High energy expenditure and APOE 4

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Josh C
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High energy expenditure and APOE 4

Post by Josh C »

Having scoured the webs, and just recently finished Dr bredesden's book. I find there to be a lack of separation as to who this advice actually applies too!!

Those of us who work physically active jobs and play a wide variety of sports, should by theory be highly sensitive to insulin. Yet adopting a a "KETOFLEX" approach seems highly impractical from a energy perspective, as well as the potentially negative effects of increased cortisol production via lack of glycogen stores from higher thresholds of training. Eating that many calories of Fruit and vegetables, is definitely going to have negative effects on digestion, and I don't see how certain carbohydrates are going to be an issue when timed correctly around training etc.

Also the protein recommendations seem to be very low for somebody who is building/repairing tissue at a higher rate than the average being. The protein recommendations themselves are enough to turn heads, with a lack of solid evidence to support such low amounts.

It seems like the protocol is suited towards those who have sedentary lifestyles, with no regards to the Pro/Recreational athletes among us. The physiology of a highly active person is quite different to that of a sedentary being, who has to force themselves to move due to their workplace environment. And I'm just curious as if there is any research on highly active individuals who carry one or two of the APOE4 gene?

Obviously i am by no means dismissing Dr Bredesdens work, it just seems to be a little impractical for the lower/middle class upon us.
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Re: High energy expenditure and APOE 4

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Josh C wrote:Those of us who work physically active jobs and play a wide variety of sports, should by theory be highly sensitive to insulin.
I disagree with that assumption, and so would Tim Noakes, professor emeritus in the Division of Exercise Science and Sports Medicine at the University of Cape Town, South Africa. He has run more than 70 marathons and ultramarathons, still runs mostly half marathons now, and is the author of several books and hundreds of published scientific articles on exercise and diet. In 1986 he wrote a very popular book, "The Lore of Running" where he wrote about eating carbs for performance, etc. He subsequently found himself to be terribly insulin resistant and changed his thoughts and ways. He said if you have the first edition of his book, tear out the chapter on diet, it's all wrong.

Professor Noakes is now an advocate of a low-carbohydrate, high-fat diet. In 2012, Tim founded 'The Noakes Foundation', a Non-Profit Corporation founded for public benefit which aims to advance medical science’s understanding of the benefits of a low-carb high-fat (LCHF) diet by providing evidence-based information on optimum nutrition.

Looking thin or being active does not necessarily protect a person from insulin resistance.
Josh C wrote:lso the protein recommendations seem to be very low for somebody who is building/repairing tissue at a higher rate than the average being.
True, I remember Dr Bredesen's 2nd book talking about the protein recommendation being a moving target, that some do need more than others. You might want to revisit that discussion.
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Re: High energy expenditure and APOE 4

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Josh C wrote:It seems like the protocol is suited towards those who have sedentary lifestyles, with no regards to the Pro/Recreational athletes among us. The physiology of a highly active person is quite different to that of a sedentary being, who has to force themselves to move due to their workplace environment
HI JoshC, being highly active is one of the best things you can do for your brain. personally, I am hoping to reap the cognitive benefits of several decades of non-mechanized work on my small farm! I didn’t work so hard for the exercise, but because I couldn’t afford a tractor. Research supports that the positive effects of being very active in your middle age supports cognition in later years. Your point about different protein needs is certainly valid and an important consideration. As Theresa mentions in the post above, in Dr. Bredesen’s second book he gets more specific about the need to personalize protein intake:
“...with the understanding that actual protein needs for each person are highly individualized.....It’s important to identify your personal protein needs by being aware that specific groups of people may need more protein.” Those groups include “ Those who engage in rigorous sports or physically demanding work.” (pg 153 The End of Alzheimer’s Program)
Josh C wrote:Eating that many calories of Fruit and vegetables, is definitely going to have negative effects on digestion,
I don’t eat a lot of fruits, but find that with very high vegetable intake my digestion is excellent. It might take time to adjust to the high fiber and quantity of vegetable matter, but there are a lot of studies that support the benefits of consuming a wide range of vegetables with their various phytonutrients and high fiber content.
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Re: High energy expenditure and APOE 4

Post by Nebo »

Did Noakes ever actually post bloodwork though? As far as I remember he claimed IR but never posted A1C and/or fasted insulin/blood sugar. It's one of those holes in his story that bothers me.
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Re: High energy expenditure and APOE 4

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Nebo wrote:Did Noakes ever actually post bloodwork though? As far as I remember he claimed IR but never posted A1C and/or fasted insulin/blood sugar. It's one of those holes in his story that bothers me.
I don't know, but I do know Noakes is not the only person who has become insulin resistant while highly active.
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Re: High energy expenditure and APOE 4

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TheresaB wrote:
Nebo wrote:Did Noakes ever actually post bloodwork though? As far as I remember he claimed IR but never posted A1C and/or fasted insulin/blood sugar. It's one of those holes in his story that bothers me.
I don't know, but I do know Noakes is not the only person who has become insulin resistant while highly active.
Interesting. This is new to me, are there case reports or any reading on this?
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Re: High energy expenditure and APOE 4

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Nebo wrote:Interesting. This is new to me, are there case reports or any reading on this?
I do recognize that exercise helps the body with insulin sensitivity, but that alone does not protect a person from insulin resistance.

Examples of this have been repeated to me over and over so much that I'm at a loss to point you in a specific article/paper. I do know Tim Noakes said he was diabetic (an extreme form of insulin resistance), so he exceeded those thresholds.

I know Dr Peter Bruckner, an Australian doctor who advises athletes, was once and advocate of carb loading, but was himself once overweight and pre-diabetic, is now healthy and an advocate for low carb/high fat diets for high performance athletes.

I know there are others.

I guess my best advice is to actually understand insulin resistance, (which even most doctors don't) and insulin resistance is more than HbA1c, fasting glucose and fasting insulin, then it can become evident. Some places to go to there: Dr Jason Fung, Dr Joseph Kraft, and Ivor Cummins have explained insulin resistance many times.
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Re: High energy expenditure and APOE 4

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Josh C wrote: It seems like the protocol is suited towards those who have sedentary lifestyles, with no regards to the Pro/Recreational athletes among us. The physiology of a highly active person is quite different to that of a sedentary being, who has to force themselves to move due to their workplace environment. And I'm just curious as if there is any research on highly active individuals who carry one or two of the APOE4 gene?
I think the bottom line is to remain insulin sensitive. Exercise and activity can certainly help, but aren't a guarantee. This Peter Attia interview with Gerald Shulman, M.D., Ph.D.: is "a masterclass on insulin resistance." Likewise in this interview with Iñigo San Milán PhD, San Milán studies very high end athletes at the University of Colorado Health Sciences as well as T2 diabetics. He is also the head coach of this year's Tour de France winner. Likewise, he has studied the Team Novo Nordisk, whose members are professional bicycle racers and T1 diabetics. He says the professional bike racers are the most insulin sensitive people. They can consume mass quantities of simple carbohydrates with no negative metabolic effect. What San Milán has learned is that when people do a lot of Zone 2 exercise (defined as a serum lactate level of 2.0), their mitochondrial density can increase up to 4 fold. Additionally, their mitochondria grow larger in size. Ideally, these athletes train at least 80% of their time at this level. This is what most would consider mild exercise. Many recreational athletes train harder than this and do not get these adaptations. Ideally, when training at this level, serum glucose, when measured during or immediately after the training should be decreasing. In many recreational athletes, it increases. Tim Noakes, mentioned above, noted in this story that his glucose levels rose sharply with his intense exercise.

Phil Maffetone's heart rate method is a relatively simple way to implement this (Attia interview's him here). Another, even simpler approach is to just breathe through your nose in all activity. This app uses heart rate variability to see if you are in Zone 2.

An anecdote. A friend is a Berber from Morocco. His village is in the foothills of the Atlas mountains, south of Marrakech. His father herded goats. His father walked up and down the steep hillsides with his goats most of the daylight hours, every day. His father was the only sheppard in the family and most others n the family have T2 diabetes. His father is metabolically healthy, in his 80's. The only other goat herder in the village was quite a few years older than his father. He was healthy until he died, late in life.

My takeaway is that if you are moderately active all day, and eat an unprocessed food diet limiting seed oils, especially if the carbs come from starches, you likely will be insulin sensitive. The sheppards were doing Zone 1 & 2 activity most of the days. In my observation, many recreational athletes spend most of their exercise time exercising too intently and they tend to load up on simple carbs (I was in this category at one point). They get into trouble. Go to a road race and observe, many are not metabolically fit, just by visual observation.
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Josh C
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Re: High energy expenditure and APOE 4

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TheresaB wrote:
I disagree with that assumption, and so would Tim Noakes, professor emeritus in the Division of Exercise Science and Sports Medicine at the University of Cape Town, South Africa. He has run more than 70 marathons and ultramarathons, still runs mostly half marathons now, and is the author of several books and hundreds of published scientific articles on exercise and diet. In 1986 he wrote a very popular book, "The Lore of Running" where he wrote about eating carbs for performance, etc. He subsequently found himself to be terribly insulin resistant and changed his thoughts and ways. He said if you have the first edition of his book, tear out the chapter on diet, it's all wrong.
Tim Noakes is hardly a figure i would seek to refer to when it comes to nutritional science, considering his outlandish views and dogma against carbohydrates. Also Noakes, was on the extremes when it came to carbohydrate consumption, consuming a high amounts of processed and refined gels, alongside a already carb heavy diet. No doubt extremes of "Carb loading" was also implemented during his fall in to T2 Diabetes.

Again i think we are missing the forest for the trees here, as i am simply stating my views on a moderate-high carbohydrate diet, around days when that amount of fuel would be required. I.e a weekly periodised nutritional approach for higher carbs on higher active days and vice versa.

Also the differences in submaximal repetitive activities such as running, cycling etc, have a much different physiological effect to that of a well structured resistance training plan with a lot of eccentric forces involved. Obviously a well balanced approach of resistance training, HIT and zone 2 on top of a physically active lifestyle would seem to be a great way, to improve metabolic flexibility and improve glucose utilisation without the needs of such extremes in restriction such as a keto diet.

As we are all aware, Adherence is going to be key when it comes to lifestyle change, and i guess all I'm trying to state is i feel alot of these recommendations are abit on the extreme side, considering there are many cultures worldwide that have great bio markers albeit going against these recommendations.
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Re: High energy expenditure and APOE 4

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Josh C wrote:Tim Noakes is hardly a figure i would seek to refer to when it comes to nutritional science, considering his outlandish views and dogma against carbohydrates.
I accept if your research has come to this conclusion, but as a moderator, I must remind you that all posts must adhere to the community guidelines which include:

Respect.. …Disagree with ideas, not people. You may not attack, insult, undermine, or belittle anyone. This broad prohibition extends beyond other members and this community to the world at large.

Humility. …Support your opinions with personal or clinical experience, your physician’s perspective, and/or published medical research. Avoid overreaching – we are most credible when we focus on our own personal experiences.
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