Tuesday, September 29, 2009

The Full Measure

The D’Adamo shift starts at 9:30 each Friday morning and after a week of early morning classes that stretch into clinic work that often goes into the early evening, needless to say, each of the six of us students hurry into the conference room clutching large cups of something caffeinated. Dr. D’Adamo, on the other hand, is always ready to go; he swears by some special kind of green tea. As we all plunk into our seats, Dr. D’Adamo starts riffing on a variety of topics: the perils of using peppermint Dr. Bronner’s soap to wash your face, ways we can tweak the patient interview to make it run more smoothly, and the content of the different books he brings in weekly to show us. After taking a few of our questions, Dr. D’Adamo breaks to allow the first team to take the patient who’s just arrived. Our two patients today are a couple of friends who are acolytes of Dr. D’Adamo’s who have just come off his annual conference that was held over the summer. They are mad for the GenoType plan, have measured themselves already, and are eager to have their intake done and questions answered by the man, himself.

When Sue walks off the elevator with the two other students I work with, Jaime and Jen, I can tell she means business. This is a woman not to be deterred from her GenoType: she strides swiftly down the hallway, looking me straight in the eye as she grasps my hand firmly in greeting without much of a smile: she’s ready to get to work. And get to work, we do. Jaime and Jen are 4th-years, and therefore the student clinicians while I am a 3rd year, also known as an intern. One of the clinicians is tasked with taking the patient history and vitals while the other conducts measurements; I record measurements and generally provide assistance on measuring the patient.

Sue is thin, intense and knowledgeable. She’s a nutritionist and acupuncturist and favors the color purple: her sweater, t-shirt and socks are all shot through with different shades of the color. Her salt-and-pepper hair is straight and cut in a bob style. As Jen interviews her about her history, her eyes peer through frameless glasses out onto an invisible horizon as she recounts her lengthy and detailed history. Sue already knows that she is a blood type B+ and a non-secretor (more on what the latter means in a few paragraphs). She started on the Blood Type diet and has since switched to the GenoType Diet, after identifying herself as a Nomad (again, more on this later — so much to explain, so little time). Her chief complaint consists of a host of eye problems: chronic blepharitis, corneal ulceration and chalazians. In addition to the diet, she takes a few supplements for immune support including nucleotides, olives leaf extract and echinachea. She also treats her eyes with colloidal silver eye drops. Recently, she’s experienced vitreous detachment in her left eye, causing her to see “zillions of black floaters like a meteor shower.” Problems of lesser concern are an overly revved sympathetic division of her autonomic nervous system that causes sleep disturbances with night sweats, heavy metal toxicity, deep body coldness, a self-diagnosed goiter that sits to the left of her throat and sinusitis. We have our work cut out for us.

As Jen continues the patient history, Jaime and I get to work on taking Sue’s measurements, which will be entered into the SWAMI software to determine her GenoType. The first question that often comes up, and that Dr. D’Adamo addresses in his book The GenoType Diet, is why are these measurements taken to determine genetic makeup as opposed to having lab tests done? His answer to that is 3-fold: first, lab testing takes time and money; second, there are no lab tests for every genetic disorder such as Alzheimer’s so taking a good family history is as good as doing a genetic test for determining predispositions; and thirdly, and most importantly, most genetic diseases are not caused by one gene but by a combination of genes interacting, something which genetic lab tests don’t take into account. So, instead of lab testing, we take the GenoType measurements, which give a fuller picture of an entire genetic makeup.

I will walk you through some, not all of the measurements we do and why we do them.
First, we measure trunk length and leg length to determine whether the patient’s torso or legs are longer. These measurements are connected to the level of insulin-like growth factors 1 and 2 the patient was exposed to in utero. These factors determine leg length and height and are connected to risk for various diseases. For example, having short legs is connected to an increased risk of coronary heart disease. Tallness is associated with increased risk for hormonally-dependent cancers like breast and prostate cancer. Dr. D’Adamo has linked the various leg and torso lengths, and their ratios, with the various GenoTypes.

We also measure the length of the index (D2) and ring fingers (D4) on both hands, looking for the D2:D4 ratio. Finger length shows how much sex hormone a fetus has been exposed to in the womb, predisposing it to certain illnesses. “A longer ring finger means you encountered more androgens in the womb (androgens are a testosterone precursor); a longer index finger means you faced higher levels of estrogen,” says Dr. D’Adamo. From comparing the ratios of the two sides of the body, we also get information about the body’s symmetry. Higher levels of symmetry indicate less in utero stress. Finger length ratios also correlate to GenoType groupings.

Speaking of fingers, fingerprints are also a great indicator of developmental symmetry. We take a patient’s full set of fingerprints and then examine them to see if they’re one of three patterns: arch, whorl or loop. The more symmetrical your two hands are (index finger to index finger, for example), again, the calmer was your existence before birth. Many studies have been done linking specific diseases to fingerprint patterns and Dr. D’Adamo uses them as clues to a patient’s GenoType. What I found the most fascinating about fingerprints is that if a person has horizontal lines on her fingers, it indicates gluten sensitivity and malabsorption; this can be reversed with proper diet.

Jaw angle is the next measurement we take to help determine GenoType. This is called gonial angle. There are three basic jaw angle groupings: wide-angled, which lends the face an almond shape, and narrow, also called “lantern jaw,” and everything that falls in between those two. “Statistically,” D’Adamo writes, “an almond-shaped jaw seems to correlate to such disorders as toxemia during pregnancy, pernicious anemia, ulcers, and migraines in women, and to migraines in men. Square- or lantern-shaped jaws, on the other hand, may reflect more slippery tissue, and that may be why they’re more correlated with breast and uterine cancer: The cancer cells have an easier time detaching from slippery tissue and spreading through the body.”

Blood type is also factored in to GenoType, as is secretor status, which is a fascinating thing. Secretor status is linked to your blood type. Basically, your secretor gene controls whether you secrete your blood-type antigen in your body secretions like saliva, mucus, etc. Eighty-five percent of people are secretors and it is the non-secretors who have greater environmental sensitivities, a harder time burning fat, weaker defenses against parasites, and are generally your problem patients. Secretor status is determined by a blood test.

We take a lot of other measurements and since there’s not enough time here to discuss them all, I’ve included a complete list of the measurements we take at the bottom of this posting. Please pick up Dr. D’Adamo’s book The GenoType Diet for a further discussion of particular measurements, if you’re interested. At the end of the appointment, we take our full list and feed them into the SWAMI software, which then swiftly makes thousands of calculations to tell us the patient’s GenoType.

Back to our faithful patient, Sue, who, it turns out is an Explorer. Sue’s hydrogen is off the charts so D’Adamo diagnoses her with small intestinal overgrowth. Breath hydrogen is another factor we take into account when determining GenoType: we determine levels with a small machine that the patient blows into after ingesting a small amount of sugar in the form of lactulose, which transits the GI tract. If there is lots of intestinal overgrowth, the little critters will give off copious amounts of hydrogen. As we print out Sue’s diet and recipe plan, D’Adamo tweaks SWAMI to deemphasize foods that cause bacterial overgrowth. He emphasizes foods that have butyric acid (an anti-inflammatory particularly indicated for the GI), choline (which prevents inflammation), lauric acid (as is found coconut oil, which is useful for its antimicrobial properties) and lignans (high in phytoestrogens). He also recommends that she puts tomato slices on her eyes when they flare up, as tomatoes agglutinate staph, which he diagnoses are responsible for her infections.

Along with her brand new Explorer diet protocol, D’Adamo also gives her a long list of supplements to take home. For those of you interested, I’ve listed them below. Needless to say, Sue is in for an adjustment period as she comes off her old list of supplements and switches up her eating habits. But for this kind of patient, a challenge is just what she wants. We’ll visit with her in a month to see how she’s doing.

Next week in The Shift: Maura finally explains the characteristics of each GenoType.

If you have any questions or comments, please make them known! Email me at: maura.henninger@gmail.com.



Sue’s full list of supplements and why she’s taking them:
• Licorice: This was prescribed for her overactive sympathic nervous system. Licorice is known to block 11 hydroxysteroid, which is responsible for converting cortisol to cortisone, which can actually act as a precursor to cortisol, causing a build-up in the bloodstream. It is also a potent antiviral and anti-inflammatory.
• Methionine: Augments licorice effects.
• Potassium: Licorice can produce salt and water retention (this is called pseudoaldosteronism). Extra potassium is needed to counteract this.
• Cortiguard: An NAP product that contains bacopa leaf and boerhavia to maintain proper cortisol levels.
• Polyflora B: An NAP product that contains acidophilus and other healthy bacteria particular for B blood type.
• Deflect B: An anti-lectin supplement also produced by NAP for the B blood type.
• Burdock: He recommended either capsules or cooking up a “chunk” and eating it. It’s a blood purifier.
• Arabinogalactan: Support liver and provides immune support.
• Intrinsa: An NAP product to help balance GI flora.
• Fucus: Prohibits lectin binding especially in digestive tract.


The full list of measurements taken to determine GenoType:
Height, weight, waist circumference, hip circumference, somatotype, trunk length, leg length, upper leg length, lower leg length, upper leg space, tendon visibility, wrist encirclement, handedness, intracellular water %, extracellular water %, body fat %, lean muscle mass % (the previous four measurements are taken with an impedance machine), Carabelli cusp absence or presence, incisor shoveling absence or presence, cranial width, cranial length, gonial angle, blood type, PROP taster status, secretor status, caffeine sensitivity, lactose tolerance, ethnicity, present or absence of urine free radicals, urine analysis full reading, hydrogen breath test taken at 5 intervals, length of index and ring fingers, fingerprints on both hands with presence or absence of white horizontal lines.

Sunday, September 20, 2009

Send in the Clown

**Names and some details have been changed to protect the anonymity of patients.

Jane, our first patient, is a professional clown and 45-year old the mother of four daughters ranging in ages from 11 to 19. Jane’s friend Angela, who is a nurse and longtime patient and proponent of Dr. D’Adamo, has urged her for years to see him to address a myriad of mysterious health concerns. When I greet her in the lobby, I shake her hand and begin to size her up, as you can tell as much if not more about a patient’s health from what she doesn’t tell you as from what she does. Jane, who is about 70 pounds overweight, strikes me as a free spirit: a flowy purple sweater over a grey and blue striped tank top, black jeans, grey Pumas with a rainbows on the sides, and a necklace of pretty multi-colored gems. Her skin was sallow and her eyes had bags beneath them. She was cheerful, but her energy radiated weariness, as well. Her gray is wavy around her face and she greets me with a big, if not slightly tentative smile. With that, we headed upstairs to get her started on her intake.

On a patient’s first visit to the Clinic, we focus on a few things. First, we take a comprehensive patient history and do a modified physical exam that involves assessing the patient’s lungs and abdomen, as well as doing a Chinese medicine tongue diagnosis. Dr. D’Adamo has advised us that much can be gleaned from just a simple look at these three things. And then the fun begins: we begin GenoType measurements. Jane’s main concern is weight loss, but she is also tired all the time and has had chronic back pain for 15 years, as well as difficult rashes in her groin area and on her feet. She’s tried a number of weight loss programs from Weight Watchers to Weigh Down, with limited success, mainly because she has trouble with consistency. But with Angela’s help, she has been following some of Dr. D’Adamo’s protocols and has lost twenty pounds. Our task now was to assess what her GenoType is and put her on an appropriate regimen that would address her concerns.

Last week, I talked about how genes affect our health, the basic idea being that we are born with a set of household genes and a set of luxury genes and it is through the latter that we can affect and improve our health. In fact, humans have 30,000 genes and, as D’Adamo points out, this is fewer than most plants, which have 60,000. So, why are we humans so complex and varying? The reason lies in epigenetics: the way your cells affect your genetic activity, which is then passed down to your kids and your grandkids.

A little science lesson is in order here (believe me, I’ll make this as painless as possible). A lot of epigenetic programming happens inside the womb. If you go back to the town hall analogy I used in my first posting, you’ll understand Dr. D’Adamo when he says, “Right from the beginning, your town meeting is under way, with diet, environment, and genes beginning their lively debate. This debate has enormous significance for the being who will emerge into the world nine months later.” When you’re born, your GenoType materializes as a result of this prenatal environment, your preprogrammed genes and whatever occurred within the womb. This is when diet and environment — what the individual can control — begin to have an effect on health.

How exactly can we affect change on a gene? There are two ways. The first is called methylation. When a gene becomes coated with methyl groups, it winds up, effectively silencing it. Methylation is what determines your eye color, and a bunch of other things, before you’re born. But once you’re set free in the world, methylation continues, and this isn’t necessarily a good thing. For example, you want to methylate genes that cause you to store fat or have an asthma attack but demethylation can occur when you’re stressed out or eating the wrongs things, resulting in the wrong genes getting up to the microphone and wreaking havoc on the town meeting. “We don’t know everything about what causes either the beneficial or the detrimental methylation process to occur. But we do know that diet, supplements, and exercise play a huge role in quieting the genes we most want to silence,” says Dr. D’Adamo. (See The Economist article “The Origin of Diabetes: Don’t Blame Your Genes” for the more on gene methylation at http://www.4yourtype.com/distributor_links.asp under the heading Genomic News.)

The second way we can tinker with how our genetic destiny plays out is through histone acetylation, which is similar to methylation. An unwound DNA strand is six feet long; histones are like little spools that wind DNA into your cells. When DNA is all wound up in a histone, it’s silenced but if the histone is acetylated it — you guessed it — is no longer quiet and the problems start. Specific enzymes are needed to remove the acetyl group, spool up the DNA around the histone, and make everything nice and noiseless again. These enzymes are controlled, again, by diet, exercise and lifestyle. None of these elements are as important as what happens in the 9 months you spend as a fetus but, as Dr. D’Adamo says, “Diet and exercise can play a big part in altering our genes, especially if they’re geared, as the GenoType Diets are, to our existing genetic and epigenetic programming.”

So just how exactly do you figure out your GenoType, whether you’re a Hunter, Gatherer, Warrior, Nomad, Teacher or Explorer? That’s what our dear patient Jane wanted to know, as she was ready to start taking the weight off and addressing her rashes and fatigue. But it wasn’t as easy as having a quick look and making a diagnosis.

Here are just some of the measurements we took during our time with Jane that go into determining GenoType, the meaning and significance of which I’ll explain in next week’s posting: height, weight, waist circumference, hip circumference, somatotype, trunk length, leg length, upper leg length, lower leg length, upper leg length, tendon visibility, write encirclement, handedness, presence or absence of carabelli cusp, presence or absence of incisor shoveling, cranial width, cranial length, gonial angle, blood type, secretor status, body type, and caffeine sensitivity. We also took her fingerprints to examine them for patterns, did a urinary analysis to examine for any irregularities as well as presence of free radicals and administered a hydrogen breath test to determine the level of bacterial overgrowth in her gastrointestinal system. All of these figures are fed into Dr. D’Adamo’s SWAMI software, which does well over a hundred thousand calculations and feeds out not only her GenoType, but also a comprehensive diet and exercise plan, complete with menus and recipes.

But that would have to wait until next time, as we needed to send some of Jane’s labwork out before we had all our data in place. Needless to say, our little clown Jane left in a bit of a daze, but armed with a few supplements including Gastro-D to reverse bacterial overgrowth and Deflect for Type A to get help her cells fight off lectin assault and help her metabolism. (See below for details on the supplements).

Next week, we’ll examine why these mysterious measurements are taken and we’ll profile the 6 GenoTypes, as well as meet our next patient.

Some of you have been asking about Dr. D’Adamo’s take on H1N1, or swine flu, and what he recommends to both prevent and treat it. Please see http://www.dadamo.com/science_bloodgroups_influenza.htm.


Supplement Info (From 4yourtype.com):
Gastro-D: The DGL assists in protecting the stomach lining, and in combination with seven other synergistic ingredients, Gastro-D Complex is an essential supplement for individuals with occasional stomach problems.

In addition to DGL, Gastro-D Complex includes Mastic Gum, which may help to protect the gastric mucosa; Safflower Tops may help to provide additional support against H. Pylori infestation, especially for blood type O non-secretors; Bentonite Clay assists in attracting and soaking up environmental toxins; the inner bark rind of Slippery Elm protects the GI tract from excess acidity; and Bismuth helps protect the lining of the stomach from stomach acid.

Deflect for Type A: This contains N-Acetyl D-Glucosamine, Chondroitin Sulfate, D-Mannose, Cranberry concentrate, Pineapple concentrate, N-Acetyl Cysteine, and Fructooligosaccharides. Dr. D’Adamo has specially formulated this combination to correct previous lectin damage and remove lectins currently adhered to the body’s cells.

Sunday, September 13, 2009

A Few Words on Blood Type

Before I say anything about our first patient in the Clinic this week, let me first talk a little bit about the Blood Type Diet. Back in 1996, the book Eat Right For Your Type came out and became a sensation. Since then, Dr. D’Adamo’s books have sold 5 million copies worldwide and have been translated into 65 languages. Person after person, after reading my blog and learning that I’ve been working with Dr. D'Adamo have voiced their skepticism or humbly offered that they just don’t understand why it works. Certainly, this is understandable. People trying to lose weight will blindly look to the latest fad (Grapefruit! Cabbage! Fasting!) in a desperate attempt to knock off the accumulated baggage of nightly dances with Ben and Jerry, without any understanding of why the plan they’re undertaking works or even if there’s any science to back it up. Who cares why it works, as long as it worked for someone, right? With Blood Type, the research is actually there to back it up.

So what happens when you eat something and what does it have to do with your blood? I'll use myself as an example. I’m a Type 0. In a nutshell, I’m supposed to eat lots of proteins, including red meat, and stay away from wheat and dairy. Let’s say I eat a bagel with cream cheese for breakfast. That bagel and that cream cheese—and all foods, in fact— are packed with things called lectins, which are proteins found on the surface of the cells food. So, I’ve had my breakfast and the bagel bits and their accompanying lectins are swimming around in my stomach and they eventually enter my bloodstream where they meet my blood cells. Now, my blood cells will see the bagel and cream cheese lectins as foreign invaders (also known as antigens) and attack them with their own army of antibodies. This will result in the clumping of blood known as agglutation, literally the gluing together of tissues. This inflammation will lead to a host of health problems that can range from simple bloating, constipation and weight gain to full-fledged gastric ulcers and even severe respiratory allergies and autoimmune disorders. Bottom line: you want to reduce your body’s inflammation as much as possible. Dr. D’Adamo has tested hundreds if not thousands of foods and how they interact with each blood type, drawing correlations between disease and blood type. All you have to do is go on Dr. D’Adamo’s incredibly active message boards to see how many people for whom this has been an effective approach in everything from curing diabetes to lowering cholesterol to weight loss to simply clearing away that low level fatigue that seems to plague many of us.

I’m not going to take up any further space here by explaining each of the blood types, as my focus is D’Adamo’s more recent project the GenoType Diet, which is what we’re using in Clinic this fall.

For a good overview of the Blood Type Diet, check this Seattle Times article: http://www.dadamo.com/media/seattle.htm.

Do you want some basic guidelines on how to eat according to Blood Type?
Type O: Eat a high protein diet with lots of vegetables and fruit; limit grains, beans and legumes. Intense physical exercise suits you best, such as running or martial arts.
Type A: You’ll do best on a vegetarian diet. Dairy and too much wheat will make you feel sluggish and cause accompanying health problems; soy and pineapple will aid your metabolism. You’ll benefit most from exercise that calms your nervous system such as yoga, tai-chi, golf and brisk walking.
Type B: You are a balanced omnivore: you should eat meat, dairy, grains, fruit, vegetables, fish, beans and legumes in equal measure. To lose weight, avoid chicken, corn, lentils and peanuts. You should do moderate physical exercise that engages your mind such as tennis or cycling.
Type AB: This type is the anthropologically newest blood type, a combination of A and B. Foods that cause weight gain: red meat, kidney and lima beans, corn and wheat. Foods that encourage weight loss: tofu, seafood, dairy and green vegetables. AB’s are have the high stress profile of Type A’s so should also engage in exercises such as yoga, tai-chi, dance and hiking.

Sunday, September 6, 2009

The Shift Has Begun

I knew this was going to be a different kind of shift when Dr. Peter D’Adamo showed up at the University of Bridgeport College of Naturopathic Medicine Clinic and started to rearrange the furniture and clean the shelves in the rooms where we — the six students working with him — would be seeing patients. Something very different was afoot here. It is perhaps an understatement to say that Dr. D’Adamo’s approach—based on decades of research on blood type and, more recently, genotype—is more progressive than what we learn in traditional naturopathic medical school classes. But nowhere else will you find someone more dedicated to the naturopathic principle of Tolle causam (treat the cause). And, while the science upon which he bases his findings is fairly high-level, his interventions (diet, exercise, supplementation and lifestyle recommendations) are well within the familiarity level of your average medical student toiling away in the clinical setting. So, though the six of us were still trying to absorb the scientific background behind The GenoType Diet upon which we’d be basing our patient visits, we all got our Windex bottles out and squirted away and made sure the chairs matched in the consultation room in preparation for what was to come.

Dr. D’Adamo is the author of the New York Times bestselling Right For Your Type series, which takes the ABO blood type as the primary determinant of diet and disease. A second-generation naturopathic doctor, he also started and runs the New England Center for Personalized Medicine in Wilton, founded the Institute for Human Individuality at Southwest College of Naturopathic Medicine, has written four medical software systems including the SWAMI software that we will be using at UB, holds a number of patents in cosmetics technology and nutritional supplementation and, well, is a second-degree black belt. And those are only a few things on his resume; to say that the man is meticulous is an understatement. The idea behind the shift is this: to see a patient in a series of four consultations and to develop a diet and lifestyle regimen constructed around the patient’s GenoType. During the first visit, we take a comprehensive history, do a laboratory workup and a take a series of measurements to determine GenoType; at the second, we talk to the patient about nutritional recommendations based on our findings; the third visit will be spent making any changes necessary and addressing the patient’s concerns; and on the final visit, we do a wrap-up after eight weeks to see how the patient has progressed.

On his first few days at the Clinic, Dr. D’Adamo lectured us extensively on the science behind blood typing and his more recent work, which is the basis for his book The GenoType Diet. The GenoType Diet is based on something called epigenetics. Here’s how Dr. D’Adamo describes epigenetics: “[It] is the study of changes in the genetic expression that are not linked to changes in the DNA sequences but related to the influence of the environment on the genes being expressed or not — basically whether a gene is silenced or activated.” Thirty percent of our genes are not subject to epigenetic control — these are called household genes. The other seventy percent, or the luxury genes, are open to epigenetic change. Dr. D’Adamo describes them like this: “In these genes, it is almost as if there is a great, big volume on the gene, which the environmental conditions adjust upwards or downwards depending on whether more or less of what that particular gene codes for (enzymes, proteins, hormones, etc.) is required.”

In The GenoType Diet, D’Adamo likens this to a big town hall meeting in which various genes are competing to speak at the microphone. When a problem comes up, there are the people who get up first, talk the loudest and generally take over. Then there are the people, who make up the majority, who sit there quietly, listening and observing. D’Adamo’s goal is to get the right genes talking at the right time. For example, if you’re fighting off a cold, you want your anti-inflammatory genes speaking up, while you keep the inflammatory genes in their chairs. As D’Adamo puts it, “We want to be sure we’re hearing from the right parts of our genetic makeup and silencing the genes that are not so helpful. The genes that predispose us to certain diseases and disorders should be encouraged to stay away from the microphone. The genes that help us feel healthy and happy that lead to a long life and a vital old age should be invited to have their say.”

When the body becomes sick due to an imbalance in the body’s genetic response, the best way to get it back on track — in D’Adamo’s estimation — is through diet and nutrition because foods and supplements are the most effective way to silence and encourage genes at a cellular level. The body can, essentially, be reprogrammed to respond in a more genetically capable way and once this reprogramming is complete and the body is responding in healthier ways due to the repair of cellular damage, dietary restrictions can be eased.

We will continue to unpack the science behind Dr. D’Adamo’s work in upcoming installments of The Shift. As he said to us a few days ago, “Complicated things that contain truth will stick and distill; if something doesn’t contain the truth it will always remain complicated.” In the upcoming weeks and months, I hope to be able to get to highlight some truths and demonstrate how and why this approach works, as we follow our patients through their weeks of treatment.

In next week’s posting, I will discuss the six genetic archetypes, or GenoTypes: Hunter, Gatherer, Teacher, Explorer, Warrior and Nomad. I will also talk in detail about the measurements taken that determine a person’s GenoType and walk you through a visit with our first patient, including using the SWAMI software.

If you’d like to find out more while waiting for your next installment of The Shift, read more at dadamo.com.

And for more information on Dr. D’Adamo’s tips on keeping your immune system in top shape, as well as cutting edge supplements you can take to ward off other immune hazards, go to: http://www.4yourtype.com/2009_newsletter_v6n8.asp#SWAMI