Food Restrictions Questions

[SusanJ]

My frustration is in figuring out why I lost some weight, but cannot budge the rest I need to lose to be in a healthy range.

A couple things you might look at.

You mentioned feeling stressed. Cortisol will definitely impact your metabolism, as will thyroid issues. Perhaps you can work with your doctor to see if both are where they need to be.

The other, counter-intuitive, idea is to increase your calories (especially protein for weight lifting/muscle building). When you get around 1200 calories your body might be thinking it's in starvation mode, and hanging on to every ounce it can, by lower your metabolism. Easy enough to try for a couple months to see if it makes a difference.

[Jan18]

Not all Apollo members carry an ApoE4 allele, and for the Apollo members who are 3/3's, saturated fats like butter or coconut oil are not as big an issue as they might be for 4/4's. Substituting olive oil or avocado oil might be a better path for the ApoE4/4s. If you read the Apollo materials, they also recommend eating small amounts of beans if you are insulin sensitive. They are really good for providing prebiotic fiber.

Hi JML
Thanks for letting me know that. I always think it is only those of us with one or two ApoE4 alleles that are on Apollo's site. Ok, I understand now. Sure wish I were one of them! It's really hard to cut out dairy, grains, starchy vegetables AND saturated fats. <sigh>

However, since I posted, I have been fasting 22-24 hours every other day and my ketones are now 1.1-1.4!!! I also sometimes drink coffee with -- yes -- 1-2T of heavy cream (then restrict my sat fat even more the rest of the day) and 1/4 c. of walnuts on 22-24 hour fasting days and still reach those levels. Gundry's new book, The Keto Code, told me a study was done and they found that when one is fasting, eating a small portion of nuts if needed to curb hunger will not interfere with ketone production (in my case, I have to do it so I can take my supplements in the morning -- I can't take them with dinner or the B vitamins will affect my sleep.) I am delighted this works! And encouraged now that I'm burning more ketones! With this alternating schedule, I am also in a good ketone range on my alternate days, which are intermittent fasts of 16-18 hours!

I'm finding that macros averaging 62% fat, 21% protein and 17% carbs is working for me. What remains to be seen is my weight loss. So far, my "plateau" has ended and I lost 2 lbs last week.

P.S. I often include 1/4 c of beans during a day to help achieve the fiber recommendations. They don't seem to bother me.

So perhaps I have discovered the key for me. Hope this keeps working!

Jan 18

[Jan18]

My frustration is in figuring out why I lost some weight, but cannot budge the rest I need to lose to be in a healthy range.

A couple things you might look at.

You mentioned feeling stressed. Cortisol will definitely impact your metabolism, as will thyroid issues. Perhaps you can work with your doctor to see if both are where they need to be. Thank you, SusanJ, yes, both are where Bredesen recommends!

The other, counter-intuitive, idea is to increase your calories (especially protein for weight lifting/muscle building). When you get around 1200 calories your body might be thinking it's in starvation mode, and hanging on to every ounce it can, by lower your metabolism. Easy enough to try for a couple months to see if it makes a difference. Thanks, yes I know about "starvation mode!" My calorie deficit is geared to lose a pound a week based on my results of my basal metabolism and moderate activity, according to my FMD. And if you read my reply here to JML you'll be happy to see what I discovered of late! I really appreciate you offering help, though! Thank you!!!

[JML]

However, since I posted, I have been fasting 22-24 hours every other day and my ketones are now 1.1-1.4!!!
I'm finding that macros averaging 62% fat, 21% protein and 17% carbs is working for me. What remains to be seen is my weight loss. So far, my "plateau" has ended and I lost 2 lbs last week.

Congratulations for finding what works for you (and for having the persistence to keep trying!)!

[anne from california]

We are cautioned against eating refined carbs like breads and grains, starchy vegetables like white potatoes, grains, sugars along with dairy. I am going all the way back to the beginning of learning this protocol to ask for clarification. And maybe I'm so confused with what Gundry says and what Bredesen says. I thought Bredesen agreed with Gundry on foods (not including Gundry's new book, Breaking the Keto Code.)

I know they spike insulin and spiking insulin over and over is what leads to insulin resistance.

BUT....

Must we eliminate them completely and forever? Can't we see by Keto Mojo if they spike our insulin and if not, use them in moderation (for example, if used in small quantities, especially when paired with other foods that don't spike or actually lower insulin?)

Does this protocol mean never, ever again consuming any of those foods, or any with lectins, or any sweets? I have this mental picture from what people have said that they only ever eat nonstarchy vegetables, healthy fats (no butter, no MCT, no coconut, no cheeses, no foods with saturated fats) tiny amounts of only pastured eggs, chicken and fatty fish like salmon. Period. (Although I don't need clarification on fish, because I'd only eat salmon anyway. Not a fan of fish.)

I know I'm asking this AGAIN, but I have not gotten a clear picture of what this diet for life should look like. If it is that strict (as I described above) I don't think I can do it. Plus how can it be healthy to cut out beans, when beans and greens are the two things the Blue Zone diets have in common and I thought people in the Blue Zones not only lived longer, but also had lower incidences of AD. (And yes, I know there are other factors in Blue Zones communities, but diet is a big one and we can also replicate those other factors, like daily movement, socialization, etc.)

The Apollo website has all of those foods -- which I thought were expressly forbidden forever -- in a good number of its recipes! So what's the deal?

I apologize for my ongoing confusion and frustration with the diet protocol. It would be helpful if someone who is solidly on this protocol would post a typical week's worth of meals they eat to give us a better idea. I have asked these kinds of diet questions before, so I sincerely apologize if I have been given definitive answers and don't remember them. The amount of learning and tweaking and new information, along with the basics, is overwhelming to me at times.

Jan, these are all great questions. I have several "competing" issues--family history of late-onset Alzheimer's (despite my 3/3 status), high LDL/ApoB (but high HDL and low trigs, go figure), osteoporosis, sleep dysfunction (the only time in the last decade that I have slept a full 7 hours without HOURS of mid-night wakefulness was when I had COVID a few weeks ago and had taken both melatonin and nighttime cold meds). Today, yet another report that my mother's memory loss has worsened. At 86, she's about eight years into cognitive decline. I have tons of energy and a busy brain, so I exercise a lot (daily walks of 2+ miles, Pilates 4 or 5 days a week, weight training 4 days a week), am up late and awake early (and--see above--awake in the middle of the night), and love to cook. But I don't know quite what to cook because of the conflicting health information out there. Bredesen's program seems too low in quality protein and calcium for these osteoporotic bones. If I go too low on carbs, I'll have complete insomnia. With those lipids, saturated fat should probably be off the table entirely (or not?). I'm low BMI--barely 120 pounds at 5'6"--so too much intermittent fasting/time restricted eating is not my friend. I have a swallowing disorder that makes pills a really tough go, and a goofy reaction to supplements, like mag threonate, that are supposed to help with sleep. (Last time I took mag threonate, the walls in my bedroom were pulsing and I had total insomnia. Did not sleep. Just lay there listening to my racing, pounding heart and wondering when the Go Ask Alice experience would stop. The same happens to me with progesterone, which is one of the reasons I quit bioidentical hormones. The hallucinations and the breakthrough bleeding that reminded me of being 15 again.) So, just chiming in to say I get it, the frustration. N=1 seems to keep coming back to "doesn't work for me." Yet I stay in the game with some hope that I might prevent myself going the route of all my maternal female ancestors.

[Julie G]

We are cautioned against eating refined carbs like breads and grains, starchy vegetables like white potatoes, grains, sugars along with dairy. I am going all the way back to the beginning of learning this protocol to ask for clarification. And maybe I'm so confused with what Gundry says and what Bredesen says. I thought Bredesen agreed with Gundry on foods (not including Gundry's new book, Breaking the Keto Code.)

I know they spike insulin and spiking insulin over and over is what leads to insulin resistance.

BUT....

Must we eliminate them completely and forever? Can't we see by Keto Mojo if they spike our insulin and if not, use them in moderation (for example, if used in small quantities, especially when paired with other foods that don't spike or actually lower insulin?)

Does this protocol mean never, ever again consuming any of those foods, or any with lectins, or any sweets? I have this mental picture from what people have said that they only ever eat nonstarchy vegetables, healthy fats (no butter, no MCT, no coconut, no cheeses, no foods with saturated fats) tiny amounts of only pastured eggs, chicken and fatty fish like salmon. Period. (Although I don't need clarification on fish, because I'd only eat salmon anyway. Not a fan of fish.)

Wow, this sounds very restrictive and not necessarily reflective of KetoFLEX 12/3. I eat using this dietary pattern and thoroughly enjoy my food, but then again, I like most food. I like to think of it as a mildly ketogenic Mediterranean diet — without the wheat pasta and bread, but there are plenty of other delicious alternatives to mimic them. Let me try to clarify a few points.

Re. lectins, Dr. Bredesen is more lenient than Dr. Gundry and encourages folks to minimize them if they are sensitive or have autoimmune conditions. Interestingly, lots of antioxidants are found in the parts of the food with higher lectins, (almond skins being one example) so it's a balancing act.

As we age, many need higher levels of protein because our gut health erodes and we're unable to absorb protein the way we did when we were younger. Too little protein can lead to muscle wasting, etc. Your description of "tiny amounts of protein" is scary, especially for an aging population. I did a macronutrient breakdown for a healthy, age 64 year-old woman, 5' 6" 130 lbs. in a macronutrient ratio guide and in The End of Alzheimer's Program and she ate 2 small eggs eggs and 4.85 oz of salmon in a day. Keep in mind that Dr. Bredesen is NOT counting incomplete protein from vegetables towards your total protein intake. The last thing he wants to do is limit veggie intake for fear of over-consuming protein.

The Apollo website has all of those foods -- which I thought were expressly forbidden forever -- in a good number of its recipes! So what's the deal?

AH has recipes that use sugar and simple carbs??? I don't think that's true. There are some recipes that use saturated fat (like coconut oil or milk) because not everyone hyperaborbs dietary fat. Very often, you can substitute EVOO or avocado oil instead, which is often suggested in the recipes themselves. Very small amounts of pseudo-grains (like tartary buckwheat), legumes or colored tubers have been featured in some recipes because they're an excellent source of resistant starch (level 3 of the brain food pyramid). And, small amounts of optional A2 dairy are also used in many recipes for those who can tolerate it. You'll recall that that A2 dairy tops the pyramid, featured below.

Pyrmid-Final.png

FWIW, I don't feel deprived of sweets because I still eat dark chocolate, berries, and occasional almond flour treats (like pancakes), using stevia or monk fruit. Have you ever experimented with alternate flours and sugars?

You ask a really great question about whether or not we need to give up inflammatory foods forever. Dr. Bredesen would encourage you to do your best, especially if you're increasing dietary fat as the combo could set the stage for vascular disease.

The diagram below may help you get a handle on how to put together a plate of food using KetoFLEX 12/3. It represents a day's worth of food.

image.jpeg

I love JD's reminder that you don't need to be perfect using this approach. I'm certainly not, but have still experienced an amazing health transformation eating this way. You couldn't pay me to go back to my old way of eating. Nothing tastes as good as being healthy feels. Just my two cents.

[JD2020]

You ask a really great question about whether or not we need to give up inflammatory foods forever. Dr. Bredesen would encourage you to do your best, especially if you're increasing dietary fat as the combo could set the stage for vascular disease.

This got my attention. My dad's vascular disease is quite serious. Do I understand then that inflammation + high fat diet = vascular disease?

[Julie G]

This got my attention. My dad's vascular disease is quite serious. Do I understand then that inflammation + high fat diet = vascular disease?

I'm sorry to hear about your dad. Yes, Dr. Bredesen is nervous about combining inflammatory foods with a higher fat diet. For that reason, he encourages folks to give up all forms of sugar, simple carbohydrates, grains, and conventional dairy BEFORE adopting a higher fat diet. He believes that combo could increase inflammation, raise glycemic markers, and set the stage for vascular disease. In The End of Alzheimer's Program, we wrote a chapter entitled "Put Out the Fire" with the rationale for giving up each of these food groups.

[JD2020]

In The End of Alzheimer's Program, we wrote a chapter entitled "Put Out the Fire" with the rationale for giving up each of these food groups.

Thanks. I will reread that section today. As I've posted endlessly, maintaining weight is a concern. It seems that my body does very different things with 100 calories of olive oil vs 100 calories of grains, so there are competing issues.

[Jan18]

Re. lectins, Dr. Bredesen is more lenient than Dr. Gundry and encourages folks to minimize them if they are sensitive or have autoimmune conditions. Interestingly, lots of antioxidants are found in the parts of the food with higher lectins, (almond skins being one example) so it's a balancing act.

AH has recipes that use sugar and simple carbs??? I don't think that's true. There are some recipes that use saturated fat (like coconut oil or milk) because not everyone hyperaborbs dietary fat. Very often, you can substitute EVOO or avocado oil instead, which is often suggested in the recipes themselves. Very small amounts of pseudo-grains (like tartary buckwheat), legumes or colored tubers have been featured in some recipes because they're an excellent source of resistant starch (level 3 of the brain food pyramid). And, small amounts of optional A2 dairy are also used in many recipes for those who can tolerate it. You'll recall that that A2 dairy tops the pyramid, featured below.

I love JD's reminder that you don't need to be perfect using this approach. I'm certainly not, but have still experienced an amazing health transformation eating this way. You couldn't pay me to go back to my old way of eating. Nothing tastes as good as being healthy feels. Just my two cents.

Julie,
Thanks for the clarification and for the care and time you offered me in your answer. I really appreciate your generous help. You are a wealth of information and a Godsend to me and so many here.

I don't seem to have a problem with lectins (and have indeed read in several places that the majority of people don't -- I somehow developed the impression that everyone should steer clear of them.). My bad?

I understand about the saturated fat not being as problematic for those who aren't apoe4's. I was just disappointed to find ghee and coconut oil/milk in some of the recipes that looked good to me....but then not being able to use them since I mistakenly assumed all of the recipes were well-suited to us, too (like the keto hot fudge sauce for us chocolate lovers. Sigh.) You can't always substitute EVOO for those in all recipes.

As far as sugar/simple carbs, I thought I saw maple syrup in some of the recipes, which I thought was a no-no as well. I also thought I saw white potatoes, but forgive me if I'm mixing up recipe sources....I read a ton....and that could've been in some vegetarian source, as they do eat white potatoes.

And what is Bredesen't take on organic soy products? Without going back to my Gundry sources, I thought soy was also off his list. I'm trying to reduce animal products as much as possible and looking for other protein sources. I read in one place that soy is bad and in another that it is wonderful. What about Greek yogurt (plain, no sugar)? I am having a very hard time consuming enough calcium (1200 mg) without dairy. I usually only get 1/3- 1/2 of that. And my cardiologists have said do NOT take calcium supplements. I'll still include occasional eggs and wild caught salmon, but in small quantities.

This isn't the first time that someone here has suggested I was being "too strict", so I appreciate that. I also have somehow gotten Gundry's "no's" ingrained in my head and have to remember he was dealing with largely autoimmune diseases or folks with verified leaky gut issues (or whatever, not necessarily the general population.) So I wasn't having any legumes (and concerned about that!) I find I do well and can still achieve mild ketosis with small amounts.

I've got a lot of question about how vegetarians achieve ketosis without going overboard on carbohydrates, since that is the focus when you are vegetarian. Is there a source on that here or on Apollo Health that you can point me towards? My search hasn't yielded results yet.

I just get overwhelmed with all the information, especially when I read conflicting opinions (like on soy or calcium supplements.) I read at Ocean and John Robbins' Food Revolution source, and of course other places, that bone health is a balance of the osteoblast and osteoclast activity and that dairy actually wasn't recommended. They cited studies showing the countries with the least amount of dairy had the least amount of osteoporosis (granted, other factors could have helped account for that, like their daily activity) and that those with the most soy did very well.

Now I'm worried about my heart rate, which is in the mid-60's and higher when I sleep, when it should be lower for restoration (as measured by my Fit Bit Versa 3). I read that fish oil lowers heart rate and wonder if I should be concerned about that. I take Nordic Naturals DHA (which is higher in DHA than EPA since I saw you say that Bredesen recommends something like 1,000 mg of DHA for us Apoe4's, right? (I have higher than desired cholesterol and LDL but two CAC scores 5 years apart of 0% and no EKG or EEG test abnormalities.)

And I still do not have a good, Bredesen-trained 2.0 practitioner here, which is a continual source of stress for me. Melissa from Apollo recommended one who is licensed in many states (based out of CO) who charges -- sit down -- $14,000 to be a new patient! (He does complete testing, but if you don't need certain ones, the money stays in your account for future tests, if necessary, she said.) I find that charge unreasonable. I wouldn't have to ask all this stuff here if I just had a good practitioner! I talked to Dr. Ann Hathaway's office last fall about becoming a new patient, but when I finally pulled the trigger to schedule last week, was told she isn't accepting any new patients until the new trial she's doing is over, likely end of the year or next spring. I've gone 5 years without a good practitioner and really want someone as knowledgeable as her, since she works with Dr. Bredesen so closely. I'm willing to travel to the West Coast to make that happen as I'm so tired of being confused and stressed with so many unanswered questions. (Way more than I've asked here.....)

I've done a Zoom call with Dr. Felice Gersh out in CA (whose interview I saw on the Alzheimer's Summit) and she disagreed -- with convincing reasons -- with what a local gynecologist here wanted to do for hormones. So I am in the process of setting up an appt to work with her. She is double-board certified in OB-GYN and functional medicine and very aware of Bredesen's protocol and knows Dr. Hathaway, and has good things to say about her, so I feel I can get good hormonal supervision from her until I am able to work with Dr. Hathaway.

Comments welcome.