16 replies to this topic

[giftsplash]

I have been on a strict Paleo diet for over 3 years, in Sept after getting my blood work done I realized that my LDL-P which seems to be the leading predictor of heart disease (Peter Attia, Dr Dayspring) was over 2300 which put me in the highest percentile. Following James Cain's great post on lowering his LDL-P by going vegan I wanted to see what I can do without altering my diet very much.

Bit About Me:
APOE 4/3, 44 Years Old, Male, 175 Pounds, 6 foot tall.

The Numbers:
Dates: 9/6/2013, - 10/24/2013 – 12/10/2013

Cholesterol – 252, 188, 163
LDL – 193, 127, 91
HDL – 40, 41, 43
TRIG – 149, 101, 143
LDL-P – 2321, 1645, 1281

Diet Changes:

I cut out red meat, but still ate chicken or fish at least once a week. Cut fat intake to under 20% a week.

Supplements:

My protocol was based on previous studies many of which have been posted here before. If someone is looking for a particular study please let me know and I will dig it up.

Niacin 500mg X 2 times a day, worked up to 1500mg X 2 times a day.

Sytrinol X 2 times a day

Policosanol at night

Glucomannan 1400mg X 2 times a day

Artichoke Leaves – 500 mg X 2 times a day

Tocotrienols 50mg X 2 times a day

Soy Protein with Soy milk about once a week.

What I did not take:

I did not take Oatmeal or Plant Sterols since they seem to not be as effective in APOE4's

Effect:

I definitely saw a decrease in my sex drive and strength. My testosterone dropped from 765 to 251.

Moving Forward:

I have stopped all the supplements and over the last week, things seem to be getting back to normal. I drew blood for testosterone test today should know results next week, but I suspect it's climbing back to normal levels.

Over the next 4 months I would like to focus only on keeping fat intake to under 20%, no red meat and add an intermittent fasting day. I will repost my results in 4 months. However in the mean time Five Diets is doing some interesting work and I am fascinated by how his results will look.

My Take on the Paleo Diet:

I have been extremely happy going Paleo. Before Paleo I used to be sick with a cold or a flu at least 20 days out of the year, since going Paleo I have been sick maybe 4 days total over the last 3 years. And the cold or flu never stayed more than a day.
But my problem with Paleo community is 2 fold.

• 
  This mantra of everyone needing to eat high fat high meat intake diet for optimum health is idiotic. I have never seen any study which showed that high fat diet woks for people who are APOE4. But I have seen a number of studies that show that it is detrimental to cardiovascular health. (Berkeley Heart Lab). I really wish someone in the Paleo community addressed the elephant in the room, because their mantra is hurting 25% of the population.
  
• 
  Over the last few years I started to see formula in the Paleo community which bothers be. When ever a study comes out which does not fit the narrative (China Study, etc) the study is dissected and scrutinized beyond belief. However when ever a study which supports the narrative comes out it is never questioned and is accepted as truth. I see this as intellectually dishonest.

I am a little lost about what I should do now. Clearly I cant continue eating high fat meat diet, yet once you cut out most meat and try to keep your fat under 20% eating Paleo starts to suck. So maybe going Mediterranean / Low Fat Paleo might be a good alternative. Still not sure what to do about grains.

Quick Point About APOE4:

For APOE4's looking for an optimum diet I would recommend looking at the eating habits of the people of Papua New Guinea. It seems that is where the highest concentration of APOE4's in the world is. (around 40%). Based on the values I have seen it seems like 69% / 21% / 10% - carbs/fat/protein is the norm which makes sense based on previous APOE4 studies.

[James Cain]

Excellent results. Thanks for posting the numbers! I am curious about how your numbers would look without the supplements, especially niacin, and if you were to cut out the last remaining sources of cholesterol. That's just for my intellectual curiosity though. I'd suggest what you're doing is likely largely mitigating your risk, and if it's sustainable then keep going with it.

I agree with your take on "classic Paleo" diets. There have been many iterations and schisms of the "Paleo" diet, and beginning with the "safe starches" and now resistant fiber, I have read of many followers of the diet increasingly adding carbs (even beans! *gasp*) in place of fat and sometimes protein and feeling better for it. It seems to be catching on and is becoming acceptable to label yourself Paleo while consuming a low- or lower-fat diet. I think much of the reasoning falls back to what we should avoid in our diets rather than what we should include.

Your triglycerides and LDL-P are good but seem a bit higher than expected. Some related questions: 1) how has your weight changed between the tests, 2) how was your physical activity changed between the tests, 3) what are your major food sources of carbs (and fat and protein), 4) what is your pattern of alcohol consumption?

[BioFreak]

any idea why your testosterone levels dropped that much?

[giftsplash]

James:

I plan on going the next 4 months with no supplements, and I do suspect that niacin was most responsible for the results I got. I will post my results.

• 
  My weight did not change very much for the whole experiment I varied between 173 and 178. Which has roughly been the range before the experiment.
• 
  There was no change in my physical activity before, during and after the experiment, which was about 1 workout per week of HIIT training (15 to 20 min). And about 3 runs per week between 2 and 4 miles at 7:30 to 9:30 min/mile pace depending on who I am running with. But I did see diminishing results during weight training which were obvious.
• 
  For this experiment I did not want to change my diet too much as far as denying myself any food but I had no problem adding different foods even if they were not paleo. I did ad some rye pumpernickel bread. And I still ate at Chipotle at least once a week with (chicken / beans / rice / guac). A few interesting notes about my diet. I found that I was consuming between 800 to 1000 calories less per day on average but my weight did not change. I suspect the loss of appetite was due to Glucomannan. This might also explain the drop in strength. I also notice that I lost my desire for fruit. When I was strict paleo I would constantly crave and eat fruit. I suspect that paleo was not giving me enough energy that my body craved. Now that I was eating a lot more carbs such as bread all desire for fruit was gone.
• 
  I suspect my numbers could have been a bit better if I abstained from alcohol completely but I did average about 2 drinks per week over the 3 months. I suspect that for APOE4 alcohol has more downside than an upside.

Another interesting note was that my skin became a lot harsher and not as smooth I attribute this either to niacin or possibly bread and gluten.

BioFreak:

Good question, I suspect it was due to policosanol since I was eating very little cholesterol and policosanol was blocking my production of cholesterol. But I am not sure. My testosterone has always been in the above 700 range before the experiment but my DHEA has always been low (between 60 and 70) and it did not change much during the experiment, I am still not sure of the reason for this. I suspect that Propecia has something to do with it. I plan on getting off of it for a few weeks in february and retesting my dhea.

[BioFreak]

Propecia is a testosterone -> dht blocker. In theory, it should increase testosterone...

And I just found a study to prove it:
http://www.ncbi.nlm....pubmed/14624915

So, if there are no other factors, it's most likely policosanol?

pubmed says unlikely:
http://www.ncbi.nlm....pubmed/24113041

strange. Maybe it was something else?

[Hebbeh]

I would suspect testosterone would decline with the a major decline in cholesterol. Also, the soy products (especially the isoflavone content of soy milk) are known to be very estrogenic in men and can negatively impact testosterone.

[BioFreak]

Me too, but that study shows otherwise.Maybe the decline is not enough, or maybe the body does unbound bound testosterone instead (not sure if this is possible though).

I was thinking about soy also, but once a week seems so insignificant - could that be enough to have such a major impact?

[giftsplash]

I considered soy to be the guilty party also, but I only took it about once a week, which included 2 scoops of soy protein with 2 glasses of soy milk. Not that large a dose.

I have no proof of this and it's only a speculation but I would not rule out a possible interaction between soy and Propecia. Propecia produces some very strange hormonal changes in some people and even though I never had any problems with it, I wonder if adding another item which messes with your hormones could produce the effect. But it's just a shot in the dark. There obviously been a lot of people who mess up their lives with Propecia, luckily I have not had any problems with it and I have been on it for over a decade.

I did a thyroid panel and DHEA test 8 days after I stopped taking all the supplements. I will have the results probably on monday. If anything jumps out I will post it.

[DAMI]

What does your diet actually look like? Where do you get your carbs from?
Did you ever try a high-MUFA diet? Is there evidence that these fats are also bad for APOE4s?
Finally is low LDL-P really a guarantee for preventing heart disease? Isn't oxidation of ldl-particles the actual cause of heart disease? What about your ldl-particle-size and glycated hemoglobin?

[platypus]

I would be worried with such a drop in T. Personally I'd try to tweak the regimen to return T to it's previous level. Have you considered taking a larger dose of Sytrinol? Have you checked your homocysteine-levels?

[JohnD60]

For APOE4's looking for an optimum diet I would recommend looking at the eating habits of the people of Papua New Guinea. It seems that is where the highest concentration of APOE4's in the world is. (around 40%). Based on the values I have seen it seems like 69% / 21% / 10% - carbs/fat/protein is the norm which makes sense based on previous APOE4 studies.

That is interesting that the people of Papua New Guinea have the highest concentration of APOE4s in the world. But I fail to see the logic behind wanting to follow their diet. It isn't as if many of their tribe ever reach an advanced enough age where they show symptoms of alzheimers. But if you are going to follow their diet, should you not mimic their history of cannibalism?

As has been said, it seems direct cause and effect here, that the lower of the cholesterol resulted in lower testosterone. Given that you have APOE4, I would think that you would be happy with elevated cholesterol levels.

And although LDL may be the biggest predictor of Heart Disease on your blood panel, I believe it much less a predictor than Diabetes or Obesity.

Edited by JohnD60, 26 December 2013 - 06:06 PM.

[giftsplash]

Dami

Here is what my diet looked like in terms of fat/protein/carb breakdown

Average Daily calories pre experiment – 1994
Average Daily calories during experiment – 1972
(very surprised by this, since I was under impression that I was eating a lot less, at least I was compared to how I was eating right before my experiment. But over the long haul it's about the same.

Average Daily Fat Intake pre experiment – 56g
Average Daily Fat Intake during experiment – 41g

Average Daily Carb Intake pre experiment – 280g
Average Daily Carb Intake during experiment – 310g

Average Daily Protein Intake pre experiment - 97g
Average Daily Protein Intake during experiment – 76g

Average Daily Cholesterol Intake pre experiment – 257mg
Average Daily Cholesterol Intake during experiment – 110mg

LDL Size was 21
Hemoglobin stayed around the same pre and after experiment at 14.9

Platypus

Just got my results back and after staying on the same diet but without supplements for 2 weeks my T levels are back to 653 from 251.

JohnD60

“But I fail to see the logic behind wanting to follow their diet. It isn't as if many of their tribe ever reach an advanced enough age where they show symptoms of alzheimers. “

Source please?

The Kitava Study

During an inventory in 1989, we found what appears to be one of the last populations on Earth with dietary habits matching what would have been the case for the population of Homo sapiens in their original habitats on the island of Kitava, one of the Trobriand Islands in Papua New Guinea's archipelago. The Trobriander people have been thoroughly studied by social anthropologists and human ethologists such as Malinowski, Powell, Weiner and Schiefenhövel [1-20], but medical reports have been few [21, 22].

No indications of coronary heart disease
We noted a lack of sudden cardiac death and exertion-related retrosternal chest pain among Kitava's 2,300 inhabitants (6% of which were 60-95 years old), as well as among the remaining 23,000 people on the Trobriand Islands [23, 24].

The oldest living person during the survey was a 96 year-old woman, and during a previous visit a vital 100 year-old man was interviewed.

http://www.staffanli...itavaStudy.html


"But if you are going to follow their diet, should you not mimic their history of cannibalism?"

If there was cannibalism it would only have minor contribution to their daily food intake, enough to be too miniscule to consider. And if we did consider it I don't think it would be that nutritionally different than the organ meat from animals they are already consuming.

As has been said, it seems direct cause and effect here, that the lower of the cholesterol resulted in lower testosterone.

I don't think this was due to cholesterol intake but rather by my stifling my own cholesterol production most likely with Policosanol. Like I stated at the top of the post my T levels are back to 653.

And although LDL may be the biggest predictor of Heart Disease on your blood panel, I believe it much less a predictor than Diabetes or Obesity.

I am not obese or have diabetes, so I think it's wise to focus on my LDL-P numbers.

Edited by giftsplash, 27 December 2013 - 01:23 AM.

[JohnD60]

JohnD60

“But I fail to see the logic behind wanting to follow their diet. It isn't as if many of their tribe ever reach an advanced enough age where they show symptoms of alzheimers. “

Source please?

The Kitava Study

During an inventory in 1989, we found what appears to be one of the last populations on Earth with dietary habits matching what would have been the case for the population of Homo sapiens in their original habitats on the island of Kitava, one of the Trobriand Islands in Papua New Guinea's archipelago. The Trobriander people have been thoroughly studied by social anthropologists and human ethologists such as Malinowski, Powell, Weiner and Schiefenhövel [1-20], but medical reports have been few [21, 22].

No indications of coronary heart disease
We noted a lack of sudden cardiac death and exertion-related retrosternal chest pain among Kitava's 2,300 inhabitants (6% of which were 60-95 years old), as well as among the remaining 23,000 people on the Trobriand Islands [23, 24].

The oldest living person during the survey was a 96 year-old woman, and during a previous visit a vital 100 year-old man was interviewed.

I was going to site this data http://www.indexmund...ctancy-at-birth which shows that for those born in 1960 the average live expectancy in Papua New Guinea was 39.6 years (vs. 73 years in the U.S. for those born in 1960). Earlier data would have been more useful, but 1960 is the oldest I could find. Using your data for just the 3200 Kitava people, it still demonstrates a large difference in life span contrasted against U.S. data http://www.indexmund...ctancy-at-birth (14.7% over age 62 in the 2000 census). And thus I think the 6% over the age of 60 number makes my point that not enough people in Papua New Guinea live to an advanced enough age whereby their diet would evolve to mitigate for their genetically slightly higher chance of getting Alzheimers

[giftsplash]

Of course the average life span would be a lot lower in hunter and gatherer society compared to the US. But this is due to higher infant mortality rates not diet.

From the Kitava Study.

“Child mortality from malaria and other infections was relatively high, and the average lifespan was around 45 years”

“There is no evidence to suggest that the people who died before the age of 60 are the ones who would have otherwise suffered from cardiovascular disease.”

“The elderly residents of Kitava generally remain quite active up until the very end, when they begin to suffer fatigue for a few days and then die from what appears to be an infection or some type of rapid degeneration. Although this is seen in western societies, it is relatively rare in elderly vital people. The quality of life among the oldest residents thus appeared to be good in the Trobriand Islands.”

“The remaining life expectancy at 45 years of age is more difficult to determine, but may be similar to Swedish figures. “

My point of looking at their diet is not so much that we eat taro and coconut but that a lot can be learned about successful fat/protein/carb ratio in an area high in APOE4's

[forever healthy]

being APOE3/4 myself i have compiled some research to build a holistic view on the implications of APOE4 for our knowledge base:

 

https://brain.foreve...splay/PUB/APOE4

 

feedback welcome

 

best michael

Edited by forever healthy, 06 July 2016 - 12:25 PM.

[docmaas]

Site requires login and there is no way to sign up.

 

thanks,

 

Mike

being APOE3/4 myself i have compiled some research to build a holistic view on the implications of APOE4 for our knowledge base:

 

https://brain.foreve...splay/PUB/APOE4

 

feedback welcome

 

best michael

 

[forever healthy]

the url has changed:

 

https://brain.foreve...isplay/EN/APOE4

 

 

Site requires login and there is no way to sign up.

 

thanks,

 

Mike

being APOE3/4 myself i have compiled some research to build a holistic view on the implications of APOE4 for our knowledge base:

 

https://brain.foreve...splay/PUB/APOE4

 

feedback welcome

 

best michael