Diet Priorities

[Stavia]

Good question Julie. I assumed the usual apoe4 pattern with raised LDL and not one of the extra double whammy patterns.

[lumia]

Lumia, nice to see you posting again . I agree with Stavia & others that in general glucose trumps lipids BUT you mention dyslipidemia. Can you better describe that for us? Dyslipidemia typically refers to high LDL, low HDL, and high TGs... in which case replacing some carbs with healthy (unsaturated) fats should also help with that. Have you checked your advanced lipids? A1c? Fasting glucose & insulin?

I have an older report that was around the same time when I first posted here (May 2014), i.e. without any type of conscious dieting:

Fasting glucose 95
Cholesterol 232
Triglycerides 134
HDL 45
LDL Calculated 160

This is what I can get for now. I'm moving right now, so I can't get many stuff.

[Julie G]

That helps me better understand, Lumia. You're basically dealing with both elevated glucose AND dyslipidemia. Replacing some starchy or higher glucose carbs with healthy (unsaturated fat) should help with both. A stressful move doesn't make it any easer . Take care of yourself in the midst of it all...

[Stavia]

That helps me better understand, Lumia. You're basically dealing with both elevated glucose AND dyslipidemia. Replacing some starchy or higher glucose carbs with healthy (unsaturated fat) should help with both. A stressful move doesn't make it any easer . Take care of yourself in the midst of it all...

agreed.
High TG's usually are caused by excess carbs. And the TG's have to be packaged somehow as they are not water soluble, so the liver has to make more LDL particles to transport them. I would suggest getting your TG's down under a 100 and closer to 70 or 80 if you can manage, and then seeing what LDL particle number you are left with. You may be pleasantly surprised!

[Tincup]

I agree with Stavia. If you drop your Tg's, your HDL should also increase. An ideal TG/HDL ratio is < 1 in md/dL units. Continually elevated Tg's are typically from excess carbs being converted to fat, also depressing HDL.

Ivor Cummins's blog post here summarizes Dr. Kraft's lifetime of work here: http://www.thefatemperor.com/blog/2015/ ... -missed-it Essentially Kraft found that a very high percentage of those with a normal glucose tolerance test (100 g glucose with glucose and in Kraft's case insulin measured over the next number of hours) had an abnormal insulin response. Kraft calls this diabetes in-situ. Kraft also did ~3,000 autopsies where he saw first hand the impact of insulin on the blood vessels. If you browse around the rest of the site, Cummins makes a good case that many of the lipid metrics are proxies for insulin resistance. IR is the root of many chronic issues.

All that being said, my consultant, Steve Gundry, has noticed that animal saturated fat will spike sdLDL (small dense LDL) in E4's (but not others). At a conference I was at last weekend, a lipidologist said sdLDL have a lifespan of 5 days compared to 2 days for LDL-P. Hence they have longer to oxidize. So I agree with Julie to replace animal sat fat with veg. unsaturated (but not processed seed oils!) fat.

[Stavia]

All that being said, my consultant, Steve Gundry, has noticed that animal saturated fat will spike sdLDL (small dense LDL) in E4's (but not others). At a conference I was at last weekend, a lipidologist said sdLDL have a lifespan of 5 days compared to 2 days for LDL-P. Hence they have longer to oxidize. So I agree with Julie to replace animal sat fat with veg. unsaturated (but not processed seed oils!) fat.

agreed George. Dr Kraus feels the same, and we have seen on the forum how e4's LDL particle number rises with increased saturated fat.

[Stavia]

All that being said, my consultant, Steve Gundry, has noticed that animal saturated fat will spike sdLDL (small dense LDL) in E4's (but not others). At a conference I was at last weekend, a lipidologist said sdLDL have a lifespan of 5 days compared to 2 days for LDL-P. Hence they have longer to oxidize. So I agree with Julie to replace animal sat fat with veg. unsaturated (but not processed seed oils!) fat.

agreed George. Dr Kraus feels the same, and we have seen on the forum how e4's LDL particle number rises with increased saturated fat.

[GenePoole0304]

there is another narrative in the video

http://freetheanimal.com/2016/03/low-ca ... etheanimal

Heart disease and Alzheimer have similar pathogensis and should not be treated separately

"Several conditions known to increase the risk of cardiovascular disease — such as high blood pressure, diabetes and high cholesterol — also increase the risk of developing Alzheimer's. Some autopsy studies show that as many as 80 percent of individuals with Alzheimer's disease also have cardiovascular disease."
http://www.alz.org/research/science/alz ... d_risk.asp
http://www.ncbi.nlm.nih.gov/pubmed/20413875


http://www.ncbi.nlm.nih.gov/pubmed/11461163

[Hubbs]

Hubbs, did you notice that your glucose was better controlled with slightly higher fat, 65% vs. 50%? Also, did your elevated fasting BG improve with higher fat? I went back and found your NMR results and see what you're up against. FWIW, I still think working on your higher glucose numbers will also reduce your small LDL-P.

Julie, I looked through the month of glucose/food tracking and do see more BG spikes following lower fat but higher protein/carb meals. But there were also spikes following higher fat very low protein/carb meals. I will try to balance each meal more carefully with 60%+ fat. The challenge is that when I try to increase fat intake but have to limit animal product (seafood) to 4oz/day, I ended up eating so much nuts and seeds and avocado, with omega 6 high and weight gain.

[Julie G]

I hear you, Hubbs. Sorry you’re having such a struggle. FWIW, with both elevated post-prandial BG & small LDL-P, I still think controlling glucose should be your main focus. If it’s any reassurance, here’s a recent blurb from a Chris Kresser transcript discussing how higher Omega-6 from REAL food is vastly different than higher Omega-6 from processed or fast food:

Earlier on—and anyone who’s been following my work for a while will know this—I used to put a lot of emphasis on the omega-6-to-omega-3 ratio and it’s importance, but over the past couple of years, I’m changed my mind about that and gradually revised my views, and I’ve been writing about that and speaking about it, so this probably won’t be news to you, but it seems now that there’s less evidence really supporting the importance of the ratio and more evidence just supporting the overall intake of omega-3.

For example, if your intake of omega-3 is really low or nonexistent, you’re going to have problems. Of course, your ratio will be high because you’re almost certainly getting omega-6 from the diet. It’s much harder to avoid than omega-3 is. But if your intake of omega-6 is higher, especially if it comes from real, unprocessed food—which I’ll come back to in a second—let’s say you’re eating avocados and chicken skin and nuts and natural foods that are high in omega-6, but you’re also eating some preformed EPA and DHA from cold-water fatty fish and some other omega-3’s, plant-based omega-3’s from vegetables, walnuts and flaxseeds, etc., from my reading of the research and a lot of discussion with Chris Masterjohn, whose opinion I really respect on this issue—he’s done a ton of research on the polyunsaturated fats—and in my reading of the literature, there’s not a lot of evidence supporting the idea that that person who’s eating real-food-based omega-6 even in substantial amounts and omega-3’s is going to be at increased risk of disease. The omega-3 index was created with this whole ratio in mind, so even someone like that, who’s eating healthy omega-6’s and a fairly substantial amount of omega-3’s, will still probably score in the yellow category on that test, but I don’t really think that you can say that that person is going to be at significantly increased risk of disease.

I know G has played around with lowering his BG by increasing fat to 65% (?) alternating with semi-fasting days eating lower fat. He’s also yielded an excellent LDL-P with this strategy. A version of that might be worth a trial.