Our first guest: Dr. Thomas Dayspring...

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Julie G
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Our first guest: Dr. Thomas Dayspring...

Postby Julie G » Tue Feb 24, 2015 3:01 pm

I want to give full props to Thumperama for recommending & setting up this initiative. Over the coming weeks, as time permits (day job!) he plans to query some top experts in the field of AD/CAD (as well as various health personalities) regarding some of our unanswered questions. Those who've been here long enough realize that there is a tremendous lack of peer reviewed science providing APOE ε4 carriers with a consensus on preventing either disease. Even more frustrating, the advice from experts is often wildly contradictory. Our activism on this initiative will hopefully begin to move the scientific community towards conducting potentially lifesaving research on our behalf. In the meantime, our goal is to get some top minds working on this puzzle with us.

Our secondary goal is to get these folks to work with us free of charge ;) Some may ask to be compensated; we'll deal with that as it arises. Ultimately, we'd like to establish an ongoing Q & A opportunity. perhaps a podcast featuring a variety of experts.

Our first guest expert will be Dr. Thomas Dayspring. He's generally considered to be the top lipidologist in the U.S. Here's a link to his bio where you can also download his complete CV: http://www.biomarkerbliki.org/author/5

We've come up with three questions that he's agreed to answer without being compensated. Here are the questions:

1. Is there a general dietary recommendation that you would give to ApoE 4 variant individuals (and are there differences between a 3/4 and a 4/4) to reduce their likelihood of Alzheimer’s Disease/dementia and cardiovascular disease. It’s quite common for members of the ApoE4.info forums to take one of two paths to address their disposition to these diseases:

Strategy A: Focus on strictly lowering dietary fat to address our population's tendency towards higher LDL-C/P. Some hypothesize that this may also prevent amyloid plaque deposition. Some members who employ this strategy are also vegetarians/vegans. Rice and/or beans are often staples. Caloric restriction is sometimes concurrently employed to avoid insulin resistance.

Strategy B: Focus on increasing healthy fats (MUFAs, nuts) to address/prevent insulin resistance and induce mild ketosis. Members who employ this strategy tend to be omnivores, who eat small amounts of proteins rich in Omega-3s and plentiful non-starchy vegetables. Many of these members concurrently employ caloric restriction to overcome our propensity for higher LDL-C/P and to further enhance mitochondrial function.


2. Given the recent research that suggests it’s the amount and function of an individual's ApoE that convey dementia risks rather than the underlying genotype, do you have suggestions for how individuals concerned about this should go about testing for ApoE and therapies that may benefit them by increasing the ApoE levels?

3. If ALL other risk factors are minimized (high HDL-C/P, low glucose markers and inflammation markers, low Lp[a]); is it OK for those who carry an E4 variant to have slightly higher LDL-P/ApoB?

I'm looking forward to Dr. Dayspring's thoughts on these questions. Thumperama will post them as soon as he receives the reply.

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Re: Our first guest: Dr. Thomas Dayspring...

Postby J11 » Tue Feb 24, 2015 5:29 pm

A lipidologist might be just what we need.

One of the hits in the exome scan was LIPC rs121912502 listed on OMIM as S267F.
LIPC is the hepatic lipase gene which in one of the cited studies noted a relation to APOE.
The frequency listed on dbsnp is T=0.0004 and it is pathogenic.

It would be sure interesting to know whether there were a connection between this problem and AD.
The numbers of people who have some of these SNPs are so low and some of the risk for cardiovascular
problems so high that it is not easy to figure this one out.

We have recently done a blood test for lipase, so we should know soon if anything is unusual.

This might offer pay as you go consults with such experts. Possibly linking up patients who have odd genetic
mutations with interested researchers might also be a direction.

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Postby Stavia » Wed Feb 25, 2015 12:13 am

Julie good questions. Could you please add strategy C of the middle road?

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Re: Our first guest: Dr. Thomas Dayspring...

Postby bentkat » Wed Feb 25, 2015 5:34 am

I look forward to reading Dr. Dayspring's responses and listening to future podcasts.

Thanks Julie for getting this new field of inquiry started and all that you do for our community.

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Re: Our first guest: Dr. Thomas Dayspring...

Postby thumperama » Wed Feb 25, 2015 6:35 am

@Stavia

That's a good suggestion and it may, in fact, be what Dr Dayspring recommends. The purpose for the question structured in such a way was to reflect a general bifurcation of the ApoE4 "expert" dietary recommendations and approaches by members of our forum community.

I suspect there will be an individual variability, N=1 component to his response. Regardless, it should be informative for the community.

Does this make sense?

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Postby Stavia » Wed Feb 25, 2015 10:17 am

Yip :)
Im just musing on perhaps an unnecessary dichotomy ie polarisation of diets. Cos I suspect the majority of people (who are likely not as disciplined as Julie or George for instance) fall in the middle.

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Re: Our first guest: Dr. Thomas Dayspring...

Postby SusanJ » Wed Feb 25, 2015 5:32 pm

Squarely in the middle, here. Hmm, suddenly I'm hearing, "stuck in the middle with you..." :lol: Feel free to hum along.

As an e3/4, I found I don't do so well lipid-wise with higher fat, don't tolerate most grains (joint pain, but small amounts of rice and buckwheat are okay), legumes are a non-starter for my GI, and the calories have to come from somewhere. So, I probably eat more starchy veggies than others here, because if I don't, I lose weight, and at 114 pounds, I can't really afford that.

I'll be really interested in what Dayspring has to say.

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Re: Our first guest: Dr. Thomas Dayspring...

Postby GenePoole0304 » Wed Feb 25, 2015 8:57 pm

" Dr Greg Brown has reported: "In an analysis by Maher et al. of the Lp(a) data in the
FATS trial, lowering LDL levels in those with high LDL and high Lp(a) levels
dramatically reduced risk. Without treatment, these patients had a 42% risk of a major
clinical event, including MI, the need for revascularization, or CV death over the 2.5 year
study. When LDL levels were lowered aggressively, even though the Lp(a) levels
remained high, the risk of this group was reduced to less than 10%, for a roughly 75%
reduction in the risk of a major cardiovascular event. While Lp(a) (and probably risk)
may be modestly lowered with niacin the rapy, and with estrogens in women, aggressive
lowering of LDL levels appears to be the most reliable way to treat patients at high risk
due to elevated Lp(a)."

https://www.lipidcenter.com/pdf/Entire_ ... xities.pdf

http://www.lipidcenter.com/pdf/Lipoprot ... atment.pdf


https://www.youtube.com/watch?v=Ri1EEpzvpso

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Re:

Postby Gilgamesh » Wed Feb 25, 2015 10:59 pm

But Strategy C isn't "in the middle", it has a focus on a completely different independent variable: overall energy intake (a variable ignored by many researchers looking at the effects of dietary constituents, which makes their results nearly meaningless).

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Postby Stavia » Wed Feb 25, 2015 11:09 pm

Arghh too many variables!! I really dont like the high fat/ low fat dichotomy - I think its too narrow a focus to define our diets as LFHC or HFLC exclusively(no offense meant to other people who find ot useful). Gilgamesh - I meant an "in the middle" fat percentage. There needs to be an option of MFMC (middle fat middle carb). Pretty please?
And a fourth option of CRON without defining macronutrient percentages.


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