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.

I think yesterday’s Grand Rounds at The University of Bridgeport went well. As seems to be the case more and more these days, I had a surfeit of material; much more than I could contain within the two hours allotted --even though I had limited the lecture to only the first part of standard presentation (‘Adjusting People to Genes’).

Dr. Natalie Colicci, my associate over at the D’Adamo Clinic and an alumnus of the Naturopathic Program at UB, thought it was a success and the students (third and fourth year) paid seemingly rapt attention.

It was nice to also see a few of my associates from bygone days including Dr. Eugene Zampieron, Dr. Leigh White and Dr. Ginger Nash-Wolfe.

UB/ND’s Dean, Dr. Guru Sandesh Singh Khalsa and Associate Deans Dr. Elizabeth Pimentel and Dr. Christina Arbogast Woolard have done a wonderful job getting this program up and running. After the lecture Dr. Arbogast gave us a tour of the teaching facility and the University Clinic, which was most impressive. I enjoyed meeting many of the students, administrators and faculty and was pleased to see that a generally positive, professional and pleasant tone permeated the facility. The UB Clinic sees a lot of economically disadvantaged families from the Greater Bridgeport area --many of whom would not normally be able to afford naturopathic health services on any sort of limited budget.

Dr. Arbogast and I talked about my doing some type of special shift in the Clinic, where students who were interested in my research could receive some in-depth training. I’m sure we’ll revisit this sometime in the future, but the idea of teaching in a clinical environment did seem very attractive to me, if indeed a new obligation would appear to be the last thing I need in my life right now.

They asked me to come back in April to finish up the lecture and perhaps delve into some of the epigenetics material as well. I was surprised to hear from the students just how many were already registered for the IFHI 2009 Conference.

How refreshing was this reception as compared to overall apathy and lack of acceptance I’ve received at Bastyr University, my own alma mater. One of undergraduates recently wrote to tell me that during one of the nutrition classes he attended, the instructor proceeded to describe my work with blood groups as ‘unscientific’ and followed that assertion with a description of the ABH Secretor System which my friend described as ‘not having one single correct fact .’

How different is this Bastyr University from the school I knew and loved.

Gerhard Uhlenbruck, everybody’s favorite lectinologist, recently wrote to let me know that he had penned the forward to a new book ‘Micronutrients’ by Uwe Grober (MedPharm) and kindly included a copy. Very nice book which I anticipate will get some thumbing-through over at the D'Adamo Clinic.

A recent review article on ‘Dietary Lectins as Disease Causing Toxicants’ written by Rabia Hamid and Akbar Mascod (Pakistani Journal of Nutrition 8 (3) 293-303, 2009) referenced three of my works in its citation list.

The second sentence in its abstract just about says it all:

It is now well established that many lectins are toxic, inflammatory, resistant to cooking and digestive enzymes and present in much of our food.

Maybe I’ll send a copy over to Andrew Weil.

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.

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 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)