I write a weekly email to the ND students on my shift at the University of Bridgeport Health Science Center. If in the course of working with a patient a concept arises that appears to require more in-depth knowledge I often specify certain research articles for the students to read in preparation for the next shift. This is not typical of clinic shifts and my shift is thought to be among the more demanding. Despite (or perhaps because of) this, a place on the shift rotation is always in high demand.

Recently the discussion came round to two concepts related to both cancer and inflammation: endoplasmic reticulum stress (ER stress), which results in poorly manufactured proteins; and the subsequent unfolded protein response (UFR), which occurs as a result of the dangerous aspects these improperly folded proteins pose to the cell.

After providing the students with 6-7 key studies, I began to suspect that they might need some cheering-up. So I appended this little ditty to the email:

A polymath is someone who is interested in everything, and nothing else.'

-Umberto Eco

A polymath (Greek πολυμαθής, polymathēs, "having learned much") is a person whose expertise spans a significant number of different subject areas. In less formal terms, a polymath (or polymathic person) may simply be someone who is very knowledgeable. Most ancient scientists were polymaths by today's standards.

How do YOU propose to become a polymath? What might you need or observe?

1. Confidence

Firstly, and this might be obvious, there must occur a huge leap in self-confidence. If you are easily intimidated by learning new things, or think you are somehow less smart than others, becoming polymathic will not be easy.

The learning-intimidated state is overcome by taking the first few baby steps in developing a new appreciation of just what you are capable of being aware of. This might be as simple as arriving at the conclusion that, since you are (at the very least) in control of your own life, who else is better capable?

I once had to do an interview with

http://en.wikipedia.org/wiki/Michio_Kaku

Well of course I got all bent out of shape. The guy is like one of the smartest people on the planet. etc. etc. etc. string theory, etc. etc. etc. skeptic, etc.etc. etc.

As I got more twisted and twisted, I went to dinner at an old friend's house. These people were once our next door neighbors and we've kept in touch over the years, despite (or perhaps because) we don't have very much in common. On hearing my lament, the husband listened and simplified the whole thing for me by identifying the one basic truism:

'He may be smart, but he don't know what you know.'

Anyway, we couldn't get a time that worked for both of us and the interview never took place, but I did learn something about myself.

2. Rush/ Don't rush.

How often do we use time to avoid something? To just get 'it' over? However, far from telling you to slow down, I'm suggesting that you rush with a purpose. Not just to 'get it over with ', but rather to 'just to get to the end of it.' Then, instead of just moving on, going back and revisit that notion that caught your eye. Getting to the end of something lets the brain 'pin the four corners' of the concept and set aside space for conceptualization and context.

This observation has an important metaphor about disease and health buried within it.

Health is often like a car speeding down the highway: scenery flying by, but just barely noticed. Windows up. AC on. Favorite tunes playing. The conversation centering on some arcane subject. However, the timing belt breaks. So now we are going zero miles per hour, perched aside a forlorn stretch of highway. Initially we can only think about getting out of here ASAP. But soon other senses intervene and we begin to mesh with this new reality. Perhaps a tall copse of Shepherd's Purse. The sound of a small stream heard but not seen. The alluring shade of a nearby tree.

Disease as metaphor, disease as teacher.

3. Quantity has a quality all of its own.

Think of it like this: if you were pouring a concrete floor, it would be rather silly to start in one corner, pour a one-foot-square area, wait for it to cure and dry, and then move on to the next square. Not only would it be inefficient, but the floor itself would have very little structural integrity.

What should we do instead?

We'd pour 'skim coats' over the entire area, perhaps in several layers, trying to cover as much of the entire area as possible. Now, if I were insecure about my 'footing', and had to make the choice between standing on a one by one-foot-square of concrete or the first layer of a thin skim coat covering the entire area I might opt for the apparent security of the fully-completed one-foot square (and indeed, most testing is done on a person's ability to make the 'most perfect' one-foot square). Trouble is, I'm on a square of concrete that doesn't allow me to move anywhere else.

That's the problem with developing polymathic knowledge: there is an initial 'awkward stage' that many people find troubling, especially if they are insecure, or have been led to believe that all things taught to them must have immediate 'meaning'. However, there is a fix for this and a few of you have already figured it out:

4. Wonderment.

Wonder is often compared to the emotion of awe but unlike awe wonder inspires joy rather than fear or respect.

So you might say that wonder is curiosity tinged with the prospect of potential joy.

Closing

Thus we have two choices with this week's assignments. We can moan about the amount of reading on what (after all) is just a clinic shift; start with the first article, tediously plow through it in workmanlike fashion, and then move onto the next, and the next.

This will take hours.

Or we can isolate the key concepts (in this instance I've supplied them: molecular chaperones and the process of n-glycation) gain a cursory understanding of these concepts and then skim through the articles, 'wondrously' luxuriating in areas that catch our attention and/or fit our model of the big picture. Each iteration (or skim coat) deepens knowledge and allows for the creation of more and more interconnectedness.

So, as you might gather, far from being onerous, polymathic behavior is a labor-saving device.

Diabetes Metab. 2009 Sep;35(4):262-72. Epub 2009 May 5.
Intestinal microflora and metabolic diseases.

Serino M, Luche E, Chabo C, Amar J, Burcelin R.

Recent advances in molecular sequencing technology have allowed researchers to answer major questions regarding the relationship between a vast genomic diversity-such as found in the intestinal microflora-and host physiology. Over the past few years, it has been established that, in obesity, type 1 diabetes and Crohn's disease-to cite but a few-the intestinal microflora play a pathophysiological role and can induce, transfer or prevent the outcome of such conditions. A few of the molecular vectors responsible for this regulatory role have been determined. Some are related to control of the immune, vascular, endocrine and nervous systems located in the intestines. However, more important is the fact that the intestinal microflora-to-host relationship is bidirectional, with evidence of an impact of the host genome on the intestinal microbiome. This means that the ecology shared by the host and gut microflora should now be considered a new player that can be manipulated, using pharmacological and nutritional approaches, to control physiological functions and pathological outcomes. What now remains is to demonstrate the molecular connection between the intestinal microflora and metabolic diseases. We propose here that the proinflammatory lipopolysaccharides play a causal role in the onset of metabolic disorders.

Increasingly, studies are showing that changes in the microflora content of the digestive tract can be linked to metabolic illnesses, including type II (adult onset) diabetes and obesity. Blood group and secretor status play an important role in conditioning the overall characteristics of the digestive tract, including influencing the appearance and frequency of many strains of bacteria.

Pathol Biol (Paris). 2008 Jul;56(5):305-9. Epub 2008 Jan 30.
Role of gut microflora in the development of obesity and insulin resistance following high-fat diet feeding.

Cani PD, Delzenne NM, Amar J, Burcelin R.

A recent growing number of evidences shows that the increased prevalence of obesity and type 2 diabetes cannot be solely attributed to changes in the human genome, nutritional habits, or reduction of physical activity in our daily lives. Gut microflora may play an even more important role in maintaining human health. Recent data suggests that gut microbiota affects host nutritional metabolism with consequences on energy storage. Several mechanisms are proposed, linking events occurring in the colon and the regulation of energy metabolism. The present review discusses new findings that may explain how gut microbiota can be involved in the development of obesity and insulin resistance. Recently, studies have highlighted some key aspects of the mammalian host-gut microbial relationship. Gut microbiota could now be considered as a "microbial organ" localized within the host. Therefore, specific strategies aiming to regulate gut microbiota could be useful means to reduce the impact of high-fat feeding on the occurrence of metabolic diseases.

It has been known for quite a while that the colons of obese individuals are considerably longer than non-obese people. Now the idea is increasingly being advanced that obesity is, in part, related to greater "energy harvest." This would appear to throw the time-honored "just eat less and exercise more" argument right out the window and verify the common observance that many overweight people do not consume any greater amount of calories than many non-obese people.

J Pediatr Gastroenterol Nutr. 2009 Mar;48(3):249-56.
Intestinal microbiota during infancy and its implications for obesity.

Reinhardt C, Reigstad CS, Bäckhed F.

Sahlgrenska Center for Cardiovascular and Metabolic Research/Wallenberg Laboratory, Department of Molecular and Clinical Medicine, University of Gothenburg, Gothenburg, Sweden.

Obesity is a worldwide epidemic, threatening both industrialized and developing countries, and is accompanied by a dramatic increase in obesity-related disorders, including type 2 diabetes mellitus, hypertension, cardiovascular diseases, and nonalcoholic fatty liver disease. Recent studies have shown that the gut microbial community (microbiota) is an environmental factor that regulates obesity by increasing energy harvest from the diet and by regulating peripheral metabolism. However, there are no data on how obesogenic microbiotas are established and whether this process is determined during infancy. The sterile fetus is born into a microbial world and is immediately colonized by numerous species originating from the surrounding ecosystems, especially the maternal vaginal and fecal microflora. This initial microbiota develops into a complex ecosystem in a predictable fashion determined by internal (eg, oxygen depletion) and external (eg, mode of birth, impact of environment, diet, hospitalization, application of antibiotics) factors. We discuss how the gut microbiota regulates obesity and how environmental factors that affect the establishment of the gut microbiota during infancy may contribute to obesity later in life.

9/11/09

Last night Dr. Andrew Weil was on the CNN's The Larry King Show. Dr. Weil, reacted to a question about blood types and diet with the response that he thought of the BTD had "no scientific basis". He verified this by saying that if people tested the blood of dogs they would say they should be vegetarian rather than carnivores. I have already addressed this mistaken assertion of Dr. Weil's (humans and other species glycosylate their tissues differently, and linkages of certain physiologic functions to the blood group genes also vary by species), but it seems that he needs to keep re-asserting this incredibly naive argument.

In a series of rotating criticisms Dr. Weil other venues asserted that the problem with the BTD was that he "sees no convincing link between lectins and the molecules which determine blood type." (AARP Magazine) After being subsequently challenged by numerous editorial letters, he eventually responded that "he did not agree with restrictive diets." I've previously responded to Dr. Weil's assertions in this blog, but wanted to resurrect my most recent response and make it a bit more current.

Finally I'd like to challenge Dr. Weil to an open forum discussion of the scientific merits of the theories and associations developed, observed or reported by myself and my father. This can occur at any time or place of his choosing. If he is as committed to investigating the truth of his assertions as one would suspect, I have no doubt that he will be as anxious as I for this to occur. I can be contacted through this blog, or at my clinic.

[Now on to the previous blog entry]

8/18/08

The more I read of Andrew Weil's efforts to debunk the work of my father and myself, the more I'm convinced I can't simply turn the other cheek and let these so-called skeptics just get away with disingenuous portrayals of the science behind this diet. His recent slag-job in AARP Magazine is just more proof that I will need to react in a timely and concise manner going forward.

"D'Adamo theorizes that the basis for such differences is our reactions to certain food proteins called lectins. Lectins are common in plant foods, especially grains and beans, and may be involved in food allergies and some immune disorders. But there is no convincing evidence for any interactions between lectins and the molecules that determine blood type."

"Yet some people swear the blood type diet has worked for them. There's a reason for that. Making changes in how we eat is not easy. To follow any prescribed dietary program with rules and restrictions represents a significant commitment of mental energy toward self-improvement. That alone can lead to a greater sense of well-being and better health. But if you want to eat a better diet, I recommend you rely on information grounded in nutritional science."

I think I got on Dr. Weil's bad side a few years ago when I replied to a question posed to me about my recommendation that blood type As eat peanuts, while Dr. Weil was saying that peanuts were dangerous because of the aflatoxin. My response was that this was a silly piece of advice since the only place you can get aflatoxin is in health food stores when you grind your own peanut butter; all the commercial forms must be assayed for it before they can be sold.

Over the next few years Dr. Weil kept up a consistent attack on me and the theory, usually basing his case on the rather odd observation that animals have blood types and yet don't follow the Blood Type Diet.

However with the AARP column Dr. Weil instead shifted to what he considers the lack of proven association between dietary lectins and blood groups.

It's a bad place to pick an argument, since at that point the argument moves up the academic ladder to areas he would be wise to not tread. There are numerous and well-documented links between lectins and blood groups. Searching MEDLINE for the terms ABO Blood Groups and Lectins yields 687 published studies[0] In fact the term ‘lectin’ was derived in 1954 from the Latin for legere, to pick or choose, it having been coined thus to call attention to their blood type specificity.

Dr. Weil's claim appears to have not been researched to any great degree since it appears to me to have been taken from an incorrect assertion that often finds its way onto the Wikipedia entry on the Blood Type Diet.

In fact, blood group specificity is listed as one of the nine major factors influencing glycosylation in the gut (glycosylation is the process of manufacturing the sugar molecules that lectins bind with). Other factors include diet, age, animal species, disease and bacterial population.

Independent of the lectin hypothesis, in my opinion the secretory differences (digestive enzymes, etc.) between the blood groups are an even more significant reason behind the need for the tailoring nutritional needs to these genetic markers.[1] But Dr. Weil doesn't know about these links or chooses to ignore them altogether. Then again, every critic seems to have their own favorite aspect of the theory.

Given his harsh take on my work, it was surprising to read some of his statements about the need for keeping an open mind about alternative medicine. Kinda wish he would practice what he preaches. In a reply to one of his own critics (Arnold S. Relman, editor-in-chief emeritus of the New England Journal of Medicine)[2], he writes:

"As a researcher, you have the luxury of insisting on rigorous scientific testing, and you have the leisure to wait for results to come in. As a practitioner, you are in the trenches, working with patients who have medical needs. And you often have to guess, and you have to make use of your best medical judgment in the absence of definitive evidence."

No argument there.

"In my experience-- I consider experience to be one valuable source of data--many patients use alternative methods because they find that they work. And if a patient has tried a method and found that it works, that patient needs no further proof, does not need to read the reports of a randomized, double-blind, controlled trial in a medical journal to be convinced of the efficacy of treatment."

Even better.

"I don't think you can have it both ways; you can't demand evidence, and then when evidence comes in that contradicts your preconceptions, say you aren't going to look at it."

Words to live by.

Now if Dr. Weil were to keep an open mind, I'd recommend that he read up on the work of William Boyd, who first wrote of the blood type specificity of lectins more than a half centry ago [3] or review the research of Martin Nachbar[4] from the 1980's. Lots of interesting stuff there. A trip to MEDLINE would also be helpful.[5],[6],[7]

In an article critical of Dr. Weil written for the New Republic Relman touched on many of Weil's factual inconsistencies and concluded that:

Weil considers himself an authority on almost every field of medicine. [8]

Finally, it could be argued that the possible reason Dr. Weil supplies for why some people swear that the blood type diet has worked for them ("a significant commitment of mental energy toward self-improvement") may well be the exact same reason some people derive benefits from his own books, tapes and recommendations!

But let's at least end on a somewhat positive note, with a quote from someone who does have experience with lectins. Gerhard Uhlenbruck is one of about three or four top lectinologists of the last century and renowned for discovering the structure of the Thomsen-Friedenreich antigens and the structure and specificity of (aflatoxin-free, I'm sure) peanut lectin. This is what he recently said:

When I first heard of Peter D'Adamo's blood group diet, of course I was very skeptical: Should we have missed in our book (Prokop/ Uhlenbruck: Human Blood and Serum Groups) such an important aspect? But years later, my interest switched to the nutritional field while working on the so-called Metabolic Syndrome, my interest increased in studying the role of genes in metabolic processes. I found out, that Peter D'Adamo's blood group orientated diet could probably be a first step in the right direction..

Back soon with a more positive, happy and helpful blog.

There is something that the Japanese call 'Wabi-Sabi' and which they seem reluctant to define, particularly to 'outsiders' or Gaijin as foreigners are known over there. Wabi-Sabi is a kind of poetic quality, a nebulous feeling, sometimes melancholy, sometimes zen-like and blissful, that -they say- permeates the nature of things.

Wabi-sabi is the beauty of things imperfect, impermanent, and incomplete. Of things modest and humble. It is a beauty of things unconventional. 'Wabi' is seen in the lines of a face, the record of a lifetime of laughter or pain; the knarled trunk of a tree. 'Sabi' is literally a translation of the word patina; the polishing (or in some folks 'grinding') effect of time.I think computers can suck the Wabi-Sabi out of almost anything, since by their very nature they only allow entry to the 'expected' way, which is probably why we can't use them for very long periods of time without mental and physical health consequences.

Brian Eno once said that the problem with computers is that there is not enough Africa in them, and that a nerd is a human being without enough Africa in him or her.

Make sure that there is plenty of Africa and Wabi-Sabi in your life.

This is the time of our lives. The past may have been better or worse on one level of another, but hey, the past is past. 'Create each day anew' wrote Morihei Ueshiba, the founder of Aikido, in the Art of Peace.

Is today going to be a success or failure? Only I can decide. However, if I carry the trials and tribulations of yesterday with me, what possible outcome can I expect? Many people have written me over the years, depressed and angry because they seem to fail again and again at following the diet.

Well, I need go no further than look at my own failures to know what at least works for me.

The trick to surviving failure is to refuse to be disillusioned by it. It is this gradual effect of disillusionment ('retreat after defeat') that saps the will and prevents us from enduring to the end in order to triumph over our challenges.

The first step in mastering this process is the least obvious. Don't make the mistake of degrading your failures by stripping them of their spiritual value. The ability to learn from mistakes and shortcomings is the most powerful stimulant to success that I know of.

It is also why most successful people are actually experts in failure.

Failures are always so much more interesting than successes from an analytical viewpoint, and it is a shame that our society encourages us to run away from them, feel embarrassed by them, or sweep them under the rug.

If you look at the origin of the word 'Aikido' it derives from the phrase 'the way of Aiki.'

Aiki is a blending and harmonizing energy, the perfect example of which is the so-called 'Tenkan Step', which is an entrance into your attacker that involves a step to the outside of his body and 180 degree turn and stepping back once again. What this does is place you shoulder-to-shoulder alongside your attacker so, for that instant in time, you both look out at the world from the same perspective and viewpoint.

Try giving a 'failure' the Tenkan step. Interesting things may happen.

The last few weeks in the clinic have continued to keep the old spark going. How much better I enjoy practicing by myself! No rush, no big administration hassles, no egos to stroke. Just patients and health problems. In prior times it seemed I'd almost forgotten why I went into this profession! In future blogs I'll spend some time detailing a few of the more interesting case histories since I do seem to be seeing quite a few interesting cases these days.

I've been joined by my friend, Dr. Ginger Nash, who has really brought a nice energy into the practice. We've decided to rename the clinic The NE Center for Personalized Medicine (from the prior 'D'Adamo Clinic') to hopefully get the message out there that this concept is bigger than any one person.

I meet this afternoon with the administration and faculty of the naturopathic college at the University of Bridgeport to lay the the groundwork for my Personalized Medicine shift in the UB Naturopathic Clinic. I'm very excited about this as I love teaching and as the UB clinic serves a somewhat underprivileged section of society, I'm psyched to put resources like SWAMI GenoType into the hands of people who really need the help.

If you are interested in becoming a patient of the Personalized Medicine Clinic Shift, contact the Health Sciences Center at UB for more information. This may be an especially good option for folks who are on a limited income as the total fees for the visit are very reasonable ($45 base charge plus $125 surcharge for all testing and materials). Of course it is a teaching environment, so you'll have students in the room, but as clients of my own clinic soon learn, much more information floats through the air when I've got to explain each and every aspect of my thoughts and plans.

I recently did an interview with the Association of Accredited Naturopathic Medical Colleges for their newsletter and website. Although they did excise some of my more pithy remarks, I think it is still a pretty good reflection af where my head is nowadays about health and natural medicine.

The last few weeks have been devoted to finishing up the SWAMI GenoType and SWAMI Xpress programs, working on my 1971 VW Westfalia restoration, and trying to fins time to get out and sail a bit, though the weather this spring and summer has been 'wet' to say the least.

It is a constant source of amazement that this website continues to be graced by the generous efforts of others. To all of you who have given so freely of your time, creativity and energy over these last ten years, I thank you.