Chapter I

Introduction

The way our body reacts with any stimulus is determined by the information found in our genes. The information not only dictates the way our body structures are arranged and formed but also how these structures will function. The genetic code also provides how one individual will differ from another person but also how different he will be from the other individual. The difference could be very minute or very great but still many points of similarities place one person into a class of organisms which they share these similarities. Blood type is one characteristic which is determined by our genetic code. It places one in a group of individuals of the same type and it distinguishes him from other persons with different blood types. It may even affect how one will react to certain stimulus from his environment. According to Dr. Peter D Adamo blood types is one of the medically recognized variations as such that of fingerprint patterns and DNA analysis used today to find out causes and cure for diseases. He said that using blood types in this context will bring the science of genetics one step further wherein we used the information in our genes in our understanding of how one human being is unique not only in his structures but in his responses to the demands posed on him by the environment. In his book entitled Eat Right for Your Type he stressed the influence of blood type in determining the resistance of a person to disease as well as his susceptibility because it reflects the genetic information which dictates his responses to the demands imposed by the environment. He stressed the foods most suitable for each blood types: type O benefits most from high protein low carbohydrate diet, type A from high carbohydrate low fat diet, type B from dairy products and can tolerate variations of foodstuffs, and type AB can tolerate most foods which are not suited for type A or B. There are many methods of analyzing blood types, the most common is the ABO system based on the antigen found in the surface of the red blood cells of an individual. This system was introduced by Karl Landsteiner in 1900 after his discovery of the two red blood cell antigens A and B with which he formulated the Landsteiner Rule: that one has no antibody for his own antigens and that he produces antibodies for antigens he does not have. This precludes that one produces antibodies to protect himself from the many antigen he is exposed to and not to his self-antigens. In this ABO system an individual belongs to the type A if he has antigen A in his red blood cells. If he is type B he has antigen B. If he has both antigen A & B then he is type AB and if does not have any antigen he is type O.

The heritability of blood types was discovered in 1903 wherein genes carrying information for the production of antigen A and B are found in chromosome number 9. An allele of these genes is inherited from one parent. The alleles of antigen A and B are co-dominant meaning anytime one inherits an A or B allele then it will always be expressed. The discovery found that O gene is actually recessive and must be inherited from both parents to be expressed. The gene O carries information for the allele of the H-antigen which is the precursor for either antigen A or B. The transmission of traits on blood types follows this pattern of inheritance: 1. AA parent can pass A gene only. 2. AO parent can pass A or O genes. 3. BB parent can pass B gene only. 4. BO parent can pass B or O genes only. 5. OO parents can pass O gene only. 6. AB can pass A or B genes only. Since blood types are determined by an individuals genetic make up, the process by which it was transferred from one generation to another is as old as man itself. In the journey of man from creation, his development and changes towards a modern organism involved many evolutionary changes designed on one particular objective survival. According to a documentary entitled The Journey of Adam featured both in the National Geographic Channel and Discovery Channel human history started in Africa about 40,000 B.C. The existence of the first humans was of isolation and there is no stimulation for the production of protective mechanism. Their interaction with the environment is limited to food gathering through hunting and day to day survival. The only danger posed on them was being eaten by predator animals, both large and small (worms and parasites). In this condition, anthropologist inferred that the blood type predominantly was type O. The British National Blood Transfusion Service stressed that type O mast have evolved first because all humans can receive this type of blood without any reaction. The theory that type O evolved first is even strengthened by an experiment and research done by a group of researchers published in the journal of Nature Biotechnology in April 2007 that type A, B & AB can be converted to type O by using a glycosidase enzyme from a certain bacteria to strip the red blood cells of the antigen they carry. As the number of humans grew, game for food became less abundant so the early humans were forced to move around available space and began to discover new foodstuffs. These evolving humans began to try eating available vegetations in

addition to the dwindling supply of meat from animals around them. In response, man evolved into a more domesticated existence and agriculture was born. This was documented about 25,000 to 15,000 B.C. in Asia and the Middle East where blood type A initially appeared. Although there were some evolutionary biologists who theorized that type A might have evolved first followed by type O through the deletion of a single nucleotide. Although this is consistent with the accepted patterns of early population movements and varying prevalent blood types in different parts of the world, it is contradictory to earlier theory that type O evolved first and which is more accepted by the scientific world. As the journey of man continued, climate changed necessitating changes for better survival the birth of type B blood documented to have developed between 10,000 and 15,000 B.C. in the heart of the Himalayas, India and Ural region of Asia. These people have more balanced diet as compared to the first two human types. As evolution endured, intermingling of cultures and tribes occurred, there was amalgamation of the human characteristics, some of which made man stronger, some made him weaker. Anthropologist recorded the first appearance of blood type AB about 1000 years A.D. among type A Caucasians and type B Mongolians. The evolution of blood types clearly showed the journey of man for survival. His genes dictated the best way to respond to the ever changing world where he lives. Many anthropologists believed that man his marker, his blood type influences his functions, responses and ultimate distinction from the rest of the living system but also to other human beings. The usefulness of blood type analysis were then limited to the determination of what type is appropriate for transfusion in cases where blood and blood products are needed in the treatment of a particular illness until Del Nagro in 1998 in his theory of Light and Dark based on his research where he found that some viruses that infect human cell in the lungs and mucosal epithelium take along ABO blood antigens from there then cause mutations and carry these changes to the second recipients of the viruses to elicit a host response against non-self antigens. He further theorized that there is communal immunity and that individuals in a population make up the diversity of unique antigen moieties which keep the population as a whole resistant to infections. In the search for cure of many diseases it has been found out that certain diseases are more common in a particular blood type than other types. Although no conclusive evidence has been written, blood type influence on a persons reaction to illness remains a frontier still to be discovered. This study explores the possibility that blood type influences the food preferences of an individual which makes one susceptible to a particular disease process.

Research Problems What is the distribution of ABO blood types among the employees of the University of La Salette? What are the food preferences of the employees of the University of La Salette? What are the prevailing diseases among the employees? What is the relationship between the blood type of the employees, their food preferences and the prevailing diseases among them?

Research Objectives 1. To find out the distribution of the ABO blood types among the employees of the University of La Salette. 2. To find out the food preferences of the employees. 3. To identify the prevailing diseases among the employees. 4. To find out the relationship between the blood type, the food preferences and prevailing diseases. Framework of Analysis The study will use the concept of input-process-output system using the profiles of the respondents, their blood types, food preferences and their personal history of diseases and illness as well as in their family as the input. The process will involve the analysis of the profile of the respondents, analysis of their blood types, food preferences and their disease history and their family and the assessment of the relationships of the three variables. The output will be the relationship of the three variables with one another as to the influence of blood types with the food preferences and the prevalence of a particular disease in the employees and their families.

Relevance of the Study This study seeks to stress the role of blood type in the determination of food preference of an individual which will eventually influence his susceptibility to certain diseases as found out in many foreign researches. This study will be conducted to find out if the results among foreign respondents are the same among Filipinos wherein no parallel studies were done yet. The results of the study will help the researcher in her practice of giving diet recommendations to her patients which is a great part of treatment of patients.

This will also help the University in determining the probable diseases that its employees will suffer and thus will pave the way for better provisions of health benefits. The employees will also benefit from the results because it will give them better insights of how to take care of their health and to give them better ideas of preventing diseases running in their families.

Scope and Limitations This study focuses on the blood types, food preferences and prevalence of diseases among the employees of the University of La Salette. The unit of analysis for this study is at the University level. The variables will then be applied to the bona fide employees thus an institutional study. The applicability of the study is limited to the university thus any conclusion that is drawn from this study may not hold true to other communities.

Hypotheses The main assumption of this research is that blood type determines the food preferences of an individual thus will determine the susceptibility of the person to certain diseases. In line with this, the hypotheses of this research are: 1.) blood type O are usually carnivorous but are more resistant to cardiovascular diseases; 2.) blood type A are usually vegetarians but are more susceptible to cardiovascular diseases; 3.) blood type B are usually of varied diets and more resilient to cardiovascular diseases than type O; 4.) blood AB are usually tolerant to newer diet regimens but exhibit extreme responses to diseases either very resistant or very susceptible.

Definition of Terms Allele forms of a single gene that control the same inherited trait located in the same site in a homologous chromosome Anthropologist a person studying man both as an animal and living in a society, his origins, development, distribution, social habits and culture. Antigen substances or materials not synthesized by the body thus are considered non-self; these substances usually stimulate the production of antibody which has

the ability to destroy the particular substance which leads to its production (Microbiology for Health Sciences by G. Burton, Lippincot Williams & Wilkins, 2004). Carnivorous individuals Caucasians a race of white skinned people with prehistorical origin in regions between the Black sea and the Caspian sea. Chromosome a structure found in the nucleus of a cell containing deoxyribonucleic acid or genetic material of a living organisms which often is duplicated and passed through the offspring. Diet the food or drink normally taken in a prescribed course of what is to be eaten or not (Grolier Dictionary, 1992). Dominant it is an allele which carries a trait which is always expressed whether in a diploid or haploid number. Evolution the gradual continuous changes from simple to complex forms in response to environmental conditions by natural selections of randomly occurring mutations (Grolier Encylopedia, 1997). Gene a particular segment of the DNA molecule containing specific information that codes for the production of certain protein responsible for a particular function in the body (Microbiology for Health Sciences, 7 th Edition, Lippincott, 2004). Genotype the genetic make up of an organism which depends on the DNA sequence of its genes (Principles of Anatomy & Physiology by Tortora, 10 th Edition, John Wiley & Sons, 2003). Heritability capacity to transfer a trait to the offspring Immunity the freedom from any liability usually an illness (Websters Dictionary, 2000). Immunoglobulin antibody; proteins produced by the immune systems to destroy antigens. Phenotype the observable expression of a genetic trait influenced by the environment on its degree of expression. Preference liking; first choice; favoring (Rogets Thesaurus) Prevalence the number of cases of a disease existing in a given population during a specific period or time (Microbiology for Health Sciences by G. Burton, 2004). Susceptibility the lack of resistance to the damaging effects of an agent (Principles of Anatomy & Physiology by Tortora, 2003).

Tolerance ability to endure, withstand certain imposition or demand Vegetarians individuals who prefer plant foods or foods derived from plant source

Chapter II REVIEW OF RELATED LITERATURE

Dr. James DAdamo, a naturopathic physician in his book entitled One Mans Food published in 1980 had condensed his observations of his patients who were given certain dietary regimens for a particular disease that some improved, some did poorly and some even worsened. He narrated that even though these patients received the same type of treatment for the same disease, still there were variations in the responses. He then tested his theory by testing the blood types of his patients and made an individualized diet regimen based on observations of individualized reactions for each blood type. He was so surprised by the results that his conviction that blood types influences a persons susceptibility to the disease and body mechanisms for recovery. The book published in 1997 Eat Right for Your Type by Dr. Peter J. DAdamo, the son of Dr. James DAdamo discussed how he followed the research and study of his fathers pursuit of the influence of blood types on disease. He went on to search

for the scientific basis of his fathers observations. And this time, more conclusive evidences were found no t only by the author but other researchers as well when more diseases were found to be correlated with certain blood types. In an article published in the British Medical Journal in 1954 about the relationships of stomach cancer with the ABO groups by J.E. Aird found that stomach cancer was linked to low levels of stomach acid production which was more common among type A individuals. This study also found out that Pernicious Anemia is also more common among type A individuals, a condition which predispose a person to insufficient acid secretion since this anemia requires vitamin B12 for absorption and this vitamin needs sufficient acid secretions in the stomach for its absorption in the gastrointestinal tract. In 1976, R.J.Garrison, R.J.Havlik, R.B.Harris et.al. made a study on ABO blood groups and cardiovascular diseases which showed that there is significant association between blood types with type O having the lowest rates of claudication of arteries. Serum cholesterol was slightly higher among non-type O blood types. The study was published in November-December issue of Atherosclerosis. A Russian article published in 1979 about an analysis of the distribution of ABO system blood groups among patients with spinal osteochondrosis syndromes showing regular influence of the genotype on the development of spinal osteochondrosis and determines the mechanism of the immune response to this disease with type O demonstrating the least frequency and type A with the highest frequency of the disease. The study was done by M.S. Ritner, I.R.Shmidt et.al. The relationship between the erythrocytic antigens of the ABO/Rh system and cardiovascular pathology was studied by E.N.Meshalkin, G.N. Okuneva et.al. done in Russia and published in Kardiologiia in April 1981 and revealed that the prevalence of type B gene and Rh+ phenotype is increased in patients with acquired heart disease while type A Rh + showed more prevalent in patients with congenital, acquired and ischemic heart disease. Immunohistochemical study of blood group activities in the alimentary canal in normal and pathologic conditions with reference to the nature of epithelial mucopolysaccharides done by T.Oshima, H. Maeda, N.Tanaka & T. Nagano published by the Department of Legal Medicine, Kanazawa University School of Medicine, Japan in 1988 showed that the quantitative and qualitative changes in blood group activities were closely associated with those of epithelial mucopolysaccharides and that ABO antigenic activities were located in the PAS stainability of mucins and goblet cells of the alimentary canal. The 1989 issue of the Folio of Parasitology published the research of H.Kumar & S.Santhanam on Blood Groups and Filariasis showing the results of that filarial infection has no blood group predilection.

P.Bouree & G. Bonnot studied the relationships of ABO/Rh blood groups and HLA antigen with parasitic diseases and published the research in June 1989 in the Journal of Egyptian Society of Parasitology and showed that there are more hookworm infestations among the type O groups, giardiasis in type A, Enatmoeba coli among type B with type AB the most resistant to parasitism. An article published in the Europian Journal of Clinical Microbiology and Infectious Diseases in August 1989 titled Relationship Between Infectious Disease and Human Blood Type, the research done by S.A.Berger, N.A. Young & S.C. Edberg found that anthropological surveys suggests that geographic and racial human blood groups reflects susceptibility of populations with specific blood types to the plague, cholera, smallpox, malaria and other infectious diseases. A.M.Zemskov, V.G. Perederil et.a l. studied the relationships of immunological reactivity to blood groups showed the different pathological reactivity dependent upon blood group on the content of population of lymphocytes, immunoglobulins and grade of immunodeficiencies. This study was published in April 1990 in Vrach Delo. In June 1991, an article about oral contraceptives and antithrombin III: variations by dosage and ABO blood group was published in the American Journal of Obstetrics-Gynecology showing that there is larger decline in antithrombin III in type O women using the highest dose estrogen preparation and for women who are nontype O using the lowest progestin preparations. An article published in the Journal of Egyptian Society of Parasitology in December 1991 about the relationships of parasitic infection to blood groups in El Minie Governorate, Egypt found that there is more giardia lambdia infestation among type A and more E. coli cases among blood type B. A research entitled Longitudinal Study of the Association between ABO phenotype and total Serum Cholesterol Levels in a Japanese Cohort done by F.L.Wong, K.Kodama, H.Sasaki et.al. published in the Genetics Epidemiology in 1992 found that type A maybe more predisposed to cardiovascular disease than other blood types due to more elevated cholesterol levels as compared to other blood types. I.A.Akhund, I.A. Alvi et.al. of the Department of Physiology, Liaqat Medical College in Jamshoro who studied the relationships of ABO blood groups with myocardial infarction and angina pectoris published in October 2001 in their College Journal found that there is direct relationships between blood group antigens and coronary artery disease. The group stressed the existence of special genetic makeup which influence the susceptibility of individuals to this kind of disease. A study done by P. Suadicani, H.O.Hein & F. Gyntelberg of the Epidemiological Research Unit, Clinic of Environmental and Occupational Medicine

of Bispebejrg University Hospital, Copenhagen NV Denmark and published in International Journal of London in June 2005 entitled Airborne Occupational Exposure, ABO phenotype and risk of Obesity found that there were no significant correlation between type O men and obesity but there is significant results in type O men exposed long term to airborne pollutants to increased prevalence of obesity especially those in asbestos, welding fumes and breath irritants. A research done by A.I.Sharara, H.Abdul-Baki et.al. of the Department of Internal Medicine, American University of Beirut Medical Center published in November 2006 about the association of gastrointestinal disease phenotype with ABO blood groups and Helicobacter pylori virulence-specific serotypes found that there was higher prevalence of type A patients with gastric malignancy and infection with cytotoxin associated gene A-positive strains of blood. T.Abo, T.Kawamura et.al. of the Department of Immunology, Niagata University School of Medicine, Niagata, Japan studied the relationship between diseases accompanied by tissue destruction and granulocytes with surface adrenergic receptors in 2007 published in the Immunological Reviews found that the key factor connecting to tissue destructions are determined by the antigenic surface receptors found in the blood cells. The relationship of Helicobacter pylori positivity with age, sex, and ABO/Rh blood groups in patients with gastrointestinal complaints in Turkey, a research done by T.Seyda, C. Deyra, A.Fuson & K.Meliha publisehed jn June 2007 at Ankara Research and Training Hospital, Ankara, Turkey showed that there is no relationships with infections of H. pylori to age, sex and ABO/Rh blood groups. There were numerous studies and researches done showing the correlation of the ABO blood group system and a particular disease as well as the immunological reactions. All of the studies reviewed were done by foreign authors. Results were leaning towards the influence of blood groups on susceptibility of an individual to disease. Extensive search was done to find out any study done locally on the influence or relationship of the ABO blood group with any variable such as disease susceptibility, immunity or behavior but none has been found up to this point in time.

Chapter III

METHODOLOGY

Research Method The descriptive normative method is used with the survey questionnaire as the tool for data gathering. There are no other inclusion criteria except being employee of the University. The questionnaire was patterned from the survey questionnaire of Dr. Peter DAdamo in his study of diet regimens designed for each blood type of his patients. The questionnaire was modified to suit the present study. Blood typing will be done through the University Diagnostic Laboratory and recorded as part of the health record of the employee. The survey and blood typing will be done during one of the employees general assembly to ensure 100% participation and retrieval of the questionnaire. To strengthen the data gathering for the research, a random unstructured interview will be done at random among the employees to collect more information concerning the three variables.

Data Analysis Plan Data gathered will be treated and will be analyzed through the use of frequency, percentage, z-test and the chi-square to determine the relationship between the three variables. Tables and graphs will be used to show more clearly the relationships of the variables being studied. This will also show comparison between the four blood types and their relationship to the other two variables of food preferences and diseases.