Updated NMR LipoProfile results

[James]

Here are some updated results, both basically the same very-low-fat [CFP 72/14/14]. Here are my past results for comparison.

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           - 6/11/2014 - 6/23/2014
Chol/HDL-C - 3.4 - 3.5
Triglycerides - 106 - 87
Cholesterol, total - 116 - 112
HDL-C - 34 - 32
LDL-C - 61 - 63
LDL-P - 646 - 884
HDL-P - 25.2 - 24.6
Small LDL-P - 473 - 629
LDL Size - 20.2 - 20.2
LP-IR Score - 38 - 47

I could explain some minor differences in diets between these (and my other) tests, but I think it's pretty obvious that most of these seem largely unaffected by diet so long as long as I stick to the variables that were unchanged across trials: 1) I maintain a mostly whole-foods vegan diet, 2) stay weight-stable or mildly CRed, 3) maintain some amount of physical activity and/or stay lean. I think that these are in order of importance based on my results and published literature.

Across the vegan tests I've varied alcohol, amount and sources of fats (flaxseed, nuts, olive oil, 100% cacao chocolate, and soy products), amount and sources of carbs (fruit, grains/starch, bread, with veggies constant), sources of protein (protein powder, beans/grains, and soy products), ratios of macronutrients (15-30% fat and 55-70% carbs, with protein always around 15%), and alcohol intake (from 40g alcohol/day to none).

[Russ]

James,

How confident are you that numbers that low are actually good for your long term health as an E4?

Russ

[Janpeter]

If the only goal is lowering cholesterol than a LF diet like this is the obvious route to take. As lipid numbers are easily ascertainable, and still the focus of the medical establishment and big Pharma, it is tempting to make them the focus of gauging one's health status. They may well be, but the arc of recent studies is trending against this view.

I think eating a healthy LC diet, knowing that cholesterol may stay high, and testing for other markers to see if CVD is taking hold is another route that may ultimately be more neuro-protective. Despite my "so called horrific" LDL-P of 3000, my very recent calcium score ( I'm 48) is less than 20. My A1ac is perfect and my CRP ( I'm aware of the APOE4 effect) numbers are extremely low. So for now I am done doing the NMR chase down the proverbial rabbit hole. Homocystein and other markers of course not.

But this is a HUGE question for all us in APOE4 club to grapple with.

For me I still think Alzheimers is a worse, and more untreatable disease, than is heart disease. I am currently somewhat biased towards the view that higher cholesterol is neuro-protective. But I will see were the science takes us ( hopefully) on this question.

[James]

Veganism aside (although I believe dietary cholesterol plays a bigger role for most with ApoE4), a mostly whole-foods and plant-based diet is absolutely the best dietary approach. If you eat meat and animal products they should be an accompaniment to a plant-heavy diet rather than the primary portion. The amount of dietary fat seems to be far less important in this context. My own results, and published literature, seem to support this, though there are always individual differences to consider.

I am quite confident that my diet and my LipoProfile results give me the lowest possible risk for Alzheimer's and CVD. Mechanistically, the basic premise of the lipid hypothesis has overwhelming supporting evidence. Dietary modification of the lipid profile has a much better track record than modification though medications, and I am confident that the improvements in my lipid profile after switching to a mostly whole-foods vegan diet accurately indicate significantly reduced risk of disease.

On top of an extremely good lipid profile, I have phenomenal fasting and postprandial glucose, markers of inflammation, blood pressure, and CBC/other blood tests, although I'm active and maintain a mild calorie restriction. Interventional, epidemiological, and historical studies overwhelmingly support a whole-foods, plant-based diet for optimal metabolic health and low occurrence of related diseases, so biomarkers aside I still feel confident that I am maximizing my capacity for healthy aging. Sure, it would help to have hard data about CVD and dementia pathologies (CIMT, CAC, plaque imaging, etc.), but lacking these does not discredit any of the above. I'm simply doing what I can with my resources and sharing my results for others to consider.

[Stavia]

James, what is your HbA1c if you don't mind sharing?
And what do you feel about low fat organic dairy like ricotta etc? And the occasional free range organic egg yolk?

[Janpeter]

James, you may be absolutely correct with your dietary approach. It certainly is in concurrence with Berkley Labs and
Ornish and co. who advocate a low fat mostly wholefood plant based diet. I think those of us who are choosing a LC "mediterranean" diet are going out on a limb with very little medical establishment support outside a few such as Davis / Perlmutter / Krause etc.
I actually am limiting my animal protein to 150-200 grams of fatty fish, the occasional small amount of grass fed lean red meat, and the occasional free range egg. I eat copious amounts of non-starch vegetables, about 20 "servings" a day !
I eat no starch, grains, or fruit. Even with 20 servings of Veg and 200 grams of protein, there is no way to get to my 1900 daily calorie goal at 5' 11". I weigh 165 pounds and have 9% body fat. So I am left with the choice of adding starch or fat to increase calories. As the typical combo veg and protein yields about 600-800 calories I add the rest ( right now ) with about a cup of EVOO. So my macro ratio is: 60% fat, the vast majority from EVOO, Avocado and Flax seeds / 25% Complex carbs solely from Veg / 15% protein mostly Fish, some lean grass fed meat, and some eggs.
I agree that an "Atkins" like LC diet allowing processed foods high in saturated fat is probably a bad approach. Although I could argue that it is better than a "Vegan" HC diet based on lots of refined carbs. So in many respects our mutually different approaches do share some commonalities.

I would love to see the food composition of your meals ..so we all can have a clearer understanding of what you eat. Maybe I'm missing something.

If I for instance would eat 2 cups of steel cut slow cooked oatmeal (part of my previous Berkley LF diet) my post prandial BG would easily go over 140...so for me thats a big no no.

[Russ]

Just a thought, but what if the magic is a mix of the 2 built upon what is common as a foundation… i.e. always eat a diet of only whole real fresh foods - mostly plants, and never eat refined grains, sugars or processed seed oils. But sometimes go only plants and sometimes more animal products. Sometimes take on more fats and sometimes more starchy carbs - perhaps seasonally? Also, the variability of intake daily (e.g. intermittent fasting and occasional feasting) might be valuable. Might make sense i evolutionary context in that our ability to take up fat (and fat soluble vitamins) better than others would be an asset under such variability, but perhaps that attribute becomes a curse if the fat is there all the time? Certainly a seasonal 'no meat' cleansing fast appears to be a common part of traditional cultural diets.

Hugely speculative, but just wondering if their might be some truth in both perspectives…. For now, high fat but right fat seems to make most sense, but fully agree jury is still out…

[Ski]

The lower carb, low sat fat, more mono fat seems to work for me. That leaves me no option but for the rest in protein. So I seem to be left with mainly animal protein or protein shakes to get the calories. I wish there were other options...is soy supposed to be bad?

[Julie G]

James, thanks for sharing. I repeatedly ascertain that we learn the most from generous shares like this. Out of curiosity, to what do you attribute your decreased small LDL-P to in the first test? Jumping from 473 to 629 is pretty major. From what I've read, the small LDL-P is supposedly more prone to oxidization.

Jan Peter, I just saw your comment about your decent CAC score despite a higher LDL-P. Congrats. To what do you attribute your success there? Have you kept glucose/inflammation markers low? If so, what indicators were you using for inflammation. It translated nicely

[KatieS]

Jan Peter:
"If I for instance would eat 2 cups of steel cut slow cooked oatmeal (part of my previous Berkley LF diet) my post prandial BG would easily go over 140…so for me thats a big no no."

I have the same oatmeal 1pp BG despite blueberries! What is a "perfect HgA1c" ? Seems like I should go even further to eliminate grains.