Tags: personalized medicine
This Transfusion: Parachutes and death from gravitational challenge | Hawthorn and heart disease | Blood group A and ovarian hyperstimulation syndrome | Rh blood group and hearing loss | Epigenetics, diet and super oxide dismutase (SOD)
Welcome to The Weekly Transfusion, 1.5 for the week of April 13, 2009.
Insufficient evidence for parachute use to prevent death and major trauma related to gravitational challenge
As with many interventions intended to prevent ill health, the effectiveness of parachutes has not been subjected to rigorous evaluation by using randomised controlled trials. Advocates of evidence based medicine have criticised the adoption of interventions evaluated by using only observational data. We think that everyone might benefit if the most radical protagonists of evidence based medicine organised and participated in a double blind, randomised, placebo controlled, crossover trial of the parachute.
Evidence based medicine is the buzz-phrase of the moment, the idea being that you scour the medical literature on a particular association,for example using the herb Hawthorn to treat chronic heart failure. You set the selection criteria, such as the type of study (placebo controlled, etc.) and the amalgamate the data. Evidence Basis has some very important advantages, namely that it gives the most accurate current assessment of a treatment or strategy since you are pooling all the available data.
One problem with evidence based medicine is the simple reality that evidence and benefit are not always the same thing. As shown by this slightly tongue in cheek study, there is still an insufficient evidence basis to conclude that parachutes are effective in preventing major trauma related to gravitational challenge. The researchers failed to find suitable studies showing the effects of using a parachute during free fall, despite setting logical criteria (death or major trauma, defined as an injury severity score > 15) and scouring he available literature.
Setting artificial standards can also impeded the workings of common sense: Edward Murphy put it best in his classic The Logic of Medicine: 'Only a fool would require a double-blind study to see if it was raining outside.'
Lack of evidence is not evidence of lack.
Evidence based medicine has potential to revolutionize day to day health care. However I think an even bigger revolution lurks under the surface: The reinterpretation and reorganization of medical facts derived under the older 'disease-care paradigm' by evolving paradigms that better fit new real-world circumstances.
A common argument against the need for heterodoxy in medicine is that 'when facts are proven, they stop being alternative.' This may well be true, but it neglects that facts themselves are forever open to reevaluation, deconstruction and recycling. Much of my work with the ABO polymorphisms was the simple reappraisal and restructuring of the conventional biomedical literature on the subject --but done with an eye to its ulterior benefits in naturopathic circumstances. Had they not been subjected to the 'naturopathic lens' these facts may well still be floating in their own splendid isolation.
Hawthorn extract for treating chronic heart failure
For the physiologic outcome of maximal workload, treatment with hawthorn extract was more beneficial than placebo... Exercise tolerance were significantly increased by hawthorn extract... The pressure-heart rate product, an index of cardiac oxygen consumption, also showed a beneficial decrease with hawthorn treatment... Symptoms such as shortness of breath and fatigue improved significantly with hawthorn treatment as compared with placebo...These results suggest that there is a significant benefit in symptom control and physiologic outcomes from hawthorn extract as an adjunctive treatment for chronic heart failure.
I first wrote about Hawthorn (Crataegus spp.) in my book Eat Right For Your Type over thirteen years ago, making specific reference to its benefit for blood group A individuals with cardiovascular problems. In general the plant has a good track record, especially, if used in quite low doses for extended periods of time. The herb seems to allow cardiac patients to derive extra benefit from exercise (link), has some very nice effects on the artery lining (link) and has been shown to lower blood pressure in patients taking diabetic medication. (link)
Hawthorn was shown to be well tolerated and safe. However, it should not be used as a substitute medication in circumstances of active heart disease or concurrently with other cardiac medicines unless under the supervision of a physician trained in its use. In one study, it actually seemed that the hawthorn group had a worse outcome than the placebo group. (link) Hawthorn also does produce occasional side-effects, though they appear uncommon and rather mild.(link) Perhaps this is the darker side of the biochemical individuality revolution; it's no longer acceptable to claim that all natural products are safe in every person. Anything that can add to the personalization of herbal recommendations can only help to increase their safety profile.
Blood type A women get more complications from fertility treatment
Ovarian hyperstimulation syndrome is a potentially life-threatening complication during controlled ovarian stimulation for fertility treatment. Since no association of this condition with ABO blood groups was known, we compared ABO antigens with severity and onset of symptoms in a case-control study...The odds ratio for patients undergoing controlled ovarian stimulation with blood group A versus O to develop the early-onset form of this condition was 2.171 (p-value 0.002). Blood group A may be associated with early-onset ovarian hyper-stimulation syndrome in Caucasians...This possible association may be considered for an individualized hormone dosing in controlled ovarian stimulation.
Ovarian hyperstimulation syndrome (OHSS) is a complication from some forms of fertility medication. Most cases are mild, but a small proportion is severe. Symptoms can range from a more mild form that includes abdominal bloating and feeling of fullness, nausea, diarrhea, and slight weight gain to a more severe form that includes and fullness/bloating above the waist, shortness of breath, urination significantly darker or cessation of urination altogether, calf and chest pains, marked abdominal bloating or distention, and lower abdominal pains. This study looked at 127 Caucasian patients hospitalized because of ovarian hyperstimulation syndrome after receiving in vitro fertilization, in the period from January 2000 to February 2007 and found that blood group A was markedly more frequent and blood group O less frequent in patients with ovarian hyperstimulation syndrome.
Other studies have found a slightly greater incidence of ovarian cancer in women who are blood group A (link) and blood group antigens (as mucins or 'blood group substances') are known to be richly deposited on ovarian tissue. (link) Hopefully fertility specialists will consider individualizing hormonal treatment by blood group when working with fertility patients.
Four patients developed thrombosis (clots) in the jugular or subclavian vein, none of whom had blood group O; this correlates with earlier studies linking blood groups other that type O with an increased risk of thrombosis (link) at some of this clotting may in fact be due to enhanced sensitivity to estrogen, at least in women who are not blood group O.(link)
What was that? Being Rh positive may increase your risk of hearing loss
Noise-induced hearing loss (NIHL) is one of the most common occupational problems and is one of the main causes of deafness. Many factors cause NIHL. Individual susceptibility is one of them. Rhesus (Rh) antigens and ABO blood groups can be factors in determining individual susceptibility. In conclusion, we suggest that the people with Rh-positive blood group are more prone to develop NIHL.
The researchers looked at factory workers who had been exposed to a noise level more than 85 dB for 8 hours a day for a period of over 15 years. Two hundred and nineteen (55.4%) of Rh-positive workers and seventeen (39.5%) of Rh-negative workers have noise-induced hearing loss, and the difference between the two groups was statistically significant (P < 0.05). There was no link between hearing loss and ABO blood type.
If you are a rabid reader of this blog, you'd immediately notice that these results are just ever-so-slightly statistically significant (and not be much of a discovery) since given enough noise, virtually anyone will develop hearing loss. However we could speculate that something in being Rh positive influences the structure of the ear anatomy to make these people more likely to get hearing damage. Or on the other hand, what is it about being Rh negative that makes these people less likely to get hearing loss?
An earlier study with infants and adults also showed a higher incidence of hearing loss in Rh positive people, with a slightly better level of significance (0.01) if the mother was Rh negative blood type (which might support the idea that the problem would then be seen in the incompatible Rh-positive children). Another maternal influence via blood group!
Diet influences epigenetic regulation of super oxide dismutase (SOD) gene
The impact of nutrition on the epigenetic machinery has increasingly attracted interest. The aim of the present study was to demonstrate the effects of various diets on methylation and gene expression. The antioxidative enzyme mitochondrial superoxide dismutase (MnSOD) was chosen as the model system because epigenetic regulation has been previously shown in cell lines for this gene. A 3-fold increase in the expression of the MnSOD gene was associated with decreased CpG methylation of the analyzed promoter region in the vegetarian group compared with the age-matched omnivores group. These results indicate that diet affects the epigenetic regulation of human MnSOD.
The super oxide dismutases are a class of enzymes that catalyze the conversion of free radical superoxide molecules into oxygen and hydrogen peroxide. They are an important antioxidant defense in nearly all cells exposed to oxygen. SODs 'outcompete' healthy tissue for the damaging free radical molecules. They protect the cell in a way reminiscent of a common scene in the the old Laurel and Hardy movies where two soldiers in a trench hoist a helmet on a stick above their heads and then retrieve it having been shot full of bullet holes. Although SOD supplements are a common item on health food store shelves, oral SOD products are completely destroyed in the gut, so methods to increase the native (endogenous) production in our own cells would be optimal.
Epigenetics is best explained as the 'non-genomic' or 'post-genomic' control of gene expression, mechanisms such as DNA methylation, or histone acetylation, which act a 'volume controls' on the ability of the cell to read the section of DNA that contains that gene. In the case of this study, the vegetarian group has less methylation on the CpG section of promoter region of the SOD gene.
In English, what they are saying is that diet removed some of the restrictions (methyl groups) on the part of the gene that activates it (the promoter region). Removing methyl groups usually takes the brakes off a gene, especially when they are in the gene's cystine-rich 'front.'
Exciting stuff. Now we'll need to see exactly which specific foods have the maximum epigenetic effects on SOD.
Until next week.
Note to readers: By mistake I had uploaded an earlier, non-spell-checked version of this entry on Monday. I beg your indulgence on this matter. Although I am a reasonably good speller, if truth be told I am a terrible typist.
Welcome to The Weekly Transfusion, 1.4 for the week of April 6, 2009.
Editorial: Medical journal statistics for autodidacts
You can become a better consumer of health information if you take the time to read the research source material (i.e the scientific publication in which the original claim was made). Of course if the study is technical you can see quite a bit of jargon that you may or may not understand. However many medical terms are widely understood and where you bump up against the odd phrase or name that you don't comprehend, there are usually places on the Internet where you can find simple, easy to understand explanations. Wikipedia is actually pretty good for this type of look-up, as long as the subject at hand is not controversial.
However, methodology and monikers aside, most scientific studies distill down to a simple testable premise which is easily understand by almost anyone. Did the medicine work? Was the association between this gene and that disease valid? Past asking the question, what is needed next is to look at and gauge the value of the answer. Surprisingly, even though this is usually some sort of statistical type of answer (and most laypeople are not well versed in statistics) once you know what to look for, you'd be amazed just how easy it is to evaluate most studies.
Most research studies feature a subsection entitled Results or Conclusions. It is here that the results are most often given. There are many way of calculating statistical significance, but the premise is quite simple: What is the chance that the thing we just observed/ hypothesized was random versus the odds of it being due to the relationship we are studying. This is known as probability and in statistics is usually called the P value. To find out just how significant the results of any study are, just look for the P value. The smaller this number is, the less likely the results occurred by chance. Put another way, the lower the P value the more likely you'll want to view the results as significant or important.
The great Ronald Fisher viewed P values as measures of the evidence against a hypotheses, sort of like how a prosecutor presents a case based on exceeding the jury's sense of 'reasonable doubt.'
Now for the secret (OK, not so secret) key to taking control of the medical facts in your life: The standard level of significance used to justify a claim of a statistically significant effect is when P is equal to or less than 0.05; in essence, a one-in-twenty chance that the result had nothing to do with your hypothesis.
For better or worse, the term 'statistically significant' has become synonymous with P<=0.05.
So when looking at any published results, always look for the P value and if it is greater than five cents on the dollar (0.05) you'd probably want to ignore that results (unless the premise of the article was that the researchers failed to show a relationship, which is of course just another type of observation; however, these types of studies usually don't make it out of the researcher's file cabinet) or take a look at the methodology behind the study (scientists are human; studies can be poorly designed and the conclusions derived may not have been the best test of the hypothesis).
So, P<0.05 means the results are significant, but just barely. Good enough to convict, but also likely to send a few innocent people to jail as well, since there are still strong indications that the hypothesis fails to account for the whole of the facts. Personally I like to see P values of at most 0.01-0.02 before I get excited about anything I'm reading. However I do make exceptions for studies with small numbers of participants, or if the we're dealing with an herb or vitamin where the effects studies may be slight or slow to surface.
Oftentimes you'll see P values with lots of zeros. That means they've found a more statistically reliable result. For example, the P value in the following article is P<0.001. This actually means that there 1 in a 1000 chance of the result being a random occurrence and a 999 in 1000 chance that the result was related to the premise of the study.
Just remember, look for at least a P<0.05. That means the results were statistically significant. Beyond that the more zeros you see in the P value, the better. Try your new-found statistical powers on the articles below. Look for the P values in the studies. What do they signify?
Now that you can evaluate scientific material at its source, you'll be less likely to fall for the 'man bites dog' con-jobs that are all too commonly reported in the news or as what passes for scientific discussion these days.
Resting heart rate as a low tech predictor of heart problems in women
In a large, diverse group of postmenopausal women, resting heart rate was an independent predictor of coronary events, with higher heart rate associated with greater risk. The relation between resting heart rate and risk of coronary events was stronger in younger postmenopausal women than in older ones. Resting heart rate did not independently predict stroke.
In general, age, body mass index, and saturated fat consumption were higher and cardiovascular risk factors such as hypertension, diabetes, smoking, hypercholesterolaemia, and depressive symptoms more prevalent in women with higher resting heart rate, as was self reported nervousness. Physical activity and alcohol use were inversely related to heart rate (both P<0.001), and heart rate was lower in women who used postmenopausal hormone therapy than in those who did not (P<0.001).
One can't argue that this is about as low tech a predictor of future health problems as one is likely to find. It has already been shown that resting heart rate predicts coronary events in men. For women however, the relation between heart rate and coronary events or stroke has been uncertain. The study broke the participants into groups including a 'high heart rate group' whose heart rate was greater that 76 beats per minute and 'low heart rate group' whose heart rate was greater than 61 beats per minute. The association with 'coronary events' (aka heart attacks and death). This association appears stronger in women aged 50-64 than in those aged 65 or older
Being overweight makes you age faster
Obesity and weight gain in adulthood are associated with an increased risk of several cancers. Telomeres play a critical role in maintaining genomic integrity and may be involved in carcinogenesis. Using data from 647 women ages 35 to 74 years in the United States and Puerto Rico (2003-2004), we examined the association between current and past anthropometric characteristics and telomere length in blood. These findings support the hypothesis that obesity may accelerate aging, and highlight the importance of maintaining a desirable weight in adulthood.
A telomere is a region of repetitive DNA at the end of chromosomes, which protects the end of the chromosome from destruction. When DNA needs to be read (to replicate itself, or generate RNA so as to begin coding proteins) a problem arises in that the enzymes that duplicate the chromosome and its DNA cannot continue their duplication all the way to the end of the chromosome. They need a blank area to 'park' much like the cassette tapes of days past had white 'leader tape' at their front and the back so that the tape head did not start in the song itself. Unlike cassette tape, every time DNA reproduces, a bit of the white leader tape, the 'telomere' at the end, is frittered off and has to be replaced. Telomeres and replenished by an enzyme, the telomerase reverse transcriptase. Telomeres protect a cell's chromosomes from fusing with each other or rearranging - abnormalities which can lead to cancer - and so cells are normally destroyed when their telomeres are consumed. In the women studies for this article, those having a higher body mass index (BMI) in their 30s were associated with shorter telomere length in their 40s (P < 0.01).
I suspect some of this association is epigenetic, and points again to the fact that the GT5 Warrior epigenotype may well need to get their weight profile optimized early in life and be increasingly calorie conscious as they age.
Vitamin D, adult-onset diabetes and metabolic syndrome
Vitamin D is a potent immunomodulator that also enhances the production and secretion of several hormones, including insulin. Vitamin D deficiency has been associated with increased risk of type 1 diabetes. Glycemic control and insulin resistance are improved when vitamin D deficiency is corrected and calcium supplementation is adequate.
More and more information is surfacing about vitamin D (actually more of a hormone than a vitamin) and insulin resistance. Studies consistently show that vitamin D levels in both North America and the Pacific are typically lower than optimal. In the USA , most vitamin D intake from foods is provided by fortification. Canada and New Zealand have fewer fortified choices, and intakes are correspondingly lower. The mechanism of action of vitamin D in adult onset (type 2) diabetes is thought to be to its role in the control of plasma calcium levels, which help regulate insulin synthesis, but may also be the result of vitamin D stimulating the insulin secreting (beta) cells of the pancreas directly. If you have a history of metabolic syndrome or adult onset diabetes in close family members you may want to consider adding vitamin D to your supplement regimen. However, make sure that you do it in partnership with a nutrition professional.
One from the vaults: Mom's blood type can influence child's risk of Strep (1978)
In a prospective study of maternal genital colonization with streptococci at the time of delivery, epidemiological data, including blood type (ABO group), were recorded for the 1,062 patients studied. Blood type B was found in a statistically significant (P <.005) higher proportion of patients colonized with streptococci (28%) compared with the total population (16.4%)
Evidence suggests that probiotic supplementation does change the vagina flora of women. Since it appears that the route of transmission of Streptococcus is from the birth canal, physicians should recommend probiotic supplementation for pregnant women beginning 3-4 weeks prior to expected date of delivery as a way to prevent streptococcus infection in neonates. This should be especially emphasized if the mother is either blood group B or AB.
This study again illustrates the fact that some of the best ABO correlation studies are outside the purview to today's physicians, most of whom would tell you that any research from 1978 is better suited to a history class than to any thing taught in medical school.
Since Mother's Day is fast approaching, also remember that recurring otitis media (ear infections) is strongly associated with the child's mother being blood type A. In fact the correlation here is quite startling. Children of mothers who are blood type A are twenty seven times more likely to get a second ear infection within one year of contracting the first. To give you an idea of just how strong this association is, look at the chart below to compare the RR (relative risks) of a few other disease/ lifestyle links.
Update: IfHI 2009
Just a quick word to the wise about the IfHI Conference, Norwalk Connecticut, June 5-7. We had run out of available rooms at the Dolce Center Campus. However 10 additional rooms have just been made available. Unlike previous conferences, where attendees could book almost to the day of the event, IfHI 2009 looks like it will be completely booked by the middle of May, a full month before the event. If you are planning on attending, either for certification or just personal enrichment, please make your reservations ASAP, especially if you want to stay overnight on campus.
Until next week.
Welcome to The Weekly Transfusion, 1.3 for the week of March 31, 2009.
I've slowly been coming around to the notion that it is not enough to simply shrug off ad hominem attacks on the links between blood groups, diet and health. Yes it is nice to combat ignorance with patience and understanding. But there are often other motivational factors at work besides simple ignorance. The food and diet industry is big business. Many pet theories and systems abound: For example, it would be unlikely that many vegans would be comfortable with my suggestions for blood type O, or that many low-carbers would be all that happy with those for blood type A. Add to that the fact that my naturopathic training often sets off alarms in skeptical circles and professions in direct competition for you nutritional eyes and dollars.
There is also the challenge to the dominant nutrition paradigms which is inherent in any personalized approach. If your company makes vitamin E, soy flakes or whole wheat bread you will not be all that happy to find out that I don't recommend your product for everyone.
Yet there is still a voice in my head which says, 'Why adopt a path of confrontation?' I mean wouldn't it be better to just try to stay above the fray? In reality it would. However, almost all media nowadays is pure spin, and because it is digital, it persists indefinitely. True, the path of enlightened patience such as that of a Gandhi would be most desirable. But these are different times. As Ho Chi Minh put it, had Gandhi been in French Indochina rather than in British India he would have ascended to heaven long before he eventually did.
Consequently I'm perceiving a change in my attitude towards those whose only goal is to disparage. I have no interest in becoming prosecutorial and finding de novo fault in others; we certainly don't need any more of that. Hopefully I'll also have the courage to change my own opinions when shown to be misguided or incorrect. However, I will now actively address and debate misrepresentations of my work and writings --hopefully in an even-handed manner that educates while it redresses.
Meat intake and mortality
Red and processed meat intakes were associated with modest increases in total mortality, cancer mortality, and cardiovascular disease mortality. During 10 years of follow-up, there were 47,976 male deaths and 23,276 female deaths. In general, those in the highest quintile of red meat intake tended to consume a slightly lower amount of white meat but a higher amount of processed meat compared with those in the lowest quintile. Subjects who consumed more red meat tended to be married, more likely of non-Hispanic white ethnicity, more likely a current smoker, have a higher body mass index, and have a higher daily intake of energy, total fat, and saturated fat, and they tended to have lower education and physical activity levels and lower fruit, vegetable, fiber, and vitamin supplement intakes
No rational person would debate that when making generalized assertions about a heterogeneous population as a whole, diets very high in red meat and processed meats are not very healthy. However this behavior often comes with its own baggage. The fact that the study participants exhibited unhealthy behaviors such as smoking, lack of physical activity, and maintaining a higher body mass index pretty much mix things up, since all of these are known to cause chronic disease. Another confounder is the sad fact that people who eat lots of processed meats just don't take as good care of themselves as those who avoid them. We could probably draw similar conclusions about heavy meat eaters and fatalities from automobile accidents, since people who avoid processed red meat probably buckle also their seat beats more frequently as well.
More tellingly, this study failed to look at individual markers of variation. Blood group A subjects would have been expected to have the typical negative reactions to red meat, since most biomarkers 'down-side associated' with red meat consumption/malabsorption (von Willebrand Factor, E selectin, intestinal alkaline phosphatase, blood viscosity) are associated with type A. Scan at the literature for the last 50 years and you'll see that virtually every study that looked at coronary artery disease, ischemic heart disease or myocardial infarct show a prevalence of type A.
Also a similar specificity of resuts would probably have occurred had the looked at secretor status as gene also has a major effect on intestinal alkaline phosphatase levels. Allowing for individual variation, use of grass-fed meats, non-inclusion of subjects who used processed meats, and a look towards the composition of the 'whole diet' would have probably yielded quite different results.
Vegetarians have fewer cancers but higher risk of colorectal cancer
The overall cancer incidence rates of both the vegetarians and the nonvegetarians in this study are low compared with national rates. Within the study, the incidence of all cancers combined was lower among vegetarians than among meat eaters, but the incidence of colorectal cancer was higher in vegetarians than in meat eaters.
Compared with meat eaters in the cohort, and after adjusting for age, sex and smoking status, the vegetarians in the cohort showed an 11 per cent lower incidence rate of all cancers. However, vegetarians showed a 39 per cent higher incidence rate compared with meat eaters, which almost seemed counterintuitive. However I have noticed that colon cancer does seem to have its fair share of vegetarians, especially those who are type O.
Theodor Hahn is credited as being the first of the pioneers of the naturopathic/ water cure movement to integrate vegetarian dietetic principles. He was convinced that a meat-free diet would prolong life. In fact he was so convinced of the value of a vegetarian diet that he spent a great deal of his professional life writing books and pamphlets on the subject and was the editor of a magazine called The Vegetarian. He died of colon cancer at the age of 59. One of my most vociferous critics in years past was a type O vegetarian naturopath who recently also passed away from colon cancer in his early 50's.
Perhaps they would have died at an even younger age had they not been vegetarian. Ultimately there is no answer, but it is ironic that the people responsible for integrating vegetarian diets into naturopathic medicine died so young of colon cancer.
I doubt that it is anything in the meat that would offer vegetarians any chance of avoiding colon cancer. More likely their vegetarian diet was rich in plant and legume lectins which were just not right for their type. Many lectins can have hyper-proliferative effects on the intestinal tract, especially the lectin from peanuts [link 1], [link 2] which is not a good food choice for type Os.
The Science Thing: CBO says less than 50% of all medical care is based on adequate evidence.
Drugs and medical devices must be certified as safe and effective before they can be marketed, but with limited exceptions the regulatory process for approving those products does not evaluate them relative to alternatives. Meanwhile, medical procedures—which account for a much larger share of total health care spending—can be in widespread use without a systematic review of their impact. Appraisals of the current situation vary widely, but some experts believe that less than half of all medical care is based on adequate evidence about its effectiveness—a gap that may never close entirely but that remains troubling.
So, the pot does call the kettle black or as they say in Hungary 'Bagoly mondja verébnek, hogy nagyfejű ("The owl tells the sparrow that it has a big head.") Many conventional medical authorities and skeptics are quick to brand alternative health practices 'unproven' or 'unscientific'? Yet the dirty little secret is contained right in the statements of Douglas W. Elmendorf, director of the Congressional Budget Office.
Not that anyone on alternative medicine, should crow. All right, maybe we can crow a little. However, the record in Alternative, Integrative and Complementary medicine (all monikers I detest, even though I'm responsible for one of them) is even worse. Efforts are now underway to close down the NIH Office of Alternative and Complementary Medicine. Frankly, I think this is a good idea. The avowed purpose of the office from the start was to 'prove' alternative medicine. You can't really be non-subjective if you set out to 'prove' something. Add to that the fact that they study some of the strangest stuff you could imagine - due to the fact that, like any bureaucracy, pride of place goes to those with the sharpest elbows.
Why most published research findings are false.
Simulations show that for most study designs and settings, it is more likely for a research claim to be false than true. Moreover, for many current scientific fields, claimed research findings may often be simply accurate measures of the prevailing bias.
And the author doesn't even discuss the most common reason you need to be careful in evaluating science information. Someone, somewhere most likely stands to make a buck out of the result (your humble author included).
William Hogarth had a great quote along similar lines:
The problem with the ancients was that they tried to make medicine an art and failed. The problem with the moderns is that they tried to make it a business and succeeded.
Here it is.. another Monday and another research grab-bag.
Five daily portions of fruits and vegetables raise serum antioxidants in three months
To explore the effects of increasing fruit and vegetable intake and the resulting effects on levels of circulating micronutrients in a community-dwelling population with an already high consumption of fruits and vegetables, 112 volunteers (86% women) underwent targeted dietary counseling for three months. At the beginning of the study and after 4, 8 and 12 weeks a food frequency questionnaire was filled in, and plasma levels of dietary antioxidants as well as biomarkers of oxidative lipid and protein damage were determined. Compared to baseline, especially the intake of fruits was significantly improved after 3 months of intervention, and mean plasma levels of lutein, zeaxanthin, β-cryptoxanthin, lycopene, α- and β-carotene, retinol, α-tocopherol, vitamin C and vitamin B6 were increased. Biomarkers of oxidative stress remained unchanged. Thus, a nutritional counseling program is capable of improving plasma levels of antioxidants even in a health-conscious population.
What is especially interesting about this study was that they used individuals who were already eating a pretty healthy diet, which just goes to show that even if you follow the BTD or GTD in terms of food choices, something as basic as making sure that you get the required amounts of recommended fruits and vegetables can make a big difference.
Schizophrenia, gluten, and low-carbohydrate, ketogenic diets
We report the unexpected resolution of longstanding schizophrenic symptoms after starting a low-carbohydrate, ketogenic diet. After a review of the literature, possible reasons for this include the metabolic consequences from the elimination of gluten from the diet, and the modulation of the disease of schizophrenia at the cellular level.
Previously, Dohan (Acta Psych Scand 1966, 42(2):125-152) observed a decrease in hospital admissions for schizophrenia in countries that had limited bread consumption during World War II, which suggested a possible relationship between bread and schizophrenia. Early work with lectins clearly showed that the brains of schizophrenics bind lectins differently than the brain tissue of non-schizoprhenics, which appears to make sense in that the carbohydrate content of schizophrenic brain tissue (in addition to dementia and a few other illnesses) revealed the existence of spherical deposits in the inner and middle molecular layers of the dentate gyrus in the hippocampal formation which contained fucose, galactose, N-acetyl galactosamine, N-acetyl glucosamine, sialic acid, mannose and chondroitin sulfate; many of these blood group active carbohydrates with known lectin binding affinities (link).
Over the years some of the most stirring letters I've received from book readers have centered around improvements in family members with schizophrenia. Almost all of these letters have been from or about blood type O schizophrenics, which may mean that the nutritional approach to schizophrenia might necessarily differ by foods and blood type. We are now only beginning to understand the effects of tissue glycosylation on the development and maintenance of brain neural networks (in particular those utilizing the blood group O specific antigen fucose).
Lectin-epithelial interactions in the human colon.
Similar changes in glycosylation occur in the colonic epithelium in inflammatory conditions such as ulcerative colitis and Crohn's disease and also in colon cancer and precancerous adenomatous polyps...Tools are now available to allow fast and accurate elucidation of glycosylation changes in epithelial disease, characterization of their potential lectin ligands, whether dietary, microbial or human, and determination of the functional significance of their interactions. This should prove a very fruitful area for future research with relevance to infectious, inflammatory and cancerous diseases of the epithelia.
In years past I've written about the effects of some dietary lectins on the cells of the colon, in particular the lectins found in mushrooms, fava beans and jackfruit. Most of the plant lectins are specific for the Thomsen-Friedenreich Antigen (T antigen) a pseudo blood group antigen which is often expressed in pre-malignant cells of the colon.
Here is a quote from a study examining fava (broad) bean lectin:
VFA stimulated an undifferentiated colon cancer cell line to differentiate into gland like structures. The adhesion molecule epCAM is involved in this. Dietary or therapeutic VFA may slow progression of colon cancer.
Here is a quote from a study examining standard commercial supermarket mushroom lectin:
Agaricus bisporus agglutinin (ABA) isolated from edible mushroom has a potent anti-proliferative effect on malignant colon cells with considerable therapeutic potential as an anti-neoplastic agent.
Here is a quote from a study examining jackfruit lectin:
(Jacalin) Lectin binding to human colonocytes can predict the presence of malignant and premalignant lesions of the colon, and has potential as a noninvasive screening tool for colorectal neoplasms.
If you have a family history of colon cancer, or have been diagnosed with colon abnormalities (such as polyps) you may want to investigate adding more of these foods to you diet (using the BTD as a guide to which would be best for you)
Human pseudogenes of the ABO family show a complex evolutionary dynamics and loss of function.
The GT6 glycosyltransferases gene family, that includes the AB0 blood group, shows a complex evolution pattern, with multiple events of gain and loss in different mammal species.These results suggest that some of these GT6 human pseudogenes may still be functional and retain some valuable unknown function in humans, in some case even at the protein level. The evolutionary analysis of all members of the GT6 family in humans allows an insight in their functional history, a process likely due to the interaction of the host glycans that they synthesize with pathogens; the past process that can be unravelled through the footprints left by natural selection in the extant genome variation.
Pseudogenes have been defined as nonfunctional sequences of genomic DNA originally derived from functional genes and are sometimes referred to as 'Junk DNA.' However new finding are suggestive that these areas of non-coding DNA and RNA may be involved in developmental changes which differentiate the functions linked to the blood type genes that occur between the various species.
Another nail in the coffin for the 'animals have blood types and don't eat right for their type' criticism of the Blood Type Diet by the nincompoop Andrew Weil.
The Effect of ABO Blood Types on Periodontal Status.
A relatively higher percentage of A group patients was found in gingivitis group and relatively higher percentage of O group patients was found in periodontitis group. A significant relationship was also determined between Rh factor and gingivitis. ABO blood subgroups and Rh factor may constitute a risk factor on the development of periodontal disease. However, long-term studies are needed to make a more comprehensive assessment of the effects of ABO group on periodontal diseases.
I'm sure that secretor status had something to do with these results, since it has an effect on pellicle formation (link) I do however, agree with the results. In my own patients I have seen periodontal disease resolve easily in many type A's by simply getting their gingivitis under control. Type O's on the other hand have a harder time of things, especially if their protein intake is not adequate.
That's about it for this week.
A bit of news: I would be willing to entertain questions about topics that might be of interest to this community. Just drop a comment (link is below). I will not however, respond to questions of a personal medical nature, nor give medical advice. Thanks for respecting this caveat.
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".
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.
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.
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.
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.
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.
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.
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.