New Under the Sun:
Volume 3, Issue 3
Greetings!! Although we are only beginning the third month of the year, by this point, most individuals have given up on their New Year’s resolutions. Time to take stock. If you resolved to eat and behave in healthier ways, but have slipped off track, it’s time to get realigned to move smoothly and successfully into the future.
Assisted Reproduction: Technology has been used to help couples conceive for about one quarter century. During that time, thousands of children have been born who otherwise would not. This has made for many, many happy families, but the benefits are not without costs. The most familiar cost is that of giving birth to multiple offspring at one time. Humans are adapted to have one offspring per pregnancy. A pregnancy with multiple fetuses is problematic for numerous reasons not least of which is that preterm infants are at great risk of health and developmental complications. Therefore, there is now a strong push within the assisted reproduction community to view a multiple pregnancy as a failure of technique. The goal is one healthy fetus per pregnancy. Given that goal, British researchers did a meta-analysis of 25 studies comparing birth outcomes for both assisted and natural singleton births. The rate of preterm births among assisted singletons is double that of those conceived naturally. In addition, 40% more of assisted singletons were small for gestational age compared to unassisted singletons. These differences held even when pregnancies/births were matched for mother’s age and parity. Therefore, the differences in birth outcomes between the two forms of conception require further study. If age and parity are matched, what other factors that differ between the two groups could account for this gap? In addition, women using assisted reproduction techniques, need to be fully informed that even when assured that the resulting pregnancy will be a singleton, that there is still a significantly higher risk of a poor or problematic birth outcome compared to a singleton pregnancy achieved by natural methods. Frans M Helmerhorst, Denise A M Perquin, Diane Donker, Marc J N C Keirse. Perinatal outcome of singletons and twins after assisted conception: a systematic review of controlled studies. BMJ 2004;328:261 (31 January), doi:10.1136/bmj.37957.560278.EE.
Foreign Birth and Healthcare: Large numbers of studies have shown that there are racial and ethnic disparities in health outcomes. The reasons for these disparities are many. [Click here to read my abstract on this issue: http://www.ncbi.nlm.nih.gov/pubmed/12640358] The study presented here discusses one factor which perhaps receives less attention than it should: foreign birth. The researchers examined records from the 1998 cancer screening data of the National Health Interview Survey of 32,440 respondents. Based on survey results, African Americans had at least as many cancer screenings as did Europeans Americans. This was not the case for those of Asian, Pacific Island, or Hispanic origins. However, when these groups were subdivided by those who were born in the US and those who were not, US birth resulted in non-significant screening differences when compared with European Americans, whereas foreign birth, even of those of European ancestry, resulted in significantly lower cancer screening rates. The researchers concluded foreign birth would explain some of the racial/ethnic health disparities seen in the US. They posited that the factors associated with foreign birth that could lead to lower screening rates include: poor English language skills, gender restrictions, limited access, and culturally incompetent medical care. Mita Sanghavi Goel, MD; Christina C. Wee, MD, MPH; Ellen P. McCarthy, PhD, MPH; Roger B. Davis, ScD; Quyen Ngo-Metzger, MD, MPH; Russell S. Phillips, MD. Racial and Ethnic Disparities in Cancer Screening: The Importance of Foreign Birth as a Barrier to CareJ Gen Intern Med 18(12):1028-1035, 2003.
Comment: The factors associated with the health disparity issues of foreign-born individuals are poignantly covered in the book The Spirit Catches You and You Fall Down by Anne Fadiman. This book is now required reading for first year medical students in many medical schools, so there is hope for improved care from the next generation of physicians. For those who are interested in understanding how those from other cultures, in this case the Hmong, attempt to adjust to American culture, particularly that of the medical system, this book is an excellent read.
Book Review: Live Right 4 Your Type by Peter J. D’Adamo is a thick, detailed prescription on how to live a happier, healthier life individualized by a person’s blood type. That is, a person with blood type O has a different health/behavior prescription from one who is blood type A, and so on. D’Adamo is a naturopathic physician so his “take” on the issue of health is a mixture of biomedical and alternative methodologies. The text is heavily referenced and written in a very technical style replete with jargon. Given that he is writing this book for the general public, I found it curious that this technical information was not provided in more accessible language. Generally speaking, jargon-laced language is used when: 1] the author wishes to show off and/or speak only to those “in the know” in his field; 2] the author is unable to restate the material in a more accessible style either because he has a poor grasp of the material himself or inadequate writing skills; 3] the author wants the material to sound more impressive than it really is.
D’Adamo’s main thesis is that the different chemical structure of each blood type has major effects on an individual’s health. If one does not eat the proper diet for a particular blood type and does not behave in ways appropriate for that blood type, one will have poor health and a less-than-optimal life. In addition to the more technical information, the text is spiced with anecdotes of those who have followed the diet and plan for their blood type and have achieved amazing results by doing so. It would seem that D’Adamo is really on to something here. However… Once again, an inadequate knowledge of evolution and adaptations trips up an author.
D’Adamo appears to believe that our four blood types are unique to humans, that O was the blood type of our foraging ancestors, and that the other blood types developed subsequent to the origins of agriculture and pastoralism/herding. If this were the case, then all other primates (humans are a primate) should have only type O blood. Unfortunately for D’Adamo, macaques, the dominant family of Old World monkeys that includes baboons, have all four blood types. Blood type O is very rare among baboons, at least those in biomedical facilities. The last common ancestor of humans and baboons lived about 33 million years ago. It appears the four blood types have great time depth. Gorillas (with whom we last shared an ancestor 7 – 10 million years ago) have primarily blood types B and O, while chimpanzees (with whom we shared an ancestor around 5 million years ago) appear to have primarily blood types A and O. Unless every wild population of chimpanzees and gorillas has been tested (which, of course, is not the case), it is impossible to conclusively state that these apes lack the other blood types. This is because of the Founder Effect and Genetic Drift.
The Founder Effect occurs when a small portion of a larger population migrates to a new homeland, cuts off ties with the original group, and has no other population with whom to mate. The new population, therefore, starts out with very limited genetic diversity which is unlikely to get any larger. In fact, what will most likely happen is that the genetic diversity will decrease over time as some individuals die before reproducing, or are unable to reproduce. It is due to the Founder Effect and Genetic Drift that the aboriginal populations of Central and South America were 100% blood type O. Similar effects occurred in Australia where the aboriginal populations have extremely high rates of blood type A: in central Australia, one tribe is 54% type A while those surrounding it average 40%. As one moves towards the coasts, the percentage lessens. Since Australia was first settled at least 60,000 years ago and since the aboriginal population never developed agriculture or pastoralism (how do you herd kangaroos?), it would seem that blood type O ought to dominate there as opposed to the Americas where agriculture developed 5,000 years ago. In addition, if D’Adamo is correct about the major impact of blood type on health, personality, and behavior, the entire aboriginal population of Central and South America ought to share a health, personality, and behavior profile. Clearly, this is ludicrous. And we haven’t even mentioned what blood types must mean for baboons.
The blood type O diet is a close match for the diet recommended by AnthroHealth. But then this is to be expected since he considers type O to be the blood type of our foraging ancestors. According to D’Adamo, the primary sources of protein for type A’s should be seafood and soy-based food products. They can also eat cultured dairy foods and limited amounts of grain. As I pointed out above, the aboriginal population of central Australia, hundreds of miles from the coasts, has extremely high rates of blood type A. Should we assume that because soy, dairy, grains, and seafood played no role in their diets for tens of thousands of years that they were, therefore, unhealthy and dysfunctional? I think not.
To be fair, D’Adamo does include good information about various diseases. And, if you ignore his blood type subdivisions, he does offer some valid advice about diet and lifestyle. But the blood type subdivisions make Live Right 4 Your Blood Type more metaphysical than biological. D’Adamo even notes that he is somewhat uncomfortable about tying personality/behavior to blood types, stating that it can seem more like astrology than biology. And he is correct.
AnthroHealth Tip of the Month: Still trying to lose weight? Not feeling as healthy as you’d like? Solution? Eliminate cheese and bread from your diet. Yes, this can be difficult. Both are, in their own way, addictive. But they fill you up with saturated fat and relatively empty calories. For calcium, protein, and healthy fats, almonds are a much better choice than cheese. For fiber and a multitude of important nutrients and antioxidants, fruits and vegetables are far superior to bread and processed grains. And more calcium can be obtained from spinach seasoned with lemon juice or a spinach salad tossed with tomatoes. Follow this advice, and the excess pounds should begin to melt away while your overall health improves.
© 2001-2009 Kathleen E. Fuller, PhD. All rights reserved.