Newcomer trying to find her way through the Maze!

Newcomer introductions, personal anecdotes, caregiver issues, lab results, and n=1 experimentation.
M Claire
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Newcomer trying to find her way through the Maze!

Postby M Claire » Fri Sep 24, 2021 6:55 am

Hello everyone!

I am hew here and glad to find a place with fellow E4 carriers where I can learn and try to find my way through the maze.

I have been interested in healthy eating for a long time, as a single-allele carrier of the apoE4 gene and coming from a family with many overweight members and a very high prevalence of diabetes, but I have never found something that works for me. I have read about nutrition extensively (the Okinawa plan, plant-based books, various paleo books, the Pam McDonald ApoE specific book, diabetes specific books, nutritonal research, etc.)

About nine years ago, I went fully vegan for more than two years following the Dr. Fuhrman vegan diet (sort of a slow-carby higher fat vegan regimen), but eventually gave it up after I developed a relatively rare form of eczema called dyshidrosis that caused intense itching, bleeding, peeling skin, etc. in spite of never having had this kind of issue in the past. After I went back to omnivorous eating, the eczema receded gradually until I was eventually symptom-free. Fast-forward several years later, I again decided to try a vegan diet this past spring, this time following a low-fat, whole starch-based plan of the type that Dr. Barnard/Dr. Greger would recommend, and within a month, the eczema returned with a vengeance. As I have been reading about this form of eczema again and trying to wrap my head around it, I have seen that dermatologists have noted an increase of incidence in relation to vegan diets. Apparently, it is triggered primarily by nickel/cobalt sensitivity. Unfortunately, nearly all of the foods that a plant-based eater would turn to for protein and healthy fats (flax, soy, lentils, chickpeas, and all other legumes), are extremely high in nickel and cobalt, as well as most whole grains and a number of fruits and vegetables. I know that I am reacting to legumes this time because I get intense symptoms within half an hour of eating them. Additionally, I know that when I am having regular flare-ups, I also begin to react to histamines, which further complicates matters. I don't know what to do. If I tried to limit these triggers, I can't see how I could remain healthy on such a restricted diet, nor do I know if it would even cause my symptoms to go away. Strangely, when I was eating omnivorously before, I eventually got to a point where I could again consume foods that had previously triggered very bad episodes during my first bout with dyshidrosis, such as grapes, berries, citrus, and tomatoes, and no longer react. While eating omnivorously, I did not react to legumes, but now I do. It is so frustrating and confusing.

I was initially just concerned about diabetes, but now I am especially worried about brain health. One direct relative, who is an ApoE 4 single gene carrier like me, is showing signs of impairment at a relatively early age. It is very worrying and frightening. She is diabetic and has tried so many different approaches to manage her T2DM and has worked for long periods of time in conjunction with nutritionists who have prescribed various eating plans (low carb, plant based, keto, etc), but she has not achieved diabetes reversal or normal weight and now her memory is significantly slipping. It increases my feelings of urgency and also frustration at being stuck in a sort of health/diet labyrinth which seems to have no exit.

Currently, I am in my mid-30s and have a healthy BMI and engage in moderate aerobic exercise about 8-10 hours a week getting around on foot in a hills/valleys environments. However, I suffer from frequent fatigue and sugar cravings, persistent melancholy, and prolonged time to recover from stressors, which I see now may all be tied to the E4 gene.

From all that I have read lately (population study data, mechanistic data, case studies), I have formed the idea that I should basically be eating a low glycemic diet of mostly non-starchy vegetables, MUFAs, and some lean proteins, essentially vegetable soup or salad with a little olive oil and seafood thrown in, as well as restricting my eating window to some degree and getting good sleep, daily exercise, reducing stress. Have any 3/4s had success with this kind of regimen? If so, were you able to incorporate some berries or beans?

Best wishes to all fellow explorers in the maze!
Last edited by M Claire on Mon Oct 04, 2021 7:29 am, edited 2 times in total.

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Re: Newcomer trying to find her way through the Maze!

Postby CindyM » Fri Sep 24, 2021 11:09 am

M Claire wrote:Hello everyone!

I am hew here and glad to find a place with fellow E4 carriers where I can learn and try to find my way through the maze.

I have been interested in healthy eating for a long time, as a single-allele carrier of the apoE4 gene and coming from a family with many overweight members and a very high prevalence of diabetes, but I have never found something that works for me. I have read about nutrition extensively (the Okinawa plan, plant-based books, various paleo books, the Pam McDonald ApoE specific book, diabetes specific books, nutritonal research, etc.)

About nine years ago, I went fully vegan for more than two years following the Dr. Fuhrman vegan diet (sort of a slow-carby higher fat vegan regimen), but eventually gave it up after I developed a relatively rare form of eczema called dyshidrosis that caused intense itching, bleeding, peeling skin, etc. in spite of never having had this kind of issue in the past. After I went back to omnivorous eating, the eczema receded gradually until I was eventually symptom-free. Fast-forward several years later, I again decided to try a vegan diet this past spring, this time following a low-fat, whole starch-based plan of the type that Dr. Barnard/Dr. Greger would recommend, and within a month, the eczema returned with a vengeance. As I have been reading about this form of eczema again and trying to wrap my head around it, I have seen that dermatologists have noted an increase of incidence in relation to vegan diets. Apparently, it is triggered primarily by nickel/cobalt sensitivity. Unfortunately, nearly all of the foods that a plant-based eater would turn to for protein and healthy fats (flax, soy, lentils, chickpeas, and all other legumes), are extremely high in nickel and cobalt, as well as most whole grains and a number of fruits and vegetables. I know that I am reacting to legumes this time because I get intense symptoms within half an hour of eating them. Additionally, I know that when I am having regular flare-ups, I also begin to react to histamines, which further complicates matters. I don't know what to do. If I tried to limit these triggers, I can't see how I could remain healthy on such a restricted diet, nor do I know if it would even cause my symptoms to go away. Strangely, when I was eating omnivorously before, I eventually got to a point where I could again consume foods that had previously triggered very bad episodes during my first bout with dyshidrosis, such as grapes, berries, citrus, and tomatoes, and no longer react. While eating omnivorously, I did not react to legumes, but now I do. It is so frustrating and confusing.

I was initially just concerned about diabetes, but now I am especially worried about brain health. One direct relative, who is an ApoE 4 single gene carrier like me, is showing signs of cognitive impairment at a relatively early age. It is very worrying and frightening. She is diabetic and has tried so many different approaches to manage her T2DM and has worked for long periods of time in conjunction with nutritionists who have prescribed various eating plans (low carb, plant based, keto, etc), but she has not achieved diabetes reversal or normal weight and now her memory is significantly slipping. It increases my feelings of urgency and also frustration at being stuck in a sort of health/diet labyrinth which seems to have no exit.

Currently, I am in my mid-30s and have a healthy BMI and engage in moderate aerobic exercise about 8-10 hours a week getting around on foot in a hills/valleys environments. However, I suffer from frequent fatigue and sugar cravings, persistent melancholy, and prolonged time to recover from stressors, which I see now may all be tied to the E4 gene.

From all that I have read lately (population study data, mechanistic data, case studies), I have formed the idea that I should basically be eating a low glycemic diet of mostly non-starchy vegetables, MUFAs, and some lean proteins, essentially vegetable soup or salad with a little olive oil and seafood thrown in, as well as restricting my eating window to some degree and getting good sleep, daily exercise, reducing stress. Have any 3/4s had success with this kind of regimen? If so, were you able to incorporate some berries or beans?

Best wishes to all fellow explorers in the maze!
Welcome to the Forum, M Claire!

I love how you said "explorers in the maze". It is true that there is a huge maze of information out there about diet and nutrition, and you are not alone in your frustration. There is no one size fits all food plan as you've discovered. I commend your dedication to finding the right food plan to gain optimal health and reduce your risk for developing Alzheimers. You have made a great start in your journey with your aerobic exercise, healthy BMI, and knowledge you've gained through reading. Luckily, you are still young and have time on your side to protect your cognition and live a long and healthy life!

If you haven't seen it already, I encourage you to check out our primer. This is a fantastic resource which explores areas such as the science behind the ApoE4 gene and the lifestyle factors that impact its expression. Our how-to guide is another helpful resource on how to search for topics and how to subscribe to topics of interest and more. You can also check out threads that have been started by other members in their 30's in our stories. They are easy to find since many state their age in the thread's subject.

Luckily, there are many individuals on this site that will be able to help you out with your questions.

Again, welcome! We are here to assist you, so please feel free to reach out any time!

Best,

CindyM

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Re: Newcomer trying to find her way through the Maze!

Postby floramaria » Sat Sep 25, 2021 11:18 am

M Claire wrote:Currently, I am in my mid-30s and have a healthy BMI and engage in moderate aerobic exercise about 8-10 hours a week getting around on foot in a hills/valleys environments. However, I suffer from frequent fatigue and sugar cravings, persistent melancholy, and prolonged time to recover from stressors, which I see now may all be tied to the E4 gene.

From all that I have read lately (population study data, mechanistic data, case studies), I have formed the idea that I should basically be eating a low glycemic diet of mostly non-starchy vegetables, MUFAs, and some lean proteins, essentially vegetable soup or salad with a little olive oil and seafood thrown in, as well as restricting my eating window to some degree and getting good sleep, daily exercise, reducing stress. Have any 3/4s had success with this kind of regimen? If so, were you able to incorporate some berries or beans?

Best wishes to all fellow explorers in the maze!
Hi M Claire and welcome to the community. I agree with CindyM that you might find that starting point with the Primer would provide you with a solid understanding of how the ApoE4 allele impacts us and what you can do to reduce risks associated with the allele.
Exercise is one of the best interventions, and it seems that you are doing well with that. Good sleep is important and Time restricted eating has benefits that you’ll read more about as you explore the forums .

Diet can have a major impact, so learning more about that can provide some guidelines as you adjust your diet. Many of us here are following a ketogenic, which, as you mention, is low glycemic. But the diet you are suggesting for yourself sounds impossibly limited especially if you intend to stay with the diet longterm. I’ve been following a ketogenic diet for several years, and I do incorporate some berries and beans, Just in much smaller quantities than I used to consume them, like a 1/4 C of beans added to a salad instead of having a big bowl of black bean soup. And while I used to eat mainly vegetarian diet with a little animal protein here and there, I am much more omnivorous now.
As I read through your post it sounds like the vegan diet you have followed is really not agreeing with you! Your body seems to protest.
Your discovery of the connection between your eczema and nickel/cobalt sensitivity is really interesting.
Do you have deep convictions or beliefs that make following a vegan diet essential for you? Some of the symptoms that you list…sugar craving, fatigue , melancholy…may be linked more strongly with your body’s reaction to your diet than with ApoE4 allele.
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Re: Newcomer trying to find her way through the Maze!

Postby M Claire » Tue Sep 28, 2021 9:15 am

Hi, thank you so much for your advice and questions!

I have been working through the Primer with an Apoe4 family member. It is very interesting and helpful, but even with a biochem background, it's a lot to take in and keep in consideration. The effects of ApoE4 are vast.

No, I do not have a religious commitment to veganism, although I would prefer not to eat animals. Mostly I was impressed by the arguments of plant-based doctors like Dr. Greger, the Adventist health study and other epidemiological data, the heartening testimonials of health turnarounds, and so forth. The data seems compelling, everything from intramyocellular fat being the cause of insulin resistance (and thus people reversing their diabetes on a HCLF diet) to the post-prandial effects of fat on blood fluidity (sludging/RBC aggregation/impeded flow). Looking back, it seems like the vegan community rarely mentions the ApoE4 population.

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Re: Newcomer trying to find her way through the Maze!

Postby Quantifier » Tue Sep 28, 2021 3:30 pm

Hello M Claire,

I'm a long time vegetarian, ApoE 3/4, and have been reducing what little animal-sourced foods remain in my diet over the more recent years. I have been transitioning my diet gradually to be both in compliance with Bredesen's recommendations and my personal values. What I eat is a lot of fresh, non-starchy vegetables - either as salad (when eating at home) or just large chunks of vegetables when I take them to work. Salad always contains avocado and walnuts, and is dressed with extra-virgin olive oil. Vegetables I take for work also have walnuts and avocado included. This is followed by a serving of low-glycemic fruit (most often strawberries). Dinner includes a small salad, but consists mainly of some kind of legume-based dish - a curry, homemade hummus, some bean stew etc. Beans are always pressure-cooked. Other foods between lunch and dinner can be assorted nuts, unsweetened non-dairy milk, edamame etc. I fast from dinner time to lunch of the following day, usually about 16 hours.

I feel fine with this lifestyle, I do supplement for vitamin B12, vitamin D + vitamin K2, zinc, magnesium, algal omega3. Have you tested for any nutrient deficiencies? Also, do you eat enough protein? Dietary protein is important for satiety. I know that on days I have enough protein for lunch I don't need to snack much before dinner.

Oh, I occasionally measure my morning blood glucose and ketones - my blood glucose is usually in the 70-90 mg/dl range, and beta hydroxybutirate usually between 0.5 mM and 1.1 mM. I used to have mornings with lower beta hydroxybutirate measurement, but I solved that by not eating fruit after dinner. OTOH I know I go out of ketosis after lunch, and that causes some sleepiness some 2-3 hours later (especially if I'm at home, at work I just keep busy enough to force myself into some level of alertness).

Regarding animal protein - I still eat about 3 eggs a week, and am looking for ways to replace them - I'll probably do some kind of soy-based food and a vegan choline supplement.

So yes, a plant-based diet that follows Bredesen's recommendations can be done, but you need to find what suits your individual body and your circumstances.

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Re: Newcomer trying to find her way through the Maze!

Postby M Claire » Tue Sep 28, 2021 5:07 pm

Thank you, that is so interesting! I really appreciate all of the details you included about what you have put in place and how it is working for you. Thank you so much for sharing.

I really don't know what to do. I am hesitant about switching over to seafood because of contaminants more broadly, and the risk of amyotrophic lateral sclerosis specifically. But I really doubt that I can get enough protein from legumes and not start having dyshidrotic flare-ups again, given what my last attempt was like. It seems like if I go too far along the plant-based spectrum, I start hitting histamine trip-wires, but I don't know why. And I react pretty badly to eggs as well (intense itchy eyes and arthritis-type pain).

Anecdotally, I might add that I have observed this around me as well. It seems like quite a few vegans I have known have been plagued with obscure inflammatory and/or auto-immune conditions after adopting veganism. One family member had to quit after they developped interstitial cystitis. Another close relative who was carefully following a well-respected doctor's plan developped uveitis and meibomian gland dysfunction which lasted for many months and finally resolved after they returned to omnivory.

I should definitely tell you as well that when I took K2 and zinc as a vegan nursing mother, following Dr. Greger's recommended amounts, I wound up in the hospital with a blood clot, the etiology of which was never established by genetic testing or any other examination, but for which I needed to take blood thinners for half a year until it resolved. I strongly suspect that the supplements caused the clot, zinc and K2 both being pro-thombotic.

This is pure and complete speculation, but I almost wonder if the epidemiological observations about herbivory and longevity are not well and truly just correlational. Which is to say, perhaps genes like ApoE3 which confer obvious longevity advantages (less diabetes, less CHD, less dementia) also allow people carrying those genes to thrive on 100% (or nearly) plant-based eating, wheras ApoE4 carriers who face clear health and longevity challenges are also saddled with specific metabolic conditions that make it more difficult to thrive on complete herbivory, and thus tend to naturally deter them from that way of eating (thereby giving rise to the population discrepencies). Again, just a thought that went through my head...

In any case, I will definitely be trying at least three of your practices: 1) the bulk of my calories from veggies and MUFAs, 2) a relatively short eating window, 3) no fruit at night.

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Re: Newcomer trying to find her way through the Maze!

Postby Quantifier » Wed Sep 29, 2021 12:02 am

I'm sorry about your health complications. Would it be possible for you to test for what it is you are reacting to? Or to do some kind of controlled elimination diet? (Can you find a doctor or dietitian who could work on this with you?)

In my household it is actually my husband, who is ApoE 3/3, who has the allergies and sensitivities - and he improved a lot by eliminating gluten-containing foods. I don't seem to be particularly sensitive to anything so far.

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Re: Newcomer trying to find her way through the Maze!

Postby floramaria » Fri Oct 01, 2021 10:23 am

M Claire wrote:Hello everyone!
I am hew here and glad to find a place with fellow E4 carriers where I can learn and try to find my way through the
Hi M Claire, Since some of the replies to your post did not quote you, prompting a notification email to you, in case you are not following the thread, I am posting this to let you know that you have new responses .
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Re: Newcomer trying to find her way through the Maze!

Postby M Claire » Mon Oct 04, 2021 7:12 am

Thank you everyone for your answers and support!

I have been reading about OMAD feeding windows the past several days and wondering if that might be a good fit. I think I will try to work down towards it and see how narrow a window I can do. Most of the time when I eat in the morning, I am not hungry, and I have a capacity for eating a large volume over a relatively shorter period of time. I am thinking about doing my OMAD in the late morning because in the evening, there is so much going on with feeding the children and then getting them off to bed that the idea of having my meal of the day at that time doesn't appeal to me.

If anyone has experience with OMAD and wants to chime in, feel welcomed. I have enjoyed reading the OMAD experiences of others on the forums. I saw that Dr. Longo (apparently a reference person on healthy aging) frowns upon this form of fasting, but I do not know how much he can speak to its effects on the Apoe4 minority and our specific and unique metabolic characteristics???

In other news, I have been fascinated to watch the effects of regular moderate exercise on my ApoE4 family member who needs to regularly check blood sugars. While that family member has been visiting me, we've walked roughly 25 minutes on steeply ascending and descending terrain, 4 times a day (about 100-120 minutes daily). The blood sugar readings are in a much narrower range than they were six weeks ago and the average has dropped from 160/150 to 130 and continues to go down. Insulin needs have been reduced by 30% and other medications have also been reduced. It's a real window into how crucial exercise is for ApoE4 carriers, and so gratifying to know that there are things we can do. Our ApoE4 bodies were made to move! They need movement like they need food and water. Exercise also seems to provide some leeway for intake of starches, though simple starches will still send the blood glucose up unless exercise is performed just after ingestion.

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Re: Newcomer trying to find her way through the Maze!

Postby M Claire » Mon Oct 04, 2021 7:26 am

PS: Does anyone know if OMAD can work for T2 diabetics? I don't know if my dear family member would even consider it, but they are frustrated with some stubborn intra-abdominal fat, which does our brains no favors at all, and it seems like OMAD could really help shed that. Moreover it's easier than juggling macros and micros in Cronometer over the course of the day and sometimes through the night.

As an anecdote, someone in my husband's family reversed her T2 diabetes after some prolonged fasting that was the secondary result of having a very major surgery and needing to be on IV nutrition from quite some time afterwards. She remained free of diabetes for several years, until weight became a problem again.


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