new e3/e4

Newcomer introductions, personal anecdotes, caregiver issues, lab results, and n=1 experimentation.
MAC
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Re: new e3/e4

Postby MAC » Sat Sep 03, 2016 9:09 am

TheresaB,

I don't view your protocol as extreme IF there is an absolute connection to direct cognitive (ie, lack of brain destruction) benefit. Who would not follow this regiment if told categorically it would help prevent looming cognitive disease??!!

Do you have a baseline cognitive performance and are you tracking ongoing for a feedback loop?

Being southern mediterranean, some of your dietary restrictions yes are "severe", but not exceptionally in my mind. The challenge is that my life is not centered on me, but my family, immediate family, and social circle: mostly mediterranean, relatively young, and NO ONE is practicing any type of major dietary restrictions (my daughter is Vegan, my brother in law is gluten free).

Avoiding carbs (bread and pasta) although perhaps difficult, is really not that hard: eat more veggies to get some sustenance. No meat, dairy or cheese, yes a bit extreme, but I hate milk, but love fish, so moving more towards a fish centric diet wouldn't be hard for me.

You mention shellfish 1st priority intake and then white fish...can I consider all fish good to eat in the context of replacing meat? I mostly eat white fish or salmon?

The fasting period (16 hrs) is extreme for me I think.

Taking all these supplements, again extreme for most people, I concur. Are there 1 or 2 you consider MUST?

I am making slow pivots toward this type of lifestyle change, in the "generally healthier" context, motivated by parents history, and my own 3/4 diagnosis.
MAC
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Re: new e3/e4

Postby ru442 » Sat Sep 03, 2016 9:31 am

MAC wrote:Avoiding carbs (bread and pasta) although perhaps difficult, is really not that hard: eat more veggies to get some sustenance. No meat, dairy or cheese, yes a bit extreme, but I hate milk, but love fish, so moving more towards a fish centric diet wouldn't be hard for me.


Avoiding complex carbs is important especially if you are IR, and adding bulk with veggies and nuts really helps with this. Many here have to restrict calories so that may play a part in your plan (not sure on your BMI or if you have weight issues). I personally don't restrict my calories, I eat until I am full, which usually involves a Jethro Bodeen size salad bowl (if you've watched the Beverly Hillbilly's you know what I am talking about!).

MAC wrote:You mention shellfish 1st priority intake and then white fish...can I consider all fish good to eat in the context of replacing meat? I mostly eat white fish or salmon?


I eat a lot of shellfish when it's affordable... shimp is generally cheap, but I also buy crab, lobster, scallops etc. when it is on sale at the local supermarket or online (http://www.fultonfishmarket.com/ in Chicago... they deliver). When I don't feel like shellfish I trend toward cod fish, and pepper in some salmon. My new favorite is Arctic Char... extremely mild and full of great fat.

MAC wrote:The fasting period (16 hrs) is extreme for me I think.


Trust me this gets easier as you take the journey... my first couple months I had to eat 3 times a day, and I had to snack in between (some nuts, avocados etc. to feel full). Then you find yourself not being hungry in the morning... and by lunch time you are ready to eat. In general I eat my last meal by 8pm, and then my first meal is lunch 16 hours later.
Male 4/4 56 yrs., "Live, Laugh, Love"

MAC
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Re: new e3/e4

Postby MAC » Sat Sep 03, 2016 9:37 am

ru442,

I have NO baseline functional bloodwork to reference. On the IR, how is this determined and if NOT IR, then does that change the carbohydrate management, or just reduce just because it's better for you?

Eating more fish and nuts and healthy veggies, not an issue.

I read on the SUPPLEMENTS section that taking fish oil supplements is NOT good for E4 carriers, so how to reconcile with eating more fish?
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Re: new e3/e4

Postby Tincup » Sat Sep 03, 2016 9:47 am

MAC wrote:ru442,
I have NO baseline functional bloodwork to reference. On the IR, how is this determined and if NOT IR, then does that change the carbohydrate management, or just reduce just because it's better for you?


Dr Kraft's data suggest that 80% of those who have a normal glucose response on an oral glucose tolerance test have an abnormal insulin response. This presages future IR & T2. Without going to the trouble of a full blown oral glucose tolerance test with insulin assay, a fasting insulin <5 probably puts you in the clear.

MAC wrote:I read on the SUPPLEMENTS section that taking fish oil supplements is NOT good for E4 carriers, so how to reconcile with eating more fish?


Dr. Gundry specifically prescribes 1g/day of DHA for us as E4's. I think there can be an issue with bleeds with male E4/4's. Gundry tests us and wants us between 10-12 on the Omega 3 Index.

On time restricted feeding, this is an excellent interview. The concept appears to be a very powerful metabolic tool.
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Re: new e3/e4

Postby MAC » Sat Sep 03, 2016 10:10 am

GeorgeN, can I have these tests prescribed in a routine physical bloodwork, or are these specialized tests?

Re time restricted feeding, fascinating stuff. A lot of this epigenetic stuff seems paleo connected...did our ancestors have less AD??!!
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Re: new e3/e4

Postby SusanJ » Sat Sep 03, 2016 10:30 am

MAC, no one knows if our ancestors had less AD - aging is a top risk factor for AD and our distant ancestors just didn't live that long. Even more recently, from 1800-1850, the average life expectancy in the US was 37! And if any Paleo blogger makes that claim, run the other way.

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Re: new e3/e4

Postby MAC » Sat Sep 03, 2016 10:35 am

SusanJ, right, if life expectancy is much less than traditional LOAD onset, we'd never know. I've read in many articles that looking at 2nd/3rd world AD is risky since life expectancy is so low, in the context of trying to correlate E/E genetics and lifestyle to LOAD.
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Re: new e3/e4

Postby TheresaB » Sat Sep 03, 2016 10:37 am

Mac,

No cognitive baseline. We got into this after learning of our ApoE status, not because of any noticeable cognitive decline, so we haven't especially been motivated for that.

Two absolute supplements - I guess I would say fish oil for 1000 mg of DHA and Niacinimide. But that's a TOUGH QUESTION!

To be honest, I don't understand the biological rationale behind all the supplements I take, and much of what I take is based on what I need (blood test results). I take the niacinimide because Dr Gundry recommended it to us for brain health in our very first consult, not as a result of any biomarker, yet he didn't mention it in his presentation at the Ancestral Health Symposium. In addition to fish oil, his presentation recommended certain supplements because they're cheap, easy to get, and beneficial for Apoe4s: Grape Seed extract and Tumeric. (He ususally cites pycogenol too, but didn't in his presentation). Grape seed extract ameliorates fructose induced hypertriglyceridemia in rats. I started taking curcumin (tumeric) to try to reduce the swelling in my foot, only later did I learn there's a benefit to my brain!

I need to supplement my Vitamin D because my level was low, but if it wasn’t low, supplementing would be a waste of money. Similarly with B-12 and with fish oil, some folks don't need to take it.

I take methylfolate because I have two half mutations of the MTHFR gene which makes me a poor methylator so I need to try to keep my homocysteine down. (homocysteine - dementia connection). Knowing what I know, I wouldn't give up the methylfolate, but do I recommend it for everyone? No.

I take Modified Citrus Pectin, psyllium, and Schiff's Digestive Advantage to try to build up the good bugs in my gut (gut-brain connection) because I've had three foot surgeries and nasty ear infection over the past four years for which I was prescribed antibiotics and pain killers. So while I've felt okay, I can't help but think after all those prescribed pills, my gut biome needs help.

Which, oh by the way, on the subject of gut biome, if you feel the need to address it, first I recommend watching this presentation, "Do You Really Want A Hunter Gatherer Microbiota? Pearls and Pitfalls for Your Gut Health" by Dr. Michael Ruscio, a functional medicine doctor.
https://www.youtube.com/watch?v=69ePHDbbNoQ Rather than just following the prevailing attitude that everyone should add fiber and probiotics to enhance their microbiome, he offers a voice of reason, advising caution with specific examples as to how to go about this, since this "one size fits all" advice can make some feel worse. He discusses tailoring diets according to symptoms.

In addition to supplements and other things, Dr Gundry explains why shellfish is his preferred source of animal protein in his Ancestral Health Symposium presentation and during the Q&A session that followed. https://www.youtube.com/watch?v=Bfr9RPq0HFg But I can talk about that later after I get back from my walk.
-Theresa
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Re: new e3/e4

Postby Nancy » Sat Sep 03, 2016 10:38 am

Mac, I too grew up on the Mediterranean diet, so the Stavia/Bredesen/Gundry ways of eating are not all that difficult for me, either. That is a huge plus. We are doing this for our families, another powerful motivator. You seem like an intelligent, determined person. I believe you will thrive with your new information.
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Re: new e3/e4

Postby Tincup » Sat Sep 03, 2016 11:57 am

MAC wrote:GeorgeN, can I have these tests prescribed in a routine physical bloodwork, or are these specialized tests?

Re time restricted feeding, fascinating stuff. A lot of this epigenetic stuff seems paleo connected...did our ancestors have less AD??!!


You should be able to ask for fasting insulin, that is pretty routine, though you'd have to ask for it. If you are in US, you can order yourself and get drawn at a LabCorp location. Again in the US, here is info on an oral glucose tolerance test with insulin assay.

One way to look at our gene is one that a) is more inflammatory; b) survives deprivation better; and c) does not do well with excess. I interpret this to mean my genetics are not well matched to my current environment. Hence I make a choice to put myself in a state of relative deprivation and less abundance. I try to minimize inflammation as indicated on Gundry's tests as much as possible. As discussed here, the incidence of E4's is much lower where agriculture developed and increases as you move north or south from there. So those with your heritage would be less likely to be carriers.
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