merouleau intro

[MarcR]

The numbers are here: https://wiki.apoe4.info/wiki/index.php?title=Biomarkers

[MarcR]

RBK, I use the Precision Xtra with ketone test strips to verify my status once or twice each week. Recent morning readings have varied between 0.9 and 2.4.

Juliegee, thanks for mentioning Dr. Samuel Henderson's work again. I just read this interview with him ...

http://www.meandmydiabetes.com/2011/09/ ... rotection/

... and I see a lot of promise for me, my father, and even my dogs.

[MarcR]

One more thing ... Juliegee, I am really looking forward to your upcoming test results. Instead of trying high-MUFA keto myself, I'll wait and see how it worked for you. In the meantime, I think I'll try to replace some of the beef, egg, and dairy fat I have been consuming with coconut oil.

[Julie G]

Yeah, I've read that interview before...so much great info. Thanks for posting the link.

I recently consulted with Dr. Henderson via email about our (E4 carrier's) predicament with elevated LDL & LDL-P. He very graciously took the time to explain why that occurs and recommended a slightly different course of action for us.

The general model for why E4 carriers have elevated blood lipid levels relates to the differential binding of different isoforms of APOE to lipoprotein particles. E2 and E3 preferentially bind triglyceride depleted lipoprotein particles, such as HDL, while E4 preferentially binds triglyceride rich lipoprotein particles, such as VLDL. The binding of APOE4 proteins to triglyceride rich particles is sufficient to slow activity of lipases on cell surfaces. Because the lipase activity is reduced, E4 carriers are slower in clearing VLDLs from circulation and therefore have elevated triglycerides in circulation (Dong et al 19994). I don't think it is accurate to say they hyperabsorb lipids.

Medium chain triglycerides (MCTs) are not processed the same way as LCT and do not end up in lipoprotein particles. Therefore, MCT metabolism should not be influenced by E4 carriage status. In support of this idea, we found no difference between levels of induced ketosis in E4+ and E4- subjects (Henderson et al 2009). Importantly, coconut oil contains mostly C12 and C14 fatty acids, which will be packaged into lipoprotein particles and their digestion, will be slowed by E4 carriage status, leading to a poor lipid profile. So, I would urge that E4 carriers do not try to induce ketosis by use of coconut oil. I would stick with MCT oil.

You are doing the right thing by trying to induce ketosis by diet. I think this is most important for E4 carriers to lower risk of Alzheimer's.

So, if I am understanding this correctly, E4 carriers, who are seeking the potentially neuroprotective properties of ketosis, could use MCTs and avoid hyperlipidemia. Really intriguing. Since coconut oil is 65% MCT and 35% LCT, you'll still see a bump in LDL-C and LDL-P because of that 35%. An interesting experiment would be to eat the same healthy diet that you were eating before your last NMR, but supplement with enough MCT oil to remain in ketosis Check out the thread for more info viewtopic.php?f=4&t=287

In the meantime, I'm collecting data for both of us and will do my testing in the next 10-14 days, that should give my lipids enough time to settle back down. I'm eager to see if this Mediterranean ketogenic diet will yield better numbers.

BTW, your new numbers are far from arthrogenic with large buoyant Type A partcles and very few small particles. We KNOW your LPIR is excellent based on your last test, I noticed the latest just estimated How was your homocysteine and CRP?

[MarkES]

Thanks for posting the update, merouleau. I just wanted to repeat the data together for comparison.

Code: Select all

                                                 small   LDL
LDL-P  LPIR  TC  HDL  LDL  TG  TC/H  TG/H  HDL-P LDL-P   sz   Notes
  721    2  202   79  118  26   2.6   0.3   28.2  <90   21.5  16/8 IF, high fat, no PUFA oils
 1846  <25  273   70  189  72   3.9   1.0   38.6  <90   22.2  16/8 IF, keto, no PUFA oils

EDIT 3/18/14: include the <25, <90 notation.

[Julie G]

Hey Mark, one quick correction. Merouleau's LPIR was reported as <25 per the specific test used. Skibike had the same experience. That doesn't mean his LPIR was actually 25. That test reports any number below 25 as <25. Did you use the cheapie test we had linked to the site, Merouleau?

[MarcR]

I'm not sure what circumstances prompt LipoScience to issue "<" qualifiers. The August NMR was ordered by a physician, and I ordered this one myself from MDLabTests.com for $75 ($69 published price plus a $6 fee tacked on while checking out). Both tests provided the same result items. Also, both gave me the same "<90" small LDL count. I think Walk-In-Lab has the abbreviated NMR with no LDL-C, HDL-C, triglycerides, and total cholesterol readings in addition to the normal one.

So Mark, I agree with Julie that your table above would be more accurate with < symbols preceding the 25 and the two 90's.

Julie, the only other result I have received was a singleton I ordered from RequestATest, Mag RBC, which was in-range at 5.2. I'm awaiting the rest of the results from DirectLabs. (I compared MDLabTests, RequestATest, Walk-In-Lab, DirectLabs, and PersonaLabs and ended up with three orders to minimize the fees.)

Julie, I found this passage from the interview to be particularly interesting:

The MCTs are metabolized very efficiently, so those medium-chain fatty acids are cut off very quickly. When you take in an large amount of the MCTs, you can get this large amount of medium-chain fatty acids in your duodenum, which can be for some people hard to tolerate. So if you can slow that digestion down a little bit, then you can reduce the adverse events you see with the MCTs. In our formulation we mix in some long-chain triglyceride, and we recommend people take it with a meal. It’s better if they take it with a fatty meal, a little bit of cheese, maybe, or something that can slow the digestion down a little bit.

I understand the value of the prescription medical food product in some contexts, but I do find myself wondering if coconut oil with its natural blend of MCTs and LCTs is a reasonable stand-in for the Axona + cheese regimen described by Dr. Henderson. I prefer natural products like cold-pressed extra virgin coconut oil over highly manufactured foods.

[Julie G]

I hear you & largely agree. I much prefer natural foods, like real coconut oil. I also think coconut oil has antimicrobial properties (and other benefits) that MCT doesn't have. FWIW, I wasn't suggesting Axona, but rather pure a MCT oil if you were most concerned with LDL-Cand LDL-P. You have naturally great lipids, a healthy lifestyle and diet. I trust you'll figure out a way to stay in ketosis that doesn't impact your health...and teach us all in the process

[RBK]

Merouleau,

As for MCT versus coconut oil, I couldn't decide either. I need the coconut oil because of the lauric acid for other issues (HSV-1), but I wasn't loving the 35% long chain. In Dr. Mary Newport's book, she suggests combining 16 oz of MCT oil with 12 oz of heated (so liquid) coconut oil. Once combined, they stay in liquid form, which I find easier to use as well. That quantity combination then fits perfectly in a quart mason jar without being overly full. This combination then has 15% long chain. I do eat other fats as well, mostly from plants and dairy (trying for more goat cheese products, as they too carry medium chain), but one serving a week or so of red meat. I too am usually a believer in the full blown natural product, but this is the compromise I've reached for the time being. Some days I won't add/use as much of the combo, if I'm getting extra coconut or coconut milk or goat's milk products.

I say all of this just to let you know what I'm trying. I have NO idea what this is doing to my lipids yet, but it is the trial I'm on. Right or wrong, don't know yet.

[MarkES]

I edited my post to include the <25, <90 notation. A possible downside to recording values this way is that it is no longer a pure number and it may not automatically sort, if attempting to sort data.

I prefer natural products like cold-pressed extra virgin coconut oil over highly manufactured foods.

viewtopic.php?p=2110#p2110

I supplement with magnesium (400 mg) and potassium (1 g - yes, that's ten 99 mg capsules daily) for the same reason that I consume extra salt.

Wouldn't it also be natural to get magnesium and potassium from food?

try these ketogenic diets, high-fat, low-protein diets, low carbohydrate as well, because remember, you’ll make glucose from the proteins, so in a true ketogenic diet, you eat very low amounts of protein. You're basically eating very, very large amounts of fat.

Sounds like a nutrient deficient diet.