The second conference of the Institute for Human Individuality The Four Masters: Nutrigenomics in Practice heralded the start of a new era in medicine. It took place in Tempe, Arizona, between April 15-17, and this year the event lasted two and a half days, packed with new information for clinicians and the public alike.

On arrival delegates were fingerprinted, and asked to put two pieces of paper in their mouth to assess a bitter taste, but were not told why. The reason for this became apparent later.

Dr. Bland - FUNCTIONAL MEDICINE/NUTRIGENOMICS

The first master to speak after the opening ceremonies on Friday Morning was the widely venerated Dr. Jeffrey Bland PhD. Dr. Bland is author of the book Genetic Nutritioneering, - a Functional Approach (which contains a chapter on blood groups), and also wrote the preface for 'Live Right for Your Type'. He set a lively pace to the start of the conference, introducing the connection between genetics and inflammatory conditions, pharmacogenomics and the "trilogy of omics": functional genomics, proteomics and metabolomics.

The latest definition of nutrigenomics includes: "The study of how different foods may interact with specific genes to modify the risk of common chronic diseases... seeks to identify the bioactive molecules in the diet that affect health by altering the expression of genes... the influence of diet on health is related to an individual's genetic makeup."

Genetics is closely linked with evolution, and Dr. Bland expounded the two different theories relating to evolution: natural selection and adaptation. He said that if human evolution happened by natural selection, it took hundreds of millions of years. The subsequent transition from the 'average' human less than a hundred years ago to the typically unwell obese junk-food eating subfertile American could not have happened by the same method, but by the modulation of gene and protein expression and function that controls our phenotype (how we look and feel) by food and the presence of absence of nutrients. This situation is unsustainable, and according to Dr. Bland it is based on a false set of assumptions which are eventually guaranteed to bankrupt the medical healthcare system while opening the door for the development of 'personalised medicine' through the diet/chronic disease connection. Numerous scientific references demonstrated how the revolution in nutrigenomics is taking medicine away from "Taylorism", or standardisation of the client, towards an age of investigation and respect for individuality. The implication throughout was that nutrigenomics is not a fad, but is here to stay. Dr Bland’s message is to encourage people to "exercise their central nervous systems" to find out what is behind the media manipulation, and ''get on the bus or be left behind at the bus stop".

The ability of folate to modify gene expression was discussed extensively during the lecture. Using folate in preconceptual care can be extended beyond the traditional role in prevention of neural tube defects according to recent research: maternal folate supplementation decreases incidence of childhood acute lymphoblastic leukaemia in offspring; coronary heart disease may be considered a long latency disease, beginning in utero; nutritional reduction of breast cancer risk may be folate-dependent; the effects of lowering homocysteine relies on folate; a specific post-methotrexate folate rescue protocol helps counteract the side-effects of methotrexate; epilepsy is sometimes related to folate.

The aetiology of Parkinson's disease, including genetic factors, environmental factors, and the interaction between them is modifiable at many levels: oxidative stress; mitochondrial dysfunction; excitotoxicity; inflammation; Dr. Bland explained how all these may respond to appropriate specific nutritional intervention.

Nutrigenomic intervention to balance immunity may be targeted at either division of the immune system, TH1, the innate (primitive, or cellular), or TH2, the acquired (adaptive, or humoral) division. Individual differences in secretory IgA and glycosylated polypeptides (ABO blood group) influence the genetic uniqueness of the GALT system (Gut-Associated Lymphatic Tissue) and enteric colon bacteria. ABO secretor status is significant in childhood asthma, allergy and atopy (TH2-dominant disorders), susceptibility to systemic inflammation (TH1-dominant). Conditions such as COPD (chronic obstructive pulmonary disease) and arterial disease depend on the the neuroendocrine immune system functioning as a whole, which is tightly controlled by genetic uniqueness (as in a polymorphism of the COX-2 gene, for example). There was much more information that Dr. Bland did not have time to present...

Dr. D'Adamo - POLYMORPHISMS

In his first lecture Dr. D'Adamo encouraged people to move away from the idea that blood type medicine is a perfect unchangeable monolithic structure. Rather it is a working system; the innovations in nutrigenomics presented at this conference along with further discoveries relating to ABO blood group and other polymorphisms can all be incorporated into the concept of treating patients as individuals.

The lecture gave an overview of the ABO blood group system and the influence of salivary secretor status: Dr. D'Adamo reviewed how gene linkage with an individual's blood group decides activity of both dopamine beta-hydroxylase (an enzyme affecting monoamine oxidase activity, which governs metabolism of noradrenaline and serotonin) and arginine succinate synthase (affecting nitric oxide synthesis, having many effects throughout the body), as they all overlap on the same gene location (at 9q34). Clinical tools such as the connection with blood group B and BUN (urea) blood values, and the haemaglutinin titer were introduced.

On Friday evening North American Pharmacal hosted a poolside reception with a blood group compatible buffet, live music suitable for all blood groups, and a chance for conference attendees to mingle.

Martha D'Adamo - MOO PAL DAN KHUM

Saturday and Sunday mornings started at 7am with meditation and breathing. Martha D'Adamo, a black belt in karate, took early risers through the Moo Pal Dan Khum exercise sequence. This is a qi gong-style series of ancient breathing exercises designed to help tone and move energy through the body.

Dr. Pizzorno - THE SALUGENETICIST

Dr. Joseph Pizzorno, originally a student of Dr. Bland, and subsequently a tutor of Drs. D'Adamo and Crinnion, presented a more detailed analysis of the crisis in healthcare. The US system has spiraling costs, and yet ranked 72nd in health of the population in a survey of 191 countries in 2002. Like Dr. Bland, Dr. Pizzorno also suggested that the solution is to move away from symptomatic treatment, whether conventional of using 'green drugs', to a new personalised curative medicine promoting health, disease resistance and reversal. An example was given of a post-menopausal woman with progressive bone loss and low sunlight exposure due to family history of skin cancers, who was unresponsive to standard natural interventions. She was found to have a polymorphic deficit in vitamin D receptors, and increasing her dosage of calcium and vitamin D to above the normal range stabilised her bone density.

Evaluation of all variables in a situation such as migraine needs assessment of 27 possible physiological dysfunctions, 25 possible environmental/drug toxins, 40 possible natural medicine therapies and evaluation of 900 research citations. This is too much for any physician to keep in their head. The increasing amount of possible causes and interventions for any given situation lead Dr. Pizzorno to investigate the use of artificial intelligence (AI) tools in natural medicine. The result is a tool using a Bayesian inference system called the Salugenicist (meaning health promotion, as opposed to pathogenesis). As one would expect from the author of so many naturopathic textbooks, the report generated by his software contains recommendations for dietary, nutritional, lifestyle and exercise, herbal adjustments and even healthy recipes based on the patient's individualised analysis.

Although fully functioning and demonstrated live at the conference, the program was estimated to be about a quarter of what will be in the final version. Impressive drill down options allowed exploration of every answer, including abstracts of referenced articles. The system is rapidly expanding, but does not yet contain blood type specific information or secretor status (one of the first questions asked by the audience). The program is designed to reduce the time spent by the doctor looking into his computer screen and give more quality time with the patient, with fewer adverse reactions of interactions and improved efficacy of intervention. With the advent of AI, natural medicine is truly coming of age. Further details can be seen at www.salugenecist.com<br />
Dr. D'Adamo - DERMATOGLYPHICS, BIOMETRICS AND SYMMETRIES

Dr. D'Adamo's second lecture introduced this surprise topic. The scientific study of fingerprints has entered the repertoire of naturopathic practitioners using genetic markers: the shape of the epidermal ridge patterns are determined between four weeks and 5 months in utero. These patterns may represent developmental pathways underlying multi-organ syndromes. Further, the height of the fingerprint ridges are a sign of gut glycosylation; ridge atrophy gives an indication of the health of the gut mucosa, and many other associations - finger length, angle of palmar creases. Also under genetic control is the ability to taste phenylthiocarbamide, which has an association with thyroid overactivity, and ear wax type, which correlates with breast cancer. The audience duly assessed their own susceptibility to disease by inspecting their fingerprint cards received at the start of the conference, relieved that it was not a plot by the Institute for Human Individuality to register people following subversive alternative medical approaches.

Dr. Crinnion - BORN IN THE WRONG CENTURY: POLYMORPHISMS AND THE TOXIC ENVIRONMENT

As a specialist in environmental medicine, Dr. crinnion started his lecture by reviewing phase I and II detoxification systems and cytochrome P450. He then developed the subject of toxicogenomics with reference to the connection between toxin exposure and cancer risk. A survey carried out specifically for the lecture showed higher self-reporting of caffeine and drug sensitivity in ABO non-secretors than in secretors. Environmental illness may also be the result of polymorphisms, and testing is now widely available.

Always the naturopath at heart, Dr. Crinnion made reference to the 12 most pesticide-contaminated foods, encouraging people to buy organic. He concluded "Genetics points the gun, but the environment pulls the trigger".

Dr. Debra Wollner - IfHI RESEARCH UPDATE

There are currently three projects at the Southwest College of Naturopathic Medicine (SWCNM) relating to nutrigenomics. Dr. Wollner gave details of a study on the "Effect of Specific Lectins on Microbial-Epithelial Adhesion". The thinking behind this is that lectins may be able to alter the association between bacteria and red blood cells. Dr. Jami Kupperman, a SWCNM graduate and research fellow, described a pilot study on how a low carbohydrate diet may interact with genetic variability, obesity and cardiovascular disease. This type of study could be the proof that individuals may do better or worse on a low carbohydrate diet depending on their blood group.

Saturday night included a Drumming up Health session with Christine Stevens, who created a community spirit through percussion. Delegates entered a trance-like state during the session, and danced while beating their drums.

Dr. D'Adamo - USING THE SWAMI SOFTWARE

Dr. D’Adamo introduced his new software package SWAMI: ‘Serotyping With Amplification, Modification, Interpretation’ (although the choice of acronym is also "a lighthearted way of poking fun at all swamis and crystal ball gazers"). The presentation pulled together all the various aspects of the whole seminar. A freeware PC application based on MS Access, SWAMI asks for blood group and secretor status, biometric (such as head size) and dermatoglyphic (fingerprint) data and family history. Two ‘reaktors’ give a numerical value for lectin sensitivity and glycosylation index. The next version, ‘SWAMI pro’, will be available soon, and will contain a Diet Generator module that generates and prints out a clinically detailed and individualised diet for each patient, a Therapy Generator that designs supplement and treatment protocols specifically for that patient, and the ability to input lab tests and other non-biometric, yet clinically significant parameters (such as Traditional Chinese Medicine diagnostics). Further information can be found at: www.dadamo.com/SWAMI<br />
In summary, Dr. D’Adamo said that the Blood Type Diet (BTD) is now evolving into the Human Individuality Program (HIP). Overall the conference added significantly to assisting the clinical understanding of genetic and biometric uniqueness of patients, which can be put into current practice alongside blood type medicine.