Naturopathic medicine is in somewhat of a life or death struggle in New York State, which is why I agreed to do the gig. Recently, the American Medical Association has announced a general strategy of opposing new or expanded licensure for non-MD health care providers., including NDs. One local byproduct of this seems to be a new smear campaign against naturopathic doctors in New York, often depicting the profession as a cartel of snake oil salesman with heads firmly planted in the seventh century.

What a selective description!

Perhaps I'll reply by describing allopathic medicine as a "Collection of bone-saws, who routinely employ toxic metals such as mercury, don't wash their hands much, and whose treatment has only been shown to shorten the lives of their patients."

Is that description true?

Well, sort of --if I was trying to describe for you the typical MD of the late 1850's.

You see, sometimes we can be even worse than wrong.

Busy writing weekend-- made more enjoyable by having finally migrated to topics that do not require much of an educational pre-buildup; just good old simple depictive writing. Grab this, measure this, do that. Went over to my little sailboat yesterday with Martha and together we managed to get most of the jackets, bottles, and whatnot out and into the garage. It was a great summer sailing around Long Island Sound. The winds were kind and consistent and the kids are now old enough to savor the experience. Winter just seems extra long and dreary when you can sail with your family and friends in such a great body of water.

Getting the boat over to the winter mooring was a scream. Literally. That day featured absolutely stupendous seas and 30 knot winds. Photographs never seem to do justice to the height of waves, but this photo of your humble blogger (with two sweaters underneath his coat) gives a slight idea of the beating my friend and I took that day. I don't normally wear my hats "homeboy style", but if the visor was in front I can assure you that the hat would have been floating some place in the background.

The other night we made salmon on a plank of cedar wood. I used a ginger-soy dressing that was wonderful, plus lots of garlic. You soak the plank in water for 15 minutes, then put the fish on it, add the fixings, then pop into the over at about 450 for about 15 minutes per pound. Some sautéed squash and onions, rice and we had a feast. Be advised though that the plank does make some smoke and if you have smoke alarms, you'll need to get your exhaust fans going!

After a week home writing, it's nice to be back in the clinic. The combination of the two (writing and seeing patients) rounds out the day nicely, especially if I can get in a bit of exercise. Someone showed me an article in one of the glossy weekly magazines about how an actress named Jennifer Lopez is following the BTD as an aid to having a healthy pregnancy. Good for her! It can't hurt, and often accomplishes miracles by itself when other methods of fertility have failed.

Speaking of miracles...

Time magazine had a discourse between Richard Dawkins and Francis Collins breathlessly advertised on the cover as "Science Versus God" or some similar dribble. In a rather underwhelming exchange, atheist Dawkins seemed to come out ever so slightly the worse, since Collins appeared every bit as rigorous a scientist, but felt compelled to admit that there were things in existence that he felt could not fall under the realm of scientific scrutiny. On the other hand, I got the impression that Dawkins rules out the existence of God simply because he feels that God is an improbability. Thus my problem with cover sales pitch: It should have been titled, "Science Without God Versus Science with God", since Collins (the coordinator of the US Human Genome Project) is not exactly the type of guy to go around blowing smoke out his mouth, dancing in a grass skirt.

I rather enjoy both of their writings, but each for different reasons. Dawkins, best known for his book The Selfish Gene, has a great clarity of vision that I admire and his thoughts are usually laid out in a rational step-wise order that a computer programmer geek (such as I) can appreciate. However, there is a persistently Cromwellian vehemence to some of his writings; especially when it comes to having a belief in anything other than the belief in having no belief.

Collins, who recently wrote The Language of God, is far cuddlier. He feels that "moral law" (as characterized by the writings of Kant) indicates there is such a thing as right and wrong, and there are some things that you "ought" to do, and some things that you "ought not" to do. In the Time discussion Dawkins pretty much makes it clear that he views things as having the ability to be bad or good, but denies that there is a bad or good.

I bring this point up because these types of media discussions just further convince me of the relative bankruptcy of language --which itself is a sure sign that the discussion is headed towards philosophy and away from any sort of objectivity.

My advice is to, skip the Time article, read Dawkin's The God Delusion and Collins' Language of God. Finally, read Stephen Jay Gould's classic article on nonoverlapping magisteria and draw you own conclusions.

Thomas Kuhn's little book The Structure of Scientific Revolutions identified the problem almost fifty years ago: Normal science tends to reward "puzzle-solvers" who choose only to work within the existing paradigm. Rival paradigms are incommensurable; they simply cannot understand each other through their own conceptual framework and terminology.

That's good news for Time. They can do this again next year.

1.

An associate of mine, an amateur skeptic with professional zeal, says that without telling me he was acting on my recommendation to look into the Eat Right 4 Your Blood Type books, found that Dr. D'Adamo denies wheat to all four blood types in his recommendations, a little feature I hadn't picked up on. "Therefore, he's just another quack, and can be disregarded." While even if the 4-type denial is true, which I haven't checked out for myself yet, having just had this conversation, I feel a little more sympathy for it, being someone with celiac sprue. My associate, however, won't admit he has psoriasis! He said if I used that word again in talking with him, he would never communicate with me again. I was hoping to edge him toward some empirical improvement with the blood type diet, but that was ended by the hammer-fall of his judgment, at least for the present. -Peter

Hi Peter,

I'd have your friend check the book again. His calculations are off.

If we look at whole wheat

Total incidence of type A secretors = 34.2%
Total incidence of type AB secretors = 1.7%

Total percentage of the population in which whole wheat is at least 'neutral' is 36%

If we look at spelt wheat

To find the total percentage of the population in which spelt wheat is a least 'neutral' (an avoid only for type O non-secretors; about 8% of the population) is even easier. Spelt has a higher mucopolysaccharide and lower gluten content that whole wheat, which may help modulate its pro-inflammatory proteins a bit, I think.

Subtracting that serotype leaves about 92% of the population (perhaps; there are other possible reasons against) who can use spelt type wheat.

However, these numbers may be optimistic: evidence suggests that our sensitivity to gluten containing foods is on the rise.

I think we will see many possible correlations between the diseases of industrialized society (such as diabetes and obesity) and their current wheat and corn based diets.

2.

I have happened across a book I think will be of interest to you. Have never seen a reference to this on the message board. It's called 'Eat to Live', by Joel Fuhrman M.D. The book is on diet and weight loss but has a 7 page piece - critique of the BTD. At least this guy did a bit of research. -Thanks Bruce.

Hi Bruce,

Maybe you should bring it up on the Forums and see what kind of discussion ensues.

I've don't know Dr. Fuhrman and have not come across his name in any of the research areas of biology and genetics that I study. I'd like to see him stick to his own projects rather than find the time to inveigle his readers with tales and criticisms of his competitors.

There was a wonderful TV program on Isaac Newton the other night. It seemed (at least to me) that every time Newton announced a new discovery --the polychromatic nature of light, the reflecting telescope, Calculus-- this other guy (whose name I forgot) would write a critique simultaneously claiming that Newton was wrong and he that had discovered this earlier anyway. Newton apparently got seriously bent out of shape by these types of shenanigans.

Stephen Jay Gould had an interesting take on this, as part of a response to criticisms of his theory of 'Punctuated Equilibrium' (1):

THE MOST UNKINDEST CUT OF ALL. If none of the foregoing charges can bear scrutiny, strategists of personal denigration still hold an old and conventional tactic in reserve: they can proclaim a despised theory both trivial and devoid of content. This charge is so distasteful to any intellectual that one might wonder why detractors don't try such a tactic more often, and right up front at the outset. But I think we can identify a solution: the "triviality caper" tends to backfire and to hoist a critic with his own petard—for if the idea you hate is so trivial, then why bother to refute it with such intensity? Leave the idea strictly alone and it will surely go away all by itself. Why fulminate against tongue piercing, goldfish swallowing, skateboarding, or any other transient fad with no possible staying power?

Gerhard Uhlenbruck, one of our IfHI speakers, says it differently:

Never chase a lie. Let it alone, and it will run itself to death.(2)

I have my own aphorism to add:

Negative reviews of popular diet books are too often found inside of other popular diet books.

I'm actually flattered that someone would go to the trouble of writing a seven page refutation of my theory. However, I don't have the time or energy to write a seven page reponse, so this must do.

But finally, I leave you with the words of my Tang Soo Do Sa Bom:

You want to show me something you've read? Great. Get out there on the floor and show me.

(1) Stephen Gould 'The Structure of Evolutionary Thinking' (2002) Belknap, Harvard Unveristy Press.

(2) Gerhard Uhlenbruck on The Individualist.

Does a word every just get stuck in your head? Today's word is definitely nincompoop.

Interesting word. I like ‘nincompoopery' as well. Apparently the origin is quite old, but uncertain. It's not used much nowadays; the New York Times used it five times in the last year. In its April 3, 2001 edition, it referred to Americans referred to as "nutritional nincompoops."

Recent BTD sightings in the popular and scientific literature would make it appear that the American consumers are not the only nutritional nincompoops.

This morning I picked up a recent issue of Women's Health magazine, featuring such sound nutritional research as ‘The Cheetos Diet,' and came across a comparison of the online diet support sites (you know, eDiets, Weight Watchers, etc.)

eDiets came out pretty well; the only down side was its inclusion of the Blood Type Diet, which in the words of Food Scientist Jennifer Anderson "is scientifically unsound."

Nincompoopery.

Wall-papering your house from the mail slot in the front door is 'scientifically unsound'. Putting out a fire with gasoline is 'scientifically unsound.' Scotch-taping bottle rockets to your sneakers and expecting to fly is scientifically unsound. How, pray tell, is factoring blood type into health calculations 'scientifically unsound'?

Media buzzwords.

'Low-Fat Diets Flub a Test' proclaims today's main editorial from the always peripatetic New York Times:

"The baffling results came from a $415 million study of almost 49,000 women age 50 to 79 who were tracked for eight years, with repeated exhortations to the low-fat dieters to stick to the regimen. In findings announced this week, the almost 20,000 women on low-fat diets had essentially the same incidence of breast cancer, colorectal cancer, heart disease and stroke as the 29,000 women who followed their normal eating patterns. The results clearly surprised the investigators and may sound the death knell for the belief that reducing the percentage of total fat in the diet is important for health."

Among other concerns, restricting fish, nuts, and seeds immediately cuts off any source of Essential Fatty Acids such as Omega-3. Low fat dieters are also more at risk of suicide.

Bad news for fans of the fat-phobic gurus like Dean Ornish, Michael Klaper, John McDougall and John Robbins (all of whom have spent the last two decades guilting people into eating extremely low fat diets) and agribusiness sycophants such as the American Dietetic Association (which spent the last two decades taking money from manufacturers of fake fat foods, so we could all enjoy a 'healthy and tasty low fat dieting').

Eat your rabbit food.Of course, all these folks are now out with their spin control: "Oh, it's not low fat that we're concerned about, it's the right fat."

Not unexpected. There's huge amounts of money at stake: Grant money, book sales, you name it.

What humbug.

Although it took me the better part of my first two decades in practice to realize it, a truly resourceful approach to nutrition is not very complicated:

It is the foods that you identify as benefical for a specific person and which truly feed him, that make him more healthy. Telling a person what to avoid will sometime make him less sick, but only rarely more healthy.

I've never seen anyone improve on a diet of rice cakes and lemon water.

Future low fat gurus may want to ponder the wisdom of cajoling sick people into draconian dietary measures.

Now, before anyone thinks that this is the ultimate validation of all things Atkins, the study also found that an increased consumption of carbohydrates and grains is safe and healthy - contradicting the claims by proponents of low-carbohydrate diets such as the Atkins that high carbs increase the risk of diabetes. Those in the study "did not show any signs of diabetes, their triglycerides were normal and their blood glucose was normal," said Dr Elizabeth Nabel, director of the US's National Heart, Lung and Blood Institute, which sponsored the $415 million study.

So, now that we know who lost, when do we find out who won?

Not any time soon. That won't happen until researchers start incorporating specific markers of genetic individuality into their study designs: Polymorphisms (like ABO blood type and secretor status); single nucleotide polymorphisms (SNPs) and metabolomics (the study of genetic differences by analysis of metabolic end products).

Until then, we will constantly be left with conflicting results and confounding, competitive theories.

Final thoughts:

Could it be that the idea was right, but the execution wrong? That the cause of some cancers does have to do with fat, but not in a way that is addressed by a low fat diet?

In other words, suppose toxins and free radicals in fat tissue do cause breast cancer and cardiovascular disease, but (unfortunately) a low fat diet in and of itself does nothing to help eliminate them?

And perhaps paradoxically, in some people, actually concentrates them instead?

Then you have a reasonable experimental model for the case of the life-long vegan who gets breast cancer.

One of my teachers used to tell us that there were two types of medical students: The first type, who go through four years of medical school; and the second type, who go through the first year of medical school four times.

Sadly, we seem destined to go through this first phase of nutrition research a few more times.

Anyway, some other news:

Put up some new sound files in the Media Center. The first is an extract of a lecture I gave at the Ontario College of Naturopathic Medicine. The second is part one of the 'Century of Blood Type Science' lecture given as the keynote address at IfHI 2003. I hope you enjoy them.

You can access these sound clips by clicking this link.