Hello! I have some burning questions for the ApoE4ers...

[DaveKeto]

Hi guys —

I’m a 3/4. There’s really no way to introduce myself and share my numbers without telling a pretty long story. Probably the best shortened version is — I have extremely high cholesterol numbers after going on a low carb diet, did a lot (and still doing) a lot of research, then started (and still am doing) a very controlled, very detailed N=1 experiment.

As an engineer I saw a familiar network model pattern with the lipid system and started testing against it with my own blood. Since November last year I’ve had 17 NMRs and am now very familiar with the pattern.

Thus, I’m not so much here for advice/support as much as it is research for these final stages before I release my data. If I could ask a few questions to the wonderful members here:

— Are there a high frequency of people here who go on a low carb diet and are 3/4 or 4/4 that had “normal” cholesterol before starting, and very high once into the diet?

— Are there people here who have chosen not to go on cholesterol lowing drugs or other measures long term and report back a dramatic jump in their cIMT, CAC, or other associated risk of CVD? (Again, only in the context of low carb)

— Other than heart disease, what else would be considered a higher risk for someone with ApoE4 who is also on a low carb diet?


Thanks so much in advance!

[Julie G]

Welcome Dave. Wow- seventeen NMRs in such a short period! I look forward to seeing your data whenever you're ready to release it. I'm quite curious to see if it dovetails with patterns we see here.

— Are there a high frequency of people here who go on a low carb diet and are 3/4 or 4/4 that had “normal” cholesterol before starting, and very high once into the diet?

The short answer is YES although we have some outliers. Some of the lucky ones are discordant in a good way; elevated LDL-C, but still maintain low LDL-P. Through several years of lipid/diet interactions, we’ve devised some strategies that move lipids in this direction. You may have as well?

— Are there people here who have chosen not to go on cholesterol lowing drugs or other measures long term and report back a dramatic jump in their cIMT, CAC, or other associated risk of CVD? (Again, only in the context of low carb)

Our members have had mixed results.

— Other than heart disease, what else would be considered a higher risk for someone with ApoE4 who is also on a low carb
diet

To clarify, the question you’re asking is what other risk a low carb diet poses to Apoe4+ individuals? Cardiovascular disease is the biggie, with vascular dementia going hand-in-hand. Of course, as you’re aware (given your name ,) there are also many benefits to be gleaned if it’s used carefully. We love long stories whenever you're ready...

[Tincup]

Dave,

I'm 3/4, also engineer. On a LFHC vegan diet (20 years) had TC~150, HDL~40, TG~50, LDL~90. Much higher numbers on keto diet (keto adapted ~6.5 years). It was this that spurred me to test for ApoE4. My vegan years also brought insulin resistance, despite being very fit.

Short answer is, I decided Dr. Steve Gundry's approach had merit. My 4/4 wife and I both follow it. Gundry's (~8 pages of) tests report the NMR results. He ignores them (says the only point to them is to encourage people to take statins). Only wants sdLDL < 30 md/dL and Tg/HDL < 1 with Tg ideally being <50. He also tests a plethora of inflammatory markers, cardiac and otherwise. My wife and I are stellar on all these. Is he right? I don't know. He has an excellent track record of keeping cardiac risk patients healthy and he told me that 30% iof his patients have at least 1 E4 allele. Engineer blogger Ivor Cummings (FatEmoporer) has done a good job showing, that these elevated markers are really surrogates for insulin levels and the risk interpretations don't apply to low carbers. I'm traveling, so don't have time to chase down links.



I posted on our initial meeting with Dr. G in the Gundry thread https://www.apoe4.info/forums/viewtopic ... 270#p16389. Some day, when I'm not busy, I'll post the update we had in January.

He has noticed that animal fat spikes sdLDL in E4's. For E4's he allows us whitefish, shellfish or omega3/pastured eggs (with a 20g/day animal protein) limit. My total protein is ~60g/day, carbs 90g/day with 50 of those being fiber. About 80% of my calories are from fat. I typically test 0.5 - 2 mmol/L serum ketones. On breath acetone, runs 45-60 ppm. I fast 22 hours/day.

[marthaNH]

My experience. HDL has always been kind of high, at least since adulthood, LDL started to creep up about 10 years ago (now age 60, female). My LDL (by any measure, particle or LDL-C) clearly responds to animal fat short term, and went from borderline/high on a low-carb, high fat diet that included cream, butter, cheese, and pork to 118 (LDL-C) and 983 (LDL-P) when I cut saturated fat back to between 7 and 9 grams per day. Good luck with your data. Numbers stay in similar range with fat at 50 to 65% of calories, a little bit of a caloric deficit most of the time.

[DaveKeto]

Welcome Dave. Wow- seventeen NMRs in such a short period! I look forward to seeing your data whenever you're ready to release it. I'm quite curious to see if it dovetails with patterns we see here.

Yes, all these blood draws appear to be paying off. Let's just say this data really is unlike anything I've read or come across since starting this journey. But I honestly don't think I'd have come at it from this angle were I not already deeply entrenched in networks and object oriented programming.

The short answer is YES. Some of the lucky ones are discordant in a good way; elevated LDL-C, but still maintain low LDL-P. Through several years of lipid/diet interactions, we’ve devised some strategies that move lipids in this direction. You may have as well?

That's the thing -- we may disagree on the "right" direction. The theory I'm testing against wraps the hypotheses that the ApoE allele is a kind of genetic configuration file for the lipid system (among several other systems in the body). This isn't to say that it isn't atherogenic on net, only that I'm more interested in its outcome involving all cause mortality with regard to a low carb, low inflammatory diet.

Our members have had mixed results.

This is a super important question. But I realize we are a long way from getting it answered other than through a sporadic convenience sampling. Too few people are on low carb diets to start, with only a subset of those potentially having ApoE4 cholesterol responses -- and to boot, there's no product or medical value to extract for doing the study, so there likely wouldn't be money to behind making it happen anyway.

To clarify, the question you’re asking is what other risk a low carb diet poses to Apoe4+ individuals? Cardiovascular disease is the biggie, with vascular dementia going hand-in-hand. Of course, as you’re aware (given your name ,) there are also many benefits to be gleaned if it’s used carefully. We love long stories whenever you're ready...

That's pretty close to what I find myself so far. The key difference is that I may be one of only a few that might consider it possible this is actual proper alignment.

[DaveKeto]

Dave,

I'm 3/4, also engineer. On a LFHC vegan diet (20 years) had TC~150, HDL~40, TG~50, LDL~90. Much higher numbers on keto diet (keto adapted ~6.5 years). It was this that spurred me to test for ApoE4. My vegan years also brought insulin resistance, despite being very fit.

Short answer is, I decided Dr. Steve Gundry's approach had merit. My 4/4 wife and I both follow it. Gundry's (~8 pages of) tests report the NMR results. He ignores them (says the only point to them is to encourage people to take statins). Only wants sdLDL < 30 md/dL and Tg/HDL < 1 with Tg ideally being <50. He also tests a plethora of inflammatory markers, cardiac and otherwise. My wife and I are stellar on all these. Is he right? I don't know. He has an excellent track record of keeping cardiac risk patients healthy and he told me that 30% iof his patients have at least 1 E4 allele. Engineer blogger Ivor Cummings (FatEmoporer) has done a good job showing, that these elevated markers are really surrogates for insulin levels and the risk interpretations don't apply to low carbers. I'm traveling, so don't have time to chase down links.

I'm very, very much of the same belief. Speaking engineer-to-engineer, I have to tell you that the system beyond Lipoproteins is one of the most fascinating and sophisticated object networks I've seen. Which is why the more I learned about it, the less the lipid hypothesis made sense. Here you have a multi-class, multi-stage, and multi-use organic device that was crafted over thousands of generations in the animal kingdom -- and somehow it has an overlooked defect of blowing up at random the endothelium? C'mon. (Again, I figure an engineer in particular could appreciate how that doesn't pass the sniff test.)

I posted on our initial meeting with Dr. G in the Gundry thread https://www.apoe4.info/forums/viewtopic ... 270#p16389. Some day, when I'm not busy, I'll post the update we had in January.

He has noticed that animal fat spikes sdLDL in E4's. For E4's he allows us whitefish, shellfish or omega3/pastured eggs (with a 20g/day animal protein) limit. My total protein is ~60g/day, carbs 90g/day with 50 of those being fiber. About 80% of my calories are from fat. I typically test 0.5 - 2 mmol/L serum ketones. On breath acetone, runs 45-60 ppm. I fast 22 hours/day.

I generally hover around 23g net carbs, 140g protein, 185g fat. I too test my ketones each morning and come in around .8-2.2. But it depends on how much time there was between when I ate last and went to sleep the night before.

You'll be particularly interested in what my data shows with sdLDL when I have it up.

[DaveKeto]

My experience. HDL has always been kind of high, at least since adulthood, LDL started to creep up about 10 years ago (now age 60, female). My LDL (by any measure, particle or LDL-C) clearly responds to animal fat short term, and went from borderline/high on a low-carb, high fat diet that included cream, butter, cheese, and pork to 118 (LDL-C) and 983 (LDL-P) when I cut saturated fat back to between 7 and 9 grams per day. Good luck with your data. Numbers stay in similar range with fat at 50 to 65% of calories, a little bit of a caloric deficit most of the time.

My whole life I've had a particular craving for meat. This might be due to ingrained rebellion at my mom and dad's frequent vegetarian cooking (never count out childhood issues :p).

With one 11 day period for a test I went heavy on monounsaturated fats in replacing saturated and generally animal fats. Interestingly, I felt much more lethargic and run down. My vegan friends said I needed more time to adjust. But to my surprise, right after I took the blood test and was able to go back to meat and SF, I had a very noticeable burst of energy that lasted over two days.

[Stavia]

Hi Dave
Here is an n=1 data point for you. I am a 55 yr old e4/e4 female.
Use to eat low fat high carb for many years. My low HDL bugged me consistently, I couldn’t get it higher with exercise or alcohol lol.

2010: you can do the conversion.
Cholesterol: 4.7 mmol/L ( < 5.0 )
Triglyceride: 0.9 mmol/L ( < 2.0 )
HDL Cholesterol: 0.78 mmol/L ( > 1.00 ) L
LDL cholesterol: 3.5 mmol/L ( < 3.0 ) H
Chol/HDL Ratio: 6.0 ( < 4.5 ) H

Then went onto high fat low carb nutritional ketosis (between 0.3 and 0.6 mmol/l). I do eat very little sat fat though. About 1gram per kg protein. I also feel bleh if I don’t have enough protein. But I eat mainly fish, chicken, mussels.

2016 results (just one reading out of about 10, all very similar)
Cholesterol: 5.0 mmol/L ( < 5.0 ) H
Triglyceride: 0.6 mmol/L ( < 2.0 )
HDL Cholesterol: 1.24 mmol/L ( > 1.00 )
LDL cholesterol: 3.5 mmol/L ( < 3.4 ) H
Chol/HDL Ratio: 4.0 ( < 4.5 )

My apoB is 0.89g/L. (range 0.49-1.05)
No NMR in my country. But I see that this apoB correlated with a particle count of about 1200.

So in answer to your question, no my LDL did not go up at all on swapping from LFHC to HFLC.
Clearly the system you are working on modelling is extremely complex and likely specific to each individual person.

edit: lol I see our labs changed the reference range for the LDL since 2010. Interesting.

[Russ]

I'm very, very much of the same belief. Speaking engineer-to-engineer, I have to tell you that the system beyond Lipoproteins is one of the most fascinating and sophisticated object networks I've seen. Which is why the more I learned about it, the less the lipid hypothesis made sense. Here you have a multi-class, multi-stage, and multi-use organic device that was crafted over thousands of generations in the animal kingdom -- and somehow it has an overlooked defect of blowing up at random the endothelium? C'mon. (Again, I figure an engineer in particular could appreciate how that doesn't pass the sniff test.)

You'll be particularly interested in what my data shows with sdLDL when I have it up.

Glad to have another engineering mind in the game . I do, indeed, look forward to your seeing data and analysis.

[apod]

Hi Dave, fellow E3/E4 here. I'll be curious to read what you discover as you travel further down this path with a scientific mind. Eventually, I'm hoping to get in for a 3rd data point on my advanced lipid numbers.

Before learning E4 status and altering diet, my TC was at 186 with TG:155 and HDL at 52. I went high-fat / low carb and cleaned up my diet and added on exercise, then TC bumped up to 199 with TG:59 and HDL at 71 (LDL-P: 1,322.) I didn't like seeing LDL-P over 1300, so I tweaked my approach to a low-fat + high-carb exercise day (hypercaloric, fairly high in fructose/sugar) and moderate-fat + low-carb rest day (hypocaloric) while keeping SFA < 15g/d by nearly eliminating animal fat / coconut fat and limiting overall SFA from fruit/nuts/seeds. This dropped TC to 132 with LDL:63, HDL:58, TG:56, LDL-P:908.

For a 3rd data point, I'm soon measuring the effects of a high-fiber, high-unsaturated fat diet (minimal animal SFA, total SFA ~20g/d) with moderate carbs averaging around 70-90g fiber/day and 90-150g net carbs, or trying to get back in to a deeper ketogenic state with SFA bumping up toward 30g/d as a consequence of MUFA-rich fruit+nut fats at closer to 50-60g fiber/d and 30-60g net carbs. With intermittent fasting, my serum ketones rise up to ~0.4-0.6mmol between meals while consuming 90-150g net carbs. I feel like somewhere in there is going to be the sweet spot for me.

With regard to cognitive function / energy, I feel great on a high fat / very low carb diet (but it seems like LDL-P, LDL-C, and TC goes up.) On the other hand, I seem to respond quite well to reducing SFA / upping carbohydrates (LDL-P goes down, LDL-C goes down, HDL-C doesn't dip too much, TG stays low), but I lose some of the low-carb mental / energy magic. And then.. looking at protein, I respond very well to hypercaloric servings of carbs+proteins for adding lean mass + strength, but theoretically I don't think this is optimal when thinking about longevity / gene expression. So, I find myself in a sort of limbo at times with 3 somewhat opposing goals. Things were a lot simpler when I was just eating real food when hungry.

Paul Jaminet has an interesting write up on low-carb + low-protein diets (where the calories of carb+protein dip < 600):
http://perfecthealthdiet.com/category/d ... eficiency/

As well as low-carb diets and increasing LDL:
http://perfecthealthdiet.com/2011/03/lo ... 0%93-help/
http://perfecthealthdiet.com/2011/03/an ... arb-paleo/

And some information on low-carb diets affecting thyroid health:
http://perfecthealthdiet.com/2011/09/hi ... e-thyroid/

This might give you a few other ideas to investigate. Good luck!