APOE 4/4 Combat sports

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Josh C
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APOE 4/4 Combat sports

Post by Josh C »

Hi there

I've just discovered I'm apoe4 4/4 which as you are fully aware can be potentially fatal if mismanaged. My real concern is at the age of 28 I've spent the last 7 years involved in combat sports, to which previously to that I was a member of the parachute regiment (British airborne for any americans), which comes with its fair share of sleep deprivation etc. I haven't been knocked out, nor seriously concussed, but I'm unsure of what to do next in regards to testing etc.

My diet has been predominantly a high carb 50/25/25 with 12 hour fasts between night and morning. And current blood sugars are am. 4.6mmol and around 5.4mmol post high carb meal I.e 75g upwards.


From what I've read, a more ancestral approach low carb etc would be most beneficial on top of the other factors highlighted by guys like bredesen.

By the sound of things it looks like an early retirement is on the cards for myself, before I do any more damage, but if there is anyone who is a doctor where/who do I go from here, as a large overwhelming feeling of apathy has swept over on top of just general confusion as to what happens next.

Obviously there is a bunch of context left out, and I'm not wanting to write you an essay, just simply some clarity as to where do i go from here, as many of you know this can be quite shocking news at first. Especially considering the way apoe4 is portrayed throughout the research/media etc.

I'm young fit and healthy, 6ft, mixed british and indian descent who works a moderately physical job and sit around 10-12% body fat year round, from my combat sport endeavours.

If anyone could possibly help point in the right direction that would be hugely appreciated Cheers
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MarcR
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Re: APOE 4/4 Combat sports

Post by MarcR »

Josh C wrote:If anyone could possibly help point in the right direction that would be hugely appreciated Cheers
The discussion and strategizing here around macronutrient ratios is all about curing and avoiding metabolic dysfunction. Just about any ratio can work. Your normal sugars and superior body composition indicate that you have healthy metabolic function, so I recommend that you continue with your preferred 50/25/25 macros and remain vigilant.

With respect to vigilance, I suggest that you monitor your ratio of fasting triglycerides to HDL-C. It's a terrific proxy for metabolic health. If your ratio exceeds 0.44 (mmol) or 1 (mg/dL), you may want to have a closer look at food macros, quantity, quality, and/or timing.

And on the off chance that you are somehow maintaining a ripped physique despite subpar food quality, I would encourage you to avoid highly processed foods. Keeping it simple, you can do that by avoiding anything containing industrial seed oils - soy, corn, canola, sunflower, safflower, cottonseed, grapeseed, peanut, sesame, rice bran.

With respect to your favorite sport, I see two issues:
  1. Blows to the head are bad for long-term cognition. Full-on concussions are terrible for us, but lesser injuries damage us also especially if they occur often - that's what Chronic Traumatic Encephalopathy is all about.
  2. There's some evidence that E4 carriers are more vulnerable. For example, check out this study of amateur soccer players.
While combat sport may not be a good choice for long-term cognitive health, the fitness it has motivated you to attain leaves many other exciting doors wide open. Might I suggest rock climbing? :-)
Last edited by MarcR on Sat Feb 06, 2021 9:34 am, edited 1 time in total.
Reason: Fix erroneous link
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Tincup
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Re: APOE 4/4 Combat sports

Post by Tincup »

Hi Josh,

Not a doc, but here are thoughts. I'm 65 and played American football at university. I managed to get through that without serious injury or concussion. I did have one, getting pushed off the top step of a school bus when 13 or 14 and hitting my head on the tarmac. Managed to walk home, but I'm sure I had at least a mild concussion.

If you retire from combat sports, that is one path. If you don't then I would recommend learning as much as you can to develop a plan if you get a TBI. For starters, never continue competing till after the TBI is totally healed as a second TBI close in time after a first is much worse. I recall a simple test, done while healthy. Have your hand around a marked stick ("yard stick"). Have someone drop it and see how far it drops before you catch it. If you think you've had a TBI, repeat the test to see how much slower you are.
In thispodcast, George Brooks talks about lactate in TBI's. This might give you ideas to implement if you get a TBI. I think ketones may also be beneficial, whether generated by you or consumed.

Another idea is to look at hormetic stressors that may be beneficial for TBI's, whether or not you retire, Hence the thoughts behind the links/searches below.

The your exercise is good. In this post, a 4/4 doc recounts her own recovery from a severe, career ending TBI using exercise starting several years after. Your glucose disposal/control is very good, likely due to your activity level. As 4's can have cerebral glucose processing issues even in their 3rd decade, this is good.

Here are a bunch of searches

Keto Also looking at beta hydroxybutyrate as a signaling molecule and not just a macronutrient.

KAATSU/BFR (blood flow restriction training)


Case study, see p 14: https://kaatsu.com/shared/magazines/KAA ... e%2001.pdf

Stroke case study 1: https://www.google.com/url?sa=t&rct=j&q ... aA5kZBQrdt

Stroke case study 2: https://www.google.com/url?sa=t&rct=j&q ... zVbs4Rs5ES

https://www.google.com/search?source=hp ... tsu+stroke

Resistance training

Intermittent Hypoxic training

See also https://www.thebreathingdiabetic.com/ and https://oxygenadvantage.com/books/

Stroke
https://www.google.com/search?source=hp ... ing+stroke

Fasting

Therapeutic hypothermia

Thereapeutic hyperthermia
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Josh C
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Re: APOE 4/4 Combat sports

Post by Josh C »

MarcR wrote:
Josh C wrote:If anyone could possibly help point in the right direction that would be hugely appreciated Cheers

And on the off chance that you are somehow maintaining a ripped physique despite subpar food quality, I would encourage you to avoid highly processed foods. Keeping it simple, you can do that by avoiding anything containing industrial seed oils - soy, corn, canola, sunflower, safflower, cottonseed, grapeseed, peanut, sesame, rice bran.
)
Are you talking specifically in regards to a higher carbohydrate diet? or as in just general highly inflammatory foods? As we know whole food high carbohydrate sources definitely have there place in metabolically healthy individuals. Obviously with this condition then different risk factors seem to appear at different age groups as i have read thus far.

But yes, unless i was being payed six figures and my living depended on it, then it would be an easier choice. As it stands now i get payed small sums to compete in return for how much effort is placed upon preparation. So it seems that a new competitive outlet will be on the cards, considering the heightened risk for 4/4's

Is there any testing that can be done such as mri, pet scan that can give an early diagnosis? Or is it simply a lifestyle management/waiting game for now?

Cheers
Last edited by MarcR on Sat Feb 06, 2021 9:36 am, edited 1 time in total.
Reason: Fix erroneous quoted link
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MarcR
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Re: APOE 4/4 Combat sports

Post by MarcR »

Josh C wrote:
MarcR wrote: And on the off chance that you are somehow maintaining a ripped physique despite subpar food quality, I would encourage you to avoid highly processed foods. Keeping it simple, you can do that by avoiding anything containing industrial seed oils - soy, corn, canola, sunflower, safflower, cottonseed, grapeseed, peanut, sesame, rice bran.
Are you talking specifically in regards to a higher carbohydrate diet? or as in just general highly inflammatory foods? As we know whole food high carbohydrate sources definitely have there place in metabolically healthy individuals.
As I said above, I don't think macros matter much. We're a flexible species. And I wasn't saying anything about inflammatory foods.

I see now that I made a mistake when I pasted the industrial seed oils link in above. I have fixed it in the original and in your quote. That article from Chris Kresser reflects my views pretty well.

You asked for advice, so I shared my simple life hack for getting out of the grocery store without a bunch of slow-acting poison in my bag. I mostly buy foods consisting of one ingredient like meat, eggs, broccoli, mushrooms, and the like. When I buy foods with more than one ingredient, I read the label to make sure that they do not contain seed oil. I think avoiding seed oils is essential to reduce our risk of succumbing to the degenerative diseases of modern civilization. Not only are they directly harmful but also the foods that contain them often have other ingredients to which our species has had little time to adapt. Note that it's nearly impossible to leave a restaurant without having ingested seed oil, so restaurant meals are best avoided / minimized.
Is there any testing that can be done such as mri, pet scan that can give an early diagnosis? Or is it simply a lifestyle management/waiting game for now?
I think the latter. You're in terrific shape currently. Maintain your musculature, monitor your metabolic health, and avoid seed oil.

I'll leave you with this talk from Dr. Chris Knobbe, an ophthalmologist who wondered why his profession has become almost entirely devoted to age-related macular degeneration. Pursuing that question changed his life. I saw him share what he learned in 2016 at the Ancestral Health Symposium, and he changed mine. His current presentation is bursting with information and more polished than the one I saw:

Dr. Chris Knobbe - 'Diseases of Civilization: Are Seed Oil Excesses the Unifying Mechanism?'
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Jenny B
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Re: APOE 4/4 Combat sports

Post by Jenny B »

Josh C wrote:Hi there

I've just discovered I'm apoe4 4/4 which as you are fully aware can be potentially fatal if mismanaged. My real concern is at the age of 28 I've spent the last 7 years involved in combat sports, to which previously to that I was a member of the parachute regiment (British airborne for any americans), which comes with its fair share of sleep deprivation etc. I haven't been knocked out, nor seriously concussed, but I'm unsure of what to do next in regards to testing etc.

If anyone could possibly help point in the right direction that would be hugely appreciated Cheers
Hi Josh C. It sounds like you have had some amazing responses to your incredible story so far. I just wanted to take this opportunity to welcome you to this community, and take a moment to show you around. One really interesting resource is the Primer written by a doctor who is herself, ApoE 4/4. It is an introduction to ApoE4 and possible prevention strategies. Also, the How-To Guide can help you navigate the ApoE4.info website. Also if you feel so moved, please share more of your own fascinating story in Our Stories.

We hope you find all you need and more.

Warm regards,

Jenny B-C
Jenny B, ND
FMCHC, NBC-HWC
ApoE4.info Sr Support Intern
Functional Medicine Certified Health Coach
National Board Certified Health and Wellness Coach
Naturopathic Doctor
MoJoe
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Re: APOE 4/4 Combat sports

Post by MoJoe »

Hi Josh
An interesting example of "gentle" repetitive head knocks (when heading the ball) giving problems in later life are soccer players. Tests have shown only the goalie is cleared of any trauma, for obvious reasons. Boxing is bad, and dementia later in life is frequent. Frequent concussion in rugby games is cause for many retirements, it is good that players are becoming aware of the long term effects.
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Re: APOE 4/4 Combat sports

Post by Family Tree Guy »

Josh-
my suggestion is to watch the Will Smith movie "Concussion". It tells the story of the doctor who uncovered "CTE" in the brains of all these former football players. I believe this would be a valuable tool for you to reflect on as you consider your exercise / sport of choice. The question becomes, in your training or competitions, how often do you get hit in the head (sub-concussive)? once per year? once per month? once per week? The movie tells the devastating story of multiple players from the NFL. My conclusion from the movie is that there really is no safe level of head impacts.

something like crossfit can be a fun competitive type sport that will not get you knocked in the head and might be of interest to you as an alternative.
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Re: APOE 4/4 Combat sports

Post by sarahb12 »

I'm not e4/e4, but I've had some head injuries in the distant past - so I've read up on the subject. One thing is a big fraction of damage happens after the impact due to chemical reactions and inflammation. So getting proper care is important.

A couple things is I try to have a couple of supplements on hand in case. Studies have shown that creatine and magnesium could mitigate damage.

One thing that helps if you're lucky enough to have it is the ccr5-d32 genetic variant. There is a pharm therapy that emulates it, but I don't think it's a common head injury protocol yet.

Also increasing BDNF (exercise is great at this) There are some excellent threads about that here on this site.
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Re: APOE 4/4 Combat sports

Post by LilleTrille »

So many good answers in this thread.

After having health issues and learning about my 4 allele, striking is definitely off the table for me. I have also witnessed two close friends having to give it up due to head injuries. Would love to go back to grappling, though, when I am healthy enough.
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