Like everyone else here I'm new to this forum, although I've known I'm APOE3/4 since February. I've been doing some research of course, and what I find most frustrating is the contradictory advice. The MIND diet has been shown in tests to reduce the symptoms of AD in those who have it AND to improve cognitive functioning in those who don't. Among other things it recommends 3 or more servings of whole grains per day and no red meat. The Grain Brain diet recommends NO grains and beef is one of the 3 primary ingredients.
The Mediterranean diet is recommended here, but why? If you look at worldwide statistics on death due to AD, the US is #2 with 45.58 per 100,000 (I'm not sure how old these number are), and Italy is certainly better at #21 with 16.96/100,000, but Japan is down at #58 with 4.23/100,000 and Singapore is #171 with 0.19/100,000. The Singapore diet is rice and noodle-based, primarily but not entirely vegetarian, with plenty of seafood and tofu for protein. Coconut is a prominent ingredient. They eat 5 or 6 meals a day and drink coffee with every meal.
So much contradictory advice regarding diet!
Re: So much contradictory advice regarding diet!
Hi Whatnext and welcome.
Alzheimers is likely multifactorial and its not as simple as just looking at traditional food of various cultures and extrapolating that one factor. If it were that simple we'd have our answer immediately and there would be no need for research.
Have a read of my introduction in the Newcomers Forum.
Alzheimers is likely multifactorial and its not as simple as just looking at traditional food of various cultures and extrapolating that one factor. If it were that simple we'd have our answer immediately and there would be no need for research.
Have a read of my introduction in the Newcomers Forum.
Re: So much contradictory advice regarding diet!
...not to mention, population prevalence of the E4 allele is quite slim in Asia 
. I agree- lots of contradictory advice. That's why we created the site. Please do start with Stavia's introduction. It's got some great information to help you with diet decisions. You may want to start by looking at your own biomarkers to see what (if anything) needs tweaking and work backwards from there.
. I agree- lots of contradictory advice. That's why we created the site. Please do start with Stavia's introduction. It's got some great information to help you with diet decisions. You may want to start by looking at your own biomarkers to see what (if anything) needs tweaking and work backwards from there.Re: So much contradictory advice regarding diet!
I did read Stavia's introduction-- she recommended the Mediterranean diet. If you look at the worldwide prevalence of the a4 allele, it's actually a bit lower in Italy and Greece than in most of Asia. Of course there must be multiple factors that cause more AD in one population than another, but relative prevalence of e4 in populations doesn't correlate with the statistics on AD. I'm not suggesting that we all start eating like Singaporeans, I'm just wondering why we should eat like Mediterraneans. I'm not trying to be argumentative-- it's just frustrating.
Re: So much contradictory advice regarding diet!
I think Stavia recommended the Mediterranean Diet because it is the most studied with regards to both heart and brain health at the time she wrote that segment. If you'll note, she emphasized the heavily plant-based aspect of that diet for the nutrient density. Here's a paper that even showed a slight improvement in cognition in ApoE4 carriers using a Mediterranean Diet. That being said, very few people here actually practice a traditional Mediterranean Diet. Instead, many use aspects of that diet (lots of non-starchy vegetables, fish, high polyphenol EVOO, nuts, olives etc.) that are particularly helpful in optimizing overall health and subsequently cardiovascular and neurological health. As a community, we're not homogenous in our dietary practices due to both conflicting evidence and individualized needs. PLEASE feel free to start a thread on diet and add your own evidence.
It's interesting and tempting to try to draw conclusions based upon epidemiological prevalence of Alzheimer's Disease. But, as Stavia pointed out, diet is very unlikely to be the only contributor to the disease. Reporting is also notoriously unreliable in many countries so the evidence is far from accurate. My guess is that simply eating less may account for the reduction of Alzheimer's prevalence in Asia. The fact that Asian diets also tend to be heavily plant based diet with seafood also may contribute to the reduction. Unfortunately, many strategies (like diet) are far from straight forward for our genotype.
It's interesting and tempting to try to draw conclusions based upon epidemiological prevalence of Alzheimer's Disease. But, as Stavia pointed out, diet is very unlikely to be the only contributor to the disease. Reporting is also notoriously unreliable in many countries so the evidence is far from accurate. My guess is that simply eating less may account for the reduction of Alzheimer's prevalence in Asia. The fact that Asian diets also tend to be heavily plant based diet with seafood also may contribute to the reduction. Unfortunately, many strategies (like diet) are far from straight forward for our genotype.
Re: So much contradictory advice regarding diet!
I recommended the traditional (yes I know there are many types) Mediterranean style eating as a beginning point for someone stuck in the SAD (standard American diet) way. I believe that huge behavior changes suddenly are not sustainable. And we are in for the long haul here. Traditional Mediterranean diets are a great intermediate step from the SAD, or maybe even the final step for some who are unable to sustain huge dietary changes.
Whatnext - you are unfortunately going to have to work out the best way forward for you. I personally do not believe there is a one size fits all diet - except there will be overlapping areas in all the options - lots of veggies including leafy green salads, no processed food, limited or no simple sugars, starchy carbs according to activity level or blood glucose parameters, olive oil, nuts, modest amounts of protein especially fish and seafood. The finer points I felt too detailed and still too controversial for a beginners guide. These being ?grains ?dairy ?lectins ?how much protein and what kind (mtor) ?LFHC vs LCHF?
Yes "experts" are publishing books contradicting each other. That's unfortunately the state of the game. I felt that a Mediterranean type diet was the least controversial starting point.
However I also believe diet is only a small part of prevention and focusing on tiny details of diet will be to our detriment if we ignore other valuable strategies.
Whatnext - you are unfortunately going to have to work out the best way forward for you. I personally do not believe there is a one size fits all diet - except there will be overlapping areas in all the options - lots of veggies including leafy green salads, no processed food, limited or no simple sugars, starchy carbs according to activity level or blood glucose parameters, olive oil, nuts, modest amounts of protein especially fish and seafood. The finer points I felt too detailed and still too controversial for a beginners guide. These being ?grains ?dairy ?lectins ?how much protein and what kind (mtor) ?LFHC vs LCHF?
Yes "experts" are publishing books contradicting each other. That's unfortunately the state of the game. I felt that a Mediterranean type diet was the least controversial starting point.
However I also believe diet is only a small part of prevention and focusing on tiny details of diet will be to our detriment if we ignore other valuable strategies.
Re: So much contradictory advice regarding diet!
I agree with you! and what little I've learned supports everything you've written about the importance of epigenetics. The discrepancy in the global occurrence of e4 vs. AD shows that. When looking at the numbers I picked Japan and Singapore as examples because I'd think reporting would be reliable in those countries.There is also very little AD in India, but I was more doubtful about the reporting there.
Unfortunately I think there are major factors beyond our control. I blame the pharmaceutical industry here in the US for aggressively marketing drugs-- and doctors for prescribing everything for everyone. They've now found a connection between AD and the heartburn drugs that are so popular here. We also live in a polluted environment: Google "flame retardants in the US" if you really want to be happy to be living elsewhere. I found this quote from an abstract titled Brominated Flame Retardants in US Food: "All US women's milk samples were contaminated with PBDEs from 6 to 419 ng/g, lipid, orders of magnitude higher than levels reported in European studies, and are the highest reported worldwide." When I was in grad school (long, long ago) I became friends with a grad student who was studying nutrition. She now teaches at a university in New Hampshire and she's doing research on the affect of flame-retardants on our ability to metabolize fat.
The list goes on. I know that I developed rather extreme attitudes long before I thought I had anything to worry about regarding AD. I take no prescription drugs at all. I see a gynecologist annually for the usual tests but that's it. Menopause hit me like a ton of bricks at the age of 54 (ten years ago), but I chose not to take hormones. I know that I have to stay healthy if I want to stay off statins and all the rest of it, so I do a vigorous weight-lifting routine three times a week and I do yoga for flexibility and balance. I don't eat sugar unless it's a social occasion in which it would be rude to refuse. I don't eat red or processed meat except in the same situation. I drink red wine. I've made minor changes in my diet since learning I'm 3/4: I now cook with coconut oil and I eat more curry.
Unfortunately I think there are major factors beyond our control. I blame the pharmaceutical industry here in the US for aggressively marketing drugs-- and doctors for prescribing everything for everyone. They've now found a connection between AD and the heartburn drugs that are so popular here. We also live in a polluted environment: Google "flame retardants in the US" if you really want to be happy to be living elsewhere. I found this quote from an abstract titled Brominated Flame Retardants in US Food: "All US women's milk samples were contaminated with PBDEs from 6 to 419 ng/g, lipid, orders of magnitude higher than levels reported in European studies, and are the highest reported worldwide." When I was in grad school (long, long ago) I became friends with a grad student who was studying nutrition. She now teaches at a university in New Hampshire and she's doing research on the affect of flame-retardants on our ability to metabolize fat.
The list goes on. I know that I developed rather extreme attitudes long before I thought I had anything to worry about regarding AD. I take no prescription drugs at all. I see a gynecologist annually for the usual tests but that's it. Menopause hit me like a ton of bricks at the age of 54 (ten years ago), but I chose not to take hormones. I know that I have to stay healthy if I want to stay off statins and all the rest of it, so I do a vigorous weight-lifting routine three times a week and I do yoga for flexibility and balance. I don't eat sugar unless it's a social occasion in which it would be rude to refuse. I don't eat red or processed meat except in the same situation. I drink red wine. I've made minor changes in my diet since learning I'm 3/4: I now cook with coconut oil and I eat more curry.
Re: So much contradictory advice regarding diet!
WhatNext,WhatNext wrote:I've been doing some research of course, and what I find most frustrating is the contradictory advice.
FWIW, the way I came to think of it is that there must be something in common with what on the surface looks like contradiction. As I presently sum up...
Each word has meaning, so maybe to deepen it...Eat whole, real, flavorful food - fresh and in season... and mix it up once in a while.
1. Whole - Whole fruits and veggies of course but also whole animals if eaten. The balance of nutrients in the whole thing is important.
2. Real - Even whole foods that aren't real don't count... factory produced fish, beef both have very different nutrient value than their naturally produced counterparts.
3. Flavorful - Added this after the argument made by Schatzker based on Provenza's work - flavor is the leading indicator of nutrient value and we should listen to our body's cravings
4. Fresh - Think now well known that particularly for veggies nutrient quality declines rapidly after harvest.
5. In season - All this debate over higher carb or lower carb is resolved by eating with seasons. Seems logical to me that being in and out of different metabolic states during the year is likely good for building a fully functional and healthy metabolism. I even think weight should follow - highest in the summer/fall and lowest in the winter/spring (following fewer carbs).
6. Mix it up once in a while - I think there's a good argument for intermittent fasting or time restricted eating. So some days it's great to skip breakfast and even lunch. I don't eat at all several times a year. At a minimum, I think this triggers helpful autophagy processes, but I also think the evidence is very strong for improving mitochondrial function.
So I don't give this stuff near as much thought as I once did... I just keep the implied principles in the back of my mind and roll with it. No need to worry about Mediterranean, MIND, Paleo, .... or whatever (although I think this is just another way to describe an ancestral/evolutionary/paleo-type diet).
Russ
Russ
E3/4
Eat whole, real, flavorful food - fresh and in season... and mix it up once in a while.
E3/4
Eat whole, real, flavorful food - fresh and in season... and mix it up once in a while.
Re: So much contradictory advice regarding diet!
Great post, Russ!
E4 carriers, from all over the world with vastly different diets, show an epidemiological pattern of very low rates of AD & CAD when they follow a traditional diet. Only when sugar, white flour, engineered oils, processed food, etc. become commonplace do we see these diseases of civilization follow. Weston Price's book, Nutrition and Physical Degeneration beautifully outlines this observation.
E4 carriers, from all over the world with vastly different diets, show an epidemiological pattern of very low rates of AD & CAD when they follow a traditional diet. Only when sugar, white flour, engineered oils, processed food, etc. become commonplace do we see these diseases of civilization follow. Weston Price's book, Nutrition and Physical Degeneration beautifully outlines this observation.
Re: So much contradictory advice regarding diet!
Thank you Russ! It's interesting that "flavorful" is number 3 on the list. When I cook for myself I make intensely flavorful food that I wouldn't risk serving to guests. I love garlic and ginger and will mince 2 or 3 cloves of garlic and a sizable hunk of ginger for a single meal such as stir-fried (in coconut oil) chicken, shrimp, or tofu with peppers or broccoli or another veggie. I do the same when I make curry--I make a mean coconut chicken curry 
I also like colorful food and will use red, yellow, and green peppers in a single meal. Of course all of these dishes are served over rice--my main carb. I eat no carbs with breakfast (nuts mostly) or lunch (salad), but I love the way rice soaks up the flavors. And it's the main staple of the diets of some countries where AD is rare, so I've decided not to give it up.
I also like colorful food and will use red, yellow, and green peppers in a single meal. Of course all of these dishes are served over rice--my main carb. I eat no carbs with breakfast (nuts mostly) or lunch (salad), but I love the way rice soaks up the flavors. And it's the main staple of the diets of some countries where AD is rare, so I've decided not to give it up.