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.

One way to truly screw up the truth is to subject it to public debate; since our minds want some sort of resolution, but out of inbred nicety we often want consensus as well. Problem is, as Winston Churchill so accurately pinned it, consensus is often “the sum total of everyone’s fears.”

People seem to have a love-hate relationship with genetics, or perhaps more accurately, an “awe-hate” relationship. Ask the average person what genetics means to them, and they will typically respond with a litany of dread, largely courtesy of the news media. Cloning. Stem cells. Genetically modified “Frankenfoods.” Yet ask that same person where they envision science will find the cure for cancer, or aging, or diabetes, and they will probably answer genetic research as well.

There are indeed aspects of genetics that are potentially disturbing. Consider the genetic modification of our foods. To a certain degree we are becoming one big uncontrolled experiment, as biotechnology inserts genes from one species into another, often for supercilious reasons. Do we need pesticide-resistant plants, courtesy of genetic engineering, or do we need more pesticide-free organic gardening?

It is precisely when biotechnology becomes the enabler of our existing bad habits that we lead ourselves into uncharted territory. It is also the time when the counter argument in favor of genetic modification of foods, that “nature does it all the time” rings hollow. “Nature” is a vast, living breathing mega-structure. To me Nature might more likely try to destroy pesticide manufacturers rather than re-engineer everything to be able to withstand their wares. It would certainly be easier.

In addition, we have the problem of the politically correct scientific conclusion. Scientists are human beings just like anyone else (stupider actually, if DNA pioneer James Watson were to be believed) and the pressure to conform or arrive at conclusions that are not socially distasteful (and hence not publicly fundable) is great.

But here’s what should be the goal: Take the gobs of generalized information out there, filter and analyze it, then let it guide our actions through the process of making the sort of useful decisions and actions that can produce positive change in public health. Our goal is not Eugenics (getting rid of genetic undesirables, like what the Nazis tried to do), but rather Yougenics --the science of studying yourself. As long as our fact-finding is based on the results that pertain only to you, the individual reading this blog, we will always remain on a strong, fair and firm ethical base.

I would go so far as to say that the absence of Yougenics is the main problem with nutrition as it is practiced today. All too often we read studies done on large groups of individuals and can only be left wondering if these results apply to us. Since nutrition began its meteoric rise in the public consciousness thirty years ago, we’ve been barraged with studies that have lead to sweeping conclusions and have then seen these same conclusions laid to rest, one after the other.

A lot of this is the result of nutrition being largely disease-based, a legacy of its years of discovery centered on finding the cause of deficiencies. Conventional nutritional wisdom came to define health as the absence of nutritional deficiency. Some of this is probably a ripple effect from the major developments that have taken place in the field of pharmaceutical drugs. But foods work differently than drugs. For example, we don’t make energy out of drugs; they don’t fuel or cellular processes. Foods are functional entities in our bodies, not drugs that prevent deficiencies, and our reactions to food are much more individualized than those we have to drugs.

Since nutritional science has such a rudimentary approach to food, it is not surprising that most nutrition research yields results that typically conflict with other results. And although it will eventually be yanked, no doubt kicking and screaming, into the genomic age, nutritionists still clamor for the next “one size fits all approach”, substituting one fad for another, each with its own army of disciples and detractors, the cycle to be repeated again and again.

An interesting observation on the Autism website points to the possibility that The Blood Type Diets can be helpful in managing kids with autism. We've seen some indication of this in the Clinic, and I've speculated in at least one book (Live Right For Your Type) that lectin avoidance may be the mechanism by which this occurs. Would be nice to see a good independent study on this. We can at least hope!

Have been re-reading Vivian Perlis' great book Charles Ives Remembered: An Oral history.

I’ve drawn much comfort from Ives over the years; certainly through his music, but also with many of the corollaries between his life and my own. Our homes are within ten miles of each other, and we both shared the benefits (and challenges) of being the sons of men who were themselves geniuses ahead of their time.

Ives was a musical genius, anticipating the serialism of Schoenberg and many other elements of modern music, such as microtones, by many decades. Unfortunately, this placed him squarely in the path of the conventional musical minds of his time. What frustration he must have felt reading reviews of his work, where instead of seeing the horizon line of a new art, the reviewer merely saw an amateur composer who just wrote down the wrong notes!

Ives had no patience for these people. On top of one review, he simply scribbled the phrase ‘rot and worse.’ To Ives, these were just mediocre minds, steeped in the traditions of the past. Problem was, they taught in the conservatories, wrote the reviews and set the standards.

"Stop being such a God-damned sissy! Why can't you stand up before fine strong music like this and use your ears like a man?"

- At a 1931 concert when a man booed during one his friend Carl Ruggles's works

Reading about Ives has also reawakened in me a sense of outrage which I had sequestered a few years back. For example, as the previous blog described, I had never actually read the Wikipedia entry on The Blood Type Diet, trusting that somehow, a fair representation would emerge.

Surprise!

It's not that I can't handle the personal attacks, I can. It's the gratuitous assaults on the research and its benefits that I just refuse to put up with any longer. Basically if 'debunkers' are going to knock my work because it sounds like the wrong notes to their ears, they should be prepared to defend their assertions.

Like my favorite peripatetic scientist, Andrew Weil.

Dr. Weil, America’s holistic doctor and author of numerous books on the benefits of hallucinogenic drugs, seems to have a thing for the Blood Type Diet. Dr. Weil, whose book sales have been sagging for the last few years but appears to have no difficulty getting major media attention, now seems to have now taken the road common to many scientists at the twilight of their careers; that of ‘debunker’. In a short article on the AARP online magazine, Weil again argues that the Blood Type Diet should 'be sacked.'

Jettisoning his previous criticisms, including the rather odd observation that animals have blood types and yet don’t follow the Blood Type Diet, Dr. Weil, now a lectinologist and glycobiology expert, instead offers his opinions on lectins and blood types:

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.

Weil should really do his homework before committing himself to the further erosion of his nutrition credentials. Certainly he should have consulted the work of Boyd or Nachbar before making such claims, since he is essentially just plain wrong.

On the other end of the spectrum we have Dr. Joseph Mercola. Dr. Mercola, who for a time shared the same literary agent with me (at his request) and claims that his website is one of the most popular health sites on the internet with a very high circulation email newsletter. Mercola recently wrote in an email newsletter that following the blood type A diet and walking a lot gave him diabetes:

I am blood type A, so I switched to a high grain diet and changed my high intensity aerobic type exercises to walking like he suggested. Well, in a few short weeks my fasting blood sugar rose to nearly 130. This told me two things. The first was that I had diabetes, and the second was that Eat Right for Your Blood Type is a flawed theory that helps some, but can really harm and damage others.

Now, Dr. Mercola is a well-trained physician, so I have a hard time thinking that he actually believes this, since I doubt that any type A I know on the diet would ever call it ‘high grain.’ But imagine if you read the following; would you believe it?

I read in a book that people with legs should move around, so I walked down the street. Well, in a few short minutes I got hit by a car. This told me two things. The first was that I had to look at the stop signs more carefully, and the second was that moving around is a flawed theory that helps some, but can really harm and damage others.

What I find especially interesting is that if anybody advocates a high grain diet it is clearly Andrew Weil.

Now, I don’t have problems with either of these two guys; I just wish they would leave me out of their marketing plans. It would really be in their own best interests as well since one of the first things any salesmanship course will teach you is 'don't knock your competition.'

I’ve recently begun to notice that some mornings I get a rash on both cheekbones. It goes away in about a day, so I never thought much about it. Martha changed the detergent that we use on the bed sheets, but that had no real effect. I though it might be related to putting my hands on my face (since I write computer code in the AM and often prop my chin on my hand when debugging lines of code). But changing my 'pensive posture' had no effect either.

The last few nights I’ve crashed on the sofa in the den since I’ve been trying to catch up on the wonderful HBO series on John Adams. Surprisingly, these few nights, despite sleeping propped up on the most uncomfortable throw pillows imaginable, produced no rash. However this last night Martha came out and gave me one of the bedroom pillows. Next morning, alas, the rash was back. This got me thinking that something was in these pillows, or I just don’t get along with the pillow covers.

So off we went to Linens N’ Things, a franchise full of extraneous stuff you can buy for your house. I picked up a few hypoallergenic pillows (the old ones were down) and some new covers. The pillow covers had a few interesting, if unsettling facts included with the label:

• Your mattress will double in weight every ten years from dust mites and their droppings.
• 10% of the weight of a two-year-old pillow is composed of dust mites and their droppings.

Household dust, by the way, is a mainly human skin cells that have sloughed off. It is estimated that the entire outer layer of skin is shed every day or two at a rate of 7 million skin flakes per minute. Tests of indoor environmental dust in homes and offices have shown it to be primarily (70-90%) composed of skin flakes.

Tried the new pillows last night and so far no rash.

While at Linens N’ Things my daughter Emily and I played our new game which we call “Try To Find Something In The Store Not Made In China.’ It took a while but eventually I found a chopping block that was made in the U.S. Virtually 90% of the stock of this store was stuff ‘Made In China’. I’m told that the percentage in Wal-Mart is even higher.

Now, I have nothing personal against the Chinese, but I do not like the long-term significance of this trend. We in the US are being lulled and seduced into over-purchasing inexpensive goods from China, which destroy our local industries, increase credit card debt, and send our currency over there. Since the Chinese are not terribly interested in American products, they send the money back here in the form of business loans, many of which fronted the now collapsing home mortgage market.

I remember laughing in history class at how the local Indians sold Manhattan to the Dutch for $24 worth of mirrors and glass beads. Yet we're doing the same thing; the only difference being the substitution of modern day equivalents; plasma TV screens and vibrating recliners.

On top of it all, China is still as repressive a government as it ever was. There is no true freedom of speech, and rural workers are almost considered second-class citizens. Never mind what they are doing in Tibet right now and that their policy in Darfur is cynical beyond belief. Add the recent heparin scare and the mercury and lead in the painted toys and I'm thinking 'hey, this system does not need to be rewarded.'

So I’ve adopted what I call my 'New Organic' policy: Just like I am willing to pay a bit more to feed my family organic produce, I am now also willing to pay more to clothe my family in goods made in other countries besides China. I will pass up on the need to purchase George Foreman Grills, Fabreeze Room Fresheners and resin lawn furniture unless I can find products that are made by the inhabitants of democratic countries with decent human rights policies, ethical manufacturing standards and proper environmental responsibilities.

Yes, there will be less things in my life, but maybe that is the real hidden benefit of it all.

Despite numerous attempts by many people to let Dr. Andrew Weil know that his traditional criticisms of the Blood Type Diet have no basis in fact, he still insists on peddling his absurd take on my work. In a recent interview for a Canadian website, Weil repeats the same criticisms he has used for the last ten years --despite the fact that they are as inaccurate and ignorant of the basic facts now as they were a decade ago.

Among other things, Dr. Weil says:

This is nonsense. I know of no evidence suggesting that prehistoric people ate diets related to their blood types. The studies D'Adamo cites have been published only by him and not in any scientific journals. By the way, dogs and other animals have blood types similar to those of humans. It would come as unwelcome news to some dogs that they should be vegetarians.

This tone suggests to me that Dr. Weil has not actually read any of my books.

I've never suggested that prehistoric people ate diets according to their blood types. No doubt they should have, but how would they have known? The blood groups were not discovered until 1900.

I have suggested that the variations in our different digestive physiologies stem from adaptations over time to changes in diet that were in part coded by the immunology that governs the gut. And that this immunology is significantly under the influence of ABO blood type.

Dr. Weil avoids or just plain neglects the physiologic links between digestion and ABO blood types. This lets him parody my theory as some sort of 'caveman-fiction.' The effects of secretor status on immune and metabolic function; the connection between lectins and allergies; the influence of blood type on intestinal enzymes; links between stomach hydrochloric acid levels and gut bacteria; the fact that the very foods we eat have 'blood types' --all of this receives no mention.

These findings and facts are part of over 7,000 peer-reviewed studies on blood groups published in the medical literature over the last century. Now, I know that allopathic (MD) education does not teach any of this, so I don't blame Weil for being initially uninformed. Everyone has got to start somewhere. However he does not exhibit any curiosity on the subject nor a desire to investigate it any further. If he'd have contacted me, I'd have probably shared them with him. Instead we're left with the rather smug assumption that since he's never heard of any of this, it must not exist.*

Folks, that is an attitude that they usually do teach you in allopathic medical school.

I've always gotten a kick out of his "Well, animals don't eat right for their type" argument. If he knew the species genetics of ABO blood groups he might be surprised to learn that the ABO gene locus resides on different chromosomes in the various species. In hogs for example, having type O blood gives you a full coat of black hair. By Dr. Weil's account, every human who is type O blood should also have black hair. Dogs, by the way, are a very cancer prone species, and do fare much better on something other than an exclusively carnivorous diet.

Sigh.

The late Arthur C Clarke said it best in his First Rule of Scientific Prediction:

When a distinguished but elderly scientist states that something is possible, he is almost certainly right. When he states that something is impossible, he is very probably wrong.

* Dean Ornish repeats a similar mantra to audiences that he is 'unaware of any studies linking heart disease to blood types', when even the most cursory of searches on MEDLINE would show 200+ articles since 1966 (and probably over 300 from 1950).