As is typical of this time of year, it’s been a very active time for your humble physician-author-blogger.

January started off with a whirlwind visit out to Arizona for a daylong presentation to the Arizona Naturopathic Medical Association. This was followed by a two week intensive period of website redesign, overhauling the website of The D’Adamo Clinic in addition to the navigation system for North American Pharmacal. The Clinic website is a simple white design that I like very much and it conveys what being inside the Clinic feels like to me. I’m not normally a fan of all-white walls, but in the Clinic it works.

The NAP redesign was much more challenging. Here the issue was to present a myriad of different links and categories in a way that did not alienate or confuse visitors. I had long admired the witty way that Apple uses to showcase their Mac computers, but was unaware of anyone other than Apple who used this widget. I suspected that the bright folks over there had conjured this up themselves. Googling around the Internet, I found a lot of threads speculating on how they did it, but no one seemed to have done it. My chance came when someone mentioned that Apple appeared to have built the showcase around a package of free JavaScript libraries called ‘Scriptilicious.’ After downloading and studying these scripts it became evident just how they did it. I’ll spare you the gory details, but it turns out that Apple did make a small coding mistake on their site, which, if you notice, prohibits them from using bulleted text on pages that use the product showcase. Maybe I’ll email them and alert them to this.

One problem you come across again and again when you program for the Internet is cross-browser support. I’ve learned the hard way that a web page that works and looks good in Firefox for the Mac may not necessarily look or work the same way in Internet Explorer for Windows. Many, many times it’s been a last minute check on an outdated browser running Windows 95 that kiboshed a terrific idea.

Putting the final touches on the SWAMI software. I’ve decided to port it to two platforms. One will be the traditional SWAMI GenoType for professionals, the other will be a SWAMI Xpress that will be available online. Introduction of the SWAMIGenoType will be linked to the IfHI 2009 Conference, where Tom Greenfield, Natalie Colicci and I will have the time to take the attendees through the interface, filters and matrices. If you are a physician or IFHI certified educator planning to use SWAMI GenoType in your practice, you’ll need to attend IfHI 2009 to get the full training.

SWAMI Xpress will contain all the base programs of his more muscular brother, but is being designed for general-purpose use. SWAMI GenoType has advanced filters and controls that allow a physician to exert complete control over the client diet and is geared to practitioners who want to have a more micrometric control over things. Introduction of SWAMI Xpress will be as part of NAP’s “Do It For A Month” program.

On the lecture horizon, I’ve got a webinar with the Massachusetts College of Pharmacy on March 31 and an upcoming Grand Rounds presentation at the University of Bridgeport College of Naturopathic Medicine on February 11. After that things calm down until the IfHI 2009 Conference June 5. IfHI should be challenging. I’ve scheduled myself for something like 9 hours of lecture time, and if you could believe it I’m stressing out about not having enough time to do justice to the material. Figured out how to control my slide show from an iPhone, which is very cool. I should be able to pace around the room and use the iPhone to cue the next slide.

After completing a few movies/animations I’ll be pretty much done preparing material for the conference, leaving plenty of time to perfect the software and get the 1971 VW Camper ready.

Got lucky yesterday. Found a site that had the entire LP of the 1974 classic The Portsmouth Sinfonia Plays The Popular Classics available as a download. I certainly don’t support intellectual property theft but this album has never made it to CD and I think the original record label is now extinct. The Portsmouth Sinfonia is the ultimate ode to amateurism: Take a bunch of English art school students --who either cannot play a musical instrument or are willing to play one they are unfamiliar with-- and put them into an orchestra. The only rules being that you had to come to rehearsal and you could not purposely play the wrong notes.

What resulted were renditions of the popular classics (Peer Gynt Suite, The Blue Danube Waltz, The William Tell Overture, etc) in which the inexperience and lack of talent produces a series of acoustic near-misses that collect into this cloud-like approximation of what the proper pitch and notes should sound like. Popular classics were selected on purpose since everyone in the orchestra would know the music and could at least aspire to what the piece should resemble--or at the very minimum whether they should be sounding higher or lower pitched notes.

Here is their rendition of Blue Danube Waltz, Op. 314 (Johann Strauss)

Beethoven was supposedly fond of listening to amateur productions of his work, and I’ve often thought that this would be among the most perfect of medical education paradigms.

A recent question posed to an internet dietician Mary Hartley sparked some outrage over on the www.dadamo.com message boards and got me thinking:

Is there any truth to the diet based on blood type?

For example, O blood type should eat more protein and AB blood type should eat more veggies.

Answer

The Blood Type Diet is outlined by Peter D’Adamo in Eat Right 4 Your Type, a diet book that has been a bestseller for over 10 years. Mr. D'Adamo asserts that your blood type is the key to your immune system, and by eating particular foods according to your blood-type, you can lose weight and prevent diseases, such as cancer, asthma, arthritis, diabetes, and others. But truthfully, there is no scientific evidence to back the authors claims, and the diets recommended for some blood types could produce nutritional deficiencies. The Blood Type Diet is just another fad diet.

Many dieticians embrace and use the research behind the Blood Type Diet, so it is not a complete and absolute truth to claim that registered dieticians (RD) know almost nothing about nutrigenomics and genetic based nutrition. However, based upon a series of interviews conducted in Holland among Dutch dieticians, it's not far from the truth:

Based on the analysis of 51 face-to-face interviews with Dutch dietitians in April 2006, it can be concluded that awareness and knowledge on nutrigenomics is low. Almost half of the interviewees had heard of nutrigenomics and nutritional genetics, but most could not explain what either were about.

Clients of more than half of the interviewees bring up the topic of heredity or family history during consultations in regard of nutrition-related diseases such as weight and diabetes. Clients almost never ask questions related to genetic testing but, if they do, it is in the context of hyper-lipidemia, hyper-cholesterolemia and other metabolic disorders.

More than half of the dietitians thought genetic testing would be relevant for dietetic practice. Most, however, experienced difficulties with identifying the practical implications of nutrigenomics. They expected nutrigenomics to offer opportunities for dietetic practice through tools for creating more personalized or individual dietary advice and prevention of diet-related ill health. Some dietitians expressed concerns about cost, the current lack of evidence, and the affect on clients’ attitudes whilst other felt they knew too little to identify their concerns.

In line with these concerns, there is feeling that nutrigenomics is not relevant to dietetic practice because of a lack of evidence, anticipated costs of testing, and the existing potential for treatment without genetic testing.

When I read these critiques from people who are supposedly experts I simply marvel at the degree of self-assurance they display despite what appears to be a complete ignorance of the subject. There is enough science behind the use of blood type as a dietary determinant to choke a horse; maybe two or three horses. However, if you don't like the conclusions (or more likely don't like who or where they came from) go ahead and criticize the science. That never fails to buy a bit of time.

I also get a bit skittish when someone who is trying to convince me of something starts their sentence off with 'Truthfully...'

The line about the diets producing nutritional deficiencies is complete twaddle. There is no proof of that whatsoever. I challenge Ms. Hartley to back up her assertions with some sort of evidence, or lacking that have the courage to retract this ridiculous statement.

Reminds me of the quote by Upton Sinclair:

If is difficult to get a man to understand something when his salary depends upon his not understanding it.

Speaking of fad diets, many dieticians still cling to the low-fat (or should I say 'fat-phobic') fads of the 1980's. There is perhaps perverse justice in a vignette I recently read in David Stafford's terrific new book Endgame, 1945. Stafford writes that after the outcry against the Nazi euthanasia program, the experts merely moved their lethal expertise away from gas to starvation:

The asylums and hospitals reverted instead to the murdering of the handicapped through lethal injection and deliberate starvation. The director at Kaufbeuren, Dr. Valentin Falthammer, was an especially keen and energetic supporter of the program, and proudly introduced a carefully crafted fat-free diet that guaranteed death to his patients and economized on pharmaceuticals. The death rate rose so high that local authorities forbade the ringing of church bells at funerals, so as to not alert the local population.

Like Peter Gabriel said three decades ago:

It's only knock and know-it-all,
but I like it.

Spent the weekend in Phoenix/Scottsdale where I lectured to the Arizona Naturopathic Medical Association. Nice crowd; surprising to me was the fact that MDs outnumbered NDs at the morning professional session. Had way too much material. The professional lecture was supposed to last four hours, and by midpoint I realized that I actually had about nine hours worth of material, forcing a truncation which certainly had nothing to do with any lack of science.

Happily, this probably means that my presentations for IfHI 2009 are already complete.

Here is a short film about the epigenetic landscape that I made for the lectures. Enjoy.

New research shows that sugar deposits may be the major cause of skin aging.

Skin science appears to have caught up with the humble sugar molecule. Wrinkles, sagging skin, and pigment deposits may stem less from the sun and more from one-way sugar molecules that we make as part of the aging process but cannot remove. With no small amount of serendipity, scientists call these wrong-way sugars ‘AGE molecules’ (the AGE stands for 'Advanced Glycation End-products').

AGE molecules are all around us, and often taste pretty good: Any time we brown an onion or caramelize sugar we are making AGE molecules. However, when you make these molecules under your skin, you’ll probably find much less to like about them.

Unlike most other complex sugars, AGE molecules are not easily removed from the body (Just think back to a time you tried to clean burnt sugar off of a piece of crockery!) And because they stay in place for years, the immune system can react to tissues they deposit in, causing inflammation, damage, and aging.

AGE molecules: Good on marshmallows, bad on people.


NAP recently released the next three D’Adamo Genoma Skin products, which now expands the line to four products:

The Day Light Face Crème is the original formula. We’ve has virtually 100% customer satisfaction with the product, including unsolicited comments from three users that it was the only product that worked on their facial rosacea.

To this base formula, I’ve added an AGE (Glycation inhibiting) toner, a rich night crème and a tissue cleanser that uses a few very interesting botanicals.

For the rest of the month, at my request, NAP is offering the complete set of four products at a savings of 50%. I asked that they try to do this so that as many people as possible can try the line. If you are looking for a great skin care line at an unbelievable price, either as a holiday gift for someone or even yourself, you might want to look into these products.

However, do it before December 31, 2008.

This has been a busy time of things lecture-wise. Last month I lectured on 'Cancer Survivorship' at Backus Hospital in Norwich Connecticut, as part of their Fall Oncology Support Series. I really appreciate that Amy, the program coordinator (Center for Healthcare Integration) took the time to write a very nice thank you note:

Thank you so very much for the wonderful program you offered at Backus last week. Your use of metaphors to translate the scientific research is so effective and at the same time so much fun to listen to. I had many a-ha moments and between that lots of laughter. You are truly a gifted teacher.

It is a great support program from an imaginative hospital.

Immediately after this I lectured to a large group of doctors and nurses over at Soundview Medical Associates in Norwalk, Connecticut. This lecture was pretty much straight blood group science and physiology and despite some early technical glitches I was made most welcome, treated to an attentive and lively audience, and had a great time.

Early October featured a lecture at the Annual Conference of the New York Association of Naturopathic Physicians in Manhattan. This lecture was entitle 'Verisimilitude and Malignancy' and discussed how cancer systems often elude the immune system by posing as quasi blood type markers. Most naturopathic physicians were new to this type of information and as I looked out into the audience all I saw was a sea of heads pointed down as they furtively scribbled note after note.

At the conference I bumped into my old friend Dr. Russell Marz, one of the top naturopathic nutrition educators, whose 'Nutrition from Marz' is a standard nutrition text in the schools. Russell also write the nutrition reviews for NPLEX (the Naturopathic Licensing Exams). We're both expatriate New Yorkers and Russell always brings out the Brooklyn kid in me. Got a nice note afterward:

Good to see you and I just wanted to tell you how much I have appreciated your work. You really have created a whole new dimension in the field of nutrition and I believe especially in the area of cancer.

As I write this I'm preparing to leave for the airport and fly to Nashville, Tennessee for the first IFHI Micro Conference. I'll be lecturing for 3-4 hours throughout the day tomorrow. Hopefully the larynx holds up. Dr. Natalie Colicci is coming along to help with the certification, and tells me that she has already packed the lozenges.

After Tennessee things calm down a bit, which is great since I've discovered a few new veins of research that I want to pursue, and have just purchase a 1971 Volkswagon Bus that I am itching to restore.

Looming on the horizon is IFHI 2009, our biannual master conference. Unlike the prior 2005 and 2007 conferences I'll be doing most of the lecturing (something like nine hours total) by myself, with assistance from Drs. Tom Greenfield and Natalie Colicci. Again and again the feedback from prior conferences has been that, although the attendees have enjoyed the guest speakers, they would prefer that I spend more time on core curriculum and training. So here it is. I'm challenged by the idea of encapsulating an entire lifespan of work into such an information intensive format.

For the first time IFHI 2009 will be held on the east coast of the US (Norwalk Connecticut). It is close to our base of operations and affords a more easy access for the EU attendees, who comprise a rather large share of the audience. Proximity to NYC also allows folks to do some Manhattan site-seeing before or after the conference. Unlike prior conferences which held about 350 attendees, IFHI 2009 is limited to 125 on site and about 25 off site attendees. Also unlike the Buttes in Phoenix, the conference price is a 'soup to nuts package.'

I designed this little flyer for the conference. Almost prophetically it is the exact same model VW Bus that I'll be restoring. However my bus in in something over 1000 parts in over 50 crates.

I thought a recent abstract from one of the premiere nutrition journals did a pretty good job of catching up to, and explaining the theory behind The GenoType Diet:

Epigenetics encompasses changes to marks on the genome that are copied from one cell generation to the next, which may alter gene expression but which do not involve changes in the primary DNA sequence. These marks include DNA methylation and post-translational modifications (acetylation, methylation, phosphorylation and ubiquitination) of the histone tails protruding from nucleosome cores. The sum of genome-wide epigenetic patterns is known as the epigenome. It is hypothesised that altered epigenetic marking is a means through which evidence of environmental exposures (including nutritional status and dietary exposure) is received and recorded by the genome. At least some of these epigenetic marks are remembered through multiple cell generations and their effects may be revealed in altered gene expression and cell function. Altered epigenetic marking allows plasticity of phenotype in a fixed genotype. Despite their identical genotypes, monozygotic twins show increasing epigenetic diversity with age and with divergent lifestyles. Differences in epigenetic markings may explain some inter-individual variation in disease risk and in response to nutritional interventions.

Session 2: Personalised nutrition. Epigenomics: a basis for understanding individual differences? Mathers JC. Proc Nutr Soc. 2008 Nov;67(4):390-4.

Melissa's forays into Tae Kwan Do made me a bit nostalgic about my days spent training in the martial arts.

Recently I was importing some old photos into iPhoto and came upon two photos of the board break from my test for Ee Dan (Second Degree Black Belt) taken Spring 2007. It is a jump double straddle kick.

You have to break two boards with each foot simultaneously. The trick is to get you knees up high and move your head forward of your body. Landing is the hard part. You can very easily land on your butt, which from this sort of altitude is not pleasant.

I wasn't good at a whole lot of other things in the martial arts; but paradoxically, this kick (which everyone else seems to have trouble with) was not only easy, but rather enjoyable. The bottom picture actually shows me coming down; the boards are already broken.