4/4 diet confusion

[slinkystrudels]

Hi , so I’m 4/4, 41 and I don’t know whether to go Keto or Mediterranean . I am aware Breseden recommends mild ketosis but how do I do that ? Is he saying it’s not FULL keto ?? And the ONLY fish I like is white fish like cod and haddock, tuna at a push. Meat wise I only eat chicken with very occasional beef.
I just know diet will be my biggest struggle because I love my food and to cook but now there’s no joy to it. I love baking cakes and milk chocolate (in moderation) but that’s now out the window.
The diet thing is really getting me down.

[TheresaB]

Hi , so I’m 4/4, 41 and I don’t know whether to go Keto or Mediterranean . I am aware Breseden recommends mild ketosis but how do I do that ? Is he saying it’s not FULL keto ?? And the ONLY fish I like is white fish like cod and haddock, tuna at a push. Meat wise I only eat chicken with very occasional beef.
I just know diet will be my biggest struggle because I love my food and to cook but now there’s no joy to it. I love baking cakes and milk chocolate (in moderation) but that’s now out the window.
The diet thing is really getting me down.

It seems your question about the best diet has been asked over and over again. And while we all share the same allele and therefore certain susceptibilities, there is no straightforward answer as to a diet we should all follow. We all possess many individual factors.

What has helped me is getting tested for certain biomarkers and going from there. For example, for me, my insulin sensitivity wasn’t an issue, but inflammation was (not uncommon in 4s). So my initial dietary changes addressed that, which included mild ketosis since that helps with inflammation. Here it is 6 years later and I’m still tweaking my diet. I recently had some food sensitivity tests and made minor adjustments yet again, the good news being I’ve been able to add in some foods I had eliminated.

The first step Dr Bredesen recommends in his second book The End of Alzheimer's Program is to address insulin resistance. So the diet you should pursue can depend on whether you have insulin resistance (which a person can have even with normal blood sugar and normal body weight see Blood Sugar and the term TOFI in Insulin resistance - A guide to associated terms). It is critical that 4s maintain insulin sensitivity. Some can get away with a fair amount of good carbs whereas there are other folks who can hardly eat any. Find where you are on the spectrum and eat what you can get away with.

I like to maintain mild ketosis, because 4s are especially susceptible to impaired glucose uptake in the brain. The brain is very good at compensating for this, so just because a person may not have cognitive issues in the slightest doesn’t mean a person doesn’t have impaired uptake. If not addressed it will worsen and eventually lead to cognitive issues. But by the time cognitive issues occur, shrinkage has already occurred in the brain. There are many other benefits to having the ability to generate and burn ketones. For some, especially when young enough and insulin sensitive enough, metabolic flexibility maybe all a person needs, for others a certain level of ketosis is necessary to maintain adequate cognitive function. You may want to read our wiki on ketosis especially the sections on ApoE4 and ketosis and Ketosis and the brain [Ketosis and Ketogenic Diet

One can go keto and avoid grains and still have bread, desserts, and such. We have some recipes in our wiki Recipes from our members. There are also other facebook groups, websites that offer keto/ApoE4 friendly recipes.

I personally follow Dr Gundry’s Plant Paradox diet Dr Gundry's Protocol He loves to cook so he has lots of recipes in his books and on his website. Some recipes I can use, some don’t accommodate my diet, so as with all recipes in books or on the web, I have to evaluate them through my ApoE4 filter.

Diet also depends on individual sensitivity to certain foods. You might want to start with the big 4 the Dr Bredesen recommends staying away from: grains, simple carbs, dairy, and lectins.

If you haven’t read Dr Bredesen’s second book, The End of Alzheimer’s Program you should. If unfamiliar with Dr Bredesen, you can acquaint yourself in our wiki: Bredesen Protocol

[SusanJ]

I just know diet will be my biggest struggle because I love my food and to cook but now there’s no joy to it.

Many of us have gone through that grief of having to change our relationship to food. My husband and I would go out to a nice restaurant at least once a week on date night years ago! Now very few restaurants can work to accommodate how I eat. Talk about a loss! Not just the food, but an endearing tradition of ours. So, I hear you.

Something that helped me in moving towards a more healthy diet were cookbooks and the website by Danielle Walker. Although not a keto person, her way of cooking (including baking with nut and coconut flours) might just show you a way to move towards less sugar, less refined carbs. It helped me see that there are still a lot of yummy recipes that fit how I eat, which definitely helps with the transition.

Here's her website to poke around: https://daniellewalker.com/recipes. I own all of her cookbooks and many of her recipes have become my go-to favs, like Peruvian Style Chicken or Blueberry Galette if you need a wonderful dessert for a party (or just a treat )

It's okay to grieve the loss, because it's not just losing the foods, but a certain way of life. And because you like to cook, do know that there are lots of options on the web to get ideas and try new recipes.

[floramaria]

I just know diet will be my biggest struggle because I love my food and to cook but now there’s no joy to it. I love baking cakes and milk chocolate (in moderation) but that’s now out the window.
The diet thing is really getting me down.

. Hi slinkystrudels, I love food and I love cooking too, so much so that I ran a small cafe out of my house for five yearsI have been following a mainly keto diet for several years now. And I still love food and cooking. The dietary changes have taken some getting used to, and definitely pushed me into uncharted territory, but once I got the hang of it, it has been exciting to experiment and to adapt recipes so they fit my guidelines. My guess is that the fact that you love to cook will turn out to be a real positive for you. You are already at home in the kitchen. You’ll still be able to bake.
Keto is so popular now that there are ingredients, recipes and entire websites that will help you. You’re right that the milk chocolate will have to go, but you’ll most likely also find that your taste buds adapt as you eat food that is not so sweet. Before long , you may really enjoy darker chocolate.
I hope you will re-connect to both the joy of eating and of cooking.

[slinkystrudels]

Thanks for the responses. I think I’m more worried because I don’t like salmon/mackerel or shellfish and apparently 4/4’s are advised to avoid chicken & beef - so it doesn’t leave much !
Also the fact that Bredesen says no dairy and that included in Keto so that’s that out .....

Is it ok to supplement the oily fish as I assume it’s for the DHAs ?

[floramaria]

Thanks for the responses. I think I’m more worried because I don’t like salmon/mackerel or shellfish and apparently 4/4’s are advised to avoid chicken & beef - so it doesn’t leave much !
Also the fact that Bredesen says no dairy and that included in Keto so that’s that out .....

Is it ok to supplement the oily fish as I assume it’s for the DHAs ?

Hi slinkystrudels, it is really not as bad as that....unless you choose for it it to be. For one thing, you can embrace changes gradually, rather than doing everything at once if that is overwhelming. The guidelines are to avoid simple carbs, first and foremost, and grains and conventional dairy. You could start by eliminating sugar. As you adjust to that, remove simple carbs and processed foods. Then move on to conventional dairy. For people who tolerate it, a small amount of A2 dairy is okay. You can also consume small portions of pastured meet and poultry and still be following the diet.

[SusanJ]

I think I’m more worried because I don’t like salmon/mackerel or shellfish and apparently 4/4’s are advised to avoid chicken & beef - so it doesn’t leave much !

Your diet needs to be sustainable - taking in account what you like/dislike and food availability. For example, I'm one of a group here who still eats chicken, pork and beef. That said, I try to find the highest quality meats I can find and that means pasture raised. I live in a more rural part of the state, so getting decent fish consistently (I only buy frozen, because really, that fish has to come a long ways to be sold where I live) is tough. For example, last week, I couldn't find cod at the grocery store. But there are several ranches around that sell pasture-raised beef, pork and chicken. Yes, it's expensive, but I rarely eat out anymore, so in my budget, it's been a wash.

So my best advice is aim for a low-sugar, whole food diet, and maybe don't stress so much over the fish issue.

[floramaria]

For example, I'm one of a group here who still eats chicken, pork and beef. That said, I try to find the highest quality meats I can find and that means pasture raised.

I am one of that group, too. Also in my diet: turkey, Cornish game hens , bison, elk, chicken liver, sheep liver, calf’s liver and bison liver, and A2 dairy. Except for my cholesterol being higher than some people like to see it, my biomarkers have all been very good with this diet.

[HopefullyNotDoomed]

Thanks for the responses. I think I’m more worried because I don’t like salmon/mackerel or shellfish and apparently 4/4’s are advised to avoid chicken & beef - so it doesn’t leave much !
Also the fact that Bredesen says no dairy and that included in Keto so that’s that out .....

Is it ok to supplement the oily fish as I assume it’s for the DHAs ?

Apparently most fish oil supplements are not sufficient for APOE4 carriers, according to Rhonda Patrick, who herself is a 3/4 I believe.

https://zenpatient.com/blog/dr-rhonda-p ... lzheimers/

DHA is an essential omega-3 fatty acid and plays a vital role in the prevention and reversal of cognitive decline and Alzheimer’s Disease
The form of DHA found in fish, fish roe, and krill oil is primarily in phospholipid form and this form is broken down to DHA-lysoPC
The form of DHA found in DHA/fish oil supplements is not in phospholipid form and is primarily broken down to free DHA
APOE4 carriers have impaired free DHA transport into the brain because of APOE4-mediated degradation of the blood brain barrier, but this degradation does not impair how DHA-lysoPC enters the brain
Dr. Rhonda Patrick proposes that consuming DHA in phospholipid form may be a strategy for APOE4 carriers to get DHA into the brain and prevent APOE4-associated Alzheimer’s Disease, which is found in fish, fish roe, and krill oil but not in fish oil supplements

So based on the limited data it would be best to just eat the fatty fish and perhaps find a high quality krill oil supplement. The APOE4 brain is very, very DHA hungry; we need more of it and the the best way to do is to get it from the best sources, which are typically fatty fish. Do you like Sardines and Herring as those could be an option as well?

[slinkystrudels]

Hopefullynotdoomed , this is is very helpful and something I didn’t know re the breakdown of the DHA. I suppose I can ‘force’ myself to eat the oily fish , perhaps with a nice dressing to hide the fishiness lol .
I was just hoping not to have to if I could take supplements instead . I will however search for a high quality krill oil straight away as I have heard it mentioned before on here .
Thanks !