Another negative lipid profile trend

[Fiver]

which diet allows the pasta and pizza? That's the winner!

So much trying and tweaking and trying again...glad to have you smart people helping out.

[Orangeblossom]

which diet allows the pasta and pizza? That's the winner!

So much trying and tweaking and trying again...glad to have you smart people helping out.

Italian diet?! Sadly, saw they were trying to get them to cut down on it though...

[ru442]

which diet allows the pasta and pizza? That's the winner!

It's the see food diet... you see food you eat it! I am not a doctor nor play one on TV, but this is not a recommended diet for apoe4

[JimBG]

Thanks all for your thoughts and comments. I think this saturated vs. unsaturated fat debate is as "clear as mud" with arguments on both sides. I believe that individual responses will also differ, and although ApoE 4 status (I'm 3/4) is a big factor, my guess is that other polymorphisms and one's gut biome also come into play. As Orangeblossom noted lipidology is quite complex and I don't think anyone has the complete answer yet. At this point I'm probably going to stick with a low saturated fat diet a while longer and see if my markers plateau out or change for the better.

Appreciate your suggestion Tom on the Med diet. I might give it a try after some time if I'm not satisfied with my results. I am very reluctant to turn to statins. A few years back my PCP prescribed them (my TC was just over 200 then) and they didn't agree with me. I felt tired, had some brain fog and frequent muscle spasms in my calves and feet. So I got off them. He's been trying to get me back on, and last year with TC at 230 I resisted. I know that when I go back and see him again he's probably going to have a coronary when he sees my numbers!

Sorry to hear Julie that you are still struggling with the flu. Hopefully you're nearing the tail end. It's a draining ordeal no doubt. I'm 63 and I don't have any history of CVD. My mom who passed away at 83 had angina and congestive heart failure. My dad is 92 and doesn't have any heart, cholesterol or BP issues. I definitely will also get a calcium score when I see my PCP. And perhaps the oxLDL. My BMI is 23.6. BP is 120/70. The numbers seem to be OK. I also have best version of the FOX03 gene (probably from dad) which hopefully can provide some offset to the ApoE polymorphism. Who knows?

On the pizza and pasta comments, being 1/2 Italian, getting away from such things with the family social pressures (along with my wife who is full Italian and not on my health crusade) is quite challenging to say the least. But I try to manage the best I can opting for salad/vegetable substitutes and very small portions, in the hope of not offending anyone. But its tough!

[optimize]

In Gundry's 2016 AHS talk, he mentioned, "..the hyper response of LDL-C concentrations associated with the E4 allele occurred only when the fat content in the diet varied".
https://www.youtube.com/watch?v=Bfr9RPq0HFg starting at about 8:20

Perhaps your LDL level is rising because the fat content of your diet has been shifting; that suggests that it might go down in future, once your diet's fat content (type and amount) is stable again.

[JimBG]

Well I obtained my lab results (including NMR tests for the 1st time). A couple of markers have improved and a number mostly line up with my home testing results. Here I compare with lab results taken 1 year ago and the most recent home testing results:

---------------4/13/17 (lab)-----------3/7/18 (home)------------3/31/18 (home)-----------------4/5/18 (lab)
Glu-------------103-----------------------84--------------------------96----------------------------98
TC--------------236-------------------- 264--------------------------253----------------------------261
Tri---------------116----------------------97--------------------------103----------------------------120
HDL-------------57-----------------------39---------------------------49----------------------------55
LDL--------------156---------------------205-------------------------183----------------------------182
TC/HDL---------4.1-----------------------6.7--------------------------5.1----------------------------4.7
Est CHD Risk----0.8----------------------------------------------------------------------------------1.0
Homocyste------7.9----------------------------------------------------------------------------------8.6
CRP------------0.30---------------------------------------------------------------------------------0.49
Free Test --------7.6---------------------------------------------------------------------------------14.2
Test------------- 363--------------------------------------------------------------------------------750
Hem A1C---------5.6---------------------------------------------------------------------------------5.1
Vit D-------------56.0-------------------------------------------------------------------------------53.6


NMR 4/5/18
LDL-P: 1974
HDL-P: 29.1
LDL size: 21.3 Pattern A
LP-IR Score: 35
Apo B: 150


I think the good news is the my A1C has declined and my testosterone has increased. Also CRP is still quite low. The bad news is that the LDL-P and Apo B is high. My understanding is that even though the particle size is pattern A the high number of particles makes that irrelevant. So I guess my next step is to get a Coronary Calcium Score test or a CIMT. The LDL-C number is quite stubborn even though I hardly ever have any saturated fats and mostly use EVOO, avocados and walnuts for my fats which along with IF keeps me in mild ketosis. Very frustrating. Any observations are welcome. (You can look at my earlier posts on this thread for more background).

[Fiver]

You doubled your testosterone, from borderline low(ish) to solidly in the "normal limits"?????? wow. I'll need to re-read your thread. But, any idea how/why this increased so much?

I understand having Italian relatives who can make extra challenges for this kind of diet. Makes to doubt the "Med diet" since it does not seem very "Italian" to avoid carbs or try too darn hard to maintain a healthy diet. I do admire their seemingly low stress levels, however! and wine....

[JimBG]

You doubled your testosterone, from borderline low(ish) to solidly in the "normal limits"?????? wow. I'll need to re-read your thread. But, any idea how/why this increased so much?

Not sure Tom. I did take TestoFuel for 4 months last year but discontinued in August as I didn't feel any different. It may have had an impact but think it unlikely that its effect would last for 9 months. I have lost now about 20 pounds over 9 months which could be a factor. Have also been doing intermittent fasting for last 6 months. Changed up my diet back in January to cut out most sat fats and replaced with the "good" ones. My workouts have been pretty much the same over the past year. My stress level has come down a lot and I'm getting good rest since retiring last March. So it may have been a combination of things.

On the Italian pasta challenge Victor Longo seems to be able to manage it from what I understand but I'm sure its not easy even for him.

[JimBG]

Got my calcium score today, my first one, and unfortunately it was 175. That puts me at the moderate evidence level for CVD. Also based upon my age, sex and race, I am at the 69th percentile, not good either. The test was done on a CT Scanner with automatic exposure control, hence my radiation dose was only 0.8mSV, comparable to a mammogram. That's good. My GP Has referred me to a cardiologist for a follow-up.

Based upon my reading on this topic till now, number one, this test trumps any other CVD risk assessment. Lipids, HsCRP, CIMT, etc. And number two this test is essentially backward looking, reflecting the buildup of plaque over the years and the risk assessment as of today. Much more important is the increase in the score from year to year. If under 15% that's good. If over that's bad.

My concern is finding the right cardiologist. I am not eager to go on a statin due to its side effects. However will bite the bullet if that's the best thing to do. Have also heard of Bile Salt Sequestrants (Welcholl?) but don't know much about them. Do statins work because they lower LDL or because they lower inflammation? Do we have a good statin thread? What have folks done with moderate and high Calcium Scores? Interested in any thoughts.

[Stavia]

Hi Jim.
Yes tricky area. You will hear two competing camp's views. Unfortunately this is not a black and white area.

Bile sequestrants (your question) have not been shown to reduce cardiovascular events. They were used widely in the 80s until it was realised that the lowering of LDL cholesterol with these drugs was a misleading surrogate marker ie no reduction in heart attacks and strokes.

Its a question of statin/aspirin versus aggressive management of diet, excercise, selected supplements. Or both. You will hear many on this forum reject the former, and your cardiologist do the opposite and he/she will recommend it. There is evidence both ways, and it is still unfortunately matter of interpretation.

But what is very black and white is that high glucose levels definitely increase risk. Watch your glycaemic control like a hawk even if you chose a statin.



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