From amywads:
Welcome Amy! I'm sorry that you're facing a host of issues. MANY of us are in the same boat. Here's a thread that covers the latest thinking in reducing Lp(a): viewtopic.php?f=5&t=1201 Many here are working on the same problem.hello im new to this forum and am apoe3/4 have high ldl (145) high lpa 75 ok hdl at 89, and am a hyper absorber of cholestrol..like many of you every day seems to be a stressful science experiment on what to eat what not to eat. In addition, i have to keep my calories up as im very active and naturally underweight and underfat. its so confusing as an apoe 4.i know i have to keep animal and SFA lower, hi as per the apoe perfect gene diet rec. high plant protein/plant fat/ high unrefined carbs. two issues with this is
High lpa has shown to increase:: with high plant fat and protein, and high carb (even unrefined) esp soy which are staples of a low ldl diet.
in addition, knowing i hyperabsorb plant sterols too makes it concering to eat a high plant fat diet
so basically im faced with eating to lower LDL but raise lpa and possibly alzheimers risk (as studies have shown SFA are HELPFUL in brain health) or lowering lp a which will likely increase LDL and possibly create more arterial plaque and cholesterol.
my daily diet looks bascially like this
breakfast: two servings of steel cut oats, quinoa, or buckwheat or brown rice, a non fat plain yogurt with grass fed whey powder and about 6-8 oz of berries, an apple and a half or cup and half of pineapple
lunch: large baked potato or sweer potato topped with almond butter and plain steamed veggies or topped with beans, plain raw veggies, corn and olive oil or avocado
1 oz dark chocolate
dinner 6-8 oz plain steamed or baked lean grass fed meat fish or poultry
two cups cooked veggies
two servings of a whole grain, pasta, rice,
dessert one full fa yogurt with honey or bowl or turkey hill all natural ice cream with some more chocolate
i exercise about 45-65 mins daily with cycling, running, HITT weight workouts etc.
I need advice.
Rather than choosing between high fat or low fat, a good starting place to work on your diet might be to check A1c, fasting glucose & insulin, as well as to begin tracking your post-prandial response to your diet. I can't help but notice that some of the foods you're eating are pretty high on the glycemic index (oatmeal, honey, ice cream, apples, pineapple, sweet potatoes corn, pasta & rice.) Many of us have lowered LDL-P -a more accurate marker of CAD/CVD than LDL- by focusing on lowering those biomarkers; improving insulin resistance which concurrently reduces inflammatory markers. There is lots of evidence that controlling insulin resistance protects both brain and heart health in E4 carriers.
I'd like to see studies that demonstrate SFA is helpful to brain health....We're struggling with this one. We have some evidence that desmosterol levels are linked to cognition. SFA raises it; but it's rarely low unless one is using a statin or eating a very low fat diet. We also know that E4 carriers exhibit impaired cerebral glucose metabolism decades before dementia manifests in a dose dependent manner; 3/4s are less dramatically affected. Ketone bodies (via MCT- high in SFA) can provide an alternative brain fuel, BUT using this concept preventatively is in early stages of understanding/efficacy. Some of us are trialing this strategy with MUFAs (rather than SFA) and still keeping LDL-P low. You can order your own LDL-P test via direct-to-consumer testing for around $75 to track.
Maneuvering through multiple issues is HARD. You are not alone, my friend. You're already doing a great job by eating primarily whole food, exercising, and maintaining a low BMI. Keep posting and asking questions. We'll do our best to help.
