Love Your Heart; Protect Your Brain

By Julie Gregory, Chief Health Liaison for Apollo Health

February is heart health month. And if you’re following the Bredesen Protocol, that matters more than you might think.

Dr. Bredesen doesn’t treat vascular dysfunction as a separate disease. He sees it as one of several contributors to cognitive decline and has even included it as one of his subtypes: type 4 (vascular). For some people it’s mild. For others, it plays a central role.

If you have cardiovascular disease, your Alzheimer’s risk rises. The encouraging part? This is one of the most modifiable contributors we see.

So let’s focus on what you can actually do.

Step 1: Know Your Vascular Picture

The vascular contributor often shows up alongside:

• Prior heart attack or ischemic stroke
• High triglycerides
• Low or dysfunctional HDL
• Elevated HbA1c
• High homocysteine
• Chronic inflammation
• Sleep apnea

If any of these apply to you, vascular support deserves attention.

A basic lipid panel doesn’t always tell the whole story. You might consider discussing advanced testing with your clinician, such as ApoB, LDL-P, small dense LDL, oxidized LDL, Lp(a), a coronary calcium score, or carotid ultrasound.

The goal isn’t anxiety. It’s clarity.

Step 2: Stabilize Blood Sugar First

For most people with vascular contributors, insulin resistance is central. Before increasing fats, focus on stabilizing glucose. That means:

• Reducing post-meal spikes
• Improving insulin sensitivity
• Lowering inflammatory load

See Stop Inflammatory Foods to understand why we are asking you to avoid them. They include:

• Sugars
• Simple carbohydrates 
• Most grains
• Conventional dairy

Even “healthy” foods can spike glucose. If you’re not sure how your body responds, a continuous glucose monitor (CGM) with simple meal journaling can be eye-opening.

While healing insulin resistance, it may help to temporarily limit resistant starches like legumes and sweet potatoes, as well as most fruits (even low-glycemic fruits — with the exception of lemons and limes). These can often be reintroduced in small amounts once metabolic flexibility improves.

Step 3: Then Add Healthy Fats — Thoughtfully

Once glucose is stable and insulin resistance is improving, you can begin increasing healthy fats.

For many, increasing healthy fats is part of re-training the body to naturally achieve ketosis. Fasting and exercise can support this transition as well.

This is especially important if you have dyslipidemia or tend to hyperabsorb dietary cholesterol, which includes many ApoE4 carriers. For these individuals, saturated fat often needs to remain modest in the long term, not just during the insulin-resistance healing phase.

Prioritize mono- and polyunsaturated fats:

• High polyphenol extra virgin olive oil
• Low mercury wild-caught fish
• Avocados
• Nuts and seeds

As you increase fats, monitor lipid markers. If LDL-P, ApoB, or small dense LDL rise significantly, adjust saturated fat downward while maintaining metabolic flexibility.

The goal is to reteach your body how to naturally achieve ketosis, restoring metabolic flexibility. Once flexibility is regained, many people can maintain metabolic resilience with less dietary fat overall — while continuing to prioritize fat quality.

Step 4: Support Blood Flow

Healthy vessels dilate. That dilation depends in part on nitric oxide.

Support nitric oxide production by regularly eating leafy greens. They’re naturally rich in dietary nitrates, which your body converts into nitric oxide—a molecule that helps blood vessels relax and supports healthy circulation.

• Arugula
• Spinach
• Kale
• Beet greens
• Watercress

Simple additions. Powerful effects.

Step 5: Consider Ketones Strategically

While healing insulin resistance, some people use short-term exogenous ketone salts or esters (not MCT oil) to support brain energetics without worsening lipid profiles.

The long-term goal remains restoring your body’s ability to produce its own ketones — but strategic support can be helpful during transition.

Step 6: Move — Especially Aerobically

Daily aerobic movement increases cerebral blood flow and supports new vessel growth.

Examples include brisk walking, cycling, and swimming, which are powerful tools. Consider exploring Exercise With Oxygen Therapy (EWOT), which can be particularly beneficial. See My Experience with EWOT to learn how powerful this intervention can be.

Blood flow is medicine.

Step 7: Find the Right Partner

If you have cardiovascular disease or significant risk factors, consider working with a cardiologist who takes a functional, root-cause approach — someone comfortable with metabolic health, advanced lipid testing, and lifestyle-based interventions.

This is especially important for ApoE4 carriers, who often show greater sensitivity to saturated fat, higher LDL particle burden, and increased vascular inflammation. Personalized lipid management matters.

The beautiful part? When you address insulin resistance, inflammation, and endothelial dysfunction, heart health and brain health often improve together.

The Bigger Picture

Cognitive decline reflects a network under stress — vascular, metabolic, inflammatory, and immune.

When circulation improves, neurons function better. When insulin signaling stabilizes, the brain becomes more resilient.

The work you do for your arteries is the work you do for your brain.

This February, take a hard look at your vascular health. It may be one of the most important investments in your long-term cognitive health.