Higher phosphatidylcholine protects against dementia

[giftsplash]

dentification of dietary phosphatidylcholine metabolites as markers for increased CVD risk

'

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3086762/

[Jafa]

Thankyou for the studylink Giftsplash. Sobering for those of us supplementing lecithin/Bettaine as well as upping egg consumption. Reassessment is probably in order.

[Julie G]

I'd be hesitant to use a 2011 mouse study to guide choline intake. See a brand new paper below that suggests benefit for our genotype:

Components of the Choline Oxidation Pathway Modify the Association Between the Apolipoprotein ε4 Gene Variant and Cognitive Decline in Patients with Dementia
https://www.sciencedirect.com/science/a ... ihub#f0020

Highlights
•One-carbon metabolism and the APOEε4 allele variant could interact in dementia.
•This potential interaction has not been addressed in prognostic dementia studies.
•We measured metabolites in sera in a longitudinal study on cognition in dementia.
•Choline oxidation metabolites seem to improve cognitive prognosis in APOEε4 carriers.
•In comparison, they may be detrimental to cognitive prognosis in non-carriers.

The take-away for me:

Interestingly however, our data suggests that higher concentrations of components of the choline oxidation pathway may be of benefit to patients with APOEε4, but potentially detrimental to patients without this allele.

[Jafa]

Thanks Julie. I missed the date on the mouse study, and now that you’ve pointed that out I recall Chris Masterjohn during one of his recent podcasts questioning the validity of the outcomes from an older mouse TMAO/choline study.

The extracts (I have yet to find a workaround for the paywall) you have kindly posted from the recent dementia study which suggests that there might be different outcomes in respect to the manipulation of the choline metabolism pathway for ApoE4 vs non-ApoE4 genotypes poses an interesting question for me. Up until now I have not sought to have my genotype and SNPs tested. I have assumed I am ApoE4 as I have a strong maternal family history of dementia and heart disease. Following the ApoE4 way and Bredesen’s ReCode protocol as much as is practicable, has been sensible and I would not change this either way if I was genotype aware. However, now there is a fork in the road, with the risk of a poor outcome if I am not E4 and continue to supplement with phosphatidylcholine. Testing might now change my practice, so will have to ponder exploring my DNA.

[circular]

I have assumed I am ApoE4 as I have a strong maternal family history of dementia...

Ah but assumptions can throw a spanner in the works. My maternal side has the AD but my mother, who also had it, was 3/3. I wish I could find out what those before her had in their genetics. I'm saving all the stamps I can in case DNA on them can ever be extracted or inferred at an affordable cost. It would be interesting if they were all 3/3, since it could suggest some other strong risk genetics at play with a mechanism worth elucidating.

[Jafa]

Thanks circ, and I hear what you say. By sheer weight of numbers there are more 3/3 AD sufferers than any other genotype, but I would have happily barked up the wrong (E4) tree as only good could have come from it. Now, it seems with respect to phosphatidylcholine metabolism that may not be true. If there are additional interventions which may be beneficial for E4, but deleterious for E3 then that might push me towards opening Pandora’s box.

[sunrise]

Anybody else out there that beats 9? Please? Please someone make me feel better about my whacked methylation pathways...

No, sorry. You win, even from amongst the FaceBook crowd. Only one gal matched your requirement. At least we know that you come by your “methylation whisperer” title honestly.

first time asking a question on this forum. i have one apoe4, do not know what the other is. I am 63 yo woman. My cholesterol prior to menopause was good, when i was under 40 it was great. now i am borderline and heading in the wrong direction. I thought that egg yolks especially would be bad for me and am confused with the high number of eggs consumed. I have known about this gene for 2 years, have gone on elimination diet and felt good but doc office visit with cholesterol heading in wrong direction when i thought i was doing everything right is frustrating, confusing etc.
I have read Bredesen, gundry, hyman, perlmutter, lugavere and feel like my head is in a washing machine. Any suggestions for whose approach is gospel for APOE4 1 copy?

[SusanJ]

Any suggestions for whose approach is gospel for APOE4 1 copy?

Hi sunrise, and welcome. Since I'm the party of needing 9 eggs, let me make just a couple comments. I'm also a 3/4 and postmenopausal. I saw my lipids change quite a bit from my 40s, too.

First, I don't eat 9 eggs per day. Having numerous methylation variants, I supplement with 1000 mg of TMG (trimethylglycine) per day, to help reduce my body's need to rely on choline for creating methyl groups. At times I have also supplemented with phosphatidylcholine (PC), another way to reduce the need to use methyl groups to convert choline to PC. I also take methylfolate, b12 and small amounts of other B vitamins per day, again, to balance out how the body creates and uses methyl groups. If you want to know more about how this works, try the wiki post https://www.apoe4.info/wiki/Methylation.

Now, as for diet, I quit using coconut oil and coconut milk and avoid fatty meats like bacon because they raise my ldl and total cholesterol way too high. I do still occasionally eat coconut yogurt and some baking with coconut flour because I eat dairy-free and low oxalate (which limits my choices for foods). I'm guessing you are eating a higher fat diet, and quite honestly, I've had to drop back the amount of fat to keep my numbers reasonable. I'm personally comfortable ATM with lipid numbers that slightly exceed the upper boundaries because my oxLDL and CRP (markers for inflammation) are very low, but I'm always looking for ways to drop those numbers.

That said, perhaps a good place to start is to look at your family health history. Do you have heart disease that runs in your family?

If so, that is a good place to start. It will be very important to reduce inflammation, especially if you eat foods that might uniquely cause you problems. You might also consider getting a coronary calcium scan to get a baseline of plaque.

If diabetes runs in your family, then I'd focus on your glucose tolerance.

And if you're like me, I have both in my family, so you have to find the fine line between too much fat and too much carb to get both set of numbers in line.

It takes some persistence, but keep trying, testing and adjusting, and do come back with any questions that pop up along the way.

[sunrise]

Hi Susan, Thank you for for the response and recommendations. My mother died of stroke at 71 and had LBD. I have been doing methylated B vitiamins, and a host of other supplements suggested by Drs Perlmutter, Bredesen, Gundry, and Amen; as well as Max Lugavere recommendations. I think all together it was just too much. What seemed the course with one, was not necessarily the same with the others. So I just felt overwhelmed and unsure how to stay well. So, overwhelmed that i was, i took it out on me with Pizza, and ice cream. Not good. I have contacted my FN Medicine doc, will do the elimination diet again, and see where i stand in a month or so.
I appreciate your taking the time to share what has worked for you. Thank you so very much. Stay well

[floramaria]

I have read Bredesen, gundry, hyman, perlmutter, lugavere and feel like my head is in a washing machine. Any suggestions for whose approach is gospel for APOE4 1 copy?

Hi sunrise! When I read the line of yours that I quote here, I really laughed because I have been there, and think “feel like my head is in a washing machine” is a perfect simile. All that information swishing and churning and one piece getting tangled up with another. SusanJ’s suggestions seem like a really good approach to figuring out what is right for you. From my perspective, there is no one whose approach Is “gospel” for those who carry ApoE4. There are individuals who strictly adhere to Dr Gundry or Dr Perlmutter or Dr Amens or Dr Bredesen, but for many of us, we are combining approaches , drawing from many sources, and creating plans that work for us individually. Even “what works” might be defined differently for different people. Personally, I am comfortable with higher lipid numbers. Whether or not that approach is working is something I hope to determine with a CAC test. ( I have been on a waiting list for 6 months. My “healthy person” concerns are way down the line in my state’s overwhelmed health care system.)

Like you I have one copy of ApoE4. I mainly follow Dr Bredesen but personally have heavier weighted focus on my microbiome, energy work through Qigong, and the way my thoughts affect my body . For me, the journey to find out what is right is one of experimentation and continual tweaking. My recommendation would be to take it slow and introducing changes that resonate with you one at a time , so you observe any significant changes. That way, you can develop a personalized program.
Maybe set the washer to the delicate cycle!