ApoE4 Can be Your Friend

Top Five Strategies for ApoE4 Carriers

• Maintain metabolic health. Maintaining metabolic health is key as it will protect your brain by providing fundamental fuel while also protecting against heart disease. While you may initially need to use supplements or medications to help support the transition to metabolic health, the optimal method involves aligning with ApoE4 ancestors by using the KetoFLEX 12/3 Lifestyle.
• Use the modified KetoFLEX 12/3 Lifestyle. The KetoFLEX 12/3 Lifestyle, which combines our plant-rich KetoFLEX 12/3™ diet with exercise and fasting on a foundation of quality sleep, will help to optimize your metabolism and fuel your brain, while also protecting your heart. This approach will naturally lead to the creation of endogenous ketosis. To better align with our ancestral gene, ApoE4 carriers may want to modify this approach by slowly extending their daily fast to 16+ hours and increasing daily exercise rather than relying heavily upon higher amounts of dietary fat. Early man fasted for long periods when food was scarce and moved throughout the day to find food. This modification works beautifully as long as you can maintain a healthy weight with strong muscles. When increasing healthy fats, limit saturated fat and instead use high polyphenol EVOO, avocados, nuts, seeds, and low mercury wild-caught fatty fish.
• Reduce Inflammation. Because the ApoE4 gene is pro-inflammatory, it’s vital to adopt frontline strategies to reduce inflammation.
  • Avoid inflammatory foods. This includes any that are processed or refined with inflammatory industrialized oils, all sugars, simple carbohydrates, conventional dairy, and grains. None of these foods are aligned with the ancestral ApoE4 allele.
  • Prevent leaky gut. Avoid the foods above along with any that cause sensitivities or allergies. Additionally avoid alcohol and smoking, while also minimizing stress. Use prebiotic fiber, small amounts of resistant starch (as tolerated), and probiotic foods to optimize the microbiome and overall gut health, as well as pastured bone broth several times per week.
  • Optimize metabolic health. The ancestral formula to achieve this goal is described above in the modified KetoFLEX 12/3 Lifestyle.
  • Maintain good oral health. You can do this by increasing professional cleanings to 3x per year, avoiding gum disease, considering an oral care probiotic, and proactively addressing cold sores (HSV-1) with a preventative regimen.
  • Exercise ancestrally. Early man was constantly on the move searching for food, interspersed with periods of more intense exercise during a hunt. We can do our best to mimic an ancestral exercise plan by avoiding a sedentary lifestyle, moving throughout the day, and including at least 30 minutes of daily aerobic exercise, preferably outdoors, with strength training 3 to 4 times per week. 
  • Manage stress. Chronic unresolved stress increases cortisol, which in turn elevates inflammation. Use any or all of the strategies that we regularly discuss including mindfulness, meditation, breathing breaks, gratitude, the Dynamic Neural Retraining System, along with HeartMath to measure your progress.
  • Consider low-dose naltrexone. Low-dose naltrexone (LDN) can safely upregulate endorphins naturally reducing inflammation throughout the body and helping to modulate immunity. This is also used to treat a variety of conditions and is typically prescribed by a functional physician. You can see Dr. Bredesen hosting a Facebook Live entitled Low-Dose Naltrexone(LDN): Why it Works so Well.
• Identify and address potential Alzheimer’s contributors. This is fundamental for not only reducing inflammation but for addressing all potential brain insults which can lead to increased Aβ and tau aggregation and reduced clearance. We can do this by following the Bredesen Protocol® and the Bredesen Seven.
• Work to reduce Aβ and tau aggregation and promote clearance. Research has revealed specific strategies that can help to do both. This is fundamental for also avoiding cerebral amyloid angiopathy (CAA), well-known to be associated with ApoE4, in which Aβ accumulates in arteries of the brain and can lead to hemorrhagic stroke. See CAA: Notes from the Frontlines for a list of additional strategies to avoid this condition. 
  • Sleep Quality restorative sleep has been shown to help reduce Aβ and tau by upregulating the glymphatic system. Side sleeping also helps to promote clearance.
  • Curcumin Research shows that curcumin prevents Aβ and tau aggregation and can cross the blood-brain barrier to protect neurons from various toxic insults of aging. It’s important to use a supplement brand that is bioavailable. Dr. Bredesen recommends 1 gram taken once or twice daily.
  • Extra Virgin Olive Oil A recent clinical trial showed that extra virgin olive oil (EVOO) not only helped to promote Aβ and tau clearance, but also enhanced the blood-brain blood barrier function, and actually improved cognition. Always try to use the highest polyphenol content that you can tolerate. These can be quite peppery and even cause a small amount of burning in your throat but can be delicious once you become acclimated.
  • Fasting A long daily fast is a primary component of the plant-rich KetoFLEX 12/3 diet. Everyone is encouraged to fast for a minimum of 12 hours daily, with at least three hours before bedtime. ApoE4 carriers are encouraged to extend this daily fast to 16+ hours — only if they can maintain a healthy weight with strong muscles. This helps to promote autophagy, a natural cellular process that helps to prevent Aβ and tau aggregation and helps to promote their clearance.
  • Aerobic exercise Aerobic exercise confers many neuroprotective benefits including increased cerebral blood flow, upregulated brain-derived neurotrophic factor (BDNF), and reduced Aβ plaques and tau aggregation. As a part of exercising ancestrally (described above), ApoE4 carriers should target a minimum of 30 minutes of aerobic exercise daily, preferably outdoors to glean the additional benefits of spending time in nature.