Hello there! Young male obsessed with optimal health and performance reporting for duty!

[christian.vuye]

Hello there, my name is Christian. I'm a 3/4.

Before I move into topics related to Alzheimer's and CVD, I would like to introduce myself by telling a bit more about myself.

I'm currently 22 years old and I am constantly focusing on being the best version of myself, both in health and performance. In the past, I have struggled with my health. As a child, until the age of 18, I was overweight. When I turned 18, I decided it was time to finally start caring about my health, since my mental performance started becoming affected by my poor diet and sleep. And quite frankly, at that age my hormones started kicking in and I wanted to look more attractive to the other sex.

As a child growing up in the early '00 my diet was poor: although my parents told me to eat a lot of veggies and fruits, we mostly ate processed crap. Both of them are overweight, borderline obese (although my mother is finally improving that - inspired by me - by basically following the Bulletproof Diet). So when at age 18 I went to a nutritionist for the first time, I was recommended to cut the sugar and sweets (good!) and focus on eating whole grains and pasta (not so good, looking back at that now). My weight improved, I got slim and together with my new diet I also started exercising rigorously, endurance running about an hour each day on top of doing weight training.

All in all, everything started being better, but I just noticed a couple of annoying things on this High carb, low fat diet:
- I was constantly hungry and never felt 'satisfied' or nourished by a meal. After finishing a meal, I was hungry again. I could eat ALL the time. My energy levels were all over the place and I would become really sleepy, really often. Not good. Not fun.
- My 'gains' in the gym were not progressing: I constantly started increasing the volume of my exercise (more running and more weight training) but the results didn't improve. Quite the opposite actually; I felt as if my body was holding on more to fat storages than before.
- I became depressed and my energy levels were down. Eventually, I got treated by a psychologist after a suicide attempt. Looking back, my testosterone was relatively low back then for a male of my age, which I assume had something to do with it. In the normal range still, but 'low' normal. At the bottom of the 'normal' range.

For a while, I kept following the mainstream recommendations, but kept falling back because I felt the need to 'cheat' on my meals with fatty foods. At some point, I realized it was time for a change and I adopted a higher fat diet. Still not high fat though, instead more high protein, moderates amount of fat and relatively low-carb. This diet, I followed together with a high-intensity exercise program. The diet was also calorie restriced. Less time in the gym, more satisfying meals and better results. I felt better than ever before, but I also felt there was room for improvement. On the diet, I cycled high protein, low carb & low fat days with, high protein, high fat, low carb and high carb, moderate protein and low fat days. The final one in that list was a so called 'refeed day'. I felt best on the high fat, high protein, low carb days. After a period of 3 months, I also did a blood panel:

Analysis 2-4-2015
Iron 191
Ferritine 88
Vitamin B12 662
Folium acid 11,1
Creatinine 1,44
e-GFR 69
Protein metabolism 77
Cholesterol total 197
HDL-Chol 72
Non-HDL-Chol 125
Ratio HDL/Non 2,74
LDL-Chol 119
Triglycerides 28
GOT (AST) 27
Gamma-GT 12
Glucose sober 77
CRP 0,4
25-OH-Vitamin D 39
Prolactin 9,7
Testosterone 22,74
SHBG 69,5
Free Testosterone 0,295

As you can see, my free testosterone was still relatively low. And I also felt like I didn't feel a 100% yet. So I swapped to a high fat, moderate protein, low carb diet with carb refeeds: something between a keto/paleo/bulletproof diet.

First of all: wow! I have never ever felt better. I 'feel' like this is the diet for me! No more energy crashes, no more hunger, I can go easily 16 - 20 hours without having a meal. My testosterone is buzzing. And while at the start I had a couple too much carb 'refeeds' which actually led to a high carb, high fat diet (which is reflected in my blood panels below, and which I sincerely believe was detrimental to my health and performance), I am currently in deep ketosis, in preperation for an athletic contest where my BF% needs to be under 10.

Analysis 6-11-2015
25-OH-Vit D 49,8
Testosterone 24,14 (<- went up together with increased fat and saturated fat intake)
SHBG 61,1
Free Testosterone 0,352 (<- went up together with increased fat and saturated fat intake)
DHEA-Sulfate 512,8

Analysis 30-12-15
Iron 49
Ferritine 135
Vitamin B12 508
Folium acid 8,3
Creatinine 0,77
e-GFR >90
Total Cholesterol 222 (still OK, but 'high' according to mainstream standard, my own pdoctor told me there was nothing to worry about)
HDL-Chol 72
Non-HDL-Chol 150
Ratio HDL/Non 3,08
LDL-Chol 131 (rose just a bit after about 4 months of high fat eating)
Triglycerides 97 (rose from 28 to 97, probably due to me eating a bit too high carb around the holiday period)
GOT (AST) 23
Gamma-GT 13
Glucose sober 82 (rose from 77, probably due to me eating a bit too high carb around holiday period, just like with trigs)
CRP 1,3 (I had a cold around this period)
Testosterone 25,32
SHBG 66,9
Free Testosterone 0,346
DHEA-Sulfaat 422,5
TSH 1,83
IgE 210 (after this, I did an allergy test for which I tested positively on the dust mite allergy)

A couple of weeks later, I did a hormone test, because I was worried I might have a bit too much estradiol (fat around waste and chest was getting really hard to get rid off) and this came in completely normal, but testosterone produced elevated:

Testosterone 38,14 (my doktor asked me if I was injecting extra testosterone lol! I told him it was because of my increased saturated fat intake)
SHBG 75
Free Testosteron 0,530 (FINALLY in the higher 'normal' range, I definitely felt this in the gym!)
Estradiol 19,2

A couple of months later, I had another 'general' blood test done:
Iron 91
Ferrtine 69
Proteinmetabolism 80
glucose sober 95 (I continued having too much 'refeeds', which had a clear effect)
CRP <0,3
Vitamin D 64 (all those months of supplementation finally payed off!)
Testosterone 39,49
SHBG 86,4 (does anybody maybe know why it is so high?)
Free Test 0,483
TSH 3,29
Ige 192

Most recently, I did a 'heart health' blood test, which got me worried about my cholesterol levels:
Creatinine 0,77
Cholesterol, total 275
HDL Chol 62 (how did this drop from 72?, I continued eating high fat!)
Ratio HDL/Non 4,4 (this got me a bit worried, because my LDL went up, HDL went down)
LDL Chol 197 (got me worried a bit too!)
Tryglicerides (already lower, but still not low enough, started taking fish oil 4g/day)
Fasting glucose 90 (still not low enough either)
TSH 3,1
Potassium 4,2
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My apologies for putting up a wall of text and blood panels like that, but I felt it was necessary to get a clear image of my situation communicated to you. I hope you understand and take the time to go through them.

In any case, at the moment i am preparing for an athletic competition for which I need to lose fat. This are my current macro's:
Net carbs: max 25g/day
Protein: 70-120g/day, pushing towards upper limit
Fat: rest

Why so low in carbohydrates? Because I feel I am extremely sensitive to carbohydrates and I would like to restore my insulin sensitivity (which I probably lost after 2 decades of eating crap like a kid) and improve my fasting glucose and triglyceride numbers. I have been eating under 50g net carbs for the last couple of weeks (and with that number I was in ketosis), but I feel that the lower I go in net carbs, the less hunger I feel. This goes well with my calorie restricted plan of 2000kcal/day. As I still have a couple of pounds to lose in fat before the competition in 6 weeks, I plan on pursuing this ultra low carb diet at least until then. I also have better mental clarity and practive intermittent fasting (ranging from 16 to 24h fasts each day).

Next, I would like to ask you a question: one I feel nobody really has an answer to, but a question which I would like you guys to shed some perspective on. Should I eat more or less saturated fat? For about two months, I ate a saturated fat restricted diet: 30-35g of saturated fat per day. With my caloric requirements and with the purpose of maintaining ketosis, I felt this is the lowest I could go. Ate a lot of olives, avocados, macadamias and salmon. Most of my calories came from monounsaturated fat. But I feel like there is something strange going on: when I decrease my saturated fat intake, like I did in the past couple of months, my libido goes down, as well as my athletic performance. I just do not feel as energetic after a while. I suppose this might have something to do with testosterone production being lower. Does any one of you know how different saturated fat and monounsaturated fats influence cholesterol, and thereby testosterone production?

Obviously, for the athletic competition, I want to be the most energetic and lean as possible. For this reason, I reduced by net carb intake to 25g/day for the next six weeks (to completely reduce hunger and sweet cravings) and increased saturated fat to around 80g/day (for more energy and to maximize testosterone production). However, the thing that I keep asking myself in my head as a 3/4: will this saturated fat eventually kill me? I feel so much better with increased SFA intake, especially in terms of libido and exercise, but I have this constant fear that I might be damaging my arteries & brain.

What is your perspective on this? And does anybody know why suddenly my HDL went from 72 to 62? Is this due to increased carbohydrate intake during that period?

PS: A couple of months ago, I went to London to be a part of a Zestology podcast, where Dave Asprey (author of the Bulletproof Diet) was the guest of the evening. You can watch it here, around 1:19:40: https://www.youtube.com/watch?v=Fo3_z4AaRlA

I asked him the following:

Christian: What is your perspective on saturated fat intake and the APOE4 gene mutation? Isn't increased saturated fat intake going to increase LDL-C AND LDL-P for carriers of the APOE4 gene mutation?

Dave Asprey: Your supposition though, that if you eat saturated fat - any kind of saturated fat - and you have APOE4 then you LDL particles go up. That is not an untrue statement. A saturated fat includes C8 and C10 oils, which are technically saturated but do not behave like saturated fats. Unlike the other MCT oils that are saturated fats and DO behave like long-chain saturated fats. That is one of the reasons I recommend the stuff that I do versus MCT, which includes some things that behave like long chain fats. So, I think what you mean, is that if you eat a long chain saturated fat, your LDL particle number will go up. Now, if your LDL goes up and your HDL goes up as well, your triglycerides drop, your homo cysteine drops, your Lp Pa2 drops and your CRP drops... does that not factor in into the overall risk equation that we got looking at LDL-C? It does! Because, if LDL-C is damaging your arteries, by definition you will have an enzyme Lp-pla2 that will be expressed from the damaging of your arteries. So, if you are worried about that, and I know some people that are very focused on that, look for Lp-pla2! If you have damage, you have damage! If you have high LDL and you do not have damage... do you know high LDL makes it easier to put on muscles? It makes you more resilient to certain kind of poisoning? There is actually benefits to LDL, it is not a bad thing as long as there is no inflammation and damage. Like, show me the evidence. If you have APOE4 and you have high LDL, show me that it is causing damage, than you might need to change.

Anybody any thoughts on this?

[Julie G]

Welcome Christian! I have a son close to your age and I wish he cared about his health like you do. I'm beyond impressed with your improvements- KUDOS.

I've noticed the same with saturated fat. Minimizing it yields prettier lipids for me, but I feel somehow less energized and satiated. I'm not sure of a scientific explanation for that, but I believe it's a real phenomenon. I have no idea why your HDL dropped. My guess is that it's just a test variation as opposed to a truly significant outcome.

Great question to Asprey. While I like his answer, I'm not sure it's proven science. Many are guessing that the C8 & C10 won't increase LDL-P, but I've not seen peer-reviewed evidence, certainly not in an E4 population. Many here would agree with his stance that elevated LDL-P alone isn't a cause for alarm, but when combined with other inflammation markers, it may be a different story. Once again, we need more evidence to back that using hard endpoints like coronary calcium or actual events.

[Lucy5]

Hi Christian and welcome to our site. First, let me say thank you for sharing your journey with us. I'm so impressed by your discipline pursuing your health/fitness goals...wish I could borrow just a little bit of that discipline from you!

I am not an expert in lipids or achieving ketosis as that has not been my particular focus at this point. But if you've been browsing thru our forums, you may already know that many others here are very focused on the areas you've discussed and will, I'm sure, weigh in soon with their own experiences regarding diet & exercise.

We're all here because we hope to modify the potential negative effects of E4. That said, you'll find that we don't all respond to diet, exercise and other lifestyle strategies in exactly the same ways. And frankly, not all experts agree on the best diet for our population; it's just not settled science at this point (which you're prob already aware of given your own experimentation with diet prepping for your upcoming competition). The interplay of gender and E4 load along with individual genetics makes it pretty complex. But as a 22 year old male with a single E4 allele, you have so much time to experiment with lifestyle strategies (and follow the growing body of research) to help you stay healthy (& competitive!) in the years ahead.

If you haven't already, please check out our Newcomers Forum and especially our Primer written by our own physician member, Stavia, which is, we believe, the most comprehensive information you'll find in one place regarding the E4 allele.

Looking forward to seeing you on the forums and joining in the debate, Christian!

[MarcR]

Welcome, Christian!

Opinions in this community on saturated fat and on lipid biomarker management vary widely. Over the past year or two the most talkative among us have established this rough consensus:

1. The science is unsettled - studies conflict and key questions have not been asked.
2. It's an advanced topic that should be set aside until/unless one has addressed the fundamentals:
   1. Establish and/or maintain insulin sensitivity.
   2. Exercise and establish a healthy musculature.
   3. Adopt healthy sleep habits and address any issues.
   4. Alleviate excessive stress.
   5. Emphasize nutrient-dense whole foods in diet. Limit or avoid processed foods.

In my opinion, (a) requires one to have (b)-(e) in reasonable shape, so the basics boil down to (a). Since your ability to maintain a 16+/8- intermittent fasting regimen without excessive hunger proves normal (insulin-sensitive) metabolic function, I think you're approaching the saturated fat question at a good time in your health life.

To help you choose your own way forward, I recommend that you read these two recent threads, which highlight a range of member perspectives:

Chris Masterjohn on saturated fat
Rethinking the etiology of CAD

On a personal note, I was inspired to respond to you because despite our age differences - I'm 53 - your health journey and mine are similar. An E3/E4 male like you, I too ruined my health with bad lifestyle. At age 46, I was sedentary, obese (5'11", 230 lbs), chronically sleep-deprived, and I felt terrible. I too cut out sugar and began exercising vigorously as a first step, and it helped a lot but did not take me as far as I wanted to go. Curtailing seed oils and processed foods five years ago and adding 16+/8- IF almost four years ago yielded additional improvements, and dropping calorically dense carbohydrates (other than root vegetables in modest quantities) three years ago helped me establish weight stability at 160-165 pounds along with a consistent sense of well-being. I applaud you for taking control of your health early in life - buoyed by vibrant health and energy, your decades as a young adult promise to be enjoyable and fruitful.

[Nancy]

Oh, interesting question from you Christian, and answer from Asprey re:LpPLA2. I did not know much about what that number meant. Asprey said it meant there is damage being done when it's high. So I decided to look at my labs from this past winter then spring. My LpPLA2 after being on Atkins and using mainly Atkins products was 212 (high). My LpPLA2 after getting off Atkins for a few months and eating normally for me (prior to my APOE4 knowledge) with things like oatmeal, fruit, veggies, lean meats, brown rice, beans, whole grains etc., was 95. Much better! BUT, my triglycerides were higher second test. I wonder which is worse
I have now switched to high fat, medium protein, and pretty low carb diet and include NOW brand mct oil twice daily. I get tested again in November. I will be curious to see what my LpPLA2 is then. I will post my labs.

[Nancy]

Oh, and welcome! Thank you for joining us. You are wise to start taking care of your health at such a young age!

[christian.vuye]

Hey guys! Thank you all for the insanely kind words! I feel at home already. For a change, it is nice for people to complement me about my rigorous commitment towards my health, instead of telling me I'm a weirdo! Thank you for making my day and sharing your stories.

[christian.vuye]

Oh, interesting question from you Christian, and answer from Asprey re:LpPLA2. I did not know much about what that number meant. Asprey said it meant there is damage being done when it's high. So I decided to look at my labs from this past winter then spring. My LpPLA2 after being on Atkins and using mainly Atkins products was 212 (high). My LpPLA2 after getting off Atkins for a few months and eating normally for me (prior to my APOE4 knowledge) with things like oatmeal, fruit, veggies, lean meats, brown rice, beans, whole grains etc., was 95. Much better! BUT, my triglycerides were higher second test. I wonder which is worse
I have now switched to high fat, medium protein, and pretty low carb diet and include NOW brand mct oil twice daily. I get tested again in November. I will be curious to see what my LpPLA2 is then. I will post my labs.

Hmmm... Interesting indeed. Doesn't shed Atkins in the most positive light. If I may ask, what were your main sources of fat? I remember seeying Atkins products in the store and being disgusted by the 'frankenfoods' they are; a bunch of processed crap. Did they contain Omega 6 oils? Did you use a lot of Omega 6 oils? I heard these could be inflammatory.

[Ruth]

Welcome, Christian! Wow, your journey so far is inspiring. Thanks for your openness about your struggles. Congrats on turning things around!

[apod]

Welcome to the club! Fellow E3/E4 here (32yo.)

What athletic competition do you have coming up? While losing weight, 70g of protein seems a bit low (although, I suppose there's a balance between higher homocysteine, IGF1, & mTOR vs higher muscle mass.) Your HDL:TG ratio looks fantastic on the first set of labs, I've never managed to get my trigs that low. On the next go around, maybe look into an NMR Lipoprofile (LDL-P) or something that will give you small-dense LDL particle numbers.

I've been curious about the SFA thing too, particularly with C8 and C10. I've slid my fat / carb / sfa intake and fasting window all over the place and haven't seen too much action on my lipids (lower TC, lower LDL, lower TGs on a low-SFA diet; higher HDL, lower TC:HDL ratio, lower A1C on a very high-fat diet.) I'm currently doing around 18g/d of SFA if I don't count C8 with my other long-chain saturated fats, or ~50g/d of SFA if I do. In the recent past while consistently consuming the least carbs and fasting the longest between meals, I did notice some very high glucose spikes when I ate any substantial amount of carbs outside of my fat+veg based diet, where insulin sensitivity & glucose disposal didn't seem to be necessarily improved for me by this sort of diet. Although, with consistent carb restriction and diet adherence, these aren't major issues on a HFLC diet, since I don't need much insulin and theres not much glucose to be disposed. It's easy to overthink these potential diet / exercise / supplementation tweaks.