APOE 4/4 Specific diet - Dr. Gundry or not?

[dfmcapecod]

Just like trying to read history about which side of the Middle East conflict is "more right", I cannot for the life of me find heads or tails about whether Gundry's APOE 4/4 approach is a truck load of horse manure to sell his line of skin care products and thousands of dollars a year in supplements, or is steeped in clinical truth. The diet is incredibly restrictive, and I've read hundreds of posts on here from the backlogs. I am not starting from square one.

I can find just as many skeptic debunkers on here and the general internet trashing his anti-lectin approach as I can those who swear by the methodology. What is really lacking is proof and quantifiable ways to measure the things that it claims to be addressing.

If I were to sum it up, this forum seemed to go through a love fest for him in the peak of his books, but has grown cold to that approach in recent years (2017-19).

So, being someone in my 40's, do not want to run this diet to its nth degree unless there is some kind of empirical way to measure inflammation, stress and overall cardiovascular health. I seem to see plenty of mentions of the typical blood test measurements for cholesterol, but many diets, vegan, Mediterranean, etc will all have positive impacts on that too, which is demonstrable.

So what is it, does this forum support his Diet approach for 4/4's with empirical evidence or is it more blind faith? What should I measure myself in my own bloodwork to see whether I'm reducing stress, inflammation risk?

Being in my 40's, cutting lectins out hardcore could have a major major impact on me one way or the other, and there seem to be quite a few people that puke on Gundry's own citations in his book. Not to mention the impact on the diets of those around me, who are not 4/4's.

Please help me make sense of this....

[circular]

Hi dfmcapecod,

I'm not a Gundry expert so can't comment on all your questions. I trust you're in a huge crowd of people on and off this forum asking these questions to themselves if not aloud. I've been comfortable eating almost completely his way because I reacted to many of his bad lectin foods long before he hit the scene.

I'm not sure whether he believes his entire program is necessary specifically with respect to apoe4, but he did a recent podcast on apoe4. You might want to listen to it or read the transcript for his thoughts. He mentions small dense LDL from animal meat being particularly bad for e4. Interestingly, he's also said that higher sdLDL propensity is something people are born with and doesn't change much if at all in their life, so it only needs to be tested once. [EDIT: I got sdLDL confused with Lp(a) ... sdLDL does get retested to keep track, but not normally Lp(a) which is genetically determined.] So here I am with 3/4 and low sdLDL, even when eating a fair amount more animal meat than he recommends. Given, he probably recommends low animal protein for more reasons than just sdLDL (MTOR, IGF1 ...), but sdLDL is something you can measure that he strongly believes links e4 to Alzhiemer's.

His program overall seems to dial down inflammation, which of course is good for preventing all chronic diseases, but so does the Mediterranean diet.

These days, that is recently, I'm worrying less about the details of diet and supplements (not to say not focused on them) in favor of being far more committed to a strong meditation practice (of a 'rigorous' type [not at all the right word for it]; ie, beyond relaxation). I think meditation is a much bigger player than represented by content here. I think the developed world has completely lost its way by living nonstop in the logical mind rather than seeing it as a tool or 'sixth sense'. We can feel this in the vast intellectual fragmentation, with all its mixed messages and conflicting data, that raises our cortisol and other stress responses that can kill our neurons. This isn't to say I'm rooted in nirvana yet! I guess you could say I'm following a gut feeling that turning the mind inside out will be much better for everything about me long term. Now let's see how committed I stay to this practice ...

[SusanJ]

Being in my 40's, cutting lectins out hardcore could have a major major impact on me one way or the other, and there seem to be quite a few people that puke on Gundry's own citations in his book. Not to mention the impact on the diets of those around me, who are not 4/4's.

On the subject of diets, there is no perfect answer. I have the sense that Gundry plays a little loose and fast with things to make it easier for people to understand what not to eat. I personally cringe every time I hear that cashews are bad because they are a legume.

But, I think the point of any of the diets out there, be it MIND, Mediterranean, Gundry, etc, is to reduce the inflammatory burden on your body by generally eating foods that are not processed. Everyone has different genes and gene expression, so maybe I can eat cashews and someone else might not.

That said, I was diagnosed with rheumatoid arthritis in 2009, and for some time have followed the work of Sarah Ballantyne, who holds a PhD in medical biophysics. Her first book was an eye-opener for me on how food could overstimulate my immune system. She has a blog and several books, and currently working on a book about the microbiome. Her blog posts and books are filled with citations useful for any rabbit hole you want to dive into. Although science-based, her writing is accessible to non-scientists.

Here's a post about the Autoimmune Protocol (AIP), of which she is credited with creating: https://www.thepaleomom.com/start-here/ ... -protocol/. Her view of lectins is more nuanced than Gundry's, looking at specific types of lectins and why some foods might be bad (hint, lectins are in all foods, but certain kinds wreak more havoc). For example, squash stays on her to eat list. And following AIP showed improvement for those suffering with IBD in a recent study.

I also like that in following her work, I can piece together the puzzles of why certain foods bother me. I gave up dairy 20 years ago and felt immediately better, and when my joints started aching 10 years ago, I gave up gluten and felt immediately better. Then I recently read through one of her post that explains why I likely feel better without dairy, gluten, yeast, corn, rice AND potatoes, which has nothing to do with lectins per se, but cross-reactivity to protein snippets: https://www.thepaleomom.com/gluten-cros ... ing-it-up/. Certainly makes sense for me with a hair-trigger immune system that my antibodies are loaded and looking for bear.

Now the difference for me is that I'm an E4, so I go easy on the red meat and saturated fat part of the AIP diet. They just do scary things to my lipids, so that's my personal departure from AIP to stick to more fish, poultry, avocado and EVOO.

So, you'll never find a consensus on any of these diets, because you have to try, tweak and see what works for you, your genes and your gene expression. Gundry patients on the forum often say that he wants them to be very compliant and once their labs improve (and they do get improvements), then they can experiment with adding back foods.

And impacting those around you. Yep, it's real. My husband is a 3/3, loves and can eat pasta like no tomorrow, and his A1c and triglycerides both stay low. So, he makes his pasta and I make my spiralized veggies with pesto. But he also has learned to love a lot of the recipes I now make and says he feels healthier for it.

So, I hope you don't throw your hands up in frustration. Just focus on eating whole foods, cutting back on the processed ones and see where that takes you on the road to better health. Try a couple weeks without wheat products or dairy or something else you suspect gives you problems and see if you feel any different. As we say here, it's all an N=1 when it comes to what works for our own health.

[Plumster]

What is really lacking is proof and quantifiable ways to measure the things that it claims to be addressing.

The best I've found is the review of Gundry's book The Plant Paradox on Red Pen Reviews. Their review is very extensive. You can find it here.

[circular]

What is really lacking is proof and quantifiable ways to measure the things that it claims to be addressing.

The best I've found is the review of Gundry's book The Plant Paradox on Red Pen Reviews. Their review is very extensive. You can find it here.

Plumster, interesting site I was unaware of. I only read the summary, which seemed balanced on the surface.

[MarcR]

So what is it, does this forum support his Diet approach for 4/4's with empirical evidence or is it more blind faith?

I don't think a consensus regarding the scope of applicability of Dr. Gundry's protocol exists here. That said, I haven't seen much in the way of "blind faith". I think the entire spectrum of Gundry opinions here is represented by thoughtful, intelligent people.

[Tincup]

Hi dfmcapecod,

He mentions small dense LDL from animal meat being particularly bad for e4. Interestingly, he's also said that higher sdLDL propensity is something people are born with and doesn't change much if at all in their life, so it only needs to be tested once. So here I am with 3/4 and how sdLDL, even when eating a fair amount more animal meat than he recommends. Given, he probably recommends low animal protein for more reasons than just sdLDL (MTOR, IGF1 ...), but sdLDL is something you can measure that he strongly believes links e4 to Alzhiemer's.

Circ, I read the transcript and I did not see where he says sdLDL only needs to be tested once. I can say as a patient, that is a metric he looks at every time our blood is sampled.

Gundry's approach is very much based on his clinical experience. Theresa & I have posted links to seven of our consults with Dr. Gundry, including transcripts of the consults and labs, if you are interested. We haven't posted our two most recent consults as are involved in caregiving for a seriously ill family member and haven't had time.

An example from our last consult. One of the tests Gundry now runs on us is the PULS test. One of the items tested in PULS is IL-16

(others are:
MCP-3: Guides immune cell direction & activity
sFas: Prevents cell death
Fas Ligand: Initiates cell death and recycling
Eotaxin: Activates immune cells at areas of damage
CTACK: Helps clean up damaged tissue
IL-16: Recruits & activates immune cells
HGF: Stimulates tissue and repair
HDL: Helps remove bad cholesterol
HbA1c: Diabetes marker)

We had recently been making our own yogurt using Lactobacillus reuteri ATCC PTA 6475 with 1% A-2 milk. This was our only recent change in our diet. In my case, my IL-16 doubled, in Theresa's it went up 10X. Our conclusion was the A-2 milk was the culprit. If you look at our labs you can see he typically tests for many inflammatory and other metrics that are not commonly tested for. This is what he uses to make his clinical observations. Whether these tests are the correct ones to be running, I can't say, however his approach, at least for patients, is to optimize these values. Personally, I've had autoimmune issues since birth, I'm now 64. I adopted Gundry's approach in 2014. My autoimmune issues improved 80%. I've since fine-tuned within his list on things that I'm still sensitive to. I've improved the 80% to about 95%. I can't say this is optimal for all or all 4's but it has made a big improvement for me. Also, as a patient, or in his books he doesn't push his supplements. His supplement marketing partner is Guthy Renker, I'm sure they are very good at what they do, but I do agree their approach is obnoxious. I look at his diet/lifestyle advice as separate from the supplements.

[circular]

Circ, I read the transcript and I did not see where he says sdLDL only needs to be tested once. I can say as a patient, that is a metric he looks at every time our blood is sampled.

Thank you for the correction Tincup! I got it mixed up with Lp(a) I'll edit my post in case someone reads it but not yours.

[circular]

So what is it, does this forum support his Diet approach for 4/4's with empirical evidence or is it more blind faith?

I don't think a consensus regarding the scope of applicability of Dr. Gundry's protocol exists here. That said, I haven't seen much in the way of "blind faith". I think the entire spectrum of Gundry opinions here is represented by thoughtful, intelligent people.

Very well put Marc.

[ru442]

So what is it, does this forum support his Diet approach for 4/4's with empirical evidence or is it more blind faith?

I don't think a consensus regarding the scope of applicability of Dr. Gundry's protocol exists here. That said, I haven't seen much in the way of "blind faith". I think the entire spectrum of Gundry opinions here is represented by thoughtful, intelligent people.

Very well put Marc.

Agreed.... my take is that there are members such as Tincup that get real results from Dr. Gundry and advocate his approach with actual clinical evidence. I believe many members like me pluck parts of his protocol (I use the food matrix to make many of my food choices) along with parts from Dr. Bredesen to form a blended approach to our protocols. Many of us have also found that we can't follow as strict a diet as we lose too much weight like myself. In my opinion there is no good answer, everyone needs to follow a program that works for them, regardless of others opinions.

As for Dr. Gundry selling and promoting his own products, my sense is it's just background noise in this forum. It's America and if he wants to make a few bucks then more power to him, conversely we have the choice as consumers to buy the products we want. I generally buy the products my FMP recommends, and currently none are from the Gundry camp.

RU's 2 cents