The Alzheimer’s Gene: Controlling ApoE

The Alzheimer’s Gene: Controlling ApoE
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Diet may explain the Nigerian Paradox, where they have among the highest rates of the Alzheimer’s susceptibility gene, ApoE4, but among the lowest rates of Alzheimer’s disease.

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Back in the 1990’s, a major susceptibility gene was discovered for Alzheimer’s, called ApoE4. If we have one ApoE4 gene, either from our mom or dad, like about 15% of the U.S. population do, our risk of getting Alzheimer’s is tripled, and if we’re like the 1 in 50 folks who have ApoE4 genes from both parents, we may be at nine times the risk.

The highest frequency of ApoE4 in the world is in Nigeria, but they also have some of the lowest Alzheimer’s rates. To understand this paradox, one has to understand the role of ApoE. What does the ApoE gene do? ApoE is the principal cholesterol carrier in the brain. So, the Nigerians’ diet appeared to have trumped their genes, due to their low cholesterol levels from their low intake of animal fat, living off of mainly grains and vegetables.

High ApoE4, but Alzheimer’s a rarity, thanks perhaps to low cholesterol levels, which any of us can achieve eating healthfully. These findings suggest that long-term changes in plasma cholesterol can lead to changes in ApoE gene expression. Just because we may have been dealt some bad genetic cards doesn’t mean we can’t reshuffle the deck with diet.

We cannot change our genetic makeup, but we can reduce or prevent high cholesterol. In this study of a thousand people for over 20 years, ApoE4 doubled the odds of Alzheimer’s, but high cholesterol nearly tripled the threat; so, the risk for Alzheimer’s disease from treatable factors—elevated cholesterol and blood pressure—appears to be greater than that from the dreaded Alzheimer’s susceptibility gene. In fact, projecting from their data, controlling lifestyle factors could reduce a person’s risk for Alzheimer’s disease, even if they have the double Apoe4 gene, from nine or ten times the odds down to just two.

People tend to have a fatalistic view toward developing Alzheimer’s disease, like it’s going to happen if it’s going to happen, but studies like this undermine such a view. We just need to emphasize the need for preventing and treating high blood pressure and cholesterol in the first place to reduce our risks for heart disease, stroke, and Alzheimer’s disease and, as a result, potentially enhance quantity and quality of life. Of equal importance, these data should be comforting to anyone interested in attempting to reduce the risk for and future burden of Alzheimer’s disease.

To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video. This is just an approximation of the audio contributed by Katie Schloer.

Please consider volunteering to help out on the site.

Images thanks to PublicDomainPictures via Pixabay.

Back in the 1990’s, a major susceptibility gene was discovered for Alzheimer’s, called ApoE4. If we have one ApoE4 gene, either from our mom or dad, like about 15% of the U.S. population do, our risk of getting Alzheimer’s is tripled, and if we’re like the 1 in 50 folks who have ApoE4 genes from both parents, we may be at nine times the risk.

The highest frequency of ApoE4 in the world is in Nigeria, but they also have some of the lowest Alzheimer’s rates. To understand this paradox, one has to understand the role of ApoE. What does the ApoE gene do? ApoE is the principal cholesterol carrier in the brain. So, the Nigerians’ diet appeared to have trumped their genes, due to their low cholesterol levels from their low intake of animal fat, living off of mainly grains and vegetables.

High ApoE4, but Alzheimer’s a rarity, thanks perhaps to low cholesterol levels, which any of us can achieve eating healthfully. These findings suggest that long-term changes in plasma cholesterol can lead to changes in ApoE gene expression. Just because we may have been dealt some bad genetic cards doesn’t mean we can’t reshuffle the deck with diet.

We cannot change our genetic makeup, but we can reduce or prevent high cholesterol. In this study of a thousand people for over 20 years, ApoE4 doubled the odds of Alzheimer’s, but high cholesterol nearly tripled the threat; so, the risk for Alzheimer’s disease from treatable factors—elevated cholesterol and blood pressure—appears to be greater than that from the dreaded Alzheimer’s susceptibility gene. In fact, projecting from their data, controlling lifestyle factors could reduce a person’s risk for Alzheimer’s disease, even if they have the double Apoe4 gene, from nine or ten times the odds down to just two.

People tend to have a fatalistic view toward developing Alzheimer’s disease, like it’s going to happen if it’s going to happen, but studies like this undermine such a view. We just need to emphasize the need for preventing and treating high blood pressure and cholesterol in the first place to reduce our risks for heart disease, stroke, and Alzheimer’s disease and, as a result, potentially enhance quantity and quality of life. Of equal importance, these data should be comforting to anyone interested in attempting to reduce the risk for and future burden of Alzheimer’s disease.

To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video. This is just an approximation of the audio contributed by Katie Schloer.

Please consider volunteering to help out on the site.

Images thanks to PublicDomainPictures via Pixabay.

Doctor's Note

What dietary changes? See some of my latest videos on preventing Alzheimer’s disease:

This concept of switching genes on and off is the exciting world of epigenetics. For more, see BRCA Breast Cancer Genes and Soy and Cancer Reversal Through Diet?

If you haven’t yet, you can subscribe to my videos for free by clicking here.

188 responses to “The Alzheimer’s Gene: Controlling ApoE

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  1. it is very interesting because also Amyloid beta is a regulation of cholesterol transport,
    and anti-microbial activity (potentially associated with Aβ’s pro-inflammatory activity… i Mean the amyloid plaques itself are related to cholesterol.
    are any studies with people that already have alzheimer’s, what happen if they lower the cholesterol? My grand mother was positive
    in the smelling test for alzheimer.. (she have many symptoms but not yet officially diagnose..) and my father is suffering from severe
    lost of memory in the last few years.. with a overweight of 37 kilograms and a very sedentary life until now..




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    1. it is a bad rithm to lost weight i mean can one lost weight to fast that is dangerous? when one is big the fat is in the circulatory system all the time.. when one is losing weight it is more fat in the circulatory system? it is toxic for the liver lost 1 kilogram a week? or it is better to lost slowly , thank you!!




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      1. The speed at which one loses weight is not the dangerous aspect, or losing weight. It is HOW one chooses to lose weight that dictates the safety of it. If your father eats how plant-based doctors like Gregor recommend, then it would be healthy weight loss regardless (if he is still consuming a broad range of legumes, vegetables, plants, grains, as well as consuming enough calories to function well). If your father is eating 4k calories a day and adjusted down to 2k or less, obviously the weight loss would be much quicker than if he adjusted from 3k to 2k. It is relative to the starting point of your fathers health.




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        1. Too fast weight loss results in saggy extra folds of skin. Slower weight loss allow the skin to shrink to fit.
          I lost 100 lbs. in 5 years and suffered no unsightly folds of excess skin.




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          1. I wouldn’t label excess skin as dangerous… I would however, label higher risk for heart disease, diabetes, obesity, cancer, etc. as dangerous though. That being said, I don’t disagree that slow weight-loss is better, but not becoming overweight in the first place is best.




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          2. if i may how old are you? i wonder if over 55 the skin came back.. i don’t think so.. but of course the quality of life is a very good reason!




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            1. Yes, I was in my 50’s when I lost the weight–I am now 73. I kept it off until I quit smoking and regained 35 pounds which I am still struggling to lose.
              When I adopted the whole food plant based diet I seemed to stop aging, or it slowed down considerably.




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          3. Thank you for posting this. I have always wondered about that. No one ever talks about this point. My 70 pound weight loss (I’m only 1/3 of the way through) is taking FOREVER! But the benefit will be no sagging skin then. Great!




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      2. Hello! If I had Alzheimer’s I would test myself for anemia. Melatonin was effective for Alzheimer’s in a limited trial. “Treatment with vitamin C dissolves toxic protein aggregates in Alzheimer’s disease.” “Researchers in Sweden have discovered a new function for vitamin C. Treatment with vitamin C can dissolve the toxic protein aggregates that build up in the brain in Alzheimer’s disease.” B12 deficit is the ultimate cause of death in people with Alzheimer’s. I would ask if Niacin, which reduces Cholesterol, would be effective for Alzheimer’s.




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          1. Thank you, I have it. I have been mentally ill for years. Doctors do little for me. However, I have found that I speak the truth and my conjectures are filled with the courage of reality. May I ask what in particular sounds ill to you? Almost everything I have said is backed in literature, papers, and by orthomolecular doctors. Are you saying I am wrong to think that vitamins can “transmutate” into atoms? It is my own opinion, but if you read a chemical structure, the molecules are all surrounded by oxygen. If you scale the size of oxygen, you have the idea of the body’s reaction centers. The atoms that are reactive, like oxygen are all different sizes. Oxygen, Sulfur, Nitrogen… There seems to be great reality (truth and courage) in reactivity. I know that love is in nutrition. I am almost sure that Iron is a cure for Alzheimer’s and Phosphorus is a cure for cancer. That is, however, my opinion. It, as they say, couldn’t hurt. They say to much salt is bad. The same with Iron. Maybe the same with Phosphorus, that there are different kinds, which they’re aren’t. So for years nobody has had any at all.




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            1. By the way, everything I haven’t directly sited directly was taught to me in organic chemistry. Gave up to this class it was so challenging. If you take organic chemistry, you have to have an open mind to alchemy!




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            2. Matthew Smith: re: “Almost everything I have said is backed in literature, papers, …” That’s one thing I really like about you. Every time I have seen you challenged on a statement that you made here at NutritionFacts, you have replied politely (despite the tone sometimes used to challenge you) and backed up your statement with, what looked like at a glance, a valid looking set of research papers. Makes me smile.
              .
              re: “…and by orthomolecular doctors.” I learned something from your post. I had never heard of orthomolecular medicine before. I looked it up on Wikipedia after seeing your post. I’m guessing that I would generally not agree with the conclusions of orthomolecular medicine, but I appreciate learning about it. And your affinity for the area explains a lot about why so many of your posts speak so highly of supplements. I’m glad that is working for you.
              .
              Happy day and good health to you Matthew.




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              1. Hello Thea. I feel freer with you in my life. I am sure we will live long lives together. Orthomolecular doctors do use nutrition to treat illness, but they mostly use vitamins. In the UK, Niacin is only available in 250 mg tablets. Dr. Hoffer says you would have to have them made up in 500 mg tablets by a pharmacist, or take 8 of the 250 mg tablets. They are mostly psychiatrists, who understand that most schizophrenias are pellagra, a Niacin deficiency. Did you know that America has tariffs on outerwear and raw peanuts because we are so desperate for these things? We are desperate for any kind of cure to schizophrenia. I think pellagra and schizophrenia are the same thing, in most non surgical circumstances. Have you read about pellagra? The irritability, the depression, the anger, the sun downing, the suicide, the delusions, the voices, the disability. They might be one in the same. Dr. Hoffer told thousands of people to take Niacin for schizophrenia. Many got better as the years went on. Many people had greater hope knowing it was a deficiency of vitamins, not of medicine. Dr. Hoffer said that people with schizophrenia had superior genes. They were artists, scientists, poets, and philosophers. They were Nobel Prize winners. They are very artistic, verbal people. They are shock resistant and brilliant. They seem to be doing what they say they are doing or dreaming of doing. The stress from their life seems to come from this divide. I read about a patient Dr. Hoffer wrote about called John. He put him on 3 grams (I only need 2) grams of Niacin a day, three grams of Vitamin C, a B complex vitamin, zinc 50 mg a day, 6,000 iu of D3, and three grams of Flax seed oil a day (he said Salmon oil). I put myself on this program for my schizophrenia, my autism, my ADHD, and my other mood disorders. I feel better. I have added hibiscus tea, Iodine, Vitamin A, and salt. Did you know that many plants seem to suffer from the same kind of disease? It seems to be called chlorinosis. Doesn’t that mean it is a deficiency of Chlorine? Chlorine is needed in macro molecular doses. I would love to have some salt with you. Perhaps ever sickness is in one way or another, just a deficiency of Chlorine. Did you know that many people become vegan to treat mental health problems? Perhaps Vitamins can also be helpful.

                Here is a list of Orthomolecular doctors in your country.
                Name: Rachel Biggins
                Academic Degrees/Certifications: DipION. DIridol. NLP practitioner

                Name: Sydney J. Bush
                Academic Degrees/Certifications: DOpt (IOSc.London) PhD.hc.

                Name: Damian Kuzmovic
                Academic Degrees/Certifications: BA (Hons) in Business Studies, BSc in Nursing

                Name: Saqib Rashid
                Academic Degrees/Certifications: B.sc., M.Sc., DHM (BIH), NDTP

                Name: Nathan Bernard Stein
                Academic Degrees/Certifications: MB BCH BAO DObs DCH MMedSc( Psych) MA




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          2. Aribadabar- I really wish that you could have stated that in a way that was more respectful of his individuality and nobility. It sounded really mean and negative. It makes me upset just to read you say it that way. If we try to understand another’s point of view, we can have a more cooperative sharing of ideas, and a more pleasant way to learn about nutrition.
            Thanks,
            John




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  2. Unload that double barreled shotgun! Eat plants!

    Jeans are just an expression of your diet. So what does that say of the ones that wear the saggy genes? :)




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  3. Via 23&Me, i found out that I’m Apoe 3/4 so I try to be careful… and to paraphrase the video, with your genetics, like a certain appendage, it isn’t what you have…….it’s what you do with what you have! :)




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    1. Well if it is just cholesterol, then you need to switch to a whole food plant based diet which has been shown to lower cholesterol as well or better than the best statins. On the other hand if it is only a problem when cholesterol is oxidized, then you need to switch to a whole food plant based diet to maximize your anti-oxidants levels so as to avoid the oxidation of cholesterol.




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      1. Well you need to learn what oxidizes the cholesterol. I have eaten a whole food plant based diet with no oil for 2 years and have high cholesterol. After some of the studies I read on PubMed, I am feeling pretty o.k. with that. Seems low cholesterol and cancer are inversely related. If its a choice between cancer and heart failure, give me the heart failure, thanks.




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        1. Sorry to say that in the general population that cancer and low cholesterol is a case of reverse causation where the cholesterol level in cancer patients falls as their disease progresses. People with advanced cancer often lose a lot of weight, which is why the disease used to known as consumption. Reduce the amount of food from any diet and cholesterol drops. Plus tumors actually actively take up cholesterol. So low cholesterol does not cause cancer, but cancer can cause low cholesterol.




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          1. “Anyway, as I have always known must happen, the ‘reverse causality’ hypothesis has finally been laid to rest. A recent analysis of the longest running heart disease research project in the world (the Framingham Study) has shown that low cholesterol levels predate cancer diagnosis by many, many, years. And, to quote:

            “Based on these data, it would suggest that lower cholesterol predated the development of cancer by quite a long time. Now, that doesn’t necessarily speak to [low cholesterol] causing the cancer; it could have been related to something else altogether, but it’s not supportive of the hypothesis that cancer caused the low levels of LDL
            cholesterol. We don’t know why it predates cancer, but it would be premature to attribute it to the cancer itself.” 11

            In short, it must now be accepted that cancer doesn’t cause low cholesterol levels. Which leaves the possibility that low cholesterol levels might cause cancer. This, inevitably, leads to the next question.If low levels of cholesterol precede cancer, can statins cause cancer?” http://drmalcolmkendrick.org/2012/03/26/do-low-cholesterol-levels-cause-cancer/




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            1. Sorry Wilma but this is highly improbable. Citing Kendrick doesn’t inspire confidence since he makes money selling books saying high cholesterol is OK even good. Also, there is no link to an actual scientific publication just quotes from individuals to justify these claims.
              The idea that low cholesterol causes increased mortality, cancer or Alzheimer’s is almost certainly wrong.

              “Iribarren et al9 go beyond the usual classification of “low cholesterol” based on a single measure and instead have examined future disease risk according to whether cholesterol level was stable over about 6 years or whether low cholesterol resulted from falling blood cholesterol levels. Among nearly 6000 healthy Japanese-American men enrolled in the Honolulu Heart Study, they measured total serum cholesterol at two time points, with mortality follow-up extending for up to 16 years. Results showed the expected association of elevated cholesterol with coronary disease. In addition, falling levels of cholesterol were linked to an excess risk of hepatic disease and cancer in particular, whereas low (<4.7 mmol/L, <180 mg/dL) but stable levels over time were not associated with excess risk. Their findings provide evidence that the association previously reported between low cholesterol and noncoronary mortality probably reflected the cholesterol-lowering metabolic consequences of long-term subclinical disease rather than a hazard associated with low cholesterol per se.

              This conclusion is consistent with results of a recent meta-analysis10 of cause-specific mortality (including unpublished data on noncardiovascular causes of death) from 10 large cohort studies and 2 international studies that concluded that reduced serum cholesterol is not related to excess mortality among cohorts of employed individuals, whereas population-based studies did show a relationship. The investigators proposed that the discrepancy in results was probably due to a higher frequency of risk factors associated with low cholesterol, eg, alcohol abuse and ill health, in population-based study samples compared with employed cohorts.

              Two additional pieces of evidence that suggest that low cholesterol is not a causal factor for noncardiovascular disease are the normal to extended life expectancy experienced by individuals with genetically determined hypobetacholesterolemia11 and populations with low average blood cholesterol levels, such as the Japanese and Greeks, who do not exhibit an excess of noncardiovascular disease deaths.12"
              http://circ.ahajournals.org/content/92/9/2365.full




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              1. To your first point, Kendrick is not to be trusted since he makes money selling books saying high cholesterol is not bad. Dr. McDougall, and a lot of others make money selling books that say cholesterol is bad and how to lower it. Even Dr. Greger. As to your second point, no studies were quoted only statements of individuals, Here are some he quotes (did you even visit that page?):

                1. Williams RR, Sorlie PD, Feinleib M, McNamara PM, Kannel WB, Dawber TR. Cancer incidence by levels of cholesterol. JAMA 1981; 245:247–52.

                2. Salmond CE, Beaglehole R, Prior IA. Are low cholesterol values associated with excess mortality? BMJ 1985;290:422–4.

                3. Schatzkin A, Hoover RN, Taylor PR, Ziegler RG, Carter CL,Larson DB, et al. Serum cholesterol and cancer in the NHANES I epidemiologic followup study. National Health and Nutrition Examination Survey. Lancet
                1987;2:298–301.

                4. To¨rnberg SA, Holm LE, Carstensen JM, Eklund GA. Cancer incidence and cancer mortality in relation to serum cholesterol. J Natl Cancer Inst 1989; 81:1917–21.

                5. Isles CG, Hole DJ, Gillis CR, Hawthorne VM, Lever AF.Plasma cholesterol, coronary heart disease, and cancer in the Renfrew and Paisley survey. BMJ 1989; 298:920–4.

                6. Kreger BE, Anderson KM, Schatzkin A, Splansky GL. Serum cholesterol level, body mass index, and the risk of coloncancer. The Framingham Study. Cancer 1992; 70:1038–43.

                7. Schuit AJ, Van Dijk CE, Dekker JM, Schouten EG, Kok FJ.Inverse association between serum total cholesterol andcancer mortality in Dutch
                civil servants. Am J Epidemiol1993; 137:966–76.

                8. Chang AK, Barrett-Connor E, Edelstein S. Low plasma cholesterol predicts an increased risk of lung cancer in elderlywomen. Prev Med 1995; 24:557–62.

                9. Steenland K, Nowlin S, Palu S. Cancer incidencein the National Health and Nutrition Survey I. Follow-updata: diabetes, cholesterol, pulse and physical activity.Cancer Epidemiol Biomarkers Prev 1995;
                4:807–11

                As to your third point, “The idea that low cholesterol causes increased mortality, cancer or Alzheimer’s is almost certainly wrong.” Um, based on what? Popular opinion? Popular opinion once said ulcers were caused from stress and spicy food. Popular opinion once thought bloodletting was a good idea. Popular opinion once thought the world was flat.




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                1. Wilma. When I said that citing the opinions of Kendrick was a concern, I meant that instead of citing an article in a reputable peer reviewed scientific publication you instead simply repeated the opinions of a notorious cholesterol denier.
                  Also, I stated that the study for the source of Kendrick’s claim that reverse causation had been refuted was not cited ie “A recent analysis of the longest running heart disease research project in the world (the Framingham Study) has shown that low cholesterol levels predate cancer diagnosis by many, many, years.”
                  The other references to studies you post are irrelevant since they are not the source of that specific claim. This should be obvious since all of them are dated at least 10 years before Kendrick’s post and therefore cannot be “a recent analysis”.
                  And yes, I did click through from Kendrick’s site. All that I found was a set of comments from the study investigator not a link to the study itself. I also note that Kendrick was parsimonious with his quotes from the study investigator. For example, he omitted:
                  “Dr. Lavigne cautions the current study does not suggest that having low LDL-C somehow leads to the development of cancer. He recommended that patients diagnosed with high LDL-C should adhere to cholesterol-lowering guidelines, including the use of medications, to prevent heart disease.

                  “There is no evidence to indicate that lowering your cholesterol with a medication in any way predisposes to a risk for cancer. We suspect there may be some underlying mechanism affecting both cancer and low LDL-C, but we can only say definitively that the relationship between the two exists for many years prior to cancer diagnosis, and therefore underscores the need for further examination,” Dr. Lavigne said.”
                  http://www.sciencedaily.com/releases/2012/03/120326113713.htm

                  Frankly, if you keep believing everything you read on the websites of cranks and charlatans you will be led badly astray on the subject of nutrition and health. As for your final question
                  “”The idea that low cholesterol causes increased mortality, cancer or Alzheimer’s is almost certainly wrong.” Um, based on what?”
                  The answer of course is “based on the evidence” some of which was cited in my previous reply to you. Try doing some real research instead of just quoting hucksters.




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                2. Wilma: I don’t wish to get enmeshed in this (very good) conversation. But I would like to make one correction. You state that Dr. Greger makes money off of selling books. This statement is misleading. Dr. Greger does sell books. But every penny of every book, speaking engagement, DVD sales, etc goes straight to charity — which is currently this website. Dr. Greger has a day job and wishes to avoid the conflict of interest that comes from making money off of explaining healthy eating to people. So, he does not personally make a penny. For me, that’s one of the reasons Dr. Greger’s information is so compelling.
                  .
                  You may have already known that. But just in case someone else did not, I wanted to clarify.




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                  1. Thank you Thea, I did not know that. My main point, however, remains that it isn’t a good enough reason to discount someone’s writing, just because they sell their own books.




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      1. Maybe. If you don’t eat animal products or oil and yet have high cholesterol, does the body oxidize the cholesterol the body makes? Well I am going to stop posting about this because there is a chance my tests were wrong and maybe I don’t have high cholesterol but I’m pretty sure I do.




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        1. It’s a good question Wilma. Some people are genetically predisposed to high cholesterol. How high is high? What is your cholesterol levels and what is your LDL/HDL ratio?

          I would think that endogenous cholesterol would be able to be oxidized same as the dietary variety. That being said, I suspect that a low WFPB diet that is high in antioxidants would offer some protection against reactive oxidative species.

          Perhaps, Dr. Greger or one of the other M.D.’s who frequent the site would care to weigh in.




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          1. Joe, the reaction I get to my cholesterol numbers seems to be disbelief that I actually eat a low fat WFPB diet. Hey if the results don’t support the hypotheses, well don’t change it, ignore it, disregard it, etc. My numbers: total c 243, triglycerides 66, LDL 134, HDL 96. If I figured right ratio is 2.53 but it seems they don’t go by that much anymore. My ultrasound showed mild to no plaque (one each) In fact, I told my doctor I would not be surprised to see high numbers because that happened in the 80’s the first time I followed McDougall. Here’s a kicker for you – my cholesterol numbers were BETTER when I went off the WOE. By the way, I also have extremely high blood pressure in spite of taking Lisinopril.




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              1. Are you saying they are good? When I looked at them they seemed pretty good to me but people soon rid me of that idea due to the LDL and total. Yes the blood pressure is a big concern. I just don’t know what to do. Maybe I can work myself up to walking on the treadmill. I wonder how long it would take before I might see good results?




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                1. As Dr. Greger has opined on more than one occasion, having normal cholesterol in a country where it is normal to drop dead of a heart attack is nothing to be happy about so one would definitely want to better the recommended cholesterol numbers.

                  243 total cholesterol is considered high. 134 LDL which is considered boarder line high, BUT the recommended HDL for women is 60 or better and you beat that number by better than 50%. The recommended LDL/HDL ratios are 3.5 or lower and yours are 1.53/1 which is excellent. Recommended triglycerides are lower than 150, and yours are 66. I’m not a doctor, and even if I were, it would not be appropriate to advise you without examination, but 3 of the 5 biomarkers are excellent as compared recommended levels.




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                2. It seems high HDL levels have concentrated in at least some self reporting members of the Paleo Diet community ( https://www.paleohacks.com/cholesterol/what-is-the-highest-hdl-you-have-ever-seen-118 )

                  The problem for our Palio brethren is that not all HDL’s are created equally as sited by an article entitled “Can My HDL Be Too High?” written by a registered dietitian named Lisa Nelson RD ( http://www.healthcentral.com/heart-disease/c/45112/60628/questions-dr/ ). The ability for HDL’s to functionally perform the task of carrying LDL’s back to the liver seems to depend on their protein composition. HDL’s high in apoA-I and low in apoA-II are best for carrying out the function of LDL transport so just because one has high HDL levels does not ensure vascular protection.

                  Your HDL’s appear to be highly functional considering your ultrasound results.
                  “The proof of the pudding is in the eating” as the old cliche goes, although, one would do well to avoid Dickinsonian era puddings due to their high animal and saturated fat content.

                  There are tests available that your MD can order that report HDL quality if one were concerned.




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                  1. Thank you so much for all that information. You have made me feel tons better. And yes, I will continue to avoid Dickinsonian era puddings. lol




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  4. A very interesting article by Stephanie Seneff published in December of 2009 (easily found by Google) suggests that a low fat diet and statin drugs may be the culprits. I still maintain that oxidized cholesterol is a major contributer.




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    1. If you think that a low fat diet is to blame than you must be one of those quake cholesterol deniers. Keep eating your fat and meat and get yourself a nice brain full of tangles because you won’t accept the data being presented to you here. A low fat, animal product free diet is the CURE for Alzheimer. But people such as yourself will never get it because you don’t want to give up your meat and fat.




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      1. The brain needs good fat and good cholesterol to function…hello! Good grass fed organic meat is fine its the ransid oils and trans fats that are bad. Wake up people there are numerous studies on this so do your research!




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      2. >> Keep eating your fat and meat and get yourself a nice brain full of tangles

        Fear mongering is no way to discuss anything, and your comment:

        >> A low fat, animal product free diet is the CURE for Alzheimer.

        is clearly known already to be wrong. You make me sick.




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        1. No, you are just another cholesterol denier lemming who doesn’t want to give up meat and fat so you look for anything you can grasp onto to like the fake pseudo-science claims of the cholesterol apologists. You can deny Dr Gs findings all you like but it’s your brain that is filling up with plaque tangles weather you like it or not on a fatty meaty diet. Like it or not, a LOW FAT animal free diet is the CURE for Alzheimer. This site is not a bro-science cholesterol confusion site like the stupid keto blogs you probably get your fake info from.




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          1. guest: This video is not claiming that there is a *cure* for Alzheimer’s. This video is saying that we have some evidence that we can greatly lower the risk of getting Alzheimer’s in the first place if we eat a healthy diet.

            Those are two very different claims. A cure means that someone who already has a disease is able to get rid of the disease. http://www.definitions.net/definition/CURE On the other hand, the concept of lowering risk means that we have a chance at not getting the disease in the first place. And even that healthy diet that lowers risk is not a guarantee that the person will not get Alzheimer’s. All we know is that the chances of getting the disease are lower.

            I think it is very important that we not make claims that go above what the science actually says. Do you have a link to a study showing an actual cure? Or maybe you used the wrong word?




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              1. Thanks Alan. It was indeed interesting. From my reading: it didn’t say it could cure full blown Alzheimers. The person who had late Alzheimers was their one big failure. But it definitely seemed to show impressive results for those people that it did help. I hope a follow up study is done.




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          2. Sorry, your idea that vegetarians/vegans do not get Alzheimer’s is just untrue, and a lie. That’s obvious and common knowledge that you just deny, or lie about?




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    2. Check the video I linked in another reply to you. Dr. Greger does touch on the issues with oxidized cholesterol.

      Once in the brain, cholesterol can also undergo auto-oxidation, causing the formation of highly toxic free radicals. So, having high cholesterol levels in the blood is thought to increase the risk of dementia, not only by inducing atherosclerosis and impairing blood flow, but they may also directly affect neurodegeneration within the brain.




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  5. See Gamba et al. in Frontiers in Aging Neuroscience, 2015, vol. 7, p. 119. “Oxidized Cholesterol as the Driving Force behind the Development of Alzheimer’s Disease”.




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    1. Please note that the study you point to is one that takes a basic attitude that the cholesterol from the brain is separate from the cholesterol in the bloodstream. Thus they may only be seeing one side. The idea that Dr. Greger is using when discussing things in this video is that it is possible for dietary cholesterol to pass the BBB and enter the brain. Something that is being found in some studies.




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      1. The brain needs fuel. The only way I can think of for the brain to get fuel is from the blood supply. Maybe I am wrong but I believe the blood supply circulates throughout the body, including the brain. If that is the case, then I can’t see a way fhat blood cholesterol and brain cholesterol would be separate.




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        1. Please check out this site: http://www.brainfacts.org/brain-basics/neuroanatomy/articles/2014/blood-brain-barrier
          It discusses the Blood Brain Barrier (BBB) which blocks all sorts of stuff in our blood from reaching the brain, including cholesterol, or at least that is what people thought.

          It took until the 1960s before scientists were able to catch a glimpse of the actual barrier standing between the rest of the body and the brain. Using a microscope that was roughly 5,000 times more powerful than the one Ehrlich used, scientists could see the detailed anatomy of the network of blood vessels in the brain comprising what is now known as the blood-brain barrier.

          For more information on how cholesterol normally gets in the brain and central nervous system see this article.
          http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4383754/

          Cholesterol metabolism in brain is independent from that in peripheral tissues due to blood-brain barrier.




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  6. Given that the plagues start many years, maybe even decades before symptoms, is there any sense of when one would have to switch and eliminate cholesterol? Do the plaques stop causing further damage if the cholesterol is dropped? Seems like answers to these questions would be hard to tease out.
    Mark G.




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    1. mbglife: I saw a show on PBS (public broadcasting channel in America) about the brain. One segment in that show went into a study that was following nuns in a monastery. The nuns donated their brains to science after they died. So, one by one, the nun’s brains are being examined. I don’t remember the percentage, but a certain percentage of those brains look like Alzheimer’s brains. And yet very few showed any symptoms. All of which is to say that I think that even if we have already damaged our brain to some degree, it is still not a predetermined outcome that we will have symptoms later on.




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    2. I don’t think that there are any definitive answers on timing but there is certainly evidence of plaque reversal caused by cholesterol lowering diets and statins. And the more plaque you have, the more the risk so the sooner we start the better. Nevertheless, you are probably already aware of the very positive results from trials by eg Pritikin, Esselstyn and Ornish often with people with advanced disease. You might also want to look at the 7-page MedScape summary of this topic (which is however largely about drugs) and perhaps follow up some of the references, eg.
      http://www.medscape.org/viewarticle/568875_4

      A number of Dr G’s videos also refer to studies showing reversal caused by diet and offer some clues about timing eg
      “Those sticking to the vegetarian diet showed a reversal of their heart disease as expected. Their partially clogged arteries literally got cleaned out. They had 20% less atherosclerotic plaque in their arteries at the end of the year than at the beginning.”
      http://nutritionfacts.org/video/low-carb-diets-and-coronary-blood-flow/




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      1. Hi Tom
        Sorry, I wasn’t clear. I meant plaque in the brain that leads to the tangles that causes Alzheimer’s. It starts decades before symptoms. And since part of the problem is cell damage and death, I was wondering if reducing cholesterol is enough to arrest the disease or if it just keeps continuing to cause more damage. It scares me to think of all the junk food and animal products I ever ate before I knew better. Ugh.




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        1. Aaah, OK. You are right that there is much less information on this. There is however some evidence that statin use may reduce the risk of AD, which possibly implies either halting or reversing brain plaque progression. I think those findings are encouraging especially if they result from the cholesterol lowering effects of statins. However, those findings are far from definitive at this stage.
          http://www.ncbi.nlm.nih.gov/pubmed/20182019

          Nonetheless, I think it’s reasonable to assume that it would be of benefit especially in cases where the dementia results from impaired blood supply to the brain. Note that AD is not the only game in town and vascular dementia is the most common dementia after Alzheimer’s disease. But, like heart disease, it’s likely important to act before actual trauma/physical damage has occurred. There’s an excellent summary of the main types of dementia here
          http://www.ninds.nih.gov/disorders/dementias/detail_dementia.htm

          On Alzheimer’s specifically, the Medscape article here is a useful read also;
          http://www.medscape.com/viewarticle/466037

          None of these really answer your question directly but they suggest to me that eating right, beginning at any age, will help our odds of avoiding adverse cognitive consequences from a poor early life diet – just as they will help reduce the risk of CVD events.




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            1. Ah, yes. I should have mentioned that. It’s free to open a MedScape account and you don’t have to be a medical practitioner to join. Just create an account when you open the link – it’s quick and easy (and did I mention – it’s free!).
              They have some really excellent summaries of the current research on key issues. Of course, it’s mainly written from a diagnostic and prescribing viewpoint but the people writing them really know their onions.




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          1. Statins and low cholesterol are inversely related to cancer. I would never take a statin. There seems to be universal assumption that to have high cholesterol is to have plaques. They are not one and the same. I think it would be good if they did some studies using ultrasound and actually look at the arteries instead of making assumptions.




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            1. Yes, low cholesterol is related to cancer. Just like it is related to Alzheimer’s. This is because both cause low cholesterol. Yes, I am aware that some studies appear to show that low cholesterol appears to predate a cancer diagnosis but if I recall correctly those studies only looked 2 or 5 years previously. Cancer, like Alzheimer’s and heart disease, takes decades to develop.
              As for statins, studies show they have either no effect on cancer incidence or have a protective effect. As for your other claim “I think it would be good if they did some studies using ultrasound and actually look at the arteries instead of making assumptions.” – of course they have done studies.
              Where on earth do you get all these claims from? You should know that highly sensational fad diet books and websites run by people who might politely be described as having a bee in their bonnet (or at least something to sell us) are not the most reliable sources of information on health issues.




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            2. Yes, low cholesterol is linked to cancer in older people. Just like it is linked to Alzheimer’s Disease. This is because both cancer and AD lower cholesterol. Yes, I am aware that some studies have looked at cholesterol levels pre cancer diagnosis and are used to support claims that there is no reverse causation. However, to my knowledge such studies only look 2 or at most 5 years before whereas cancer, Alzheimer’s and heart disease take decades to develop.

              As for statins, most studies show no link between statins and cancer but some show a protective effect. As for your last claim “I think it would be good if they did some studies using ultrasound and actually look at the arteries instead of making assumptions.” Of course, they have done studies. They have been doing studies for may years eg
              http://atvb.ahajournals.org/content/19/1/2.long

              Where do you get all these false claims from? You should know that highly sensational fad diet books and websites run by people who might be politely be described as having a bee in their bonnet (or at least trying to sell something) are not the most credible or reliable sources of information on nutrition and health. Typically, they try to deal with the mountain of evidence disproving their claims by either pretending it doesn’t exist or claiming that it is the result of some century-old global conspiracy to hide the truth. These are big red flags.




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  7. This article makes no sense at all. Low cholesterol is a likely risk factor for memory and other cognitive problems. Serum cholesterol is not determined by eating foods containing cholesterol. Without cholesterol we would be dead or at least would be unable to synthesise steroid hormones and assimilate vitamin D through the action of sunlight on the skin to take two obvious examples. There is no evidence that eating animal fats leads to high cholesterol. In any case the definition of what ishould be regarded as ‘high’ is open to debate.




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    1. Don’t need cholesterol in your diet, your liver makes all you need. Check out out the epidemiology, people on low fat diets get less of the diseases of affluence. The China Study, The Blue Zones, and this web cite are a good place to look for information. Wishing you a long and happy life.




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      1. Nobody said you need to eat cholesterol. Yes the liver makes all we need without eating it, and in some cases at least, it makes what is commonly referred to as too much all by itself. Mine does. In fact, mine goes up when I stop eating it.




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    2. Kate: re: “Serum cholesterol is not determined by eating foods containing cholesterol.” and ” There is no evidence that eating animal fats leads to high cholesterol.” Study after study shows this is not true. You can take people with healthy cholesterol levels, feed them cholesterol and watch their serum cholesterol rise. Every time. There is a stronger link between saturated fat and serum cholesterol than dietary cholesterol, but both links are clearly there. You can learn more about these statements either here on NutritionFacts.org or for a whole lot of scientific detail with study after study on just this topic, check out PlantPositive.com.

      The reason this myth got started was because of some faulty studies which take advantage of the human body’s cholesterol limit. If your body is already saturated with super high levels of cholesterol, then adding more does nothing. It’s like the different between smoking 4 verses 5 packs of cigarettes a day. At some point, your risk is already so high, adding more doesn’t add that much more risk.

      re: “Without cholesterol we would be dead…” This is what is known as a strawman’s argument, because no one is arguing that we should have zero cholesterol in our body. What scientists are showing us is that we should not have excessive cholesterol in our bodies. Ie, levels that cause disease. And since our bodies make all of the cholesterol that we need, there is no good reason to consume foods which artificially boost our body’s serum level of cholesterol (and good medical reasons to stay away from such foods) into levels which cause disease.

      re: “In any case the definition of what ishould be regarded as ‘high’ is open to debate.” Given the data we have, this is not true. “High” should be any level which increases risk of heart disease or other diseases. Since people with a total cholesterol below 150 and LDL below 70 (the amount we are born with) are pretty much heart-attack proof, what counts as high cholesterol is pretty well known and unarguable. You can argue whether the cutoff should be 60 or 70, etc, but the general range of what is safe is well known. Bottom line: ‘High’ is the level that hurts us. And we know what that level is.




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        1. I’m starting to wonder if some of the user namesare fake are really a few people using aliases. Regardless, I don’t get why some people come to these boards to say how wrong the info is but offer no data of their own, mostly just to be disruptive. What a crappy way to go through life.




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    3. Do you have peer reviewed papers showing the linkage between cognitive issues and decreasing cholesterol? And have you factored in the potential that this might be a case of reverse causation. As people age and especially as they become sicker, their cholesterol falls do to many factors including the fact that they simply don’t eat as much. So it very well could be that Alzheimer’s and other chronic illness in the elderly are the cause of falling cholesterol levels rather than the other way around.

      You are absolutely right, cholesterol is essential for good health, so essential in fact that your body will make every bit of it it needs. But it is clear that with cholesterol as in so many other aspects of health, more isn’t always better. What is healthy and essential at one level can become toxic at higher levels. You definitely don’t want a cholesterol level any higher than what you body actually requires. So do you know how much cholesterol is needed to make hormones and vitamin D and the like?

      And you are absolutely incorrect about the impact of saturate fat on cholesterol level. There are any number of metabolic ward studies where they put subjects into a controlled environment and control everything they put in their mouths. In such a setting research has long shown that the cholesterol level is very sensitive to the amount of saturated fat ingested.

      And research going back decades, such as the Farmingham studies, show that the risk of heart disease drops to near zero for total cholesterol levels below 150 mg/dL. The medical/industrial complex added and abetted by the animal agriculture industry have long talked about a cholesterol level of 200 being “normal”. But 1/3 of heart attack occur in people with cholesterol levels between 150 and 200. So 200 is definitely not a healthy level. Again you have to get below 150. So you can want there to be a debate about what constitutes high cholesterol, but there really isn’t.




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      1. Does it matter how I get my level below 150?In other words if I eat hand
        caught salmon and 100% free range chicken 2 to 3 times a week and my
        cholesterol is below 150 then I’m safe right?




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        1. In addition to the total cholesterol, the LDL particle composition is of even greater importance.
          The smallest LDL particles are actually the most dangerous so the lower they are the better.

          You can find out these detailed statistics by taking a VAP blood test.




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            1. Hi Thea,

              My understanding is that small dense LDL particles are most prone to oxidation which is what makes them the most atherogenic :
              http://www.ncbi.nlm.nih.gov/pubmed/14564088

              http://www.ncbi.nlm.nih.gov/pubmed/15847025/

              http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2464759/

              http://blog.cholesterol-and-health.com/2011/03/genes-ldl-cholesterol-levels-and.html

              That particular video of Dr G, while titled germanely to the topic at hand, is mentioning the particle sizes in passing and mostly rambles about suspected Egg Board influence.

              Even one of the references (http://circ.ahajournals.org/content/113/12/1556.long) listed in that video reached the same conclusion:

              “Notably, we found that both LDL and HDL particle numbers measured during the trial had significant, independent associations with new CHD events, whereas LDL and HDL cholesterol levels did not.”

              My argument is not the HDL vs LDL but rather about the (elevated) Lp(a) and VLDL particle count as the causes for concern.




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              1. aribadabar: Thank you for looking at the video and your reply. It’s true that the video discusses eggs a lot, but I was thinking that this quote addresses your point:
                .
                “…this concept that large fluffy LDL are not as bad as small dense LDL. And indeed large LDL only raises heart disease risk 44%, instead of 63% for the small LDL. Light large buoyant LDL still significantly increases our risk of dying from our #1 killer. This was for women, the same was found for men. Large LDL only increases risk of heart attack or death 31% instead of 44%. Bottomline, as the latest review on the subject concluded, LDL cholesterol has been clearly established as a causal agent in atherosclerosis, regardless of size.”
                .
                The above quote agrees that small dense LDL is more of a problem. But think about those numbers. Large fluffy LDL is also a huge problem. If the numbers in the above quote are even close to reality, then saying that only the small particles are causes for concern would be incorrect. If I’m still not understanding your point, then I’ll have to bow out of the conversation as I may just need to learn more about this topic. I looked at the first two links you provided and I don’t see how either one makes your point. But again, I may be just missing something.




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                1. Oh Thea you crack me up! “If I’m still not understanding your point, then I’ll have to bow out of the conversation as I may just need to learn more about this topic.”

                  Ok I changed my name. Veganrunner wasn’t quite right.




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                  1. I’ll have to add with other commenters, that I think Thea is the most “Kind and Diplomatic” poster of comments on the whole of the Internet!!!




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                  2. WFPBRunner: Thank you for telling me about the name change. If you hadn’t, I would have written a whole big post about this other great poster named Veganrunner … :-) (hee, hee!)




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                2. No doubt large LDL particles ARE also a problem. My point was more of a degree of risk – both are bad but small dense LDL ones are worse as they can make you drop dead by sudden MI/stroke in your 40s while the other types take more time to develop serious CAD complications.

                  Your quote above clearly demonstrated this varying risk profile.

                  One can have a relatively low total LDL number but if the small particles are a large proportion of it the patient has comparatively higher MI risk than someone with the same LDL number but with lower subfraction of small dense LDL particles.

                  http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3038964/

                  Another related marker is Lp(a) which also worth testing as it seems independent CAD risk factor irrespective of total LDL:

                  http://www.ncbi.nlm.nih.gov/pubmed/19622820

                  http://www.docsopinion.com/health-and-nutrition/lipids/lipoprotein-a/




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            2. Decades ago I fermenter seeing an interview with a doctor who said that when they tried to figure out the only commonality for people who lived to be 100, it was that their LDL cholesterol was mostly large cell. But I’ve never heard that since. But I have heard about a relationship between how many copies of a longevity gene one has.

              Thanks for the link. Great report & info. I laughed out loud reading Dr Greger ‘s reaction to the egg board’s spin:

              “Yet check out how the egg board researcher worded it.
              –The formation of larger LDL from eggs is considered protective against heart disease, relative to small LDL.–
              That’s like saying getting stabbed with a knife is protective… relative to getting shot!”




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          1. I get the NMR lipid profile done…..My small ldl-p was 800 now 200…my LDL-P was 1622 now 748 my apo-b was 93 now 60 and still dropping.Cholesterol is 155 ldl is 75 hdl is 63 and tri’s are 47.




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          1. Maybe maybe not Thea everybody is different…Funny though I just read a report that the air we breath now is causing heart disease,Cant wait to see how they rectify that.lol thanks for the links.




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        2. Salmon is chilled with mercury and PCBs (both are brain & nerve damaging neurotoxins), which is why the US gov’t recommends only a few servings a month. But why would you want to invest and animal products knowing what they do to you? Search this site for chicken and salmon or fish and watch a few of the videos. I think that will help give you a greater understanding about them.




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        3. I would say safer, but perhaps not completely safe. Cholesterol might not be 100% of the story. TMAO , a substance created by gut bacteria from the amino acids carnitine and choline, is if anything is even more strongly correlated with CVD than cholesterol level itself. Biochemically TMAO appears to help with the formation of foam cells packed full of cholesterol, which then aggregate into the walls of our arteries and form athroscleroitic plaques. Carnitine and choline is only found in animal protein, including fish and chicken.

          BTW, carnitine and choline are only a problem when they are in the food we eat since it is the bacteria in the gut them to the problematic TMA. They are critical for our bodies, but they are non-essential amino acids, that is we can make all we need for ourselves. We don’t need to get them from our food.

          Now what I don’t know if it has been investigated yet is whether the athroscleroitic promoting effects of TMAO require a high background level of cholesterol. If so then a low cholesterol level might deprive TMAO of the raw material, so to speak, required to form plaques. So it could be possible that TMAO isn’t an issue if you can keep cholesterol below 150. Also a potential factor is the bacteria that form TMA are only found in the guts of habitual meat, egg and dairy eaters which feed on the amino acids unique to these foods. Long time vegans fed a steak in the Cleveland Clinic study didn’t see TMAO showing up in their blood since they didn’t have the right bacteria in their guts. But if I had to bet, I would say that 2 to 3 times a week is still frequent enough to keep these bacteria hanging around at the ready.

          And lastly, like everything, amount matters. So a burst of TMAO a couple of times a week with plenty of time for your body to heal between might not be a problem.

          Bottom line. You have certainly greatly reduced your chances of developing CVD by eating a diet that naturally gets your cholesterol below 150, but there could be still more that you could do if you so choose. But if eating meat a couple times a week allows you to keep on a meat free diet the rest of the time, then don’t let perfect be the enemy of good.




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          1. Well there is no proof that ur way or my way is perfect, we will only know that I guess when we die.Or how we died.Thanks for the reading though.




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          2. Would carnitine from ALCAR supplementation be treated the same as the one derived from (animal) diet or they are metabolized differently as far TMAO risks are concerned?




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            1. It should be identical since carnitine is a specific chemical and whether it comes from a complete protein or in isolated form, the bacteria in the gut will be able to use it and produce TMA as a byproduct.

              Supplements are labeled as “L-carnitine”, which just means that it contains the biologically active left handed isomer as opposed to the biologically inactive right hand isomer R-carnitine.




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    4. Um, no offense, but no evidence? Serious? I think you need to get your health information from RELIABLE sources, not the copy-cat books, blogs, and such that perpetuate bogus info to validate what they WANT to believe, based on what they read in some book written by an ill informed or lying opportunist who created fiction for profit and called it fact!.
      Humans make all the cholesterol they ever need, period. Add a dietary source and you screw with your biology on many different levels. Tolerance varies with your genetics, but you are asking for issues in any event. My own cholesterol dropped 150 points when I cut out eating animal products (and therefore ALL cholesterol). I reversed diabetes, arthritis, IBS, and other health issues including high markers and risks for too much to list, in just a few months, and went on to lose over 100 pounds too, so this isn’t about isolated issues, opinion, or theory, but medically documented fact.




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    5. It doesn’t make sense to you, but you don’t have a question, rather, Dr Greger, an M.D., who researches thousands of studies a year is just wrong. Could you please cite your sources?

      Years ago, in an effort to solve some undiagnosed medical problems, I feel for the clap-trap of paleo advocates, that we needed meat, and that beans and grains and starch will destroy us. For a year I switched from vegetarian to paleo. It was one of the worst decisions of my life. All it did was ruin my health, raise my total cholesterol from 117 to 218, and raise all my other measures, like BP, and C reactive protein (inflammation marker), etc. I then changed to a vegan diet and all was restored. The medical problem was later diagnosed and corrected.

      And this past year when I had to have an emergency gallbladder removal because a stone destroyed it, the surgeon condemned that the damage was probably done on that year of reading meats, eggs, and dairy, because they almost never see vegans with this problem unless it’s a hold over issue, like mine.

      Humans might be ‘able’ to eat animals to survive starvation from famine. But I’m interested in what is optimal for health. And it isn’t eating animals.




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    6. Kate, personally from my experience it is only those that want to keep eating animal fat and want an excuse for it are the ones that claim that animal fats do not lead to high cholesterol and what is regarded as high as open to debate. And i agree that we need cholesterol. but our bodies were designed to make all we need.It is good to know that we all have a right to choose. I will go low or no extra cholesterol.




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  8. Have you advice for a vegan of 40 years, taking B12 and omega 3s, but has high LDL Cholesterol? I avoid saturated fat and eat whole foods, avoid sugar, refined foods. I eat some nuts, a little olive oil. My vegetarian elders have or had dementia.




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    1. Do you eat a lot of beans? Dr. Greger mentions that they help pull fat out of our bodies in several of his videos. They have certainly helped by in me efforts to lose weight. I eat some type of legume at least three times a day.




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    2. Hello. Two grams of Niacin are the most effective treatment for blood lipids. Helps will all mood disorders too. Great food everywhere.




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      1. Thank you. My triglycerides are low. Niacin modestly lowers LDL, mostly lowers TG. I take methyl folate for MTHFR, so will be careful with niacin. But , yes, I will try this. I eat bean once a day. I could take care to increase soluble fiber, like chia. OK. Here goes. Thank you.




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        1. Thank you! Great work. People with Niacin deficiencies are very creative, brilliant people. They have superior genes. They are very attractive and have youthful hair. They are natural problem solvers and are shock resistant. They almost never get cancer or arthritis. They are poets, scientists, philosophers, and artists. I wish you well if your poor blood lipids were a result of a Niacin deficit. Beware of the flush, it feels like your skin is burning and your skin turns bright red. With some people the
          flush goes away after some months. Really happy days here. Plants will love us, I hope. It feels so happy. How I love people.




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    3. I am not sure that “high small dense LDL Cholesterol” is a meaningful indicator of anything despite the desperate wishful thinking you might find online in the “saturated fat is good for you” blogosphere.

      “Previous studies showing that smaller low-density lipoprotein (LDL) size is associated with greater atherosclerotic risk did not adequately control for small and large LDL particle correlation. …….. Both LDL subclasses were significantly associated with subclinical atherosclerosis, with small LDL confounding the association of large LDL with atherosclerosis.”
      http://www.atherosclerosis-journal.com/article/S0021-9150(06)00259-0/fulltext

      This subject has been extensively studied over the years. A major review in 2008 found “In summary, only LDL particle concentration, as measured by NMR, was consistently found to be associated with incident CVD after adjustment for lipids (and other risk factors). Other specific measures have been found to be associated with incidence or progression of CVD by only a minority of studies.”
      http://www.ncbi.nlm.nih.gov/books/NBK254170/

      and “Limited evidence suggested that LDL subfraction analysis is not a consistently strong predictor of CVD compared to other known risk factors”
      http://www.ncbi.nlm.nih.gov/pu

      More recently, Dr Greger has produced a good video on the topic also which refers to relevant research since 2008:
      http://nutritionfacts.org/video/does-cholesterol-size-matter/

      This video is also worth watching:
      https://www.youtube.com/watch?v=_wmidN8rYkU




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      1. Tom Goff: The quality of so many of your posts, such as the post above, is so high. I don’t think I’ve properly expressed my appreciation before. Thank you for your participation on this forum! It is SO helpful to have the kind of answers you are able to supply.




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        1. Thank you, Thea, you are very kind.
          Following up some of the claims and questions found on this site has been a great way of educating myself. I’ve found it helps to write down the key findings and references for the next time a poster mentions one of the many low carb or other nutritional fantasies circulating on the internet or presented in fad diet books.




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    4. I recommend reading Neal Barnard’s book – Power Foods for the Brain. He discusses other factors besides food which alter the risk factor for dementia and Alzheimer’s. Overall, great reference for anyone wanting to know more about how to take care of the brain.( you can also do a search on pcrm.org and get a list of 7 things to do for a healthy brain. I know two of them are eat a WFPB diet and exercise. Don’t remember the rest, sorry. Just know that I checked them off!)




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    5. Ditch the nuts and olive oil entirely and get to a BMI < 22 or even <20 and see if it drops enough. If your cholesterol becomes golden, you can add back some nuts to see what that does for you.




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    6. What is your ApoE profile? Based on the reported family history of dementia, chances are e4/4 or at the very least 3/4.

      What are your most used carb sources? How are your thyroid metrics? Hypothyroidism is linked to impaired(=increased) LDL values.

      The bean use suggestion below sounds very topical for your case.
      You need some extra omega-3 sources – flax, chia, hemp seeds.

      You may want to also check your Lp(a) as it also a CVD risk factor.




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  9. “…… low cholesterol levels, which any of us can achieve eating healthfully.” This has not been true for me. I believe it has to do with iodine deficiency.




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  10. seems apoe4 may actually be a specific evolutionary solution to a normal diet low in cholesterol making sure the brain has what it needs, as opposed to the idea it is some sort of evolutionary dysfunction.

    I bet if they look hard enough they will find an easy switch that turns it on and off.




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    1. Yes it is called the “diet” switch and it is indeed very easy. In fact it is sort of a master switch that switches on and off a lot of diseases and not just for Alzheimer’s.




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  11. One glaring question I have – as it relates to all of these studies – is whether hypertension that’s treated via diet and drugs, to the point it is <=120/80, becomes irrelevant when it comes to risk for cardiovascular disease and the like. There are people who have had benign hypertension for almost all their life.




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  12. Hi Dr. Greger and Team,
    The sound on your videos is too low to hear unless I am directly beside the computer with volume on max. I have tried plugging into external speakers but I still can’t hear it just 15 feet away at the kitchen sink. Perhaps there’s an easy fix? I love the work you’re all doing; it’s vital. Thank you so much. Melissa Kelly




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  13. I have 1 copy of the APOE 4 and just turned 60. Both my maternal Grandmother and Mother had Alzheimer’s. I desire nothing more than to avoid that disease and escape being a burden for my loved ones. I went plant based about 5 years ago but turning 60 prompted me to visit doctors to get a baseline. I seem fine for now. But– when asked what to do to avoid getting Alzheimers I got little advice. A shrug and “go for walks”, “eat beans”. I would think neurologists and family physicians would be beating the drum for lifestyle changes – especially if they are caring for an elderly person with dementia. The children and grand children should be told what to do to avoid that disease. Dr. Greger needs to get a publication in the major neurology journals to get some action on this.




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  14. Last week I read on line from a doctor stating the brain had to have a certain level of cholesterol to function properly and that low cholesterol could make our chances of getting Alzheimers. This would make sense to me. I was the caregiver for my Dad who had Dementia for 8 years. The lower his cholesterol got the worse his Dementia. When his cholesterol was higher he read a book from cover to cover every day. He watched CNN and discussed the world events at 95 years old. The doctors were not happy with it higher so they put him on statins and other cholesterol lowering drugs. Within weeks he was picking at invisible things in space and babbling. All of my family has high triglycerides and higher cholesterol. You could give us all the medicines and still our triglycerides stay high. When they tried statins on me there were times in a high stressed situation I wouldn’t know my name. I will never take them again. I eat healthy and my cholesterol is still over 200. My mind is clear and sharp, so is my sister’s and brother. Maybe it is normal for some to be higher. I wish I would have stopped my Dad’s statins. Maybe we would be celebrating his 97th birthday next month instead of missing him. He died at 95.




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    1. There is a link between Alzheimer’s Disease (AD) and low cholesterol but implying that low cholesterol can increase AD risk is a false and irresponsible claim. Ditto the claims that statins increase AD risk. The actual link is that AD lowers cholesterol, and statins may actually reduce AD risk. Falling cholesterol which is not the result of dietary improvements or statin use is often a pre-clinical symptom of certain chronic diseases like Alzheimer’s, cancer etc.

      If low cholesterol increased Alzheimer’s risk. then people whose cholesterol is lowered (by statins or diet) would have increased risk. They don’t. If anything, they have lower risk. Also if low cholesterol were a risk factor, you would expect populations with average low cholesterol levels like Africans would have higher Alzheimer’s rates than populations with higher average cholesterol levels like African Americans. They don’t
      http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3212027/

      In fact high cholesterol in mid-life is a recognised risk factor for Alzheimer’s eg
      “An association between cholesterol and the development of AD was suggested in the early 1990s and ever since, an increasing amount of research has confirmed that there is a link between cholesterol and the development of AD. A high cholesterol levels in mid-life is a risk for AD and statins, i.e., cholesterol-lowering drugs, reduce this risk.”
      http://www.sciencedirect.com/science/article/pii/S0047637405002381

      There is an association between low cholesterol in older people and Alzheimer’s. But declining cholesterol is likely to be a pre-clinical indicator of Alzheimer’s rather than causal. Certainly there is reason to believe that “an alteration in cholesterol metabolism could play a pivotal role in early stages of AD.”
      http://www.hindawi.com/journals/bmri/2006/073976/abs/

      See also this discussion:
      http://www.medscape.com/viewarticle/740572

      I understand that there is no evidence that statin drugs increase risk for Alzheimer’s. Most studies show no effect and some appear to show a protective effect.
      http://www.alzheimers.org.uk/site/scripts/documents_info.php?documentID=2211&pageNumber=8
      http://www.alzdiscovery.org/cognitive-vitality/condition/statins-for-management-of-high-cholesterol




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    2. Two grams of Niacin a day cured my high blood lipids and raised my HDL. Improves all mood disorders too. High blood lipids might be a sign of a Nitrogen deficit. Beware food processing. Foods rich in Nitrogen not bound in amino acids are hard to come by.




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  15. Very interesting point, but the life expectancy in Nigeria is 52 years, whereas in Spain is 82 years. May be the life expectancy in Nigeria would explain the low ratio of AD better than the nutrition.




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  16. I have no idea if I’m genetically susceptible to Alzheimer’s disease, but my dad had it, and I’m a lot like my dad. My cholesterol is 220 despite being WFPB for 2.5 years and vegetarian prior to that. I really want to get down to 150 or less, but I’m not sure what else to do. I have Hashimoto’s and my numbers have been wonky lately, so this might account for it being high. But, I’m worried.




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      1. Great advice. I’ve been upping my foods that actively lower cholesterol, but I need to look closer at the the ones that raise it. I don’t drink coffee, but that surprised me. Thanks for the links.




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    1. Your weight has a heavy influence on your cholesterol too. What is your BMI? Also, WFPB needs to also be low fat. Minimal to no nuts, avodado, etc. Being lean and eating very low fat is going to give you the best numbers.




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      1. My BMI is 19.6, weight is not the issue and I’m fairly active too. I don’t add oil, can’t stand avocados, but I do eat nuts. My strategy now is increase cholesterol lowering foods. Bring on the oatmeal.




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  17. It seems like, from what Dr. Greger, and others have argued, via the research literature, that there is evidence that a WFPB generally reduces risk for AD but I didn’t get much here re. specific details beyond benefits for those with ApoE (which, though ApoE presents an increased risk for AD, unlike in Nigeria, in the US we have a lot of AD but a small percentage of those are ApoE).

    I wonder if the studies behind the recent hype re. a possible new “wonder drug” for AD (http://www.theguardian.com/science/2016/jan/08/alzheimers-treatment-closer-as-brain-inflammation-shown-to-be-key)

    also contains specific clues about reducing the type of inflammation that the drug is supposed to attack, with prevention via a WFPB diet.




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    1. Well, one of the mechanisms might simply be the elimination of dietary cholesterol. We know that cholesterol causes inflammation for example:
      http://www.nature.com/nri/journal/v15/n2/full/nri3793.html
      http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3116370/
      http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3623938/
      http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2909263/

      But there are other factors also like high dietary fat and high calorie consumption (not found in people eating WFPB diets). CNN ran a story on this back in 2008:
      “Inflammation appears to be aggravated by a poor diet. Research shows that high-calorie, high-fat meals cause a sudden spike in CRP and other inflammatory markers because they flood the body with blood glucose and triglycerides.
      “The inflammation is due to a fundamental problem of using the wrong fuel for the engine,” says Dr. O’Keefe. “We’re not designed to burn this stuff, and when we do, it throws off all these inflammatory by-products.”
      http://edition.cnn.com/2008/HEALTH/conditions/10/16/healthmag.cholesterol.inflammation/index.html?_s=PM:HEALTH

      Harvard says pretty much the same thing:
      http://www.health.harvard.edu/family_health_guide/what-you-eat-can-fuel-or-cool-inflammation-a-key-driver-of-heart-disease-diabetes-and-other-chronic-conditions

      Building on these, you might also want to watch this 2012 video by Dr Greger
      http://nutritionfacts.org/video/garden-variety-anti-inflammation/




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      1. Thanks, that looks like a lot of useful info. to check out. Based on the above cited research leading to the potential AD drug showing that early stage AD seemed to occur in white matter, i.e. glial cells, my original, pretty poorly worded, question was whether there was something specific to inflammation in the brain that might be addressed by specific nutritional approaches; hopefully there will be something in that list that addresses that (or dispels any notion that there’s anything specific or unique re. inflammation in the brain).




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        1. From recollection, I do not think that there is anything in those particular citations which specifically addresses your point. My impression has been that inflammation anywhere in the body can also trigger inflammation in the brain.

          Whether there is inflammation specific to the brain in this case (AD), I don’t know. But it’s possible and both general and specific brain inflammation may play roles. However, Alzheimer’s research organisations generally conclude that a heart healthy diet/lifestyle is a brain healthy diet/lifestyle, which implies that the same inflammatory mechanisms are at play eg
          http://www.alz.org/we_can_help_be_heart_smart.asp
          http://www.health.harvard.edu/press_releases/double-duty-a-heart-healthy-diet-can-also-protect-the-brain-from-harvard-womens-health-watch
          http://www.scientificamerican.com/article/the-heart-brain-connection/

          I can’t say that I’m very familiar with the current literature in this area but the following article may be a good place to start (nothing about diet,really, I just found it a fascinating read!)
          http://www.dana.org/Publications/ReportOnProgress/Consequences_of_the_Inflamed_Brain/

          This is also an intriguing read but it provides no links/citations.
          http://www.brainfacts.org/diseases-disorders/psychiatric-disorders/articles/2015/the-brain-inflamed/




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  18. I am vegetarian & have been on the edge of having high cholesterol for several years, but my good cholesterol always was high enough to factor in & keep me at a level to where I didn’t have to take statins. However, last year, my cholesterol finally went too high & my doctor put me on a statin that worked, but I gained tons of weight, & after looking at the side effects, I went off the statin & am taking turmeric & some other herbs hoping to never have to take another statin. In my case, this theory doesn’t apply, about being vegetarian, unless I should make the change to vegan. My mother has Alzheimer’s, as does her two sisters. What are your thoughts?




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    1. Have you considered being tested for anemia? Iron is scarce in modern foods. Melatonin was effective for Alzheimer’s in a limited study. Lupron was effective for women with Alzheimer’s in a limited study. The brain is made largely of fat and Iron. Iron is good for the brain. Vitamin C, Niacin, and Vitamin E were somehow therapeutic for Alzheimer’s in animal models or small scale studies. The ultimate cause of death in Alzheimer’s seems to be a B12 deficit. I am so sorry for your family pain. Have you tried lemonade, pumpkin seeds, spinach, lentils, or tomato juice with your family? I wish there was a free treatment for Alzheimer’s.




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      1. Thank you for the info. I am taking melatonin, as well as other supplements. I had been taking a prescription vitamin & my B-12 got too high so I’m not taking it at the moment. I’ll try the additional items you mentioned.




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    2. My dear tarsitza..You know I am the only one who knows what you need. Give me the power I seek and we will have our revenge together….and don’t eat the truffles, they have strichnine! -Razzy

      OK, um I think I was channeling again…but ok now. Seriously, IF you want to understand what and why WFPB then you really owe it to yourself to watch Forks over Knives (you know, use your fork wisely to avoid going under the knife). You will learn the difference between vegetarian and vegan and WFPB vegan. Like night and day and supernova.

      Just do this terrible difficult thing … eat whole healthy delicious food …just for 21 days. weigh yourself. Ask “why didn’t it hurt?? Why didn’t I do this sooner? Why did I trust the Bolsevicks!” oops, the drugs are wearing off again…




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      1. You crack me up, and you are so right. Even though I didn’t have much real hope even after watching that movie twice…(ahem, maybe because I didn’t want to face making all those alterations in ingrained habits and preferences?)… when faced with the prospect of losing limbs, eyesight, quality of life, or having no life at all, from diabetes and other issues, giving the plan a measly 21 days seemed like a doable effort. It took less than 2 weeks to be totally blown away and convinced that a WFPB diet with NO animal products and no added oil was not just the resolution for diabetes, but a slew of long standing health issues that also allowed me to ditch about a dozen or more pharmaceuticals and feel better than I had in 30+ years!
        We have familial cholesterol issues too, but I just can’t hack statins and from what I read, numbers can be subjective. I’m sure I’ll find out someday! Just not soon I hope!




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        1. Sister! You just wrote my life story. People tell me I am amazing and strong. Bull. I was at rock bottom and ready to either get it over with and die or try some actual evidence-based nutrition. I am not strong. I am lucky. I had a non-fatal heart attack that woke me up to the fact that I was killing myself with my SAD diet. Now, some 38 pounds lighter, no angina, no IBS, vastly reduced joint pain…the list is longer than you already know anyway. Here’s looking at you Charzie. Its a new world coming.




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          1. Yay congrats dude, that is awesome! I get the same pat on the back, which seems ludicrous when those giving me approval are in just as dire straights as I was and would do a whole lot better to give it a try for themselves! I always hear people say “be patient, give them time, they will follow the example you set”. Nope, and they are running out of time. Limbs are getting hacked off, strokes and heart attacks and bypass surgeries galore, and still they don’t (or more accurately, won’t) connect the dots, makes me nuts. Well okay, nuttier! Then they get in their huddle assisted by all the durable medical apparatus, and commiserate about how miserable and unlucky they are, and my big mouth just wants to scream! Most of these people are only in their early 50’s to mid 60’s, it is so tragic. The encouraging thing is it is catching on, the word is getting out, and maybe not in my immediate circle, but healing IS happening to amazing peeps like us and all the core “groupies” that dare to open their minds to reality and give it a shot!




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            1. Yer gettin me riled. Ive got a brother who is running out of time. going like I was. TIA, stents and last time we met he says “how are those migraines you used to get? (FYI: they are gone now since I went WFPB!)” I know him. He was asking me because now he is getting them. He has mini-strokes…cant do sums without paper and even then its a struggle. But will he change? “i’m eating less red meat” I could just choke him. I believe I will. No not really, Thea’d pitch a fit.

              That is the way it will be init? Some will change, some won’t but we old ones need to teach the children well. Kids are smart…they hear the “ring of truth” when they get some straight talk. Thats how humans change. Then we can kick off at 90 or so and the kids all be saying “They didn’t know diddly about cell phoning but they sure got down with Dr. G’s nutrition. Word ya’ll. Snap.




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      2. Thank you, Rasputin. I know the way of Forks over Knife. My dear, Ras, you tell me you do drugs?? How will I ever trust you again…




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    3. I would strongly recommend you at least TRY eliminating all animal products for a time and see how it goes. It sure made all the difference for me! It can’t hurt and can only help you find the answer!




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    4. See these two below. They are telling my life story too!!!
      It took three days, three days on a plant based diet for the pain in my legs and feet to start going away. After two weeks on a WFPB diet I felt better than I had in years. The fibromyalgia was gone, the blood sugar was stabilizing, and I started losing weight. Now eighteen months later, I’ve lost 50 pounds and I feel great.
      Please give a whole food plant based diet a try. You won’t miss the dairy or the eggs and within a few months you will begin to see changes in your cholesterol. Just remember to eat those beans every day to pull that fat out of your system. Both forksoverknives,com and pcrm.org have eating plans you can follow.
      Try it you’ll like it!




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  19. Two comments inspired by this video (Alzheimer’s Gene). 1) My mother had autopsy confirmed AD; I carry two copies of the APOE4 gene that gives me a 9x higher risk of developing the disease. At my current age (71) my mother was living in the memory care unit of a nursing facility while I have no memory deficits and, in fact, am considered the ‘rememberer’ among my extended family and friends. I have made life style choices that are associated with reduced risk of AD: changed my diet to WFPB 4+ years ago, regular exercise, good social network, brain stimulation with new activities, good sleep, managing stress effectively. So far, so good!
    2) For more ‘good news’ evidence about how diet and other life style and behavior choices can reduce risk and REVERSE symptoms of dementia, please check Dale Bredesen, MD and his article published in ‘Aging’ Sept 2014 that reports on 10 case histories of dementia where 9 were able to reverse their symptoms following his multi-factoral, individualized program including changing diet.




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  20. To everyone asking about cholesterol: I have posted it elsewhere on this site, but feel I need to repeat here, too, that after six years eating whole plants (and mushrooms) only, my HDL is 35, LDL 53. It works! Just be consistent and give it time (I believe it will take way less than 6 years – I just haven’t been to a doctor for God knows how long, so I can only speak about my condition now). And I am obviously not on any medications.




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  21. Dr. Gregor, I may have missed this in the video or previous comments – did the study with Nigerians control for age? I’m assuming life expectancy for Nigerians is considerably less than here in the U.S. and obviously alzheimers is a disease of the aging. thoughts?
    Mike




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    1. Mike, I haven’t checked out the study Dr G refers to but I imagine so. This is normal practice in comparative studies of this kind.

      For example, the annual age standardised death rates from AD are reportedly 26.9 for every 100,000 people in Spain but only 3.29 in Nigeria.
      http://www.worldlifeexpectancy




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  22. What is your opinion on black cumin seeds and oils. Black Cumin has more than 600 peer reviews and has also been proven several times to help with Alzheimer’s Disease?




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    1. Did you bother to read any of the studies? Don’t you think researchers know to use age-adjusted statistics when talking about the prevalence of chronic diseases and diseases of old age? Any possibility in your mind that this sort of adjustment occurs so routinely that there is something of a convention in less formal discussion to accept loose language that omits mention of age adjustment when talking generally about prevalence, and especially when talking about risk?

      I’d note also that the text in question is open access and that Tom Goff’s existing comment was probably not far from your view either.




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  23. Nigerian Blacks have the highest observed frequency of the ApoE4 but low incidence of Alzheimer’s and may it be attributable to a low cholesterol/low saturated fat diet, but could it have anything to do with a lower life expectancy rate? Would there be any data for rates of Alzheimer’s in expatriate Nigerians living in first world countries that eat a Western style diet as a control group?




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    1. The studies controlled for age. This is standard. Maybe Greger should consider mentioning this kind of fact in order to avoid confusion, maybe even alluding to it as a generally standard practice. At least in short videos like this one, the loss of other communication would not be too great.




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  24. I also had a question, what about Dr Wallach claiming That Alzheimer disease is due to a cholesterol deficiency ? I hope you will answer me you give very good advices… émoticône smile




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    1. I am sorry but Dr Wallach has a highly dubious reputation and his claims about A and cholesterol are, frankly,ridiculous.

      See my earlier response below to Mary Yarwood.




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  25. I had a question, what do you think about hemp seeds oil (without THC lol) and Udo Erasmus Oil’s blend :) it’s still oils but his speech seems legit :)




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  26. Another questions, Dr Klaper talks about Carnitine and people who got very weak going vegan (as me…) so I started adding Carnitine (pill form) into my diet but maybe you can clear it up to new vegans as it could lead to Atherosclerosis as he mentionned :)




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  27. The ApoE story may prove to be considerably more complicated than cholesterol transport. Scientists from the Buck Institute just reported that ApoE is a transcription factor that binds to the promoter regions of 1700 genes. That’s 7-8% of the entire human genome.

    ApoE4 targets genes associated with sirtuins and aging, insulin resistance, inflammation and oxidative damage, accumulation of amyloid plaques and tangled tau among others

    .




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  28. He forgot to mention that the average life expectancy in Nigeria is 52 years. They also move more and get more sun exposure (vitamin D and serotonin). Corelation is not causation.




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    1. You forgot to read the study. They used age standardized rates. If you don’t have valid research for a sun-based mechanism, and you are hence using an empty hypothesis to dismiss valid research for a cholesterol-based mechanism, you are basically engaged in special pleading.

      Also, note that the things you mention to dispute a causative hypothesis are themselves correlations of a similar type to cholesterol. Causation cannot be seen without correlations of some kind being found.




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  29. Yes, you should really do your research. I notice that you are unable to offer any evidence that “Good grass fed organic meat is fine”. Wishful thinking and dodgy claims by people selling grass-fed organic meat are not evidence.




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  30. One of the greatest discoveries of our time was that genes are not destiny, that their actions can be modified by our behavior. Thanks!




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  31. My dad has this gene, but now at 72 still isn’t showing signs of ALZ. My mother has full blown ALZ, I don’t know if she has the gene (I am guessing you have to have the gene to get the disease). I’m a blend of the two as far as diet yet have exercised substantially more throughout my life (I am 47) than my mom. I was a vegetarian for 12 years and am now starting again on a plant based diet. I am of course worried to have this test as I have a 4 1/2 year old son. My question is could I change my ALZ potential around at this age, and how does that work as far as the gene is concerned? If the effects of the gene have begun can they be reversed throught diet?




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  32. Coconut oil, medium chain triglycerides https://www.cambridge.org/core/journals/british-journal-of-nutrition/article/the-role-of-dietary-coconut-for-the-prevention-and-treatment-of-alzheimers-disease-potential-mechanisms-of-action/1C610ECEA7E7D7CD3E7323A0477E6731

    https://nutritionandmetabolism.biomedcentral.com/articles/10.1186/1743-7075-6-31

    AC-1202 rapidly elevated serum ketone bodies in AD patients and resulted in significant differences in ADAS-Cog scores compared to the Placebo. Effects were most notable in APOE4(-) subjects who were dosage compliant.




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  33. Yes, but how do these people live? “The May 2016 life expectancy data published by the World Health Organisation (WHO) has shown that Nigeria, again, has one of the lowest life expectancy ratio in Africa and in the world; with 55 years for females and 54 years for males…”

    https://www.thisdaylive.com/index.php/2016/07/22/tackling-low-life-expectancy-in-nigeria/

    https://guardian.ng/features/nigeria-with-54-5-years-on-lowest-life-expectancy-list/




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