I'm going to try to develop the habit of posting about new and interesting research findings that I come across in the science literature. Where appropriate, I'll add some pithy commentary as well.

Research Bias Against Alternative Medicine

"Slowly they are beginning to report on the welcome trend of evidence based clinical trials for complementary and alternative medicine (CAM), including herbal remedies. Unfortunately, the media still rely for their sources on high quality medical journals, which are more likely to report negative results about CAM and positive results about pharmaceuticals, The clinical trials in the study showed no difference in quality between herbal remedy and pharmaceutical trials, but CAM was still reported on more skeptically".

Comments:

Finally someone has the courage to address the bias against plant medicines often seen in the major media and high-profile science journals. As I have said many times before, the risks of herbal medicine are often blown way out of proportion, while the corresponding high risks of certain pharmaceuticals always seem to be "acceptable in light of their potential benefits." Every medical intervention carries risk, but when viewed against the huge number of drug reactions per year (20,000+ people die every year from NSAIDs such as Advil or Tylenol) the small number of reactions to herbal medicines (mostly allergic type reactions) appear to be over-exaggerated as part campaign of deception. Thanks to my colleague Rick Kirschner for recently mentioning this article.

Take it from me: After more than a decade of similar treatment, I know one of these campaigns when I see one.

BMC MEDICINE

ABO Blood Group and the Risk of Pancreatic Cancer

In two large, independent populations, ABO blood type was statistically significantly associated with the risk of pancreatic cancer. Further studies are necessary to define the mechanisms by which ABO blood type or closely linked genetic variants may influence pancreatic cancer risk.

Comments:

This study was extensively publicized in the media, and while welcome as yet another link in the under-explored relationship between blood group antigens and cancer (see my 'Verisimilitude' lecture), these results have been reported in earlier studies (as well as similar results in bile duct cancer).

More interesting to me is the link between ABH secretor status and the predictability and reliability of the most common tumor marker test for pancreatic cancer. This tumor marker, called CA19-9, is variable based on ABH secretor status, yet this fact is virtually unknown in oncology.

PUBMED

Involvement of intestinal alkaline phosphatase with ABO and secretor blood group types

These results indicate that IAP is strongly involved in chylomicron formation and fatty acid metabolism might change among ABO blood type. In addition, ABO blood type classification in apoB-48 measurement would improve the diagnostic value in the evaluation of metabolic syndrome.

Comment:

Tom Greenfield wrote about this study a few years back, but I wanted to bring it back since, like most studies of this sort, it has gone completely unnoticed by the nutrition communinty at-large. IAP is an enzyme implicated in transcellular transport of chylomicrons, large molecules that transport dietary lipids from the intestines to other locations in the body. Since 1966 it has been known that this enzyme varies among ABO blood groups and secretor status, with type O secretors having the highest amount and A non-secretors the lowest. Since IAP is critical for breaking down dietary cholesterol and enhancing the assimilation of calcium.

This calls into question the so-called 'Bone Hypothesis,' a long-treasured argument of vegans and dietitians everywhere, that dietary protein (especially from animal sources rich in the sulfur amino acids) should increase acid production in the body, and that in response to the acid load induced by a high animal protein diet, bone may be called upon to act as a reservoir of alkali using bone calcium as a buffering source.

As the theory goes, the long-term consequence of this reliance on bone to buffer the endogenous acid would be increased rates of skeletal loss and a decrease in bone mineral density. The hypothesis would also predict that a long-term, high protein diet would increase fractures.

However, in a recent study it was found that:

Studies conducted over the past 8 years in our laboratory call the traditional high protein bone hypothesis to question. We have found that a high protein diet induces high levels of urine calcium primarily because it increases intestinal calcium absorption. Second, a low protein diet acutely reduces intestinal calcium absorption, resulting in an abrupt rise in serum parathyroid hormone.

PUBMED

No only is IAP induced at high levels in blood group O individuals by a protein diet, one can expect it to increase bone density in these people. Not only that, evidence exists which indicates that the physical expression of the blood type A antigen appears to turn off IAP in the intestinal tract.

We found that red cells of blood group A bind almost all intestinal alkaline phosphatase; erythrocytes of blood group B or O to a much lesser degree. This is in accordance with the fact that intestinal alkaline phosphatase is found more frequently in the serum of individuals of blood group O or B than in serum of persons of blood group A.

PUBMED

I challenge anyone who still clings to the idea that blood groups have no scientific role in dietary personalization to respond to these basic facts.

It comes down to this simple challenge: Either put up or shut up.

1.

IfHI Faculty Member Dr. Emily Kane sent me this note:

"Recently there was been discussion on a Naturopathic chat group about the validity of blood type diet, with (IfHI Master) Dr. Virginia Oram being one of your most fervent defenders! Our moderator commented that corn could hardly have been "bad" for all those native Americans. The highly esteemed Pam Taylor offered the following perspective:"

Back in the mid-70's a group of us were doing some comparative studies of skulls from Woodland Native American tribes and skulls from Central America with Dr. Jerry Rose (U. of AR, Dept. of Anthropology), whose specialty was medical anthropology. He pointed out the outlines of arterial imprints in certain groups of the Woodland skulls, which were noticeably larger than those from Central America. He theorized that the adaptive development of the larger blood vessels was a response to the presence of anemia, requiring greater blood flow to supply an adequate amount of oxygen and nutrients to the brain.

The discrepancy was due to diet. The Woodland tribes were known to have cultural "boom and bust" cycles where they would spend some time hunting and gathering while the population expanded and became more robust living off game, fish and berries. Skulls from these groups did not display the enlarged blood vessels. When the tribe reached a certain level of vitality with a large enough population to afford a greater division of labor, they would find a place to settle and and farm, with corn as a staple. The significant increase in corn consumption as a dietary staple eventually resulted in anemia, a lower fertility and birth rate, and a level of irritability that led to less cooperation, more fighting (as evidenced by breakage and healing patterns in the bones), increased mortality and injury, a smaller band of individuals, and eventually resulted in their having to abandon a settled life style and resume hunting and gathering.

He theorized that when native populations in Central America prepared their corn by grinding it with limestone tools the grit that mingled with the corn contained a chemical had an inhibitory effect on corn's assumed inhibition of iron uptake.

Recent rat studies indicate that the periodic iron deficiency anemia of the Woodland population during their settled agricultural periods was more likely due to the amino acid imbalance in the corn (see article notation below) rather than a specific factor inhibiting its uptake. However, the physical evidence over time consistently supported the idea that when the Woodland groups were hunting and gathering, with substantially less corn in their diet, they were measurably healthier.

Studies in cultural anthropology spanning nearly a century note specific disease susceptibilities peculiar to different blood groups. But for sure, whether it's from an anthropological perspective or a naturopathic one, the contributing factors to health and disease, whether focused in an individual or extended to a culture, are multiple and multi-layered.

On days when I have a string of obnoxious patients, I definitely miss the bone lab.

I seem to remember reading that changes in dental and skull molding were also seen in so-called 'Mound Builder Cultures' that appeared to correlate with their evolution to an increasingly corn-based diet. That corn may have had this effect takes nothing away from its sacred role in these societies. It was a key subsistence food which allowed populations to grow and avoid starvation, despite the fact that it may have been a suboptimal source of some key nutrients.

Living on an avoid food is probably better that starving because you can't find any beneficial ones nearby.

Fact is, my research has not met with great acceptance in the naturopathic community. It indicates prudence and occasionally some honest skepticism, although I also think a lot of NDs just can't grok it intellectually. So like the chat moderator, they see it in only its most simplistic manifestations, thus requiring only the simplest objections.

Although you might think that capitalizing on the potential for polymorphisms and biochemical individuality would be a 'no-brainer' in a healing art like naturopathic medicine, the reality is otherwise. Maybe in time things will change, but for now my work lies in that wonderful 'excluded middle' that Charles Forte alluded to; misapprehended by the allopaths and naturopaths alike.

Nonetheless, my old friend, Dr. Pam Snider, who is running the Foundations of Naturopathic Medicine project, an attempt to codify naturopathic tools and techniques, recently asked me to author two entries (co-author with Dr. Joseph Pizzorno on the genomics chapter; lead author on the genomic medicine chapter; and contributing author on nutrition chapter.) I don't know where I'll ever find the time to do this, by Martha has said that she would help out, which almost always makes things better.

2.

Getting ready for a lecture this weekend at Newton-Wellesley Hospital in Massachusetts. They invited me to do two lectures on Saturday, for a total of about three hours running time. I suspect they don't have much awarenes of the GenoType material, so I'll do the first session on blood groups and then perhaps the second on GenoTypes and epigenetics.

Speaking of which, running factor analysis on the GenoTypes yields interesting spacial distinctions. Here is a graph of two principal components of data aligned along the point of maximum variability seen with the so-called 'classic genes'. It helps to imagine the small lines as actually coming out at you, if the graph could be in 3 dimensions.

The Explorer GenoType sticks out under these conditions as a very unique archetype.

Dr Ken Carlin sent me this neat link that details the migrations of humans based on Y chromosome and mitochondrial DNA evidence.

We've collected some of the best pictures from IfHI 2007. Enjoy.

Should Paris Hilton serve her full sentence? Hey, why not? I've spent 45 days chained to a computer writing The Genotype Diet. I agree with Al Sharpton that the whole thing is one big insult to all those normally faceless people who just have to serve their sentences as dictated by law. Sharpton by the way, is no media pretty face. I recently did his radio show and he struck me as being quite intelligent and measured.

Wikipedia does a good job of bringing to light the differences between skepticism and pseudoskepticism, principally that pseudo skeptics have no interest other than denying what it is that they purport to be skeptical of. Much of what they brand a 'pseudoscience' is often the very beginnings of a new protoscience.

Grouppe Kurosawa has an interesting natural medicine blog that has a refreshing technical bent to it. The most recent entry is on the pathetic state of the US health care system. Think the we have the best health care system? Think again. We spend over 2 trillion dollars and rank 37th overall in quality of health care.

Now you would think that this sort of crime would generate widespread outrage. However, the Medical Industrial Complex, headed by the Current Dominant Medical System, has the public so bamboozled that this obscene lack of efficiency (which in any corporate environment would have long ago yielded to shareholder revolt and widespread executive firings) is not only tolerated, but a perverse pride is taken in the sheer magnitude of the inefficiency. We applaud as 'breakthroughs' drugs that prolong the lifespan of liver cancer patients by one month and we do nothing to address the underlying reasons people get these cancers in the first place. We wring our hands when a drug for adult onset diabetes is shown to be a menace and yet we do nothing to fix the root cause of the 'diabesity epidemic', preferring instead to find the solution through the marvelous benediction of an eleventh hour miracle drug.

And when was the last time you ever saw a pharmaceutical company post a quarterly loss?

Yet a recent show on PBS had a researcher who explained that half of all the families who file for bankruptcy are there in the aftermath of a serious medical problem. And, amazingly, about 75% of these families had health insurance at the onset of the illness or accident.

One of the reasons Allopathic medicine is so darned inefficient is that it is geared to acute medical care. This has been paraphrased as 'parking the ambulance at the bottom of the cliff.' Many of its greatest breakthroughs occurred as a direct result of observations on the battlefield, and indeed when Hollywood wants to iconify modern medicine, they always put the doctors in the location where icons come naturally: The emergency room. Here comes the gurney rolling down the corridor, everyone shouting, everything purposeful.

Who wants to watch a film of some gerontologist examining the nasty feet of an 80 year old diabetic? Yet diabetic foot problems in the elderly are a major challenge to health care.

The major fallacy of Modern Medicine is that it fails to realize the difference between a chronic disease and an acute one, usually considering chronic disease just 'very long versions' of acute disease. But there are very different mechanisms involved, especially when we look at the patient's ability to compensate and recover.

Is naturopathic medicine the complete answer? Unlikely. We've got our own golden calf. However, at least we have a better comprehension of the nature of chronic illness, and the need to mobilize the patient as part of the recovery process.

I did have to laugh recently when the local hospital sent me the nicest brochure about their new 'Integrative Medicine' department. A quick read showed just what a red herring this thing was. Everyone involved was from the hospital staff, except for a harp player who was in charge of the 'therapeutic music' part of the center. Oh, sorry, there was a yoga teacher on staff as well.

All this reminds me of the quote from the English printmaker William Hogarth that I had read many years ago:

'..the problem with the ancient physicians is that they tried to make medicine an art, and failed; whilst the problem with modern physicians is that they tried to make medicine a business.. and succeeded."