Best diet approach for a homozygous 4/4

Newcomer introductions, personal anecdotes, caregiver issues, lab results, and n=1 experimentation.
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healthnut
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Best diet approach for a homozygous 4/4

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What is the prevailing preferred diet here for 4/4? Gundry, Bredesen....? I'm 62 and had a heart attack a few weeks ago and have eaten low carb and keto most of my adult life, but ended up with a 99% occluded LAD. I work in a gym as a trainer and am very fit, I don't fit the typical heart disease victim. I thought I was beating the odds with my lifestyle, but that's not the case.

I'm going to remain keto but switch to very little saturated fat and follow more of a Steven Gundry approach with a lot of high polyphelol olive oil and olives. My brain has stayed healthy so far, but apparently plaque development can be a sign of brain deterioration in the near future

Thoughts?
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Re: Best diet approach for a homozygous 4/4

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healthnut wrote:What is the prevailing preferred diet here for 4/4? Gundry, Bredesen....? I'm 62 and had a heart attack a few weeks ago and have eaten low carb and keto most of my adult life, but ended up with a 99% occluded LAD. I work in a gym as a trainer and am very fit, I don't fit the typical heart disease victim. I thought I was beating the odds with my lifestyle, but that's not the case.

I'm going to remain keto but switch to very little saturated fat and follow more of a Steven Gundry approach with a lot of high polyphelol olive oil and olives. My brain has stayed healthy so far, but apparently plaque development can be a sign of brain deterioration in the near future

Thoughts?
Welcome, back, "healthnut' from a sister ApoE 4/4 who is 69 and a long time ago lived in Wisconsin's sister state of Minnesota. I went back and read your initial posts from 2017 and think you deserve enormous credit for having been an endurance athlete and devoting your life to navigating the Wisconsin River Dells of gene variants and helping others as a coach and trainer! My guess is getting your early triglyceride level of 5000 down to 150, managing the diagnosis of T2 diabetes in your 30's and staying fit and active has made you an Olympic star of resistance and resilience to some tricky genes.

So I hope you give yourself permission to reframe yourself not as a "heart disease victim" (although it's gotta be a gut punch) but as a strong, determined woman living with heart disease and ApoE 4 who continues to learn more about what it does and how to steer a path forward through the rapids. Dr. Gundry who specializes in heart disease risk management for ApoE 4's may be a great choice for you.

I hope you have found a cardiologist in Wisconsin you trust in the last few weeks who did something about that occluded LAD. You also have every right to seek out a second opinion. In a somewhat similar situation, a friend of mine called her primary care provider and her major medical group practice and asked them for the names of board-certified cardiologists who had begun practicing in the last 5 years. She found one who was knowledgable about ApoE4 and current research into cardiac effects of ApoE4 who was willing to spend the time needed with her to come up with a plan they both could support.

Although you mentioned having difficulty finding providers with Medicaid coverage, that may be less of an issue if you are able to travel to a university-affiliated research center. if you have a neurologist who is seeing your for your Parkinson's diagnosis (which I hope is still mild), that person may be a good person to ask. I hope you have friends and family who can also step in and help with everything from driving to appointments, if needed, to running errands and making sure the pets are cared for and your chores get doen. This is not the time to go it alone. Let others, even if they've only been casual friends before now, show their wonderful Midwest heart to help out as you get back in stride.

Hugs from a former Minnesotan.
4/4 and still an optimist!
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Re: Best diet approach for a homozygous 4/4

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Thank you NF52!!! Your words are so encouraging and helpful! I am from northern Michigan, but we are all sister-states up in these parts!

I have not found a decent cardiologist here yet, and the cardiology dept. at McLaren northern Mi was a horrendous experience, they already preformed the stent procedure a couple weeks ago. There were complications galore and I basically bled out of both places they sent in with the catheter, I was way over medicated and heparin levels were sky high. I sure hope I can find one familiar with 4/4, that would be a Godsend!

What specific program have you been following and has it been successful ?

I have Medicare with Priority now, I'm not sure what it covers....it's all a puzzle! It does seem to cover more doctors than Medicaid!

Thank you for the idea of using a university affiliated research center, Parkinson's has remained mild so far, I feel very blessed!

Again, thanks so much,
Kathy
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Re: Best diet approach for a homozygous 4/4

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healthnut wrote:Thank you NF52!!! Your words are so encouraging and helpful! I am from northern Michigan, but we are all sister-states up in these parts!...
Thank you for the idea of using a university affiliated research center, Parkinson's has remained mild so far, I feel very blessed!

Again, thanks so much,
Kathy
Hi Kathy,
Sorry about moving you from Michigan to Wisconsin and even more sorry that you've had such a difficult experience with the stent procedure. A rough guess on my part, from your 2017 post, puts you living about an hour and 45 minutes from UM in Ann Arbor, not too much further than your hospital stay in Flint. I have NO experience or personal knowledge of the UM program, so am simply saying that if the relatives I do have who live in SW Michigan (and love going to Mackinaw Island) needed a cardiologist, the University of Michigan's Cardiology Clinic is one I'd suggest they explore. They appear to have had a comprehensive prevention and rehabilitation program since the 1990's, including specialists in both lipid disorders and women's health. Here's a link from their website: https://www.umcvc.org/why-choose-michig ... cular-care
And their US News & World 2021 national ranking as #20 for heart attacks is impressive:
For 2021-22, Michigan Medicine has been ranked number 20 in the nation for Cardiology and Heart Surgery..."High Performing" ratings [are] in six conditions/procedures: Heart Failure, Abdominal Aortic Aneurysm Repair, Aortic Valve Surgery, Heart Bypass Surgery, Transcatheter Aortic Valve Replacement (TAVR), and Heart Attack.
They have 9 pages of cardiologists on their faculty and staff! Here's just one example I found here (emphasis added by me): https://www.umcvc.org/profile/310/brahm ... lamothu-md
Dr. Nallamothu is Professor in the Division of Cardiovascular Diseases and the Department of Internal Medicine at the University of Michigan. ...
Dr. Nallamothu’s research interests focus on improving the use and performance of coronary angioplasty and stenting in acute myocardial infarction and the care of patients with cardiac arrests. His work has led to long-term collaborative efforts with investigators in various Divisions within the Department of Internal Medicine and other Departments and Schools across campus. ...
His papers have appeared in the New England Journal of Medicine, JAMA, Annals of Internal Medicine, British Medical Journal, Circulation, EHJ, and JACC. He has received funding in the past from AHRQ, NIH, VA HSR&D and the BCBS Foundation of Michigan. He has participated on NIH and VA study sections targeting health services research. He is Editor-in-Chief of Circulation: Cardiovascular Quality & Outcomes, a leading cardiovascular outcomes research journal published by the American Heart Association.
As for myself, I can't begin to claim the athletic skills or lifelong habits you've had--so I've been very lucky. I follow a mostly MIND-type diet, take a small-dose statin and some supplements that many others on the forum take (B-12, D3, DHA) because I have a family history of left ventricular and aortic disease and high Lp(a). But we 4/4s are not "one size fits all", so trust what feels right for you. I'm rooting for you to find some people who make the next years lovely and joyful, Kathy!
4/4 and still an optimist!
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Re: Best diet approach for a homozygous 4/4

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Wow!!!! You are a wealth of information, thanks for sharing! :D

U of M sounds like it has a talented cardiology staff!! I’m in northern Michigan, so it would be about four hours from here

I don’t have Lp(a), but many 4/4s seem to. I have MTHFR, sterol hyperabsorber, inability to absorb non retinal A, poor absorber of oral D
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Re: Best diet approach for a homozygous 4/4

Post by SusanJ »

healthnut wrote:I have MTHFR, sterol hyperabsorber, inability to absorb non retinal A, poor absorber of oral D
Just another thought here, that with MTHFR you might have high homocysteine, which is connected to heart disease. Have you had it tested recently?
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Re: Best diet approach for a homozygous 4/4

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I do not have high homocysteine, my inflammatory markers are very low!!!
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