Interview question suggestions

[Maxlugavere]

Hey guys,

This may be late notice but I am interviewing Dr. Steven Gundry tomorrow for my film. I know he has been mentioned here before. If any of you have any burning questions (hopefully not too granular) please let me know. Happy to take any suggestions. Of course I have my own list but thought I would crowdsource.

Also will be with Dr. Perlmutter in coming weeks, as well as Dr. Isaacson, and others.

Max

[Julie G]

Waves, Max

I'm so glad that you'll be interviewing Dr. Gundry! Thanks to many members here (some of whom are patients) we've already got the details of his protocol for E4 patients. Please convey how grateful we are that he's actually created a specialized approach just for our population.

As Dr. Gundry is a cardiologist, I would love to see him team up with a neurologist, like Dr. Bredesen or Dr. Perlmutter, to further tweak his approach to better address the neurodegeneration aspect of the E4 allele. I was planning on trying to foster those connections. I'm not sure that the neurology side is even aware of him??? You're welcome to get started

A few of Dr. Gundry's ideas for us are pretty radical; i.e. the idea that LDL-P doesn't matter...it's all about sdLDL. That contradicts published research, but he MAY be absolutely correct. As you know, E4 diet/lipid interactions are woefully understudied. We'd love to see his approach better scrutinized via publications in peer reviewed journals, but totally understand that he's very busy seeing patients and running his private practice. Would he consider teaming up with other lipidology/cardiology researchers to further prove the efficacy of his protocol? We recently met with Dr. Ronald Krauss in Berkley who may be interested...just planting a seed.

Huge thanks for all you're doing, my friend. I'm super proud of you. Hugs to your Mom.

[apod]

I'm curious how his lifestyle recommendations for an average un-fit Apo E3 genotype westerner (who has difficulty utilizing body fat / balancing blood sugar) might compare with the recommendations for a very lean / muscular individual (who has no issues utilizing body fat / balancing blood sugar) with an Apo E4 genotype and a panel of methylation defects.

For fit individuals with the thrifty cholesterol-conserving E4 genotype, are animal proteins / fats (which seem to raise homocysteine / LDL-P) still the ideal fuel sources over "killer fruits" / legumes / whole grains / starches (largely absent from these meal plans) ?

[Julie G]

Hey apod, apologies if I'm covering old info for you; but Dr. Gundry's plan for E4s differs from the link you provided. He only recommends low fat fish, shellfish, and pastured eggs for animal protein. No fatty fish, chicken or beef. For fats, he recommends unfiltered EVOO, MCT, and coconut oil.

Side question: Fats raise HCY? News to me.

[apod]

Hey apod, apologies if I'm covering old info for you; but Dr. Gundry's plan for E4s differs from the link you provided. He only recommends low fat fish, shellfish, and pastured eggs for animal protein. No fatty fish, chicken or beef. For fats, he recommends unfiltered EVOO, MCT, and coconut oil.

Side question: Fats raise HCY? News to me.

Ah, perhaps this has already been covered. (I'm mostly interested in his avoidance of fruit / starches, which seems aimed at weight loss / maintenance and his thoughts on whole grains / legumes, which are usually considered heart-healthy in the research literature, but also avoided in his meal guide.)

It seems like methionine intake raises Hcy (especially into higher intakes for sensitive individuals), where the main dietary source of methionine would be animal protein. Respectively, fats (particularly ones like coconut oil) seem to raise LDL-P, especially into higher intakes for sensitive individuals. Although, I've just read he's not concerned with elevated LDL-P. Interesting.

[circular]

Hi Max,

I'm probably too late, but I wonder if he thinks one, especially ApoE4 can go too low with cholesterol since it's the precursor to important things like hormones and cell membrane structure?

Also, does he think lectins may be independently causative or associative in AD, either in general or in people sensitive to them. And if so, what would make some people more sensitive to them.

I don't expect you to see these before the interview ...

[Tincup]

Ah, perhaps this has already been covered. (I'm mostly interested in his avoidance of fruit / starches, which seems aimed at weight loss / maintenance and his thoughts on whole grains / legumes, which are usually considered heart-healthy in the research literature, but also avoided in his meal guide.)

It seems like methionine intake raises Hcy (especially into higher intakes for sensitive individuals), where the main dietary source of methionine would be animal protein. Respectively, fats (particularly ones like coconut oil) seem to raise LDL-P, especially into higher intakes for sensitive individuals. Although, I've just read he's not concerned with elevated LDL-P. Interesting.

Avoiding starches is an insulin issue. He allows limited whole fruit. Grains, legumes & nightshades are a lectin issue. If you test >16 on adiponectin, he puts you on a very strict low lectin diet ("Matrix") https://www.apoe4.info/forums/download/file.php?id=576 to minimize inflammation. He limits protein intake and is VERY aware of the methionine issue. He talked with us about talking TMG (glycine) to offset the methionine intake. I asked specifically about coconut oll in my recent call and he agreed it would raise LDL-P but said not a problem (as he focuses on sdLDL). You can see my call notes here: https://www.apoe4.info/forums/viewtopic ... 270#p16389

[Tincup]

Max,

If it isn't too late, expanding on the idea of niacinimide for E4's for brain health vs. Bredesen's homocysteine target of 6. When I questioned Gundry about this, Dr. G said he'd rather have niacinimide protecting our brains, knowing that it will be difficult to get homocysteine less than 10 while taking it.

[apod]

Avoiding starches is an insulin issue. He allows limited whole fruit. Grains, legumes & nightshades are a lectin issue.

Are these starches / fruits that impact insulin limited because of weight gain / maintenance or for other reasons (are bananas and dates considered "killer fruits" for fear of insulin itself? And the same for other whole foods like okinawan sweet potatoes?)

From Kresser -- "There are literally billions of people eating high-starch diets worldwide, and you can find many examples of cultures that consume a large percentage of calories from starch where obesity, metabolic problems and modern, inflammatory disease are rare or nonexistent. These include the Kitava in the Pacific Islands, Tukisenta in the Papa New Guinea Highlands and Okinawans in Japan among others. The Kitavan diet is 69% carb, 21% fat, and 10% protein. The Okinawan diet is even more carb-heavy, at 85% carb, 9% protein and 6% fat. The Tukisenta diet is astonishingly high in carbohydrate: 94.6% according to extensive studies in the 60s and 70s. All of these cultures are fit and lean with low and practically non-existent rates of heart disease and other modern chronic disease. I am not aware of any evidence in humans showing that starch consumption decreases longevity, and some of the longest lived cultures in the world consume large amounts of starch. The Okinawan population has the highest prevalence of centenarians in the world."

This was a recent new study: http://www.ncbi.nlm.nih.gov/pubmed/26201847

[Tincup]

Gundry himself eats Okinawan sweet potatoes. He talked to us about buying them at the farmers market. Most of his patients have an insulin problem. Notice on the resisitive starch part of the program, the resistive starches are limited. He tailors his advice to the person. What you are looking at is a generic prescription. He might have a different suggestion for you. He keeps his TG's in the 30's and his wife keeps hers in the 20's. If you were in that range, he might say to "go to town" on the starches.

In a podcast with Kiefer (author of "Carb Nite" & "Carb Backloading") the question of hormesis and "Carb Nites" came up. Gundry wasn't opposed, but implied that if he took most of his patients off a tight carb "leash," they wouldn't stop.

I personally eat a 22:2 intermittent fast (2 hour eating window/day) & don't worry about the starches too much. I made Okinawan sweet potatoes for us the other night, taro another and had plantain chips last night. We also eat jicama, tiger nuts & etc.