The Ketogenic Diet: A Neurologist’s Warning

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Re: The Ketogenic Diet: A Neurologist’s Warning

Postby circular » Mon Dec 30, 2019 10:42 am

Julie G wrote:
Even for those people who believe that the brain needs fat (which it actually doesn’t, it only needs omega 3’s) the brain has 400 miles of micro-vasculature – aka arteries – that are incredibly sensitive to fat and the damaging inflammation it causes. This we know.

Plumster, can you share the link for this quote? FWIW, I completely agree that vascular disease increases the risk of both CVD and dementia. I remain unconvinced, however, that dietary fat is a primary contributor.

Let me respectfully ask you a very important question. I'm very interested in your response. If I had vascular disease, what would the clinical signs and symptoms be? How would I know?

Also, it's been suggested (proven?) that one can be insulin resistant in the brain but not peripherally. Is the same true for vascular disease? I would think possibly so. An MRI can show microvascular ischemic disease. Mine didn't show it and my CAC is zero, but I'm pretty liberal (not crazy high) with fats.

I would think saturated fat would be important to ensure structural integrity in neurons? I think of omega 3/DHA as allowing extremely rapid signaling (don't have where I read something like that???) while being highly vulnerable to oxidative damage, while saturated fat would provide more structural integrity with less vulnerability ... but these are my uneducated words ... I don't know.
Last edited by circular on Wed Jan 01, 2020 6:33 am, edited 1 time in total.
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Re: The Ketogenic Diet: A Neurologist’s Warning

Postby Plumster » Mon Dec 30, 2019 11:07 am

Plumster, can you share the link for this quote? FWIW, I completely agree that vascular disease increases the risk of both CVD and dementia. I remain unconvinced, however, that dietary fat is a primary contributor.

Let me respectfully ask you a very important question. I'm very interested in your response. If I had vascular disease, what would the clinical signs and symptoms be? How would I know?


Julie, it's from the article for which I created this thread for discussion.

As I'm not a medical doctor, my medical opinion is of little value here, but I would look at your blood pressure first and foremost. Whether cholesterol is a factor, I don't know, but I would certainly presume so and look at lipoprotein and other markers. Your symptoms? If you were a man, I'd ask, can you do 20 pushups no problem? Why do you ask, Julie? I make no claim to be an expert. It's possible that I've completely misunderstood the issue and blood flow in the brain is not about fats at all but, rather, the function of mitochondria? My question is sincere. I fully support those of us who choose the ketogenic diet for prevention and treatment or health in general. I sincerely want to understand how hardening of the arteries in the brain happens, and causes AD, as discovered by surgeons during autopsy. Is it the diet? Is it about fat at all? Certain kinds of fat? Which?
Last edited by Plumster on Mon Dec 30, 2019 12:13 pm, edited 1 time in total.
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Re: The Ketogenic Diet: A Neurologist’s Warning

Postby floramaria » Mon Dec 30, 2019 11:51 am

Tincup wrote:
More recently, her now 87 year old sister was presenting with dementia. Her son, my cousin, chatted with me about it. I suggested supplementing his mother with caprylic acid (C8), a medium chain triglyceride that will stimulate the liver to produce the ketone betahydroxybuterate (BHB). I wasn't sure if he would do it. My aunt lives over 1,000 miles from me, but I usually call her once a week. I started to notice a big difference in our conversations. She would remember the subject of our talks from week to week and bring them up, unprompted. After four or so weeks, I reported what I was observing to my cousin. He confirmed that his mother was very "with it" now.

HI Tincup! thanks so much for posting this. It gives me the idea of trying it with my dad. He recently turned 100, and in the last year and a half has been complaining some about his memory not being as good as it had been. It was not obvious to anyone but him, but now it is getting worse to the point that he is forgetting a lot. He has resisted my suggestions that he move more. And since he moved from his own house to a community for active seniors where he gets some of his meals, he has begun to eat more sweets, though he was remarkable all his life for having less of a sweet tooth than anyone I know.
Perhaps he’d be willing to try the caprylic acid. do you know what dose your aunt takes? Does she take small amounts several times a day? though I know every individual is unique, any info you can share with me would be helpful.
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Re: The Ketogenic Diet: A Neurologist’s Warning

Postby Tincup » Mon Dec 30, 2019 12:03 pm

floramaria wrote: do you know what dose your aunt takes? Does she take small amounts several times a day? though I know every individual is unique, any info you can share with me would be helpful.

Here is what I sent to my cousin. Start with 1 tsp and work up to 1 TBL at a time (only downside can be loose stools). May want to try 3x/day as it doesn't stay in the system for too long. The C-8 will make ketones (beta hydroxybuterate) in the liver as an alternate brain fuel to glucose. If this is going to help, you should notice quickly. I recommend Dave Asprey's Brain Octane product. If you just want to try it, this is a 16oz bottle. For a lower cost, purchasing three 32oz bottles at a time.

This is Dave's guide.
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Re: The Ketogenic Diet: A Neurologist’s Warning

Postby Julie G » Mon Dec 30, 2019 1:44 pm

As I'm not a medical doctor, my medical opinion is of little value here, but I would look at your blood pressure first and foremost. Whether cholesterol is a factor, I don't know, but I would certainly presume so and look at lipoprotein and other markers. Your symptoms? If you were a man, I'd ask, can you do 20 pushups no problem? Why do you ask, Julie? I make no claim to be an expert. It's possible that I've completely misunderstood the issue and blood flow in the brain is not about fats at all but, rather, the function of mitochondria? My question is sincere. I fully support those of us who choose the ketogenic diet for prevention and treatment or health in general. I sincerely want to understand how hardening of the arteries in the brain happens, and causes AD, as discovered by surgeons during autopsy. Is it the diet? Is it about fat at all? Certain kinds of fat? Which?

Your opinion is of high value and I do trust your sincerity, Plumster. It's often hard to "read" people through electronic communication, but my intentions are good. I asked that question because I'm trying to help you feel empowered. It's very unlikely that you (or any of us) will develop vascular disease without specific biomarker changes, signs and symptoms that we can monitor and modulate as necessary. I completely agree with you that blood pressure is a big tip-off, as well as specific lipid patterns, oxidized LDL or myeloperoxidase, fibrinogen levels, omega-3 index, omega 6:3 ratio, vitamin D levels, hsCRP, homocysteine, fasting insulin & glucose, hbA1c, waist measurement, CAC scores and pulse wave velocity (PWV) testing that measures arterial stiffness. PWV is strongly correlated with both CVD and dementia, especially for E4 carriers. You can monitor it at home with a gadget called iHeart. Dr. Bredesen will be recommending it in the book as a means to monitor the effect that the KetoFLEX 12/3 lifestyle is having upon your vasculature. I recognize that the science is unsettled which is precisely why we all need to take charge of our own health and monitor as many of these parameters as we can. Living with uncertainty is hard, but if a specific strategy is moving markers in the wrong direction, you can easily change course to protect your health. By using this general approach, I've learned to trust my n=1 much more than any expert advice.

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Re: The Ketogenic Diet: A Neurologist’s Warning

Postby circular » Mon Dec 30, 2019 4:39 pm

Julie G wrote:You can monitor it at home with a gadget called iHeart. ...

Thanks for mentioning this. I'd never heard of it. When I went to the website using your link, after scrolling down it says it costs less than $149. When you click buy it costs $195. On Amazon it's available for $149. Just thought some may want to know where to get the lower price.

I wonder how connective tissue disorders might influence the results. I think for those individuals the vessels are already supposed to be less stiff due to the weaker connective tissues that line them. Maybe it's something other than the connective tissue, and independent from it, and not influenced by it, that is stiffening and then detected by the iHeart?
ApoE 3/4 > Thanks in advance for any responses made to my posts.

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Re: The Ketogenic Diet: A Neurologist’s Warning

Postby Plumster » Mon Dec 30, 2019 5:58 pm

Thanks, Julie!
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Re: The Ketogenic Diet: A Neurologist’s Warning

Postby MarcR » Tue Dec 31, 2019 11:12 am

circular wrote:I wonder how connective tissue disorders might influence the results. I think for those individuals the vessels are already supposed to be less stiff due to the weaker connective tissues that line them. Maybe it's something other than the connective tissue, and independent from it, and not influenced by it, that is stiffening and then detected by the iHeart?
The iHeart is a finger pulse monitoring device that measures the time between your arterial forward and backward wave peaks. From a 30 second series of measurements, it estimates the speed at which blood flows through your circulatory system.

The results show good correlation to Sphygmocor measurements, but you can see from the maker's own graph that there are outliers. I suspect that iHeart is using the finger pulse method from ...

Aortic pulse wave velocity and reflecting distance estimation from peripheral waveforms in humans: detection of age- and exercise training-related differences

... which notes:
although the prediction equation seemed to do well at demonstrating differences between young, old, and old exercise-trained subjects, it does not appear that it would do as well at classifying at the individual level (e.g., is APWV “normal” or “healthy” for a given individual).
So the iHeart works as a cheap Sphygmocor substitute for populations, but it is not accurate for individuals.

That said, I do think it is accurate on a relative basis. My measurements are consistent with variation explained well by recent activity trends in my life. I believe it's a good tool for allowing a single individual to track changes over time.

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Re: The Ketogenic Diet: A Neurologist’s Warning

Postby circular » Tue Dec 31, 2019 2:04 pm

MarcR wrote:... That said, I do think it is accurate on a relative basis. My measurements are consistent with variation explained well by recent activity trends in my life. I believe it's a good tool for allowing a single individual to track changes over time.

Thanks for your summary Marc! I'm trying to assess the relative value of purchasing this. If the treatment of poor velocity involves things I should be doing anyway, I'm not sure tracking it will help me as long as I'm motivated without it. I'm only thinking in terms of limiting expenses; I'm a data junkie so I have to discipline myself ;)

Do you have any desire to evaluate whether someone with zero calcium on a CAC needs this; ie, if the PWV results correlate strongly with CAC scores, I'm thinking not? (I'm back in the exhausted caregiver camp on a new front, but may get to this somehow anyway.) https://duckduckgo.com/?q=pulse+wave+ve ... fab&ia=web
ApoE 3/4 > Thanks in advance for any responses made to my posts.

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Re: The Ketogenic Diet: A Neurologist’s Warning

Postby PBW » Wed Jan 01, 2020 1:46 pm

I am enjoying reading your thoughts Tincup, Julie and Plumster. There is also the question of how and if the body is absorbing the DHA supplementation. Several of the interviews on Peter Attia's podcasts mentioned research that discovered the body was not able to absorb the DHA supplements and DHA was more important for Alzheimers patients including ApoE4. Both Tom Dayspring and Richard Isaacsen mentioned ApoE4/4 . "When prescribing statins two lower lipids one can't be too cautious with Apoe4/4. They must be monitored very closely" Or something to that effect and that was it...no specifics why or suggestions when or how to change courses. I think Dayspring may have also said the same caution must be taken prescribing PCSK9. So it seems to me no one has really answered all our questions about lipids, SFA, strokes, CAD , AD,ApoE4,MTHFR....
Last 6 mos. I have been"looking upstream" as David Sinclair puts it and focused my understanding on his research presented in "Lifespan" and his many podcasts. Also letting all the different research I have read about mitochondria's role in our bodies combined with pharmaceuticals, supplements , nutrition(ketosis, CR,fasting), exercise and sleep. Maybe it is because my mind is clearer these days, but I am feeling very hopeful that I can do more to expand on these high quality of life days. I get that Crispr may not happen in my lifetime to change my 4/4 status. But I am currently in great health and my strength and joi de vivre is returning since I have added more real foods. Don't get me wrong, Gundry did find an implication in my bloodwork that I am highly sensitive to lectins, even though I have never had any symptoms that others describe. After 6 mos of no slip up on Gundry's 4/4 diet including eliminating all coconut oil and cream, I did an N1 study the other day and bought some organic Trader Joes Fritoes (one of my favs kinda of like Stavias pastries) ,eating several handfuls on my drive back up the hill. Now I know what everyone was describing as feeling bloated..YIKES. So I try to learn from all. And enjoy spending days celebrating life in hopes that however many more days I have, I can avoid a long slow deterioration and rather die quickly as David Sinclair speaks is common in centurions. 5 more years like I am now will be outstanding ....30+ never know!!!!


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