ApoE4.Info

Hello! Look for others following the same path to share ideas.

I've been on a ketogenic diet for 1 week as of today. I did this because one, I'm a nutritionist and it's my duty to try out any diet I would recommend, and two, I've been experiencing cognitive issues for well over 3 years now. I must say I FEEL AMAZING! My energy is up higher than what caffeine used to offer. I should mention that I cut all forms of caffeine out 4 weeks ago. My focus is exceptional and I can only liken it to how I felt taking adderall intermittently in my college days years ago. I've been maintaining 1.0-3.0nm on my meter and find this is my cognitive sweet spot.

Clearly I would like to continue this and work on the ketoflex ideas shared by Bredesen while maintaining the ketones in my blood. However, given my ApoE 3/4 status, I need to keep my saturated fats low. I also have a number of other polymorphisms that suggest I should be low sat fat. In the past week, I've averaged about 35g of saturated fat per day, which isn't high for most, but I believe too high for me. A before and after analysis of my body composition showed that I actually increased my body fat while eating this way, even though my net weight loss was 3lb. That's another red flag.

So anyone else out there aiming for a low saturated fat Ketogenic diet? I avoid all forms of dairy and eat grass fed red meat only 1-2 times per month. Coconut seems to be the place where I'm getting most of my saturated fats. I need a replacement for coconut milk, which has been a easy way to thicken a soup/stews and increase my fats. Oh and I've been making coconut yogurt in the Instant Pot, which is probably the most delicious thing I've had in a while!

Hi kc. I'm really glad you posted this. After phasing in other parts of the program I started a keto-type diet one week ago too!

I actually feel surprisingly good. I did not think the change would be so clear. I have not found it to be very hard either. And I have the same questions. I really can't have my cholesterol values go further out of bounds.

Here's what I've done over time. I eliminated added sugars, eat a basic keto-diet, but avoid "bad" fats. I didn't eat red meat before anyway. And I gave up sodas a while back. I also eliminated breads, and gluten in general. Because, why not, let's see what happens. I fast for 15-16 hours, from ~7pm to ~10:30am. It's an interesting feeling to be hungry, but not bad. I have coffee when I wake up. Here's an example of lunch: ~1/2 cup of nuts, a chicken salad, square of 85% dark chocolate, maybe an avacado. Dinner might be: roasted chicken or salmon and broccoli or brussel sprouts. If we go out I get a veggie salad at Chipotle - I never could eat the burrito without making a mess, anyway. It's all made possible at this point by ~3 cups of coffee a day (kinda hard on teh stomach sometimes) and a few macadamia nuts as a reward. Does this qualify as "low sat fat" in your thinking?

I'll have a second round of tests in a few weeks. If my LDL is still high my cardiologist is going to be pretty upset. My family is amused, so far.

I lost 4.5 pounds in 3 days. (Huh?) But that leveled off now. No idea if I'm in ketosis yet.

Before that I was about "half-keto" (I know, not a thing) and cholesterol numbers were up. HDL was up, higher than niacin or a statin ever got it! But LDL was up ~35 points too, not great for me at all. TGs were exactly the same. I'm expecting the full keto-diet to give me more of the same. The cardiologist will not be pleased with the LDL. (Particle size data coming)

I'm really interested to hear from people who have done this for the long-term....

Hi KC & Tom,

I've been low saturated fat and ketogenic for about 3 years now. For most of my life I was SAD - Standard American Diet, then around 2011 I went Vegan for a few years as a strategy to keep my doctor off my back who wanted to put me on statins (never went on them). Then in 2014, I learned my ApoE4 status and shortly thereafter I heard about this website and Dr Bredesen, so I went Keto with low saturated fat. Specifically for dietary guidance, I've been following Dr Steven Gundry, who's been testing for the ApoE gene and following tens of thousands of patients for about 17 years. If not familiar, he is addressed in the Wiki. https://www.apoe4.info/wiki/Dr_Gundry%27s_Protocol

Anyway, on the diet, I lost weight, my blood sugar, insulin and HbA1c went down, my inflammation markers went down (I didn't even realize I had inflammation and was heading down a dark health path), my total cholesterol is still in the "yellow" zone but don't care because the individual component markers that matter all went in the right direction, my organ function tests are great, my hormones are good. I am so glad I have learned to eat this way, I plan to eat this way for the rest of my life unless studies prove otherwise is more beneficial. I just hope I've changed in time to make up for the "sins of my past."

So I think what you're doing is wonderful. I am glad you feel great, so often that is not the case as many find they encounter "keto flu" when trying to keto adapt, that makes it hard to keep up the motivation.

Are you monitoring your ketones? I say this because this is one pitfall I often hear, that someone eats low fat and THINKS they are ketogenic, but aren't. There are some reasonably priced monitors out there, at least two that I know of that test both ketones and glucose. Now that I'm adapted I don't measure every day, just periodically to "check in" or to see how I might react to something different.

Another thing, I found that even after starting to burn ketones for a fuel source, i.e. getting keto adapted, my body continued to this adaptation process. I base this on my multi-day fasting experiences in 2016 and 2017. In 2016, I'd been ketogenic and intermittent fasting and on a daily basis for about 1.5 years, yet still had hunger and energy issues on my multi-day fast. In 2017, 2.5 years after changing to a ketogenic diet, my multiday fast experience was much different and it was easier, this told me my body continued to adapt! I thought this was very interesting that adaptation would continue for such a long period of time.

So one week down is great, but keep up the good work!

Hi Theresa! Thanks for the reply! That's super encouraging. I do use a meter (precision) to track both ketones and glucose. My numbers have been great (GKI < 3). I'm going to experiment with adding in more non starchy veggies to see if I can keep them there. I went from eating 8 cups+ veggies per day to 2-3 on ketogenic. I find it odd that I need/should limit my veggies, but the meter will tell me! Do you have good substitutions for coconut milk by the way? I often use it to make curries or culture it for yogurt, but I'd like to switch to some sort of nut to replace the sat fats with mono and polys. Also I'd love to see what you eat everyday if you wouldn't mind sharing a sample day?

Tom, that looks low sat fat to me. You might want to invest in the ketone meter to see where your levels are and if you can add more plant matter! I found it worth the cost and very eye opening. Great job so far!

Yep. Been keto adapted since Oct 2009. Was "traditional (meat, fat, non-starchy veggies)" keto till I found out my E4 status in 2014. Switched to Gundry's protocol for E4's (his regular, but no animal/fish only shellfish, whitefish or omega 3/pastured eggs - no dairy or MCT/coconut oil). Fats are primarily unfiltered olive oil, avocados & oil, tree nuts (macadamia, pistachio, pecan, hazelnut, walnut) All our Gundry labs & stats are linked in this post. My most recent labs are linked here. and the posts that follow it. A1C from those labs was 4.6%. Did a detailed Cronometer analysis for two weeks in March 2017 with a gram scale. Here are the results:



Average saturated fat: 24.6 g

Other habits that may impact my results:

I've eaten one meal a day since June 2015. Also fasted 5 consecutive days out of every 14 since 1 May 2017. I'm weight stable when viewed from the first fasting day of a cycle to the next. When eating, ketones run from around 0.5 -2.5 mmol/L. Today (2nd day of a fast) fasting blood sugar was 66 mg/dL (3.7 mmol/L) and serum ketones were 1.6 mmol/L. At 44 hours fasting today, glucose was 54 mg/dL (3.0 mmol/L) and ketones 4.6 mmol/L. I'm not a fan of chasing ketones unless you have reason (seizures, cancer, brain fog & etc.), but am doing the fasting to stimulate autophagy, apoptosis & mitophagy.

I typically do a "superslow to failure" workout on the 5th day of a fast. I ski hard, rock climb & lots of body weight training while fasted. I also do cold thermoadaptation - 20 minute or more daily baths in 49 deg F (9.4 C) water. Also try to walk for 15 minutes in the hour after sunrise with just shorts on and again for 30 or more minutes at noon (in Colorado). Wear shades that block all light frequencies below 490 nm indoors.

In short - full on "abbynormal"...

Waves, KC! I know... feels pretty amazing . I'm so happy it's been helpful for you. I think "most" folks here who are using a keto approach are minimizing SFA. Many of us are yielding good lipids as well. Keep us posted on yours when you retest.

Hi KC and welcome.
Yes I run in mild ketosis and keep my saturated fat at 10grams ish.
I don't use coconut oil.
Just olive or avocado oil, other sources of fat are fatty fish, nuts and whole avocados. The rest of my saturated fat comes from eggs and occasional lamb.

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"I also do cold thermoadaptation - 20 minute or more daily baths in 49 deg F (9.4 C) water."

Tincup, you are one serious dude. I mean, the multi-day fasting is pretty impressive. But, 49 degrees? wow.

Tom wrote:"I also do cold thermoadaptation - 20 minute or more daily baths in 49 deg F (9.4 C) water."

Tincup, you are one serious dude. I mean, the multi-day fasting is pretty impressive. But, 49 degrees? wow.

Tom, my take on ApoE4 is that it is well adapted to depravation (and poorly adapted to excess) and is also inflammatory (which is good in an acute sense and bad in a chronic one). Also that the dementia has its root in poor mitochondrial function. These precepts guide my actions for prevention.

I look at ketosis & fasting as a metabolic "trap door" (which signals the body that scarcity is present). Likewise with hypothermic adaptation which will encourage the "browning" of white fat (growth of more mitochondria in the fat) making it more like brown fat (which is metabolically active like muscle).

Also breath training to increase serum CO2 which allows more cellular access to oxygen due to the Bohr effect. Hence more efficient mitochondria.

Can provide more info on these topics if interested.

I started with 12 hour overnight fasts, most but not all days, over the past year. And slowly eliminated excess sugars. Went to 14 hour over night fasts for a while. I usually found it easy, with periods of feeling really clear-headed - didn't expect this, even though that's what everyone says. Oddly, the most noticeable thing is that colors seem brighter...especially blues. Or maybe I just imagine that. But I feel best in hours 11-14. Recently (~2 weeks) pushed out to 16, some days, which is no trouble at all. My diet is basically keto lately - phased that in slowly. It's not the "real" keto diet - I don't eat red meat and haven't been sophisticated about the meal plan. Also, I haven't monitored ketones yet. Just trying this out. I feel like it's been no big deal. No real cravings. Not really hungry most of the time. I didn't expect the weight loss - but that's fine. There have been interesting changes in my blood work, which will take a little time to figure out. My challenges have been upper-stomach pains which are almost certainly from coffee, because I'm drinking more than usual. And I need to expand my recipes - right not it's all pretty basic good stuff, but it'll get old eventually. Given that I feel much better I would keep doing this just for the immediate feel-better benefits alone...