Fearful of Alzheimer's, I did the 23&me Health tests. I have no copies of APOE4. I do however have some moderate Insulin Resistance, so I'm still unsure of my risks.
I have had IR for 25 years, and have kept it moderate through diet, exercise and Metformin. I was 85 lbs heavier when first diagnosed 25 years ago, but have maintained "normal" weight for many years since. I eat a vegetarian healthy organic diet and get regular exercise. I use low calorie fasting from time to time to re-balance, but I still have some level of IR that I just can't quite shake.
What I would like to assess is with no copies of APOE4, what is my risk level for still developing any Dimentia?
Your thoughts appreciated.
Steve
Understanding Test Results
Re: Understanding Test Results
Hi Steve,theprez wrote:...What I would like to assess is with no copies of APOE4, what is my risk level for still developing any Dimentia?
Steve
In the same way that no one can predict precisely what your risk of any type of cancer is, no one can predict your personal risk of any type of dementia, or other neurological disease. For example, people develop Parkinson's disease who have no family history of it. Dementia sometimes, but not always, can occur with that. People may develop vascular dementia due to issues with their heart or blood vessels, and have no amyloid plaques or tau tangles in their brain (the typical signs of classic Alzheimer's.) People with ApoE 4 are more likely than someone like you to develop Alzheimer's, but about 55% of people with Alzheimer's have no ApoE 4 alleles. Advanced age itself it a risk factor. Some people develop mild cognitive impairment (MCI) and never go on to develop dementia.
So, with a big caution that statistics are useful in large groups of people, but only a guide for one person, below are the predictions from an analysis of 4 large groups of people. Three of the groups were "population-based"--meaning they followed people for a long time, in this case near Boston, in Rotterdam (Netherlands), in Sacramento (a Hispanic population study); the 4th was a targeted Alzheimer's study.
[emphasis added]The Generation Study elected to disclose the following “lifetime” risks of MCI or dementia to its potential participants: 30%–55% for individuals with APOE-e4/e4; 20%–25% for individuals with APOE-e3/e4 and -e2/e4 (with a note that risk might be lower for those with APOE-e2/e4); and 10%–15% for individuals with APOE-e3/e3, -e3/e2, and -e2/e2 (with a note that risk might be lower for those with APOE-e2/e3 and -e2/e2). These values are consistent with our findings, but use round numbers for intelligibility, and broader ranges to reflect statistical and other sources of uncertainty. The regression models are insufficiently precise for “personalized medicine” incidence estimates based on sex, education, or other factors,
APOE-related risk of mild cognitive impairment and dementia for prevention trials: An analysis of four cohorts
You have my deep respect for the incredible commitment you've made to turn your health around. That alone has almost certainly added years of "health-span" to your "life span". With a generalized estimate of a 10-15% risk by age 85 of either Mild Cognitive Impairment or dementia, you can decide for yourself what makes sense to do now. I hope it includes many things that bring you joy and purpose.
4/4 and still an optimist!
Re: Understanding Test Results
What is your risk of developing dementia? No one knows. Those of us who carry the ApoE4 allele don’t even really know our chances. We know the statistics, but they're based on historical data. For those of us who have altered our lifestyle/diet for positive epigenetic effects, those statistics likely don’t apply. There are ApoE4s who never get Alzheimer’s and there are non carriers who develop Alzheimer’s.theprez wrote:Fearful of Alzheimer's, I did the 23&me Health tests. I have no copies of APOE4. I do however have some moderate Insulin Resistance, so I'm still unsure of my risks.
What I would like to assess is with no copies of APOE4, what is my risk level for still developing any Dimentia?
I can say, regardless of genetic status, insulin resistance greatly heightens the chance of some sort of chronic disease. Personally, I’d rather be an insulin sensitive ApoE4/4 than a non-ApoE4 with insulin resistance. Of all the causes of death right now 70% fall into the categories of: cardiovascular, cancer and neurodegenerative disease and all three of those are highly correlated with insulin resistance.
You self describe as vegetarian. What kind of vegetarian? My husband used to be vegetarian, but found himself developing insulin resistance and being very hungry. He (and I, I used to be vegan) switched to adding healthy fats and eating some, not much, animal protein in the form of shellfish, whitefish and omega-3 or pastured eggs. So we are high fat, low carb, near vegetarians with outstanding HbA1cs, fasting blood glucose, fasting insulin measures and controlled hunger. Of course, other things such as stress and sleep disruption can contribute/drive hormonal imbalances also.
-Theresa
ApoE 4/4
ApoE 4/4
Re: Understanding Test Results
Similar. I do eat condiment amounts of Parmesan or Feta cheese occasionally and eggs once in a blue moon, but no meat or fish. I get Omegas from walnuts and pumpkin seeds (I eat a lot of raw organic nuts). My staples are greens, beans, vegetables, nuts, avocados, olives, olive oil, coconut (shredded and oil), a little whole grainWhat kind of vegetarian?
Typical day would start with avocado on Ezekial muffin, hummos on vegetables for lunch and salad for dinner. I rarely snack, but when I do it is usually nuts or olives, maybe a dill pickle.
I will continue with the Fast Mimicking plan laid out in Valter Longo's book and hope that that ultimately brings my A1c down from 7 to 6. It is not easy to fast that often, but I'm getting more comfortable with it.
I honestly think my diet is pretty good and don't see where it needs much tweaking. I mentioned in an earlier post that I used to take Glimeperide (a tier two sulfonylurea) which did bring my A1C into compliance, but the more I read from Bredesen, the more I feared the consequences of that drug, so I've been off it for 6 months.
Thanks everyone for the replies!
Re: Understanding Test Results
If your HbA1c is 6 or 7 you should be concerned. In his book The End of Alzheimer’s Dr Bredesen, recommends an A1c of less than 5.6. Frankly I think that’s too high.theprez wrote:I will continue with the Fast Mimicking plan laid out in Valter Longo's book and hope that that ultimately brings my A1c down from 7 to 6. It is not easy to fast that often, but I'm getting more comfortable with it.
In this study https://www.ncbi.nlm.nih.gov/pubmed/22946113
CONCLUSIONS: "High plasma glucose levels within the normal range (<6.1 mmol/L) were associated with greater atrophy of structures relevant to aging and neurodegenerative processes, the hippocampus and amygdala. These findings suggest that even in the subclinical range and in the absence of diabetes, monitoring and management of plasma glucose levels could have an impact on cerebral health. If replicated, this finding may contribute to a reevaluation of the concept of normal blood glucose levels and the definition of diabetes."
6.1 mmol/L = 110 mg/dl, 6.1 mmol/L or 110 mg/dl = HbA1c of between 5.4 and 5.5
In the recent KetoEdge Summit, there was an interview with Dr Cheryl Burdette. Regarding HbA1c, she said, “But long before you get to diabetes, all the way down to 5.2, you’re already at increased risk for your brain to shrink.” I emailed an address for her that I found on the web asking for a reference, but I never heard back.
If you’re genuinely eating low carb (levels of carb tolerance vary by individual, some have to go very low carb) and are eating a lot of healthy fats, are in ketosis or at least metabolically flexible, fasting regularly and have provided time for your body to adjust but your HbA1c has not budged, then maybe it’s time to seek the help of a low carb dieting professional.
-Theresa
ApoE 4/4
ApoE 4/4
Re: Understanding Test Results
Suggest shooting for an A1C of 5 or less. Heart disease starts around 5.1 or 5.2. Glucose is just a symptom, excess insulin is the problem. See the work of Joseph Kraft and Catherine Crofts, a search is here.
One way to figure out your diet is to get a glucometer (https://keto-mojo.com/ is a good one) with some glucose strips. Don't need to do this for every meal - you are gathering data. Initially suggest testing blood sugar before meals and an hour after. After a while, if the before numbers are consistent, you don't need to do that. Record what you eat, a good tool is https://cronometer.com/ which is both on the computer and a phone app. Then see what happens to your blood sugar on the one hour test. You'd like the glucose elevation to be as small as possible. Gave one to my 28 year old daughter and her 32 year old husband. Before meals they were 78. After they were 81 and 83 respectively. As a test, she ate a doughnut and then tested an hour later. 89 was the result. These are spectacular numbers. If you can keep yours below 105 or 100, you'll be doing well.
The idea is to figure out what foods spike your blood sugar. Twelve years ago, I was a very fit vegan. My A1C was 5.2. I still thought things weren't right. I used to make my own oatmeal by rolling organic oat groats in my own mill. When I spiked to 140 after eating them, I realized they weren't helping me. I decided to figure out how to not spike my blood sugar. My A1C has been sub 5 for many years now.
One way to figure out your diet is to get a glucometer (https://keto-mojo.com/ is a good one) with some glucose strips. Don't need to do this for every meal - you are gathering data. Initially suggest testing blood sugar before meals and an hour after. After a while, if the before numbers are consistent, you don't need to do that. Record what you eat, a good tool is https://cronometer.com/ which is both on the computer and a phone app. Then see what happens to your blood sugar on the one hour test. You'd like the glucose elevation to be as small as possible. Gave one to my 28 year old daughter and her 32 year old husband. Before meals they were 78. After they were 81 and 83 respectively. As a test, she ate a doughnut and then tested an hour later. 89 was the result. These are spectacular numbers. If you can keep yours below 105 or 100, you'll be doing well.
The idea is to figure out what foods spike your blood sugar. Twelve years ago, I was a very fit vegan. My A1C was 5.2. I still thought things weren't right. I used to make my own oatmeal by rolling organic oat groats in my own mill. When I spiked to 140 after eating them, I realized they weren't helping me. I decided to figure out how to not spike my blood sugar. My A1C has been sub 5 for many years now.
Tincup
E3,E4
E3,E4
