lower acid and higher levels found in the digestive tracts of most type A individuals.

Phytocal A also features higher levels of the important antioxidant selenium; the gastric activating cofactors betaine hydrochloride, renett and gentian root (Gentiana lutea) plus the mineral-rich herb horsetail (Equisetum arvense). Phytocal A also features significant levels of the important calcium absorption enhancer ipriflavone and a small dose of vitamin A to enhance the activity of the calcium absorbing enzyme intestinal alkaline phosphatase.

STUDY: S-adenosylmethionine decarboxylase activity and utilization of exogenous putrescine are enhanced in colon cancer cells stimulated to grow by EGF.

JOURNAL: Z Gastroenterol 1998 Nov;36(11):947-54

AUTHORS: Milovic V, Turhanowa L, Fares FA, Lerner A, Caspary WF, Stein J

ABSTRACT: Polyamines spermidine and spermine and their precursor putrescine are necessary for cell growth. Polyamine content is high in rapidly growing malignant cells, due to enhanced putrescine synthesis by ornithine decarboxylase (ODC), and increased uptake. In contrast to other cells of the body, colon cancer cells are exposed to high putrescine concentrations from the lumen. AIMS: To investigate the utilization of luminal putrescine in colon cancer, we studied the effect of a potent mitogen, epidermal growth factor (EGF), on the activity of the enzyme responsible for putrescine conversion, S-adenosylmethionine decarboxylase (SAMDC), in Caco-2 cells.RESULTS: ODC and SAMDC activity and putrescine uptake were strongly stimulated by EGF. Both synthesized and absorbed putrescine was rapidly converted to spermidine and spermine after EGF. Conversion pattern was identical in the cells stimulated with EGF only and EGF plus exogenous putrescine, indicating that, if stimulated to proliferate, colon cancer cells utilize the entire available putrescine pool. SAMDC inhibitor, methylglyoxal-bis-guanylhydrazone, induced growth arrest which was not reversed by exogenous putrescine, but only by high concentrations of spermidine. CONCLUSION: Enhanced proliferation in colon cancer cells is associated with increased SAMDC activity and rapid conversion of putrescine to spermidine and spermine. SAMDC might be a preferable target for therapeutic attempts to impair growth by reducing intracellular polyamine pools in colon cancer.

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COMMENTARY: I've talked about the polyamine producing enzyme ornithene decarboxylase (ODC) in the past. Polyamines, naturally occurring amines, include putrescine, spermidine, cadaverine and spermine. Polyamines are ubiquitously distributed throughout our cells. Cell proliferation and differentiation appear to require their biosynthesis; furthermore, their generation is tightly regulated. Cancer cells, especially those known to be steroid or insulin sensitive, are voracious consumers of polyamines. The parent substance from which putrescine (and hence, the other polyamines) is produced is the amine acid ornithine in a reaction which is catalyzed by ornithine decarboxylase (ODC).

S-Adenosylmethionine Decarboxylase (SAMDC) is a critical regulatory enzyme in the polyamine synthetic pathway. SAMDC catalyzes the removal of the carboxylate group from S-adenosylmethionine (SAMe) to form S-adenosyl-5'-3-methylthiopropylamine. This acts as the n-propylamine donor to synthesize spermidine and spermine from putrescine.Thus the enzyme SAMDC converts SAMe into the polyamines spermidine and spermine which then can act as growth stimulators for cancer cells. Of interest is the fact that this process is stimulated by the hormone EGF (Epidermal Growth Factor) which often is simualtaneously upregulated in many hormonally sensitve cancers such as those of the breast. One additional down-side of being type A or AB with regard to cancer risk is the fact that the type A antigen also fits the receptor for epidermal growth factor.So, if you are type A, should you take SAMe? I recommend against it, or if you do make sure you drink lots of green tea: Green tea polyphenols inhibit ODC which limits the amount of putrescine available for SAMDC to convert to spermine.