Drae's got Labs!

[Julie G]

Set it to 1 pound per week, agreeing with Gundry that the faster it comes off the faster it comes back.

Very reasonable, drae. I suspect I speak for many when I say I'm blown away by the many positive changes you are making in such a short period. You exemplify what we represent. -xo

Interestingly, ketosis offers smaller gains in cognitive performance to APOE4 carriers with Alzheimer's than to non-carriers with Alzheimer's.

https://www.ncbi.nlm.nih.gov/pmc/articl ... figure/F4/

Searcher, look at Figure 3 of the Henderson paper. After 90 days of treatment the highest BHB reading was 0.4 mM. That’s pitifully low and not even in the ballpark of what Dr. Bredesen recommends. The interesting point is that even that tiny amount was able to exert a positive cognitive effect on non-E4 carriers. We can guess that E4 homozygotes, who are at a much greater disadvantage in terms of a neuronal fuel shortfall, may need more For instance, I wake up with 0.8 and often get to to 3.0mM through the day by combining fasting, exercise, and a low carb diet. Cunnane has demonstrated in this paper that KBs can replace some part of that neuronal shortfall. What we don’t know is if this will be enough to prevent (or overcome) AD. We just don’t have the studies.

Re. your concern about MCT, I think it’s leap to extrapolate a mouse study to humans, but completely respect that you’re convinced. Either way, Dr. Bredesen considers insulin resistance, combined with cognitive decline, to be a medical emergency *a neuronal fuel crisis* and he recommends the use of MCT for a short transitional period while his patients heal. Using this method (combined with fasting, exercising, and a low carb diet) he’s been able to restore insulin sensitivity and improve cognition.

[Searcher]

Re. your concern about MCT, I think it’s leap to extrapolate a mouse study to humans

Julie, it's not a mouse study at all. It's a study in humans.

Here it is again:

Long- and Medium-Chain Fatty Acids Induce Insulin Resistance to a Similar Extent in Humans Despite Marked Differences in Muscle Fat Accumulation

https://academic.oup.com/jcem/article/97/1/208/2833397

Sometimes a favorable outcome happens in spite of an intervention, and sometimes because of it. The only way to know is to grasp the underlying biology. Scientific studies such as this one help us understand what's really going on. It's only through science that we can hope to keep updating our knowledge and practices.

[alangreenmd]

Hi Drae,
My opinion, only number you should worry about is the "48" unless that is cm. Otherwise, you have excellent diet. Check a chart for estimate daily calories required. Then eat 30% less each day until waist hip ratio is 0.8. And walk 30 minutes at least 5 times a week.

[Julie G]

My bad, Searcher. I got sidetracked by one of the references. Once again, I appreciate that you're convinced that MCT will cause IR, but I suspect the way Dr. Bredesen is using it is vastly different than an acute IV infusion. Perhaps the effect is different as well? FWIW, I don't use MCT because of the potential for negative advanced lipids, but have seen its short term use help others heal from IR.

[Searcher]

My bad, Searcher. I got sidetracked by one of the references. Once again, I appreciate that you're convinced that MCT will cause IR,

Julie, that's an understandable mistake. I'm prone to making far worse mistakes myself.

My being convinced has little to do with it. The scientific evidence is what matters. In the case of saturated fats (including MCT) CAUSING insulin resistance, the evidence is clear at several levels. From the intra-cellular to the systemic to the epidemiological. Nobody need suffer that particular adverse effect of saturated fats (including MCT) unnecessarily. Least of all APOE4 carriers.

Anecdotes are notoriously unreliable. Outcomes which occur despite an intervention can easily be attributed to the intervention. We have scientific processes to help us refute such errors.

You are wise to avoid MCT. Evidence obtained through scientific processes backs your decision.

If anyone wants to develop insulin resistance in a hurry, just advise them to eat lots of saturated fat (such as MCT). The more they eat, the more likely they are to succeed at this life-sapping goal. Eating unsaturated fats, by contrast, enriches life in many ways. You know this already.

[Jan]

Only thing to add to the fabulous replies already given is a hearty congratulations, drae, for more and more progress.

[Tincup]

If anyone wants to develop insulin resistance in a hurry, just advise them to eat lots of saturated fat (such as MCT). The more they eat, the more likely they are to succeed at this life-sapping goal. Eating unsaturated fats, by contrast, enriches life in many ways. You know this already.

Not talking about E4's specifically, but I have a large cohort of friends who eat huge quantities of sat fat, in the context of low carb or keto diets. They are anything but IR. Most of them have A1C's < 5.0%. Most sat fat studies I've observed are confounded by a large intake of carbs in addition to the fats.

This includes myself. I used to eat large quantities of sat fat prior to learning my E4 status in 2014. I was not IR by any stretch of the imagination. While Dr. Gundry's clinical experience indicates that sat fats are not ideal for E4's because they can increase sdLDL and oxLDL, increasing IR is not part of that experience.

I tracked my food with a gram scale for two weeks last March. My average fat intake was 175g/day, of which 25g was sat fat. Now none of the sat fat was from MCT's or animals other than from eggs, white fish or shell fish. Results from labs eating this way were A1C 4.6%, fasting insulin 2.0. Not sure if you think 25g/day is high, but I'm not IR. My BMI is 25 and my body fat, by DEXA is in the 1st percentile for my age (62).

[Searcher]

I have a large cohort of friends who eat huge quantities of sat fat, in the context of low carb or keto diets. They are anything but IR.

Tincup, in a low-carb diet, the insulin resistance induced by high saturated fat intake shows up in the response to a glucose tolerance test.

[drae]

Okay, I got a little busy, mostly with all this, so still need to re-read and go through the links you have all been so kind to provide.

In the meantime, I have eaten fewer carbs and tracked my food on cronometer one day. I only managed to eat 67 grams of carbs and I was trying to get closer to 100.

Here's today's question: would it be safer for me to go get a glucose meter now (can't afford the keto meter yet). Safer, that is, that just depending on eating low carb to keep my blood sugar down, or, should I be watching to see that I'm not doing other things that drive it up?

Stavia, I am not against your suggestion of a doctor and possible metformin, just would prefer to do it with food and exercise if that is possible and safe. I'm glad you mentioned that; I had not thought of it.

Thanks, all! Kinda taking the rest of the day off. =)

Drae

[Stavia]

Drae, I believe that if you eat as one of your proposed plans there is no hurry for a glucose meter. Your best indicator of success will be weight loss. A tape measure or scale is all you really need now as your budget is tight. Would you qualify for a funded glucose meter as you now test diabetic?
But testing your glucose isn't going to change anything during this transition phase in my view.
Baby steps Drae. Big picture.

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