New Gundry Book - The Plant Paradox

[bexnews]

I totally agree with Russ here. I am not seeing the concrete evidence to back up some of Dr Gs theories on lectins and neu5gc. Kresser weighs in on the latter and is skeptical of neu5gc to be worried about. https://robbwolf.com/2015/01/16/red-mea ... -response/

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[myrtoashe]

I've been playing with understanding ApoE all day, and of course this site is great - I wanted to know what is the update on what we should be eating (I have ApoE 3/4, and I am a physician trained in the Bredesen protocol).

Here is my question about Dr. Gundry: I hear he prioritizes sdLDL over LDL-P, and has said LDL-P is not important. However, if ApoE4 is inflammatory, isn't it better to have fewer LDL particles?

Also, ApoE4 appears to damage the blood-brain barrier (among other issues) - that is perhaps not that relevant to heart disease but a big deal for neuroinflammation, no?

This is the question: when you eat more fat, say coconut oil, which doesn't increase sdLDL but does increase LDL-P (for ApoE4), don't you then have more ApoE4 and it would cause more mischief for brain health?

I know Dr. Bredesen does recommend keeping LDL-P below 1100.

[circular]

Dr. Bredesen's verbiage is a little more nuanced in his new book:

• LDL-P ... 700-1000 'OR' see sdLDL 'OR' see OX-LDL
  
  sdLDL ... <20 mg/dL 'OR' see LDL-P 'OR' see OX-LDL
  
  OxLDL ... <60 U/l 'OR' see LDL-p 'OR' see sdLDL

Sorry I don't have the context for this handy.

[Stavia]

I've been playing with understanding ApoE all day, and of course this site is great - I wanted to know what is the update on what we should be eating (I have ApoE 3/4, and I am a physician trained in the Bredesen protocol).

Here is my question about Dr. Gundry: I hear he prioritizes sdLDL over LDL-P, and has said LDL-P is not important. However, if ApoE4 is inflammatory, isn't it better to have fewer LDL particles?

Also, ApoE4 appears to damage the blood-brain barrier (among other issues) - that is perhaps not that relevant to heart disease but a big deal for neuroinflammation, no?

This is the question: when you eat more fat, say coconut oil, which doesn't increase sdLDL but does increase LDL-P (for ApoE4), don't you then have more ApoE4 and it would cause more mischief for brain health?

I know Dr. Bredesen does recommend keeping LDL-P below 1100.

Hi Myrtoashe, its great to have a fellow physician on the boards. Welcome to our community. I look forward to more discussion with you.

In my view, this is the usual controversy between particle number and particle size, now recently with oxidized LDL thrown into the mix. Which in my view begs the question - is LDL relevant at all for AD? Its a minefield and of course everyone has a position and a theory and can cherry pick as they wish.
My approach is to have no entrenched position until we have hard evidence.
BUT I have to eat something. And as a 4/4, I normally run at a higher LDL (135) and LDL-p (1400), thus I have limited options to reduce my LDL-P to less than 1100 short of a statin. I am not going to eat a statin. And I have to eat 55% fat (plus intermittent fasting) to keep in ketosis which I need for my mitochondria (I definitely think better in mild ketosis). So I chose to eat what I consider to be the least controversial fat mainly - avocados, fatty fish, olive oil, nuts. Minimal saturated fat. (No coconut, minimal cheese and red meat). But honestly? my numbers don't change at all with different kinds of fats. I may be doing this for nothing. But I'd rather this than the other way around.

[myrtoashe]

Thank you Stavia! Thanks for the warm welcome.

Dr. Bredesen did say, try to drop the LDL-P and then play with the MUFAs and the PUFAs to fine tune. It sounds like you have already done this and this is as fine as it will tune.

I was just thinking in general, we have this problem with cardiologists focusing too much on blood vessel health (whence their obsession with statins, and even then!), and it seems that is where Gundry's recommendation to ignore LDL-P comes from. I spent some time trying to understand if ApoE rises along with LDL-P and it seems that it would (or that is the implication - I haven't heard anyone say it outright because I don't think anyone is measuring ApoE, or ApoE activity).

If you haven't tried Dr. Longo's intervention, that may be another option - if it lowers your insulin resistance further, then you can have more leeway with the diet, in theory at least. I went from being insulin resistant to not being after the 3 month intervention.

[Tincup]

I've been playing with understanding ApoE all day, and of course this site is great - I wanted to know what is the update on what we should be eating (I have ApoE 3/4, and I am a physician trained in the Bredesen protocol).

Here is my question about Dr. Gundry: I hear he prioritizes sdLDL over LDL-P, and has said LDL-P is not important. However, if ApoE4 is inflammatory, isn't it better to have fewer LDL particles?

Also, ApoE4 appears to damage the blood-brain barrier (among other issues) - that is perhaps not that relevant to heart disease but a big deal for neuroinflammation, no?

This is the question: when you eat more fat, say coconut oil, which doesn't increase sdLDL but does increase LDL-P (for ApoE4), don't you then have more ApoE4 and it would cause more mischief for brain health?

I know Dr. Bredesen does recommend keeping LDL-P below 1100.

mytoashe,

My wife and I are Gundry patients. We've recorded and she's transcribed our five consults to date - roughly every 6 months - linked here.

In our most recent labs, my LDL-P was 1116 and my sdLDL-C was 20 mg/dL on Veridia (formerly Singulex) and 24 on True Health. Even my standard lipids are decent. TC = 163, Tg = 58 , HDL =57, LDL = 102. All eating the Gundry way - I eat no land animal protein/fat except omega 3 eggs. Maybe 2x/month I eat white fish or shell fish. Probably 4/10 days I eat are not vegan (mostly eggs). I fast 22 hours daily on days I eat. Since 1 May, I've fasted 120 consecutive hours out of every 14 days. My A1C is 4.6%. I do not consume coconut oil or MCT oil. When I did a detailed diet diary in March with a gram scale & cronometer.com, here is my macros:

Code: Select all

Item   Average   Minimum   Maximum
Energy (kcal)   2,167   1,801   2,495
Carbs (g)   122   88   179
Fiber (g)   51   44   66
Fat (g)   175   143   212

All my inflammatory markers are in line, like TNF-alpha, the various interleukins, HS CRP & etc. The only thing that was out of line was homocysteine at 11, which I recently dropped to 7.7 my upping my B12 to 10,000 mcg/day.

I also did a DEXA scan a couple of weeks ago. T score = 0, body fat was in the 1st percentile for my age (62) on all limbs & torso. My BMI is 24.

In my opinion, metabolism trumps all the lipid metrics any day. I've been playing the game long enough, I can pretty much put the numbers where I want them by changing my diet or fasting program. I've also been keto-adapted since Oct 2009 and am always in mild ketosis on a morning test (0.7 - 2.0 mmol/L), even after consuming a fairly carby meal of resistant starches the night before. When I fast, I'm usually up in the 5-7 mmol/L range on ketones by the 5th day. One day my ketones were at 6.2 and glucose was at 31 (1.7 mmol/L). So I went to the gym as described in the link.

We happened to be chatting at dinner with Joe Mercola and Dr. Bredesen's wife, Aida in early August the day we got these results. The looked at them and were both impressed at our metrics.

[myrtoashe]

Thank you tincup (I know it's George, I read a lot of that thread and some of the transcripts from visits . I'm planning to sign up with Veridia (some irregularities I believe with Singulex, but I would like a place to check cytokines and I don't know of another).

I'll have to try that homocysteine/B12 trick with some of my patients, I'm glad it worked for you!

You are to be congratulated of course for your dedication, and I am also very grateful for the inspiration and the information your experiments provide. I will be trying some patients on a low lectin diet, and myself on shellfish. I really miss the animal protein, and feel a bit crazed trying to get protein from broccoli and collards but I know some people just love it. But as long as I can have crab and scallops and a sardine here and there I think I will be fine (I have to see where the old IGF-1 is off cheese, red meat, and turkey - previously at 176. I am not feeling so smug after reading that transcript).

Do you supplement with retinyl vitamin A (some people are not genetically efficient at converting beta carotene to active vitamin A - it's one of the concerns re: being vegan)?

Thank you so much for this forum and for your responses - I'm so glad to use all this info to help many patients trying to optimize health and reverse their chronic conditions. I'm seeing a friend S/P MI next week (in her late 50s) and a type 1 diabetic S/P stenting. These are all people who don't want statins, treasure their health and having this level of detailed info is so exciting!

[Lucy5]

Hi myrtoashe and welcome to the group, wonderful to have you here with us!

myrtoashe wrote: This is the question: when you eat more fat, say coconut oil, which doesn't increase sdLDL but does increase LDL-P (for ApoE4), don't you then have more ApoE4 and it would cause more mischief for brain health?

As a 4/4 layperson I've also wondered about this over the past few years, but from the studies I've seen and others have found and posted, it doesn't look like there's consensus on the subject. If you haven't seen this forum thread, you may find the discussion of interest.
-Lucy

[Tincup]

Thank you tincup (I know it's George, I read a lot of that thread and some of the transcripts from visits . I'm planning to sign up with Veridia (some irregularities I believe with Singulex, but I would like a place to check cytokines and I don't know of another).

I'll have to try that homocysteine/B12 trick with some of my patients, I'm glad it worked for you!

But as long as I can have crab and scallops and a sardine here and there I think I will be fine (I have to see where the old IGF-1 is off cheese, red meat, and turkey - previously at 176. I am not feeling so smug after reading that transcript).

Do you supplement with retinyl vitamin A (some people are not genetically efficient at converting beta carotene to active vitamin A - it's one of the concerns re: being vegan)?

Gundry told us next time we'll be using a lab opened by Mayo's which has a mass spec machine, Salveo? For some of our labs.

B12 is sublingual methylcobalamin.

Left out protein above: Protein (g) 52.0 34.6 69.8
For vegan protein, we eat a lot of nuts off his list, I know I eat more than he suggests, on days I eat. We also eat compliant plant protein such as hemp hearts, hemp tofu, tempeh (less frequently as it is soy, though on the list), the Quorn mycoprotein products on the list mostly Chik'n Tenders.

According to Cronometer:
Vitamin A (IU) 16220.4

No I don't supplement, also not completely vegan. Don't think it makes sense to be completely vegan, just limiting the animal side.

On lipids, I think minimizing sat fat is the key. JulieGee has found this too, as I recall. That being said, I don't worry about it in the unfiltered olive oil I consume.

This is from the 14 day food diary - so cumulative for the 14 days. All amounts are g except eggs which are number of.
Sauerkraut 2381
Jicama 1754.5
Guac 1742
Avocado 1045
EVOO 1036
Asparugus 898.5
Portabella Mushrooms 693
Pecan 578
Carrots 554
Walnut 507
Hazelnut 499
Chard 490
Pistachio 448
Kovita Kefir 407
Kimchi 403
Artichoke 399
Spinach 370
Balsamic Vin 364
Quorn 340
Cauliflower 329.5
Kale 305
Wine 289
Red Onion 286
Shrimp 270.5
Tomato 264.5
Beets 258
Arugula 257
Yucca Fries 237.6
Tempeh 227
Cod 223
Broccoli 183
Raddish 135
HempTofu 113
Plantain 110.5
Cilantro 110
Purple Sweet Potato 108
Green banana 103.8
Palm Heart 100
Miracle Noodles 99
Brussel sprouts 86.5
Chocolate 86
Black Olives 82
Broccoli 60
HempHearts 60
Green onion 53
Beet Leaves 50
Radicchio 47
Macadamia Nuts 30
Cassava (tapioca) flour 29.3
Flax 21.5
Garlic 18.5
Blueberries 15.6
Baking Powder 12
Vanilla 12
Psyllium Husk 10
Cinnamon 9.6
Ginger 5
Eggs 4.9
Tumeric 4.5
Corriander 4
Salt 4
Cumin 3.8
Pepper 3.5
Egg yolk 2.4
Sweet Leaf Stevia 2.4
Rosemary 2
Tumerc Root 1.5
Ginger Root 1
Agar Agar 0.5

Average daily values for nutrients:

Energy (kcal) 2167.5
Alcohol (g) 2.5
Caffeine (mg) 0.0
Water (g) 623.0
B1 (Thiamine) (mg) 1.2
B12 (Cobalamin) (µg) 0.9
B2 (Riboflavin) (mg) 0.9
B3 (Niacin) (mg) 11.6
B5 (Pantothenic Acid) (mg) 4.2
B6 (Pyridoxine) (mg) 1.7
Folate (µg) 407.0
Vitamin A (IU) 16220.4
Vitamin C (mg) 167.2
Vitamin D (IU) 27.1
Vitamin E (mg) 11.6
Vitamin K (µg) 548.4
Calcium (mg) 520.6
Copper (mg) 2.6
Iron (mg) 14.3
Magnesium (mg) 379.4
Manganese (mg) 6.8
Phosphorus (mg) 966.3
Potassium (mg) 3173.7
Selenium (µg) 41.3
Sodium (mg) 2919.6
Zinc (mg) 7.6
Carbs (g) 122.1
Fiber (g) 51.3
Starch (g) 21.2
Sugars (g) 32.1
Fat (g) 175.0
Cholesterol (mg) 131.6
Monounsaturated (g) 88.3
Omega-3 (g) 2.9
Omega-6 (g) 24.7
Polyunsaturated (g) 37.8
Saturated (g) 24.6
Trans-Fats (g) 0.0
Cystine (g) 0.6
Glycine (g) 1.8
Histidine (g) 1.0
Isoleucine (g) 1.7
Leucine (g) 2.9
Lysine (g) 2.3
Methionine (g) 0.7
Phenylalanine (g) 1.8
Protein (g) 52.0
Threonine (g) 1.6
Tryptophan (g) 0.5
Tyrosine (g) 1.1
Valine (g) 2.1

[myrtoashe]

You're a treasure trove - that's a great list! I will pass it on to the nutritionist I work with to help guide the ApoE4 patients (including her family!).

The vitamin A is not activated, it's beta carotene. Only animals provide activated retinyl form vitamin A. For some people, this is not a problem, it all depends how efficient your BCMO enzyme is converting the beta carotene into vitamin A. If you have the inefficient version though, it leaves you open to immune issues. That is why there is an emphasis on liver/organ meats in some approaches, and some people take them as supplements.