Dr. Steven Gundry with diet recommendations for ApoE4

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Re: Dr. Steven Gundry with diet recommendations for ApoE4

Post by Tincup »

Circ,

Don't know where Boston Heart gets their metrics. As I posted in the body of the above, he mentioned they saw elevated adiponectin in thin women with AD in the Framingham study. Here is a search on that: https://www.google.com/search?q=framing ... heimer%27s And one paper: http://www.ncbi.nlm.nih.gov/pubmed/22213409
CONCLUSION: In women, increased plasma adiponectin levels are an independent risk factor for the development of both all-cause dementia and AD.


On the Singulex test, p1, he looks at these inflammation markers: ENDOTHELIN, INTERLEUKIN-6, INTERLEUKIN-17A, TNF-alpha, PLAC Test for Lp-PLA 2, hs-CRP & HOMOCYSTEINE. My impression is he sees these driven by lectins.

I can say this is the topic of his second book, due out after the beginning of the year. It is also a large part of the thrust of his practice. In my links there are links to podcasts where you might gain more info. Unfortunately our hour with him goes quickly and there isn't time to have detailed discussions on every topic.
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Re: Dr. Steven Gundry with diet recommendations for ApoE4

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First, HUGE thanks to you, George. This took a lot of time to put together. I'm very grateful for your generous sharing. I have to admit, I'm more impressed with Dr. Gundry than I expected to be ;) He touched on so many of the same strategies that we've already identified for our population- very encouraging.

I keep getting hung up on some of his more outrageous claims, i.e. that LDL-P doesn't matter. He may be 100% correct; per his clinical work, he is. But I wish he'd publish his protocol for E4s in a respected peer reviewed journal for scrutiny from his peers. That being said, I think you're very wise to follow his protocol AND keep your LDL-P low.

Can you help me understand the difference between sdLDL and small LDL-P? He puts a lot of stake on sdLDL. I want to understand exactly what that is. Also, with regards to E4 carriers, he puts a lot of credence into oxLDL, but he doesn't test it? FWIW, mine tested in the lowest quartile and I basically loosely follow his approach. I really want to test adiponectin now. I suspect I'm one of those thin women who may be very sensitive. If so, what in the world will I eat? No peppers, tomatoes, cucumbers, etc. What is in your salads?

Thanks again; a super informative post. I plan to do an EBT soon. If my score above zero, I may be knocking on Dr. Gundry's door too.
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Re: Dr. Steven Gundry with diet recommendations for ApoE4

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Juliegee wrote:I keep getting hung up on some of his more outrageous claims, i.e. that LDL-P doesn't matter. He may be 100% correct; per his clinical work, he is. But I wish he'd publish his protocol for E4s in a respected peer reviewed journal for scrutiny from his peers. That being said, I think you're very wise to follow his protocol AND keep your LDL-P low.

Can you help me understand the difference between sdLDL and small LDL-P? He puts a lot of stake on sdLDL. I want to understand exactly what that is. Also, with regards to E4 carriers, he puts a lot of credence into oxLDL, but he doesn't test it? FWIW, mine tested in the lowest quartile and I basically loosely follow his approach. I really want to test adiponectin now. I suspect I'm one of those thin women who may be very sensitive. If so, what in the world will I eat? No peppers, tomatoes, cucumbers, etc. What is in your salads?
As to salads, here is what can be in a typical dinner, 4 oz guacamole (Wholly Guacamole) kimchee, sauerkraut, coconut kevita, nuts macadamia, brazil and/or hazelnuts, thawed shrimp (or lobster, clams & etc), steamed asparagus, salad (various combinations of): spinach, kale, arugula, chard, green onions, mushrooms, cilantro, ½ avocado, radish, carrots, mint, parsley, cabbage, cauiliflower, broccoli, brussels sprouts, black olives, palm hearts, artichoke hearts, jicama, dandelion greens. Unfiltered EVOO, balsamic vinegar. Sometimes make cabbage steaks, baked plantain chips. Sometimes a glass of red wine. Sometimes make bone broth. Usually chill the broth and scoop off the fat.

As to sdLDL and small LDL-P, no I can't tell you the difference. I pulled an NMR two days after the Singulex for Gundry. LDL-P was 1292 and small LDL-P was <90 (off scale low). On the HDL labs had an LDL-P of 1377 and small LDL-P of 435 (in the green in HDL's eyes) with sdLDL of 28. sdLDL was 24 on the Singulex. On the other hand my wife's HDL labs had an LDL-P of 2380 and small LDL-P of 1382 with sdLDL of 34. She was 31 sdLDL on the Singulex. He's concerned about her sdLDL and not in the least with her LDL-P. From my post: "Says there is an East Coast faction (uses LDL-P to scare everyone onto a statin) on cholesterol and a West Coast faction (trained by Berkely Heart Labs). West Coast guys think using high dose statins to drive LDL-P<1000 is crazy. " He mentioned he's in lipid discussion groups where they "yell at each other." He obviously knows he's not in the mainstream.

I'm probably not going to worry about LDL-P - for example, knowing that coconut/MCT oil will spike it. Going on his advice, I'll use them.

As to publishing. I think we are lucky he's published what he has. As a guy in clinical practice with nobody supporting the publishing, I'm amazed he does what he does.

For us, we are happy to pursue his path, given his clinical results. From reading comments on the two FB groups that follow his approaches, my wife and I are at the healthy end of the spectrum. Many comment what huge positive changes he's made in their health. One lady (a month or two ago) said the first time she met him was in the hospital when he was doing a pre-op for a quintuple bypass (that he would perform). Instead of doing the surgery, he got her to adopt his program. She did that instead of the bypass and was posting to tell everyone how great she felt. If, when we retest our EBT scans, they've increased dramatically (which I'd be willing to bet they won't), we'll reevaluate. I've known I've had an elevated PLAC or LpPla2 score. He's the only person who has suggested he can get it lowered.

Heck Juile, nobody I'm aware of tests for E4 status. He's said he's treated 10,000 patients in 15 years (not that other clinicians don't see those numbers, but the routine testing he does is much more detailed than I've seen). He is addressing heart, cognition and autoimmune issues. I'm impressed. The other thing is he is not dogmatic. He laid out his metrics - sdLDL, inflammatory markers (like TNF-alpha), IGF-1 and said "see what you can get away with while keeping these metrics low." It isn't like he says you can't eat X. It is more like, will your body let you get away with eating X and not spiking the markers.
Last edited by Tincup on Mon Jul 13, 2015 2:30 pm, edited 1 time in total.
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Re: Dr. Steven Gundry with diet recommendations for ApoE4

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George,

Thanks a ton. Really appreciate it. Congrats on your marriage may you both have many happy and healthy years together.

Was wondering how you thought the dual session worked for you. I like the idea, but worried my wife could feel like she is not getting paid attention to (I think her genetics are about 10-100x better than mine). Seems you both are in good shape and don't have outstanding issues that need deep diving into. Also seems like the APOE 4 issue could be a rathole for an hour long call as well as a way for my health issue examination to get more time than hers.... but from reading your notes, it doesn't seem like Gundry focuses too much on the APOE status?

I am guessing you went dually through the results instead of breaking it into a half hour/half hour? Anyway any thoughts you might have on a slim genetically advantaged wife with a "husky" :oops: genetically challenged husband having an hour long call together would be appreciated. I am good with managing call scope and agenda, but worry that I may be overestimating the level of difficulty.

Cheers,

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Re: Dr. Steven Gundry with diet recommendations for ApoE4

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LanceS wrote:George,
Thanks a ton. Really appreciate it. Congrats on your marriage may you both have many happy and healthy years together.
Thanks!
Was wondering how you thought the dual session worked for you. I like the idea, but worried my wife could feel like she is not getting paid attention to (I think her genetics are about 10-100x better than mine). Seems you both are in good shape and don't have outstanding issues that need deep diving into. Also seems like the APOE 4 issue could be a rathole for an hour long call as well as a way for my health issue examination to get more time than hers.... but from reading your notes, it doesn't seem like Gundry focuses too much on the APOE status?

I am guessing you went dually through the results instead of breaking it into a half hour/half hour? Anyway any thoughts you might have on a slim genetically advantaged wife with a "husky" :oops: genetically challenged husband having an hour long call together would be appreciated. I am good with managing call scope and agenda, but worry that I may be overestimating the level of difficulty.
Since she's a 4/4 and I'm a 3/4, our ApoE status was part of the whole call. In one sense, however the ApoE status only modifies the diet part of the "Matrix" program. Also his prescribing niacinimide for both of us for our cognitive function. If you agree not to share, PM me your email address & I'll share the audio with you, so you can judge for yourself. The office had set it up as two 1/2 hour calls. When he got on, Gundry said the most efficient use of time was to go through our tests together. He would say, "turn to the HDL report p X." He'd look at one of us and address their issues, then the other's issues, or talk to us both if we were similar. He basically managed the scope and agenda.

By the way, he welcomes you recording the call. I had him call a Google Voice number which forwards to my cell. You can easily record GV calls by pressing 4 during the call. Afterward, you can download an MP3 of the call. This worked well and was very clear.

Dr. G. quickly sizes up how much you know and will have the conversation at the appropriate level. Hence having read his first book, lived the Matrix Diet, listened to a number of podcasts and (in my case) looked at quite a few posts on his two FB support groups made the time much more efficient.
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Re: Dr. Steven Gundry with diet recommendations for ApoE4

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What exactly is Niacinimide? How does it differ fro Slo-niacin, for instance? Is it completely different? I'd like to understand.
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Re: Dr. Steven Gundry with diet recommendations for ApoE4

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They are related. Slo-niacin is nicotinic acid, it is effective with cholesterol lowering. Niacinimide is sometimes called "no flush" niacin. According to Dr. Gundry it is very useful for E4 brain health. See this http://www.livestrong.com/article/24578 ... acinamide/.
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Re: Dr. Steven Gundry with diet recommendations for ApoE4

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I cannot take it at this time. But for possible use in the future, are there any cautions besides the excess sweating?
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Re: Dr. Steven Gundry with diet recommendations for ApoE4

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Well shoot, some time ago I posted some links re: the adiponectin and they disappeared on the ethers. 2nd time that's happened to me.

Anyway, since then I found this thanks to George's breadcrumbs:

"Study: Fat hormone increases risk of dementia in women"

"Of the 541 women that were tracked for dementia over the following 13 years, 159 developed some form of dementia, including 125 cases of Alzheimer’s disease. The study authors found that increased levels of adiponectin increased the likelihood of dementia development by 60%, and of Alzheimer’s by 90%.

"In addition to adiponectin, the study also tracked homocysteine and glucose levels.

"Schaefer suggested that the dementia study might indicate a connection between nutrition and dementia. Adiponectin levels were found to be inversely correlated to body mass index, or BMI. Older women with higher BMIs were found to have lower levels of adiponectin, and lower rates of dementia."

[Emphasis mine] This is wild. Boston Heart Labs did not get this memo. They have me down as optimal! I feel I should discuss this with them and see what they say. So I guess maybe I need to *gain weight*!? Get some fat around my belly!? Oh, one of the articles I'd seen before suggested that sweet potato extract could raise adiponectin. I would not be at all surprised if I had been eating a lot of sweet potatoes when I tested 24.1. I go through sweet potato phases. I once read that some weight around one's belly is okay as long as you stay proportional; i.e. if the belly fat in a woman is wider than her hips, trouble is brewing. So maybe I will relax and let some on but watch that I stay in proportion and then retest everything. This is a real eye opener. Thanks GeorgeN.

http://thechart.blogs.cnn.com/2012/01/0 ... -in-women/

Okay so here's another. I haven't had time to focus on the body of it, which I may well not understand anyway:

"Cross-Sectional Associations Bet ween Abdominal and Thoracic Adipose Tissue Compartments and Adiponectin and Resistin in the Framingham Heart Study"

"Lastly, high molecular weight adiponectin is more strongly associated with regional adiposity and metabolic diseases than total adiponectin (22). Thus, our results may have been stronger if we had measured high molecular weight adiponectin instead of total adiponectin. Adiponectin and resistin are correlated with fat depots cross-sectionally, but none of these adipokines can serve as surrogates for these fat depots. Relations among VAT, SAT, and cardiometabolic risk factors [doesn't included dementia] were not fully explained by adiponectin or resistin concentrations."

http://care.diabetesjournals.org/content/32/5/903.full

So is this yet another case of the media mashing up something sensational from a scientific study?
ApoE 3/4 > Thanks in advance for any responses made to my posts.
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Re: Dr. Steven Gundry with diet recommendations for ApoE4

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George,

Glad you finally had the call (I remember the wait was like forever, too), and thanks of sharing the detailed notes. I found myself replaying a VERY similar script in my own mind as I read so glad I got most things right and that they appear to have remained similar. Only surprised he emphasized a fish oil capsule over simply eating sardines - which he emphasized to me. This is the one thing I did that had the most dramatic effect (raised Omega 3 index from 5.6% to ~10%).

The one thing that he seemed to be just toying with when I talked to him has the glycine, so I am glad to see his position is getting even stronger on that. I will look into this Trimethylglycine form.

I guess it's also time to look in to the niacinimide thing a bit more - something we did not discuss at all in my call.

Overall, I concur with your sense that he knows what he's talking about so good to have your independent view of him. He comes across even a bit over-confident in the way he talks, but I think he has better insight and data than most, so no foul in my book.

The one part of his story that still doesn't square with me is the demonization of meat per-se. I pointed out to him how hard it was to square with prevalence of E4 in hunter-gatherers, and he pointed out that we need to think of still-living hunter-gatherers as the least successful of their gene pool - which makes no sense to me. Although we still lack data, I think the answer is more likely the 'nose-to-tail' eating (note the eating the 'gorging on a big fatty brain of a zebra' I think in Circ's recent post re fiber), and also the simple logic to variability of what 'eating up' is like when food is available (and refrigerators are limited). I doubt HG's eat zebra brain for dinner every night ;-). I continue to think highly bio-available micronutrients from animal products are vital if whole, natural and in balance because they are wild (or pastured), and eaten with variability.

I also have never heard him comment on some of this mitochondria strengthening stuff due to starvation/fasting we've discussed elsewhere. Whereas eating 1x day from Dec-May has some sense to it and is likely largely a good thing, I'll bet our HG ancestors weren't so rigid in their schedule? He may be missing something here, still?
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