ABO Genotype, 'Blood-Type' Diet and Cardiometabolic Risk Factors

Genotype, ‘Blood-Type’ Diet and Cardiometabolic
Risk Factors
Jingzhou Wang, Bibiana Garcı
a-Bailo, Daiva E. Nielsen, Ahmed El-Sohemy*
Department of Nutritional Sciences,Faculty of Medicine,University of Toronto,Toronto, Ontario, Canada
The ‘Blood-Type’diet advises individuals to eat according to their ABO blood group to improve their health
and decrease risk of chronic diseases such as cardiovascular disease.However,the association between blood type-based
dietary patterns and health outcomes has not been examined. The objective of this study was to determine the association
between ‘blood-type’ diets and biomarkers of cardiometabolic health and whether an individual’s ABO genotype modifies
any associations.
Subjects (n = 1,455)were participants of the Toronto Nutrigenomics and Health study. Dietary intake was
assessed using a one-month,196-item food frequency questionnaire and a diet score was calculated to determine relative
adherence to each of the four Blood-Type’ diets. ABO blood group was determined by genotyping rs8176719 and
rs8176746 in the ABO gene.ANCOVA,with age, sex, ethnicity, and energy intake as covariates, was used to compare
cardiometabolic biomarkers across tertiles of each ‘Blood-Type’diet score.
Adherence to the Type-A diet was associated with lower BMI, waist circumference,blood pressure, serum
cholesterol,triglycerides,insulin, HOMA-IR and HOMA-Beta (P,0.05).Adherence to the Type-AB diet was also associated
with lower levels of these biomarkers (P,0.05),except for BMI and waist circumference.Adherence to the Type-O diet was
associated with lower triglycerides (P,0.0001). Matching the ‘Blood-Type’ diets with the corresponding blood group did not
change the effect size of any of these associations.No significant association was found for the Type-B diet.
Adherence to certain ‘Blood-Type’diets is associated with favorable effects on some cardiometabolic risk
factors, but these associations were independent of an individual’s ABO genotype, so the findings do not support the
‘Blood-Type’diet hypothesis.
Citation: Wang J,Garcı
a-Bailo B,Nielsen DE,El-Sohemy A (2014) ABO Genotype,‘Blood-Type’Diet and Cardiometabolic Risk Factors.PLoS ONE 9(1):e84749.
Editor: Nick Ashton, The University of Manchester,United Kingdom
Received August 15, 2013;Accepted November 18, 2013;Published January 15, 2014
Copyright: ß 2014 Wang et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits
unrestricted use,distribution, and reproduction in any medium, provided the original author and source are credited.
Funding: This work was supported by grant 305352 from the Advanced Foods and Materials Network (to AE-S). JW is a recipient of an Ontario Graduate
Scholarship.The funders had no role in study design,data collection and analysis,decision to publish, or preparation of the manuscript.
Competing Interests: AE-S holds shares in Nutrigenomix Inc.,a genetic testing company for personalized nutrition.This does not alter the authors’adherence
to all the PLOS ONE policies on sharing data and materials.
* E-mail:a.el[email protected]
A link between ABO blood group and diet was proposed by P.J.
D’Adamo in his book ‘‘EatRightFor Your Type’’ published in 1996
[1]. The ‘Blood-Type’ diets have gained widespread attention
from the public with more than 7 million copies sold in over 60
languages,and making the New YorkTimesbestsellerlist [2].
D’Adamo postulates that the ABO blood group reveals the dietary
habits of our ancestors and adherence to a dietspecific to one’s
blood group can improve health and decrease risk of chronic
diseases such as cardiovascular disease. Based on the ‘Blood-Type’
diet theory, group O is considered the ancestralblood group in
humansso their optimal diet should resemble the high animal
protein diets typicalof the hunter-gatherer era.In contrast,those
with group A should thrive on a vegetarian diet as this blood group
was believed to have evolved when humanssettled down into
agrarian societies.Following the same rationale,individuals with
blood group B are considered to benefit from consumption of
dairy products because this blood group was believed to originate
in nomadic tribes. Finally, individuals with an AB blood group are
believed to benefit from a diet that is intermediate to those
proposed for group A and group B [1]. The ‘Blood-Type’ diet also
proposes thatlectins,which are sugar-binding proteins found in
certain foods [3], could cause agglutination if they are not
compatible with an individual’s ABO blood group.
The ABO blood group is a classification of blood based on the
structuralvariation of a certain carbohydrate antigenic substance
on red blood cells. As one of the first recognizable genetic variants
in humans, the ABO blood group has been studied extensively for
its association with a variety of diseases including cancer [4,5,6,7],
malaria [8], and cholera [9]. Regarding cardiometabolic diseases,
individuals with blood group O were found to have lower levels of
von Willebrand factor (VWF) [10] and had a reduced risk of
venousthromboembolism compared to the other blood groups
[11]. Furthermore, group B individuals were found to have lower
levels of E-selectin [12] and a lower risk of type 2 diabetes
compared to group O [13]. These findings demonstratethe
potentialimportance ofthe ABO blood group in altering risk of
1 January 2014 | Volume 9 | Issue 1 | e84749
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