Alzheimer's Talk: Amyloid, ApoE4, Insulin, and More

Hey everyone,

Since it’s going to be another couple of weeks before I’ll have time to write a new in-depth post, I wanted to share another video with you. I know some of you aren’t into videos and much prefer to read, so if that’s you, just hang tight; I’ll start writing “for real” again as soon as I can. For the rest of you, though, here’s the talk I gave about Alzheimer’s disease at Low Carb Houston just two weeks ago. I had 30 minutes to give a talk that I normally give in 45-60 minutes, so I had to cut a few things out. (Also had to speak quickly!) If you want the full version, I covered a little bit more during a talk at KetoCon back in June.  

If you’re interested in Alzheimer’s disease as “type 3 diabetes” or “diabetes of the brain,” I think you’ll find these talks very educational. Even though the Low Carb Houston talk was a little shorter than the one at KetoCon, it was a bit more in-depth on the science specifically surrounding beta-amyloid. I added in some aspects that I don’t normally include, because continuing medical education credits (CMEs) were being offered for the event, so I felt like I should step things up a bit and include some of the technical details I usually leave out for an audience that’s mostly laypeople. (Turns out Houston had a big mix of everyone, so it was fine either way.) If you’re especially interested in amyloid and why I don’t think it’s a cause of Alzheimer’s and, in fact, is more likely a protective thing, you’ll want to watch the Houston talk.

The KetoCon talk includes some details on cholesterol that I skipped over in Houston due to time constraints, and also because Dr. David Diamond, Dr. Nadir Ali, Dr. Maryanne Demasi, and Dave Feldman had all spoken before I did, and they covered cholesterol and statin drugs better than I ever could have. (Good thing, because it helped that I was able to skip the cholesterol details…freed up time for looking more closely at amyloid.)

You can find more of my presentations and articles on Alzheimer’s here. I haven’t had a chance to update it in a while, but I’ll do that soon. (Need to include the Houston talk for sure!)

And don’t forget about my shiny new YouTube channel. I know many of you (me included!) prefer reading to watching videos, but for those who might enjoy watching me remind people to keep low carb and keto simple and sane, please consider checking out the channel. Topics already addressed include an intro to why I started the channel, my personal history & background with low carb, how keto works, and measuring ketones. Upcoming topics include the Keto Police™, food quality, protein (and gluconeogenesis), weight loss stalls, and thyroid function. (I see probably 2 clients a month who have unrecognized/undiagnosed hypothyroidism, and it is a major roadblock to fat loss.) If you have a specific topic you’d like me to address, feel free to suggest it in the comments.

Disclaimer: Amy Berger, MS, CNS, NTP, is not a physician and Tuit Nutrition, LLC, is not a medical practice. The information contained on this site is not intended to diagnose, treat, cure, or prevent any medical condition and is not to be used as a substitute for the care and guidance of a physician. Links in this post and all others may direct you to amazon.com, where I will receive a small amount of the purchase price of any items you buy through my affiliate links.

Has Your Cholesterol Skyrocketed on a Ketogenic Diet? Read This!

Has your cholesterol skyrocketed on a low carb or ketogenic diet?

Or did it start out already high, and hasn’t come down like you thought it would after cutting carbs for a while?

Is your doctor on your case to “do something” about it?  Are they pushing you to take cholesterol-lowering medication and stop that crazy high-fat diet you’ve been following?  

Or maybe your doctor’s actually pretty easygoing about it, but you are alarmed by the big jump in your cholesterol since you started low carb.  Maybe you’re wondering if all that butter, cheese, bacon, and red meat isn’t quite such a good idea after all...

People who adopt carbohydrate-restricted diets have widely varying effects on their lipid profile.  Generally speaking, triglycerides go down and HDL goes up.  This is practically a given.  Happens like clockwork.  Totally predictable.  If you were the betting kind, you could put money on it and have a virtually guaranteed return.  And this is a good thing.  More and more evidence is emerging that regardless of your total cholesterol or LDL, the triglyceride-to-HDL ratio is a strong predictor of cardiovascular risk.  

According to Drs. Phinney and Volek in their book, The Art and Science of Low Carbohydrate Living:

“The triglyceride/HDL ratio provides a broader assessment of risk, and its relationship with insulin resistance makes it far superior to LDL-C.  And how best to improve your triglyceride/HDL ratio?  The striking reductions in plasma triglycerides and consistent increases in HDL-C in response to low carbohydrate diets are unparalleled by any other lifestyle intervention, or even drug treatment, and therefore represents the most powerful method to improve this ratio.”

LDL is a different story.  In some people, LDL goes down, but in others, it goes up.  Something that happens on a low carb diet often, but not always, is a shift from LDL particles that are “small and dense” to LDL particles that are “large and fluffy.”  Even when the total LDL goes up, the pattern of the particle makeup shifts.  It’s believed—but has not been proven conclusively—that the latter pattern, called “pattern A,” is less atherogenic.  That is, when your LDL particles are predominantly the large, fluffy type, they’re less likely to “clog your arteries” (*groan*) and cause a heart attack, stroke, or other cardio/cerebrovascular disease than when your particles are predominantly small & dense, called “pattern B.”  So, on balance, even if LDL goes up on a low carb diet, it’s believed that the shift from pattern B to pattern A is a beneficial change and represents an improvement in your cardiovascular health.

But what if your total cholesterol or LDL absolutely skyrockets?  Does your particle pattern even matter then?  If your total cholesterol is 300, 400, 500, or higher, and your LDL is 200 or higher, surely—surely—all that cholesterol has to be clogging your arteries, right?  Surely your very next slice of bacon could have you staring down the barrel of cardiac arrest, right?  I mean, even if your triglycerides are low and your HDL is high, and your glucose and insulin are low, all your inflammatory markers are low, you’ve lost 60 pounds, your energy levels are through the roof, and your doctor has stopped your GERD medication, your beta-blocker, and your insulin injections, there’s no way your cholesterol could be that high and not cause trouble.

Right?  

Not so fast.

Podcast Interview: Real World Paleo

My third podcast interview is in the hopper and ready for you to go have a listen! First, it was Jimmy Moore’s Livin’ la Vida Low Carb Show, then it was Robb Wolf’s Paleo Solution Podcast, and now, I’m talking about real food, low-carb, and Alzheimer’s on the Real World Paleo Podcast. I’ve also recorded a fourth show, which I’m told will air sometime in December. (Details to follow.) Hey, it’s almost like I kinda-sorta know what I’m talking about! (Either that, or I’m doing a great job of fooling people into thinking I do!)

If you’ve never heard of the Real World Paleo Podcast, that’s probably because it’s pretty new. The first episode went live just this past September. The hosts are Christine Lehmann, MS, NTP, and Stephanie Ewals, NTP. Christine lives in Alexandria, VA, not far from me, and she and I met when we took the Nutritional Therapy Practitioner training together back in 2013. Christine is the “Reverse Diabetes Coach™,” and Stephanie practices nutritional therapy at Out of the Woods Nutrition, in Minnesota.

Both of these ladies know what they’re doing, and it was a privilege to be able to share my Alzheimer’s research with them and their audience. If you’ve read some of my past posts about Alzheimer’s disease, then most of what we discussed won’t be new to you, but hey, a little refresher never hurt anyone! (Unfortunately, there was a little bit of feedback on my mic again, but not as bad as when I recorded with the great Mr. Wolf.)

You can download the podcast on iTunes, Stitcher, or listen directly through Christine’s website: http://www.reversediabetescoach.com/episode-11-how-you-can-delay-alzheimers-and-dementia/

The show notes in the link above include helpful links to some scientific papers that might be of interest to you if you’d like to delve into the metabolic and mitochondrial underpinnings of Alzheimer’s.

By the way: the Real World Paleo Podcast is a great show for any friends and family members who are new to LCHF, Paleo, Primal, and just plain real food. Stephanie and Christine do a great job of introducing complex concepts and explaining them in simple but informative ways, kind of like I aim to do on my blog. It might be old news if you’ve been eating this way for a while now, but for people who are just starting to dip their toes in these waters, this show is a down-to-earth, non-intimidating way to learn about healthy fats, the importance of good quality proteins, finding the right amount and types of carbohydrates for different goals, etc.

Remember: Amy Berger, M.S., NTP, is not a physician and Tuit Nutrition, LLC, is not a medical practice. The information contained on this site is not intended to diagnose, treat, cure, or prevent any medical condition.

Podcast Interview!

Hey folks! If this is your first visit to my blog after hearing me on Jimmy Moore’s Livin’ la Vida Low Carb Podcast, here are some links to past posts I’ve done regarding Alzheimer’s disease:

• Announcement about my e-book, The Alzheimer’s Antidote
• Rant About the American Academy of Neurology’s Brain Health Fair
• Alzheimer’s Disease: Type 3 Diabetes
• Follow-up Q&A about certain dietary principles and Alzheimer's

And here’s a link to a guest post I wrote for Robb Wolf’s site, about carbs, Alzheimer's, and more, after the first interview he did with Dr. Perlmutter, after the release of the book, Grain Brain.

If you’d like to learn more about me, check out the About Me page here on this site. In the podcast, I touched only briefly on how I found low carb, so if you’re interested in all the gory details of how “eating less and moving more” failed me for most of my adolescence and young adult life, you can read about that here.  (You might also want to wait until you have an hour to spare. You will see from today’s post, or by looking through the archives, that brevity is not my strong suit.)

And now, on to the post!

The Dietetics Organization Joins the 21st Century (Kind Of...)

If you’ve been living under a rock for the past few weeks, or, unlike me, you have an actual life, which precludes you from reading as many nutrition articles, blogs, and papers as I do, you might have missed the comments from the Academy of Nutrition and Dietetics (AND) in response to the Scientific Report of the 2015 Dietary Guidelines Advisory Committee. (The AND was formerly the ADA—the American Dietetic Association—the body that oversees the registered dietitian credential [RD].)

This thing has been making the rounds in the low-carb, Paleo, Primal and real food circles, mostly because it is a refreshing—and we might even say downright shocking—reversal of course by this supremely mainstream organization regarding some of the nutrients that have been public outlaws for the past few decades. While the AND has certainly not come out and directly endorsed higher-fat, low-carbohydrate diets, here a few general points they made about the recommendations by the 2015 Dietary Guidelines Advisory Committee (DGAC), some of which agree with the committee’s findings, and some of which don’t: 

• Very low sodium diets are not appropriate for everyone, and may, in fact, be harmful for some populations. 
• There is no correlation between dietary cholesterol intake and serum cholesterol levels.
• Since the studies on saturated fat, cholesterol, and heart disease over the years have been so terribly conducted and interpreted, “the Academy suggests that HHS and USDA support a similar revision [for that of cholesterol] deemphasizing saturated fat as a nutrient of concern.”
• Carbohydrate intake is a much stronger predictor for cardiovascular disease risk than is saturated fat, and it might not be such a bad idea to replace some amount of dietary carbohydrate with fat. 

As you can see, these points mark a huge step forward for this organization, which in the past, has been tepid, conventional, and by-the-book all the way. It’s a gutsy move, and I’m thrilled to see it happen. I applaud the AND for joining the rest of us in the 21^st Century with regard to basic science about food and human health. Since I have ragged pretty hard on the AND in the past, I’m happy to be able to give credit where credit is due.

That being said, this wouldn’t be all that interesting a post if all I did was sing the praises of this document. Naturally, there are a few points of contention. So let’s look at things little more closely, celebrate the good stuff, and bring to light the not-so-good stuff. We’ll start with the not-so-good stuff and then move to the good stuff, so that we end on a positive note.

Statins: Sugar-Coating the Truth

A priest, a rabbi, and a cardiologist walk into a bar.

No, that’s not it…

Why did the cholesterol cross the road?

Nope, that’s not it either…

Did you hear the one about statins and increased risk for type 2 diabetes?

YES! That’s the one I meant. Only, this isn’t a joke.

Statin drug use is now associated with an increased risk for developing type 2 diabetes. Is this just fearmongering headlines, or is there really something to it?

  

Thoughts on the Brain Fair (Rant Warning!)

Greetings, Earthlings!

As I mentioned a few weeks ago, on April 18^th I had a table at the American Academy of Neurology’s Brain Health Fair, which was part of their annual convention. The event was free and open to the public, and as far as I could tell, it was mostly the public that came through the exhibit hall, since I didn’t get any doctors sidling up to my little corner of this shindig. (None that I know of, anyway.) My presence at this thing coincided with the launch of my e-book on Alzheimer’s disease. I am pleased to report that I had people coming up to me all day. People were very interested in hearing about the influence of food and nutrition on brain health. I don’t expect a lot of book sales to come from it, but I think I’ll be hearing from a few new clients. (And I made an Indian woman very happy when I told her it was okay to eat ghee again!)

There were some encouraging moments, and I think I dropped more than a few “knowledge bombs,” as Sean Croxton likes to say. But there were many discouraging moments, too. In fact, my main feeling on the event can be summed up in two words:

Holy, and crap.

Alzheimer's Follow-up: Q&A (a.k.a. World's Longest Blog Post)

WARNING: THIS POST CONTAINS MAJOR RANTS AND HARSH LANGUAGE. Read at your own risk.

Anyone out there watch Ancient Aliens? If so, you are probably cracking up right now. If not, you’re scratching your head, because you have no idea why this is funny. (Trust me, though, it’s hilarious.)

Seriously, though, the answer is not aliens. I might not know for sure what the answers are, but I’ll provide my best guesses/hunches.

What are the questions? Here goes:

It’s no secret that I am trying to get the word out about Alzheimer’s disease as a “disease of civilization” – that is, a condition that results from the mismatch between our physiology and the modern Western diet (refined carbohydrate-heavy, vegetable oil-heavy, low in micronutrients), and the modern Western lifestyle (inadequate sleep, inadequate physical movement, too much psychological stress, loss of human emotional connections). As of 1/18/2015, the post I wrote pointing folks toward the article I wrote for the Weston A. Price Foundation, has 1470 views. Not all that many, considering the one on Vitamin J has 13,512. (If I could get Mark Sisson to include the Alzheimer’s post in one of his Sunday Weekend Link Loves, maybe it would have more, since, thanks to a reader and friend who alerted the MDA people to it, that is where the vast majority of hits came from on Vitamin J.)

But word is spreading, if slowly. (In fact, someone is launching a Kickstarter campaign to fund a documentary about preventing Alzheimer’s, called Bread Head.) More people here and there are stumbling onto my blog, and finding the Alzheimer’s article, which is nice. One such newcomer left some very good questions in the comments section. They were good enough—and my answers complex enough—that I thought it would benefit more people if I answered in the form of a blog post, where everyone would see it, versus responding in the comments section, where almost no one would.

Armchair Experts

 

With so many people visiting to pay their respects during the shiva period following my mother’s death, I had the opportunity to overhear many conversations about diet, food, and health. It is amazing what passes for knowledge about these topics these days—and not in a good way.

If you have ever paid a shiva call, then you know that pretty much everyone who walks through the door comes bearing some kind of cake, platter of cookies, fruit basket, or some other food offering, intended to comfort the mourners. Well, the dining room table at my sister’s house was a testament to this outpouring of love and support via sugar and baked goods. For a week straight, it was covered in chocolates, cheesecake, seven-layer cookies, danishes, banana bread, brownies, muffins, bagels, and Edible Arrangements (with pineapples, melon, grapes, and strawberries artfully cut to look like flowers). (Click here for coupons, if you are so inclined!) Not to mention what was in the fridge: about a hundred years’ worth of “real food,” courtesy of many out-of-town friends flooding the local kosher deli with orders to be delivered. (Traditional Jewish-type foods, like whitefish and herring, lox and smoked sable, about eight zillion pounds of cream cheese for the eight zillion bagels out on the table, roast chicken, mushrooms & barley, and a few kasha knishes for good measure.)

As visitors made their way through the offerings, I overheard quite a few explanations and justifications for why people were picking and choosing this or that, and staying away from certain things and reaching for seconds of others. Most of this, as you might imagine, given that I have been driven to write a blog post about it, was total nonsense. (One guy even asked if we had any low-fat cream cheese. *Facepalm.*)

Most of what I overheard had nothing to do with anyone’s individual metabolic or physiologic needs. No one said anything about skipping the bagels because of a gluten issue, or avoiding the cakes because they were diabetic. (The people, not the cakes, hehheh.) Most of it was more along the lines of, “…all that cholesterol is no good for you,” or, “The brown rice is better because it’s a whole grain.” Moreover, these things were said with complete confidence. They were declarative sentences, not questions. These people honestly believed that what they were saying was factual. That they were ironclad truths. And the situation being what it was, I just didn’t have the inclination to call anyone on it. I didn’t want to stir up trouble by asking how someone “knew” that eating a lot of cholesterol is bad for them, or why they said, with complete confidence, that brown rice being a whole grain makes it a better choice. (Better than what? And for whom?)

All I did was sit back and listen, and come to the unsettling conclusion that, when it comes to nutrition, there are enough armchair experts to fill every last chair in every furniture warehouse in America.

And this got me thinking.

Fat Tuesday: More Saturated Fat Vindication Fun!

  





Hey Everyone! After my last post was mostly a linkfest, I’m hesitant to do something similar right away, but I found something the other day that I think is worth passing along. If you’ve been following me for any length of time (and I know there are at least two of you out there who have, hehheh), then it won’t surprise you when I say that a significant amount of the dietary and nutritional advice we’ve been given by the mainstream medical establishment (not to mention the supermarket tabloids, but I’m pretty sure all of us put more stock in the former than the latter) for the last sixty years is wrong. Not merely misguided, or a little off the mark, but straight-up, flat-out wrong. Now, it’s bad enough when, say, your mechanic gets something wrong. Maybe the tires get misaligned just a bit and your car pulls to the left or right. Or he thinks he’s fixed the problem, but that pesky check engine light comes back on the next day. But when doctors, nurses, dietitians, and nutritionists get it wrong, people die. Maybe not right away, but certainly over time. Remember: just because something doesn’t kill you immediately doesn’t mean it isn’t poisonous. (Lead, anyone? Arsenic? Too much sugar? Too much soybean oil? Ah, but I’m getting ahead of myself...)