Without knowing more about the MTHFR mutation, and other genetic testing I cannot begin to discuss much. I will direct you to some resources.

Before "Wheat Belly" fame, Dr. William Davis was a very accomplished cardiologist that really spent a lot of time looking into the etiology of heart disease and what different factors affect everything. He and his group were instrumental in getting the AHA to acknowledge that calcium scoring is one of the more useful tools in heart disease tracking. He even used to have a blog that was freely accessible to the public as part of a group medical practice treating patients. That's gone now, but the practice is still going strong (I think the blog is available to members still, but I don't know). It is called the Track Your Plaque: Heart Disease Prevention and Reversal Online (http://www.trackyourplaque.com/). It is a group of doctors that will work with your husband on ensuring he stays healthy and happy. I was able to find one of Dr. Davis' blog post copied onto a low carb forum that I believe is very relevant for you:

Cut the carbohydrates in your diet and what sorts of results can you expect?

Carbohydrate reduction results in:

Reduced small LDL--This effect is profound. Carbohydrates increase small LDL; reduction of carbohydrates reduce small LDL. People are often confused by this because the effect will not be evident in the crude, calculated (Friedewald) LDL that your doctor provides.

Increased HDL--The HDL-increasing effect of carbohydrate reduction may require 1-2 years. In fact, in the first 2 months, HDL will drop, only to be followed by a slow, gradual increase. This is the reason why, in a number of low-carb diet studies, HDL was shown to be reduced.--Had the timeline been longer, HDL would show a significant increase.

Decreased triglycerides--Like reduction of small LDL, the effect is substantial. Triglyceride reductions of several hundred milligrams are not at all uncommon. In people with familial hypertriglyceridemia with triglyceride levels in the thousands of milligrams per deciliter, triglyceride levels will plummet with carbohydrate restriction. (Ironically, conventional treatment for familial hypertriglyceridemia is fat restriction, a practice that can reduce triglycerides modestly in these people, but not anywhere near as effectively as carbohydrate restriction.) Triglyceride reduction is crucial, because triglycerides are required by the process to make small LDL--less triglycerides, less small LDL.

Decreased inflammation--This will be reflected in the crude surface marker, c-reactive protein--Yes, the test that the drug industry has tried to convince you to take statins drugs to reduce. In my view, it is an absurd notion that you need to take a drug like Crestor to reduce risk associated with increased CRP. If you want to reduce CRP to the floor, eliminate wheat and other junk carbohydrates. (You should also add vitamin D, another potent CRP-reducing strategy.)

Reduced blood pressure--Like HDL, blood pressure will respond over an extended period of months to years, not days or weeks. The blood pressure reduction will be proportion to the amount of reduction in your "wheat belly."

Reduced blood sugar--Whether you watch fasting blood sugar, postprandial (after-meal) blood sugars, or HbA1c, you will witness dramatic reductions by eliminating or reducing the foods that generate the high blood sugar responses in the first place. Diabetics, in particular, will see the biggest reductions, despite the fact that the American Diabetes Association persists in advising diabetics to eat all the carbohydrates they want. Reductions in postprandial (after-eating) blood sugars, in particular, will reduce the process of LDL glycation, the modification of LDL particles by glucose that makes them more plaque-causing.


You may notice that the above list corresponds to the list of common plagues targeted by the pharmaceutical industry: blood pressure, diabetes (diabetes being the growth industry of the 21st century), high cholesterol. In other words, high-carbohydrate, low-fat foods from the food industry create the list of problems; the pharmaceutical industry steps in to treat the consequences.

In the Track Your Plaque approach, we focus specifically on elimination of wheat, cornstarch, and sugars, the most offensive among the carbohydrates. The need to avoid other carbohydrates, e.g., barley, oats, quinoa, spelt, etc., depends on individual carbohydrate sensitivty, though I tend to suggest minimal exposure.

The one thing I would point out to anyone is that you can increase your HDL very fast by supplementing with coconut oil. Get a good extra virgin coconut oil that is still in the triglyceride form.

MTHFR most definitely will play into heart disease depending on the mutation. That said, you guys have probably been told that this is not one to worry about as far as that is concerned.

Here's a story:

A guy walks into a doctor and gets his lipid profile test results, and the doctor gives him a grim look and says your cholesterol is too high. Look at these LDL values, your HDL is too low and your triglycerides are out of control. We need to put you on statins, stat!

Doc, I want to avoid the meds and see if we cannot fix this with lifestyle change. Okay, but you're going to have to cut out that fat and make sure to eat lots of healthy whole grains.

Guy does just that. Eats very little fat, finds all kinds of healthy whole grains, pseudograins, legumes, and all their friends. Religiously runs like a hamster stuck in an exercise wheel, only drinks water and an occasional caramel macchiato (nonfat milk only). Three months later guy is excited to see the doctor for his first follow up blood test and results, knowing he's gonna blow this thing out of the water. The Doctor looks at him and says these are worse, we need to start you on statins right away. Look how bad your triglycerides are, and your LDL is one of the worst values I've seen plus your HDL is plummeting. Guy looks at doctor and tells him how religious he's been about diet and exercise; and doctor give a look of I'm not believing it but says "I guess it's just not going to work for you then" and hands him a prescription that guy goes and fills.

Guy still wants to kick this thing and continues the recommended diet, runs like a madman and takes his daily statin. His next 3 month follow up his blood lipid numbers slightly improve: HDL still in the drain, LDL much lower and triglycerides are still high. Doctor likes the progress but he has to point out that your fasting blood glucose is a bit high. All in all, the doctor likes this and sends him out to continue the good work.

Guy goes out and pushes even harder with the running and diet. Excited that he can even get things better. The next follow up the doctor likes the trend for LDL but wishes HDL and the triglycerides were better. He also wished the statin was working better on LDL, so he adds a prescription for ezetimibe. Tells guy that this will help with the blood cholesterol in conjunction with the statin. The big problem the doc has is your resting blood glucose is now too high and guys blood pressure is increasing. The doctor has guy go get his glycated hemoglobin check, and two days after this test his doctor calls up to say that he has turned diabetic and needs to come in for a check up and some prescriptions.

During this follow up, guy is glad to have an answer to why his energy kept swinging around like crazy. The doctor goes over things with him. Tells him guy is lucky they've caught it early and here's a script for metformin which will help insulin bind to their receptors. Hopefully this will be enough. The doc also give a script for an ace inhibitor because guys blood pressure is still high, and the tells guy he really has to fix his diet and exercise because he's putting on a pot belly.

At this point guy is a bit depressed, things aren't working and he's mad. Although he tries harder, switches fully to vegetarian lifestyle boarding vegan. Runs like crazy, tired constantly. Getting skinny, but no strength and energy. But guy is sure things will look better at the next visit. Three months later, doctor ups the statin/ezetimibe mixture and says they have to start insulin injections with the metformin. Doctor is visibly disappointed that his patient will not change, but guy is prepared this time with a detailed food diary and exercise journal. The doctor being impressed, tells guy to keep up the good work and there's nothing that can be done about the diabetes but this path should keep him away from a heart attach.

Guy keeps up the regimented program and with the insulin added he feels a bit better, but his energy is still super low and his strength is waining. He's sore all the time and can barely make from work to home and bed, but he's got to keep his routine up... The next follow up the doctor feels good about the results being in the right trend, just a few tweeks of the medication. Guy tells doctor about how tired and exhausted he is all the time. Intimacy with the wife is gone, he can barely get of bed, moving throughout the day is effort and it always seems like he has a fog clouding his brain. Doctor sends guy to get his thyroid and testosterone checked. They both come back out of control. Thyroid medication starts up and testosterone cream is applied.

Guy is finally feeling better. Doctor is happy with his numbers. His energy is up even though his strength is low. Guy has a heart attach! Stent is placed and they tell him how clogged up his arteries are and that he has to be super diligent with his heart friendly, diabetic friendly diet and lifestyle. Guy gets super depressed and tries to work on this harder still. Measuring everything, tracking everything, counting, obsessing, but the depression throws everything out of control. He needs higher doses of blood pressure medication, thyroid meds increase, testosterone plummets even with the use of the cream.

Guy hits that stage where he's accepted that life isn't going to get better, he can't run anymore and his diabetes is getting worse. Because of the depression, the doctor has added an antidepressant. Guys bathroom is one giant pharmacy to keep him going.

Is any of this sounding true? The important thing to hit here is the mistake that was made. By switching to a completely carbohydrate based diet, guy created this problem. Why? Once you intake more carbohydrates than you are able to burn off or place in glycogen storage, the liver has to do something with this. The liver turns it into fat and does a very bad job at this. This in turns pushes serum triglycerides super high for two reasons: 1) it's the first step to forming the various lipoprotiens. 2) while in a state of de novo lipogensis your body is not utilizing its fats. They stay persistent. The next stage in the process is triglycerides to VLDL and LDL. These stay persistently high for two reasons: 1) it's the second step of glucose clearance in de novo lipogensis. 2) the LDL formed through this process is a poorly formed particle that is small and dense. The liver receptors that are supposed to clear LDL for the blood stream do not recognize this particle and it passes through to remain in the blood stream.

Why is that all bad? The small LDL that stays in the blood stream has plenty of time to undergo chemical reactions in the oxygen rich environment and will form oxidized fats inside the lipoprotein. These oxidized fats then get glycated courtesy of the constantly elevated blood glucose levels thanks to eating all of the carbohydrates. Now you have a glycated lipoprotein floating around in the blood stream. So you might ask? What does that have to do with anything? ....

Well, thanks to improper fat metabolism, your arteries have been hardening because they are not getting enough good fats and cholesterol which help the remain pliable. The constant carbohydrate load causes sudden increases in arterial pressure causing micro tears in the hardened arteries. Regular LDL runs to the rescue and plugs these arterial holes (one of its main functions). Yay! Problem is this LDL patches pick up things like calcium and this calcium will now pick up the glycated small cell LDL because the glycan part of this can chelate to the calcium and it forms a bigger pocket of plaque than intended. Thankfully this too picks up more calcium and then more glycated small cell LDL.... again.... again.... again.... heart attach.

I sent these science daily links to someone today and they are relevant here (feel free to get the actual research papers. The first is a PLOSone which is free):

http://www.sciencedaily.com/releases/2014/11/141121151104.htm

http://www.sciencedaily.com/releases/2009/06/090625133215.htm

http://www.sciencedaily.com/releases/2010/01/100125172938.htm


The thing is this isn't news in the science world. Research showing these have been around for a long time. The problem is there is just as much research showing the opposite. So what's the deal? Well, almost all the research pointing to fats good carbohydrates bad have been done as controlled feeding studies. The other side is almost entirely epidemiological. In other words, surveys asking people what they ate for the last year. The other types of studies that show high fat diets are bad fall into two categories: 1) the use entirely rancid seed oils as the fat and peoples health go to crap (big surprise there). 2) they claim high fat low carbohydrate but when you look at the carbohydrate load it's really high (200g/day on the low side of these studies.

Anywho, I'm just rambling at this point. I hope I made my point, or a point. The reason high fat diets do not work for ApoE4 mutations is it just screws up fat metabolism from birth. Eat high carbs or high fat, it doesn't matter. Both will create a poor lipid metabolic state.

Please forgive all spelling and grammatical errors. Sometimes you have no time for editing.

Nutmeg76 wrote: »

It's all good info! I did have him start taking the proper B vitamins for the MTHFR (even though we don't know if he has it) because they won't hurt him if he doesn't need them. The one he is taking also helps with homocysteine levels, which I know are a problem too.

Just be careful with what you start before you know what you're working with. There are actually nine different mutation combinations just for 677 and 1298 variants of MTHFR, and not all of them really do anything. So, in some cases (like copper/zinc ratios), you might do more harm than good if you're not careful.

http://www.stopthethyroidmadness.com/mthfr/