Got my oxidized LDL results

[Stavia]

Ps Riley its very useful for us to see that we make assumptions that everyone is on the same page, its very helpful I feel for us to summarise context every now and then so that misunderstandings don't occur.
The reason why we say try higher fat (from olive oil nuts avo for you because you can't eat the fatty fish) is that it will replace carbohydrate calories and drive insulin resistace down and affect lipids possibly in a positive way. Increased protein in a bid to reduce carb calories wont do the same thing because of gluconeogenesis of the excess.

[Gilgamesh]

Excellent summaries!

Riley, note that there are also plenty of APOE-ε4s who eat very low-fat diets and have great biomarkers. They aren't posting a lot here right now, but... we are all so different! It's really hard to know what will work well for any given individual. And we all have to remember to include reports on weight stability or weight change when reporting on biomarkers, since energy-intake generally exerts a greater influence on most biomarkers than dietary constituents.

I'm currently eating nearly 4000 cals/day of 60-75% fat from mostly nuts and seeds (tons of ω-6, by the way -- but a lot of studies suggest that that's OK coming from nuts and seeds, as opposed to from refined oils from nuts and seeds) two days in row, then 450 calories of 10-12% fat on Day 3. Great lipid biomarkers, and good glucose numbers. But I had much better glucose numbers 6-7 or more years ago on 20-25% fat. But I was younger (45 instead of 52 -- I think I passed a manopause threshold). It's tricky!

[Riley]

That's a very interesting and wonderful post, Stavia .
I must admit I was a little horrified at first and yes I agree: single person or small group case studies really do seem to show us more than the very poorly controlled randomized trials - of course with many caveats too.

I've had at least three epiphanies this week.
The exercise thing really seems to be important.
The sugar thing seems even more important than I had thought before.
And a combination of a few other things too that I can't seem to put together now.
I think I'm going to start the hypoglycemic medication too - it makes a lot of sense and I've looked at the data. I also have witnessed the effects with patients and friends who seems to be doing much better than average.


I'm really good with full comprehension and assimilating logical information.
The slight ketosis "maybe" makes sense to me - I never fully understood some of the more far- out Alkalosis stuff as far a protective mechanism- although I worry about acidic free radicals, hydrogen ions, too - so I'm not sure?
I haven't seen this research .
But evolutionary-wise slight starvation periods make absolute sense and the low calorie diets have proven beneficial in some studies. That we just eat too much period is indisputable.

I know the argument now is what level of animal product if any is safe. It seems to be around 10 percent is reasonable?
My friend thinks 20 percent.
I'm not a religious fellow .
I just want to know the truth of the science.
Although I really try to practice a very strict vegan diet with no processed white flour, simple refined sugar, etc ..
I don't advocate it forceveryone - I just have to do it this way because I'm a crack addict with junk food. I fail if I'm not 100 percent disciplined. It gets real bad and i suffer a lot of depression with bad western junk eating.
Many others don't have to do this - although they are never aware of the severe vascular disease most of us suffer now either - common now for three year olds to have fat streaking is one example.

One of the more dramatic studies I've read is the ultra sound studies in brachial artery dilation after high fat diets. The high fat bolus basically shuts down our artereovascular systems ability to dilate and compensate for up to 6 hours - which puts most people in a continuous state of disease.

That said , it's hard and even though milk can be horrible the ramifications of low exogenous calcium on children can last a lifetime - so my kids drink milk still as well as eat steaks - but I teach them everything about eating healthy and plant based eating.

The beans thing: I'm not sure about beans - I have read that nothing is more firmly linked to longevity than beens and legumes.
Micheal Gregor's research says a lot about this.But I haven't looked at any of the studies on either side.

I don't like vegetable oils- I do love olives and eat them once in a while.
But it's almost impossible to keep the vegetable oils out of our diet and they are just as bad as saturated fats in my opinion. Even with a little vinaigrette on a salad that are there. We just get too much of it just by accident.
I've seen the pathology studied in arterial plaques - they are composed of all types of fats - the whole fish oil, olive oil thing never made sense and the large studies, that are not biased, are starting to show this.
It's classical correlation without causation and it seems to be behind most of the olive oil thing.


Love the website..
Thank you so much .,

[Riley]

I do eat avocado, nuts and olives.
These to me are natural foods that are far different from concentrated oils.Although in limitation because of the high calorie.

The studies that have reversed heart disease in existing severe cases of CVD have also had to limit nuts and avocado with great results.

My LDL/HDL ratio is horrific .., 8:1
I've never had it done while eating heathy .
I'm going to get all my new numbers this next week ..everything done .,
Need to make a lab list
Both for this pages stuff and for my 3 months of vegan eating to make sure I'm not lacking Bs, zinc , etc

I look forward to many more epiphanies.
Really great to talk with you guys.,

[GenePoole0304]

manopause.... for lack of a better term andropause

Well I think the remark you made on we must include if we are weight stable is very important as it will affect trigs.
IR also seems to be affected by % of bodyfat with the lower the better but it creeps up with age and other than CR one can try increasing lean muscle mass as it is more metabolically active.

I would caution even with high nut intake over short periods as any O6's can be inflammatory just have an OmegaIndex test.
O3's although they might not be as beneficial for us does not mean we should avoid them in the context above mentioned.

[GenePoole0304]

"Both for this pages stuff and for my 3 months of vegan eating to make sure I'm not lacking Bs, zinc , etc"
the list is epic.
any diet where you have to check for deficiencies is not good and the vegan diet needs supplementation which too few can do correctly, beside free living people were never doing this so it is bound to fail in it modern form, not saying it might have some useful aspects but to me it is just as artificial as eating a TV diner.
I watched Don Matesz eating a handful of bananas after exercising, yep a sugar tube if there ever was a more natural monkey staple the western adopted.
http://donmatesz.blogspot.com/2015/12/m ... bodhi.html

Read Rob Wolf's book as he tried the vegan diet which tanked his health.

[Stavia]

Riley honey heaps of excellent questions and points.
Glad you've realised we're not Atkins and high sat fat!

Yes, exercise is crucial because of BDNF. It needs to be most days and probably at least 30 mins getting puffed out. Nobody has done the science to see exactly how much but thats the most likely amount.

Secondly glycaemic control is critical for many reasons - see my summary in the newcomers forum, I've summarised the evidence. It should be your top priority, rather than worrying about lipid subfractions. Metformin appears currently to be at least safe and possibly extends life.

Ketosis isnt alkalosis. Youre thinking about diabetic ketoacidosis which is a completely differnt beast and not related in the slightest. It's about generating ketones (by fasting, exercise or lowering carbs/increasing fat or all three ) which are then used as mitochondrial fuel - this is good because apoe4s hoave a real, documented problem with our mitochondria where we cant use glucose properly, thus stressing the brain tissues generating free radicals and causing tissue damage. Please have a look at my section on this in my summary, A low level of ketones can bridge the ~10% gap we have. There is no danger in running at low levels of ketones. It happens anyway after a time fasting. This is not pop science or bro science.

Animal protein - I personally eat mainly fish or seafood. There is no true evidence about what level animal protein is safe. If someone says they have the "truth" its just their bias. Beware dogmatism. However evidence points that higher saturated fat increases rates of dementia and apoe4 has a problem with lipids already. So most of us limit our staurated fat which means we limit animal products, not fish for many of us though because omega 3s seem to be critical for us. Its in my summary why.

Please let us know which study you refer to in the brachial artery. All fat is not equal. Id like to see exactly what the food was. I'll bet it wasnt MUFA which most of us prioritise.

It's not impossible to keep vegetable oil out of a diet - many of us do. I only cook with olive oil and hardly ever eat out. Some of us take our own little bottle of oilve oil to put on salads in restaurants.

Yiu talk about plaque in arteries. Please have a look at my link to lipid metabolism in my summary, its extremely complex. What we eat does not reach our arteries unchanged. The lipid molecules undergo digestion and repackaging before hitting our arteries. And lipids make up cell walls, and omega3s are critical for this. Its a much bigger picture than just fat going from our food directly to our arteries.

So...you have made heaps of excellent points! Everything you have learned so far in your career is not necessarily transferable to apoe4s, and especially 4/4s like myself. It took me a year to get my head around the science, and Im a doctor already, it's complicated and boy, the devil is in the detail! My head spun, and I had to relearn lipid metabolism, Krebs cycle, etc from scratch. Hard work.

Great discussing stuff!

[Gilgamesh]

Let's move the question of high-fat diets and endothelial function to new thread, High-fat diets and flow-mediated dilation.

G

[Julie G]

I do eat avocado, nuts and olives.
These to me are natural foods that are far different from concentrated oils.Although in limitation because of the high calorie.

Hmmm, Interesting disconnect from Esselstyn’s approach. While I like hearing about your dietary perspective, Riley, I worry, that it may not adequately meet the special needs of E4 carriers. As Gene points out, we have no examples of indigenous people eating a completely vegan diet. We also have strong hints that specific biomarkers and serum levels of some vitamins (Omega-3 index, homocysteine, vitamins D, A, K) that may be very important to optimize for our population are impossible to do with a completely plant-based diet, especially one very low in dietary fat. That being said, with smart supplementation and the use of some plant fats, I think it’s possible to remain vegan and still meet biomarker goals.

FWIW, the vast majority of folks here eat a largely plant-based diet with strategic supplementation of some animal products. Many of us also use some supplements to optimize biomarkers.

The optimal amount of dietary fat for E4 carriers is completely up in the air. It’s one of the big unanswered questions for our population. We have lots of evidence that the E4 allele leads to disturbed lipid transportation and homeostasis, but no perfect solutions yet. I’ve created a couple of (woefully neglected) threads to collect information. PLEASE feel free to add to them.

Evidence in Favor of a Low Fat Diet
viewtopic.php?f=6&t=178&hilit=evidence+ ... ry+low+fat

Evidence in Favor of a High Fat Diet
viewtopic.php?f=6&t=179&hilit=evidence+ ... h+fat+diet

[Stavia]

Agreed Julie.
And I'd also like to add that it doesn't have to be high fat vs low fat. I personally sit between 30 and 50%, with daily variation but keeping sat fat as low as possible, as it's sustainable and seems to give me acceptable biomarkers.
Raising the fat% from low (less than 20%) certainly raised my HDL, didnt raise my LDL, and plummeted my BMI and HbA1C.