I wrote this note as a comment on my colleague Rick Kirschner's blog:

Hey Rick,

I thought long and hard on this, especially since I've spent a lot of time dealing with misrepresentations of my own work. On one hand there is the ever-present desire to turn the other cheek and convert my response into a teaching opportunity. This works in certain circumstances --often if the skeptic is actually curious about that which they are skeptical of.

Most are not.

In most other circumstances, turning the other cheek will often get that side of your head smacked as well. As Ho Chi Minh once said in reference to Mahatma Gandhi, "Had he grown up in Vietnam, he'd have ascended into heaven long before he did."

Because these people are often prisoners of their own zealotry their tactics are not very often of the velvet-glove variety. Since they don't respect that which they are skeptical of, and anything goes and every tactic is permissible

Of course this automatically brands them as pseudo-skeptics not skeptics, since true skeptics are more than happy to amend an existing opinion with the presentation of new evidence. Most of these guys just feel that modern allopathic medicine (and hence the public) is under attack from vicious, dangerous woo-merchants and it is their anointed job to exterminate this vermin.

Thus it is unlikely that appeals to reason will ever work effectively, since dialogue is not what they are interested in -- anymore than someone would ever be interested in dialoging with a cockroach before they stepped on it. People who dialogue with cockroaches usually don't step on them.

Like Ho, Adolf Hitler also had an opinion of Gandhi, remarking once to Lloyd George: 'Why doesn't someone just shoot him and be done with it?'

Let's call a spade a spade: The more extreme of these 'anti-SCAM' pseudo-skeptics will not rest until we're completely discredited and eliminated.

Thus their tactics and criticisms are almost always of the 'gotcha' variety. This is usually performed by trying very hard to cover their opponents in manure so that they can stand back, point to them and say 'look, they are covered in manure.'

Gerhard Uhlenbruck, the worlds leading lectin researcher, and one of the few scientists who has openly acknowledged the value of my work has a nice way of reflecting on the silliness of what these people do with their time:

"Never chase a lie. Let it alone, and it will run itself to death."

Stephen Jay Gould also had a nice way of turning the tables on pseudo-skeptics. This from 'The Structure of Evolutionary Thinking' (2002):

"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?

So, if Uhlenbruck and Gould are correct, why do so many people spend some much time making life miserable for people with new ideas?

Probably because, although we talk of ideas, it all distills back down to power and money. New ideas often threaten the exact type of person who (personality-wise) would go on to make the perfect pseudo-skeptic. The type of person who buys into the existing power structure, hook, line and sinker. Anything that takes away from the reflected light ('My son the doctor.') they have spent so much time and money on gaining. For which they so sacrificed and assiduously played the game in order to secure. This is not just a threat -- it is also a nightmare.

So what is the answer?

Like any test of will (and for a myriad of reasons) victory goes to those with the ultimate staying power.

In military terminology there is a tactic called 'the refuse.'

Back in the old days, these guys would just line up opposite each other on some level field and go at it. Typically, since most people are right-handed, the right side of an army's line would often be stronger than the left. Thus the idea of any good commander would be to 'refuse' to fight (usually by slowly pulling back) on his left side while trying to press the advantage on his right.

This is a fundamental tactic in Aikido martial art. It is called 'entering,' the idea being to enter inside the physical space of the attacker and then by turning as you enter, you align your force with his and for a brief transcendental moment, see the world as he sees it. Very hard to have a fight with someone who is trying their hardest to see your point of view. It is very hard to hit something which has as its ultimate goal to be where you are not.

I stopped writing for pseudo-critics years ago: You can't please them, they won't buy your books anyway and the people I really want to help educate don't want to read that type of stuff.

I just refused to do it.

Now, while most magazine articles critical of my theories have long-ago been relegated to the landfill, you can still buy my first book only in hardcover despite being twelve years in print.

Why? Because the theory works in many people and they go on to tell other people.

Now, if I need to buy a new hammer I'd be somewhat interested in reviews that tell me which hammers 'not to buy,' but ultimately if my best friend tells me which brand of hammer he's happy with, I'm probably going to go with that advice. I would also find questionable reviewers who had nothing good to say about all hammers in general.

Let's commit to always doing the hard work. Let's accept the fact that we practice a revolutionary form of medicine and let's stop looking for approbation from the very people whose preeminence we threaten and who cannot appreciate the strides we've made and the struggles we've endured in order to put this profession back on its feet.

Let every patient see the value of what we can do. These pseudo-skeptics will always have their coffee claches; their little goldfish bowls, where naturopaths do nothing right and allopaths nothing wrong. But let's refuse to make it into something bigger than it really is, because that is not the main battlefield.

Instead, let's wake up every day determined to redouble our efforts to improve the lives of our patients.

I'll end this diatribe with two more Vietnam Era quotes, which to me seem oddly relevant since US health care is currently in a Vietnam-like quagmire.

The first is from Lyndon Johnson, a fundamentally un-quotable president. Johnson did once say something I thought was of note. In dealing with criticisms of his Great Society program, he was heard to say:

'It takes a master carpenter to build a good barn. Funny thing though, is that any fool with a match can then burn it down.'

Let's remember that we are master carpenters. The public can be trusted to see the benefit of good barns. Let's also refuse to put the matches in the hands of our opponents.

The second quote is from a meeting between a Vietnamese general and an American general in Hanoi several years after the war ended.

'You know' said the American general, 'you never beat us in a single battle.'

'Yes, that is true.' replied the Vietnamese general, 'however it is also irrelevant.'

Remember water always beats rock. That's because water can go around rock. Let's refuse to butt heads with rocks.

And as the quote goes "Medicine progresses funeral by funeral."

They were referring to the doctor's funeral, not the patient's.

Take care and good luck with the new book.

Peter

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.

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.

Spent the last week lolling around Lancaster County Pennsylvania, one of my favorite places in the world. If the twenty-four hour news media leaves you with the notion that there is nothing that America can do right, visit Lancaster County. There is a lot of tourist stuff, but there are also fields and fields of the great agricultural bounty to be found in America. Corn, beans, lettuce, you name it. Rows upon perfect rows, fading endlessly into the horizon. Sturdy stone houses and hideously expensive (but quite beautiful) hand made quilts.

I was happy to learn that almost 100% of the fertilizer is natural manure-based; which, although it can be a problem with ground water runoff if improperly managed, is still better than the Monsanto-based explosives we've relied on in the past.

We were looking at schools for my oldest child, Claudia, a high school senior who will start college next year. We toured Franklin and Marshall and Gettysburg colleges. Both are gorgeous, small and inviting; just what a liberal arts college should be.

The usual protocols prevailed, typically a slide show ‘orientation’ followed by a tour headed by one of the students. I learned that at both schools, the washing machines in the laundromat will send you a text message when your wash is finished, and that at 12:00 midnight the week of the final exams, you can get free hot chocolate at the library. When I asked about the number of technical and scientific journals each library subscribed to, nobody knew the answer.

Of course, nobody ever talks about the 8000-pound elephant in the room: “Hey, just how much is this going to cost?” For kicks, I'd typically gesture to raise my hand when it got to question and answer time, at which point my legs were vigorously kicked by my younger daughter, nervously anticipating future mortification at the hands of dad's latest déclassé question.

Gettysburg College almost did the ‘anti-orientation.’ The assistant dean of admissions just went up to the front of the auditorium and proceeded to do 30 minutes of shtick. Some of it was tedious, but a lot of it was peppered with great advice, good tips to the kids about how to write the application essay and comport themselves during the interview.

• “If you don’t know Winston Churchill personally, please don’t write about how he is a role model”
• “Make a point to provide at least 50% of the total conversation.”
• “Look me in the eyes.”
• “This is not a good time to be shy or modest.”

If you have a teenage child, you will understand the benefits of this sage advice.

Gettysburg is of course the site of a famous Civil War battle, one of two that provided the turning point in fortune for the forces fighting for the maintenance of the Union. It is also the home of The Gettysburg Address, which I was surprised to discover, was not used as a name by any of the town shops or restaurants. By the way, the restaurant eating is much better than I remember from years back.

I fancy myself a fairly knowledgeable on the battle and tactics and looked forward to driving the park and discussing the history of the battle with the kids. It was pretty rough at first, since neither child is all that much into history. Sort of like our earlier trip to Cordoba. However a trip to the new Gettysburg National Visitor Center did sort of hook them in, especially the very cool 3-D type movie narrated by Morgan Freeman, which takes you through the battle, causes and aftermath, all in the very teenager friendly time-frame of 24 minutes.

Tonight is the first of the NAP Professional Webinars, and I’m told that it is standing room only (25 people are the maximum). We are using a service called GoToMeeting that allows people to hear what I’m saying on their computer speakers, see my desktop, and ask questions. Hopefully I can get the thing under my belt by show time. I'm told that it can be 'recorded' and if so, we will make it available to doctors and other professionals.

The Connecticut Post ran a very nice article on me the other day. Unlike that terrible article in Time a while back, this reporter actually took the time to try and understand the material. Of course, the comment sections of these online articles always seems to attract a screwball or two. Like Sister Marie Francis used to tell our fifth grade class at Our Lady of Guadalupe School in Brooklyn, “Empty barrels do make the most noise.”

While on the subject of criticism, we’ve finally got round to developing a standardized response area for the myriad of articles on the Internet that are critical of all the blood type and GenoType theories. In time, we’ll just keep adding to it.

Other news: I’ve just received test batches of the skin toner, cleanser and moisturizer. People who have tried the day crème are usually pretty enthusiastic about the line, and they will probably like these as well.

I've made point of never actually reading the Wikipedia entries on myself and The Blood Type Diet. However, I was playing around with the new www.cuil.com search engine and the Wikipedia entry came up for the BTD. I was pleased to see that the entry on me personally has been deleted, as I had requested. However, that was just about all I was happy to read.

I've known all along that a lot of 'Diet War' well-poisoning goes on at Wikipedia, so I was not surprised to see the normal stable of misrepresentations and deliberate factual cherry-picking that characterizes the entry. More surprising was the deliberate attempt to put various statements and values into my mouth which I had never said or written. One of the cited 'criticisms' is just a page from a MLM website.

Well, sadly enough, one just can't ignore Wikipedia, since thousands of people depend on it for information. I changed a few things up front with the entry, leaving what I thought were valid comments, even if they were negative. I tried to footnote everything where possible.

I left the following message on the Talk Page:

Rot and Worse

I extensively added my own input in response to some of the more unctous paragraphs, in an otherwise terrible entry. I've removed one criticism, which actually did nothing but link back to a general page on my own website. I've also countered several efforts to inveigle points by putting words in my mouth, including the notion that I have claimed that lectins are the 'cornerstone' of the theory and that '1000's of references cited by D'Adamo do not specifically support his associations between blood type and foods' with the obvious reducio ad absurdum that if any one of them actually did, I would suspect that they could justifiably be considered the originator of the theory.

Finally, on the subject of research. By all means. Now, what would be the null hypothesis, and how would we dispove it? Obviously to prove the whole theory, we would need to run controlled studies on each blood group versus some sort of placebo. True, the ABO testing part is simple, but don't be silly; that's only the start. What biomarkers shall we monitor? E-selectin might be a good one, or maybe just weight loss. What numbers would we need? Couple of hundred; maybe a thousand. What pre-study baselines should we have? CBC? CRP? Lewis Antigens? Follow-up? Staffing? Anyone want to hazard a guess at the price? I'd say maybe 7-10 million.

Now, without this 'burden of proof' I should not write anything, hypothesize anything or claim anything until we get the money and get the test done, even though I would be more than happy just considering the whole thing still a theory. Nothing distasteful there. Einstein had theories. He didn't have to show burns on the seat of his pants from riding light beams across the universe. Me, I just run little studies to try and poke wholes in the one-size fits all diet/disease concept.

Anyway, OK.. I get the money and get the study done. Oiula! My theory is wonderful! A medical breakthrough!

Not so fast.. 'Of course he got those results, he did that study himself. We need independant corroboration.'

Now, how many scientists do you think are going to stick their neck out on this type of research? The internet is full of 'diet war skullduggery': vegan websites which trash the theory because it tells some people to eat meat; and paleo websites that attack it because it tells some people that carbohydrates and soy may not be so bad for them.

Does Wikipedia have an entry on 'Diet Wars'? It really should.

On the other hand people can at least look at some simple anecdotal evidence (aka 'self-reported outcomes' when you are Dean Ornish).

But where this entry really misses the point, is its complete lack of any attempt to fit the Blood Type Diet into any historical context, a sad oversight for an 'encyclopedia' if you ask me. This theory was advanced almost three decades ago, with the idea that there may well be something such as a 'personalized diet.' Ten years ago it was low-fat versus low-carb. Ornish versus Atkins. Here was a system that said in essence they were both correct... to a degree. And a determinant was a simple gene that anyone could discover for free. Like it or not, from a historical perspective it will always be the first nutrigenomic diet.

So... lack of independant verification? Yes. Large body of anecdotal evidence?... Yes. Conclusions albeit circumstantially supported by the general body of evidence?.. Yes. Blood group characterizations in keeping with parameters as observed in the literature (myocardial infarct, blood rheology, soluable endothelial factors, intestinal enzymes, brush border hydroxylases, pepsinogen, etc).. Yes.

This entry sort of reminds me of the cover of 'Beggars Banquet' by the Rolling Stones. Not the nice one with the engraved invitation... The first one with the toilet bowl and the graffiti..

PeterDAdamo (talk) 12:31, 30 July 2008 (UTC)

I guess I'm going to have to pay more attention to this in the future. My advice is save a copy of the current page while you can. No doubt it will be 'reverted' as soon possible.

'I'm shocked, shocked to find that gambling is going on in here!'

-Captain Renault, 'Casablanca' 1942)