July 12, 2023
Webinar: KetoFLEX 12/3 Meal Delivery Service
Dr. Dale Bredesen and Julie Gregory were joined by Nutrition for Longevity’s CEO and founder to discuss our recent collaboration to provide a KetoFLEX 12/3 meal kit delivery service, created to provide fully-prepared chef-curated meals that give nutritional support for cognitive health.
The Bredesen Protocol® Diet — KetoFLEX 12/3 is lower in carbs and ideal for those interested in optimizing overall health while maximizing cognitive performance. For your convenience, we have included the full transcript and recording of the webinar below.
Dale Bredesen: We are now live. We have been for a few seconds here, so great to welcome everyone. We were just chatting about where the meal delivery is here, which turns out to be in the Continental U.S. Welcome to everyone. Great to have you here. This is something we’ve been looking forward to for a long time. We’re here with Jennifer Maynard, the founder, along with Dr. Valter Longo of Nutrition For Longevity. Also, of course, with Julie G. Great to see both of you. Thank you so much for being with us here today. Since we reported the first reversals of cognitive decline in patients with Alzheimer’s back in 2014 when the first paper came out, one of the most common questions that we get asked is, “How do I do the right and optimal meals for getting into mild ketosis? How do I do a plant-rich, mildly ketogenic diet with appropriate fasting periods?” What we have called KetoFLEX 12/3.
Dale Bredesen: People have said, “It’s not easy. I’ve got to search things out. I’ve got to find the right things. I’ve got to avoid the wrong things. Then I’ve got to do it week in, week out. Isn’t there some simple way that I can actually get this done?” We’re really fortunate now to partner with Nutrition For Longevity. They’ve been doing this with other diets for years, and doing it expertly, so we’re really thrilled. They’ve just been sending out the first one, so very, very excited about that. Jennifer, welcome. Julie, welcome. Thanks so much.
Julie Gregory: Thank you.
Dale Bredesen: Let’s start with some of the basics. Maybe, Julie, we go back to you as someone who’s been doing KetoFLEX 12/3 on her own, not always an easy task, for now, somewhere around ten years.
Julie Gregory: That’s right.
Dale Bredesen: Maybe talk about what it took for you to actually get going all those years ago.
Julie Gregory: Wow. First, I have to say how excited I am that we finally have created this partnership because, as you mentioned, it’s not easy to source the healthiest food. Over time, I learned that my cognition was better when I did get into mild ketosis. I did it by eating six to nine cups of non-starchy vegetables from every color of the rainbow, the cleanest I could source, preferably local and seasonable, and an adequate amount of clean protein. I leaned into wild-caught, low-mercury fish. Because I knew my brain needed DHA and pastured eggs for choline. And then lots of healthy fats. My favorite fat, of course, is high polyphenol extra virgin olive oil because it has so many independent benefits. When I began eating like that, and I basically threw away all of my processed food, my brain came alive once I got into ketosis. I mean, I think it’s the most important strategy of all the strategies that I use. I’m still using it today, and I will until the end of the race.
Dale Bredesen: Yeah. It’s very interesting for me. Coming from the lab side, there have been publications on each one of these pieces. So, publications on just polyphenols, publications on just extra virgin olive oil. Just as an aside, very interesting for me to see recently that lecanemab has been pushed as, “Oh, let’s give this monoclonal antibody.” Well, here are some things that did in their trials better than lecanemab, extra virgin olive oil alone. Ketones alone did better than this highly touted antibody, with, of course, far fewer side effects. These so-called combined metabolic activators. Then, of course, ReCODE, which did the best of all of them in terms of actually making people better. These various pieces have already been published, and then putting them together has turned out to be really powerful.
We hear again and again … I had mentioned, I think to both of you recently we just had some fantastic new data on someone who has posterior cortical atrophy, who’s just really improving dramatically. This is always great to see. This is what we were the first to report, now almost 10 years ago. So, to have this available is fantastic. Jennifer, if you could just give us a little bit on the background? How did you find this company? Why did you decide to do this? Certainly, we’re all grateful that you did. What was it that first pushed you to say, “I really want to start a meal delivery service.”
Jennifer Maynard: Yeah. A lot of people don’t realize I spent 20-plus years in the pharmaceutical biotech side of things, so I was on that side of it. I was actually living in Switzerland. I had lived in Germany for three years and in Switzerland for three years. The whole combined experience is really what pushed me to start this program. The reason why is, one, living in Europe, it was shocking to me how easy it was to eat healthy there. In fact, it was almost a little bit scary. The only unhealthy aisle in the grocery stores, I lived in a somewhat international area, was what they called the American aisle. That crushed me. I was like, Ugh. It really was a lot of processed foods, and high sugar and high corn starch and things like that. Then the rest of the grocery store was almost entirely fruits and vegetables, including what their convenience stores are.
Even in the train station, there are these little mini quick turnaround grocery stores where you can just grab something on your way home. Those are almost like produce stands, but it’s their grocery stores. They have these little tiny refrigerators because everything is fresh, and there’s very little that you stock in your fridge. That was really eye-opening, and I felt amazing eating the food there. Then I would come back, and even eating what I thought was healthy, I didn’t feel great, and stuff tasted so different. I could actually taste the chemicals in boxed foods. Which I don’t eat a lot of, but even if I ate something, that out-of-the-box processing, I could taste it. That was very eye-opening as number one.
Number two is, I mean I grew up on a homestead. We grew our own food. Even when I moved from Alaska… I grew up in a fishing village, so I’m a little bit of a fish snob. We’ll talk about that in a minute. Fish was a really important part of our diet. Then we grew a lot of our own food. When I moved to Southern California, I still had exposure and access to food, but that’s also when I got thrown into, there’s a lot of fast food. There’s a lot of other foods that I had just never been exposed to. Europe brought me back more to my roots, where it was much more like how I grew up in Alaska, and eating healthy was very easy. Then I moved back. I’m thinking, “It’s so hard to eat healthy here.”
There’s so much misinformation, and we’re so focused on the injection and the pill we’re not focusing on the most fundamental thing, which is the nutrition. If you look at all of our chronic illnesses in the US, 90% plus of them can be positively impacted by nutrition and what we put in our bodies. I really believe in food as medicine. We look at it a lot for prevention. A lot of people that are well-educated in nutrition are already trying to eat healthy. Again, it’s very hard. A lot of people are just not exposed to what is good nutrition and what does that look like. Again, it’s very difficult. I wanted to found a company that made it easy for people to eat healthy food.
We made it convenient. Changing the definition of what is fast food and what is convenient food, that healthy food can fit into that category as well. Then the other important part for me was that it was science-backed. There’s so much nonsense out there around nutrition. We wanted something that was really backed by science. Only working with leading researchers and leading nutrition experts, like yourself, that we felt could validate the nutrition space and say, “This is not just prevention. This is intervention, and it should be legitimized in that way.” That was what my passion was for founding the company.
I found Dr. Valter Longo; I just loved his work. Loved researchers in this space that take food is medicine very seriously. I thought, “This is it. This is what we need to do and bring this to life.” We launched over five years ago with a focus on how the food is grown, the source of the food, which is really key. And how do we get that to somebody in a very quick, efficient way so it’s still very fresh but easy for somebody to comply with something that may seem like a very difficult program if you were just doing it entirely on your own?
Dale Bredesen: Yeah, that’s a really good point. We hear about some of these other diets. When you talk about cognition, we hear about the MIND Diet. We hear about the Mediterranean Diet. But the point of this is that this has been optimized for synaptogenesis, for making synapsis. Now both of those diets, MIND, and Mediterranean, do not get you into ketosis, so you’re missing a critical part. As Professor Stephen Cunnane has taught us all over the years, ketosis is critical. When you have cognitive decline, you are typically in an energetic failure. So, you now start with the ability to burn glucose and burn ketones, and you should be able to go back and forth. Literally, that is metabolic flexibility.
As we get a little older, and this can happen even in your late 20s, but typically we think about it as your 30s, your 40s, your 50s, you’re now heading for cognitive changes. You lose the ability to burn that glucose, and you lose the ability to make and burn ketones. So, you really are in an energetic failure sort of state. We want to return you to insulin sensitivity so that you can burn the glucose. We want to return you to metabolic flexibility so that you can burn the ketones. That is the science behind what we actually get for the best outcomes. It’s what we found, and it’s what we used. The KetoFLEX 12/3 is what we used in our clinical trial, in which 84% of people who were already in relatively late stages.
They were at MCI or early dementia, so they were past SCI, subjective cognitive impairment, and past the period where they would just be on prevention. Yet 84% of them showed cognitive improvements. Julie, if I could come back to you for a minute. We’re getting some questions here that we’ll get to in just a couple of moments. We’re getting questions, is it gluten-free, is it dairy free? It’s all of these things. Julie, maybe you could talk about the development. I know that you and my wife, Dr. Aida Lasheen Bredesen, spent months working with Jennifer and her team to make sure that you get the best biochemistry for the best outcomes. Julie, if you could talk a little bit about what are the requirements for KetoFLEX 12/3?
Julie Gregory: Sure. As I mentioned earlier, it’s heavily plant-based. We like to encourage our participants to have six to nine cups, a minimum of six to nine cups, of these deeply pigmented nutrient-dense vegetables and lots of leafy greens. We don’t want to ignore the role of protein, but we don’t want excess protein, so an adequate amount of protein. All the protein is very cleanly sourced. We do wild-caught, low-mercury seafood, some chickens that are given pasture time, and grass-fed beef. You can practice this as a vegan or a vegetarian, although we don’t have a line yet through Nutrition For Longevity.
If you are vegan or vegetarian, please reach out to customer service at Apollo Health. We’re keeping a list of people that want that menu. When we reach critical mass, we will ask Jennifer’s team to go ahead and do that. Then, the other most important and critical factor is just healthy, clean fat. Olive oil, as you mentioned, it improves cognition, brain structure, and function. The olive oil in our kit, Jennifer, if you can speak to that, is extraordinary. I mean, it’s really a great one.
Jennifer Maynard: Yeah, absolutely. I have a bottle. It doesn’t show very good. This is the olive oil, and people get two bottles of this if they get the one with olive oil. We also have it in the dressings. Anything that’s using oil, we’re using this as our standard. What’s really special is this is from Sardinia, so one of the blues zones of the world, one of our longevity regions we focus on. We direct source this from essentially Centenarian farms, so these are very old [inaudible 00:13:26] olive trees. If you don’t know Sardinia, I’ve been out there and sourced directly myself. What’s incredible is it’s a very dry, rocky, windy, arid region, which is the perfect combination for high polyphenol olive oil. This is actually right around 650 milligrams per kilogram.
That is well above the requirement of high polyphenol. It’s even well above, and I’m not going to name any brands, but well-known brands from different regions like Morocco, different things where they’re touted for high polyphenol. This is actually higher than most of those. It’s because of a fairly harsh climate. If you know plants, plants produce polyphenols as a defense mechanism. This is a region that requires that. For the olives, the olive trees to really thrive, they produce high polyphenols. It’s a first press. These are hand-harvested, first press, so they’re not bruised. They’re very, very premium olives, and then they go into a first press pure olive oil that we test every batch. We’re really proud of this.
The orchards, if you ever get to go to Sardinia, you have to go see the olive orchards. They’re just beautiful. They’re so pristine, and they haven’t been touched with chemicals, I mean as far back as hundreds and hundreds of years. These are organic farms that are really doing their best to preserve ancient olive oil and bring it to our modern-day society. I like to say it’s not that they’ve modernized it. They’ve kept all the good stuff, and we don’t add anything to this. So, you just get that pure good. It’s incredibly high in oleocanthal and oleuropein. I never say it right, but really important polyphenols are very rich in this olive oil.
Dale Bredesen: Fantastic. Yeah. I should say one of the major points here. If you look at the work of Professor Robert Lustig, I mean Rob has put out a number of wonderful books. One of my favorites is Metabolical. He talks about how when we changed to CAFOs when we changed to all the factory farms and all the processed food, you can just follow the decline of the American health and Western health. You can see the increase in cardiovascular disease and dementia and renal failure, and so forth and so on. This is all taking, and everyone’s realizing now we need to go back to the way our grandmothers and grandfathers farmed. And stay away from the various fertilizers, the various pesticides, and the problems that we ran into, and stay away from processed food.
Just to be clear here, because there are a couple of questions about, what about gluten. To be very clear, there is no gluten. Gluten can cause leaky gut syndrome. It can cause problems for many, many people, even though not everyone is highly gluten sensitive. But at the same time, as Professor Fasano from Harvard has taught all of us, for most people, gluten can damage the lining of your gut. So there is no gluten, there is no dairy. Now what about nightshades? I know most people are not sensitive to nightshades, but some people are sensitive. Some people are sensitive to the lectins and would want to get off those as well. What about nightshades? This is a question from Cliffy. “What about nightshades?”
Julie Gregory: Are they included, Jennifer? I think, are there tomatoes, are there any-
Dale Bredesen: There’s some of them that have tomatoes in there, yeah.
Jennifer Maynard: Yeah. I wasn’t sure if that was for me. Yeah, we do have some nightshades. Everything is labeled, so every meal is. I just have an example of what the meals show up like. They’re sleeved, and they all have a nutritional facts label on them with ingredients. You can go through it, and you can look. You can also a lot of times talk to our customer service and request different meals that are nightshade free. We try to definitely accommodate different food sensitivities. We can’t accommodate every food sensitivity, but we really separate those out and really try to make it clear what is in each dish.
We do focus a lot, as Julie mentioned, on the leafy greens and the non-starchy vegetables. That is the core. Not only do you get the meals, but you get two extra containers full of fresh leafy greens, so you can add even more in. You get salad dressing packets that have our homemade salad dressing made with the olive oil. Then eggs, you get the hard-boiled eggs in the kit as well, so pasture-raised hard-boiled eggs. We try to provide everything possible, but if somebody has a sensitivity to those ingredients, we can also try to accommodate as much as possible.
Dale Bredesen: Yeah. I should mention when we first ate these, my wife and I had a couple of weeks of these and loved them. I was really impressed with what you’ve come up with. It was fabulous. I checked my own ketone levels while I was doing this, and they clearly went up. This is truly a plant-rich, mildly ketogenic diet, but it has wild-caught seafood. It has appropriate beef pasture… Not pasture beef, sorry. It’s got appropriate beef-
Julie Gregory: Grass-fed.
Jennifer Maynard: Grass-fed.
Dale Bredesen: Right, that we’ve been recommending for a long time. Thank you for putting the grass-fed beef in there. It’s been fantastic. There’s absolutely for those who are interested in protein, and there are plenty of protein sources. Yet at the same time, it is a plant-rich, mildly ketogenic diet really fantastic. I think that is a huge step in the direction of helping people with their cognition and getting back to what they need to do to pair with the rest of the things. The other thing, there’s a person here saying, “I’m a vegan.” Yeah. As Julie said, please let us know. So, when we have a significant number of people, we can go back to this.
Julie Gregory: Sure.
Dale Bredesen: As we’ve said, as far as doing KetoFLEX, absolutely. Vegan, you can do that. It’s something you can’t order yet through here, but absolutely you can do that. The key here is we’re going literally from the test tube, where we’ve discovered over the years with the over 230 papers we published that when you look at what drives cognitive decline … The major problem, of course, is Alzheimer’s. It’s by far the number one diagnosis for cognitive decline. When you do that, there are two major groups of biochemical changes that drive this problem. The first one is innate immune system activation, so things that are driving ongoing inflammation. This can be changes in the oral microbiome; this can be leaky gut; this can be herpes simplex. There are all sorts of things, dozens and dozens of things, which is why we evaluate these.
The second piece here is a reduction in energetics. If you have a reduction in blood flow, if you have a reduction in oxygenation, if you have a reduction in mitochondrial function. If you have a reduction in ketones, and the ability to make and use ketones or to make and use glucose, those are all critical. This approach with KetoFLEX 12/3 was constructed specifically to reduce the inflammatory side and increase the energetic side so that you get the best outcomes. We’ve seen it again and again and again. As I mentioned, we saw it in our clinical trial as well.
Julie, maybe you could talk a little bit about the website you founded years ago, apoe4.info. If you could talk a little bit about how many people are on apoe4.info. I think you told me recently you’re up to something like 6,000 people around the world who are now on apoe4.info. I should mention about 25% of us are APOE4 positive. If you know your genetics, and everybody should know about this because it’s critical to get on active prevention. We recommend if you’re 40 or over, please get on active prevention. Or if you’ve already begun to have symptoms, please get on reversal treatment as early as possible. That includes KetoFLEX 12/3. Of the people on your website, how many people are doing a plant-rich, mildly ketogenic diet?
Julie Gregory: I think the vast majority are. One thing we all agree about is grains are not compatible with APOE4. As you know, we are the ancestral allele. For millennia, we ate non-grain plants, and we do very well like that. We also do very well fasting because we were faced with famines over time. I think that’s one of the basic tenets that most people adhere to. We have a few low-fat folks, low-fat vegans, and we’ve got a few carnivores. We’re not monolithic, but the vast majority of people are using a KetoFLEX 12/3 approach, and it works so well for us.
Dale Bredesen: That’s a good point. Just to mention, if you have zero copies of APOE4, and that’s about three-quarters of the population, your chance of getting Alzheimer’s during your lifetime is about 9%. It’s not zero, but it’s not terribly high. If you have a single copy, that’s 75 million Americans. Most don’t know it, unfortunately. So again, good to find out. Your chance is about 30% during your lifetime, so about threefold higher than with no copies. If you have two copies, that’s 7 million Americans, including Julie G., and you’ve mentioned this before.
Julie Gregory: That’s me. Yeah.
Dale Bredesen: Then your chance, if you don’t do any of these things correctly, is more like up around 70%. It depends then on other genes. It can be as high as 90, it can be as low as about 50, but it’s somewhere in there. Most likely, you will get it. In fact, the great news then is to get on active prevention and make sure that you never have to worry. Our goal is to make it so that everybody can get to 100, stay sharp and avoid Alzheimer’s disease. We believe that with all these things that we’re learning in the laboratory and with all the clinical trials, Alzheimer’s is truly becoming optional.
Let’s come back to Jennifer here a little bit about one of the things here. Mercedes asks, “The two days without meals, should they be for fasting?” I think it was actually a really nice way to do it. You’ve got five days of lunches and dinners and then two days. The idea is you can cycle off. You can do other things, which we do all the time. You don’t necessarily need to fast. In fact, this should make it so that you don’t have to worry about fasting. Jennifer and Julie, what do you recommend for the weekends when you finish this before the next group will be started?
Jennifer Maynard: Yeah. One of the things that I love to talk to people about, and even our dieticians, is that you completely reset your taste buds every two weeks. A lot of people, we say, “Really, even if this is a big change in the way you eat, give it two weeks. Lots of leafy greens and stuff in your diet.” Sorry, my background’s blurry. You start to really enjoy this food, and that’s really important. We don’t want people to feel deprived like, “Oh. I can’t have this, and I can’t have that.” I’m a big believer that you should start to really enjoy this food. You start to taste the flavor of vegetables and different ingredients independently. When we have everything processed, you actually lose the flavor sensation of different foods, and you lose the natural … We were naturally designed to be drawn to certain colors of food.
Our body almost inherently knew what it needed. Now I joke with people, but it’s actually very sad. Your body may be looking for bright reds and purples, the foraging part of our brains of, “I need these high phytonutrient foods because I’m under stress.” Now it’s like, “Do I need a red velvet cheesecake, or do I need some raspberries?” We don’t know anymore. Between artificial flavors and coloring and everything, our bodies are so deceived. I feel like this type of eating, this clean eating, gives you a new appreciation for food. You actually start to taste it. You start to enjoy it. We’ve had people go, “I never thought I would like leafy greens, and now I’m really looking forward to them.”
Julie Gregory: Yes.
Jennifer Maynard: First and foremost, I think it starts to train you how to enjoy these things, how to even cook them on your own. We see people after they’ve done this for a few months; it just becomes their nature. Which is a big change for a lot of people. That’s the first thing I would say. I, myself, cheat. I do this, I do that. But I really eat this way every day now because it’s just what I enjoy. Having eggs. I eat mainly plant-based. I eat a little bit of fish, and I eat a little bit of eggs, and I love my eggs. I know I’m getting it because also eggs are very high in omega. A lot of people don’t realize chickens can process omegas wonderfully, so your eggs can have high omegas in them. And then fish as well.
Dale Bredesen: And choline.
Jennifer Maynard: Yeah.
Dale Bredesen: Choline is a huge problem.
Jennifer Maynard: Absolutely.
Dale Bredesen: One of the biggest issues in Alzheimer’s disease is low acetylcholine. You need that choline, and most of us don’t have enough choline. I like that part of yours. By the way, I loved your Sloppy Joes also. It always was fantastic. Yeah, there were some things in there that I thought were just fantastic, just absolutely delicious.
Jennifer Maynard: Yeah. We really try to come up even with comfort food dishes, things that, especially when people are under stress. You actually need the best food when you’re under stress. Our bodies kind of seek out these comfort foods, which in our standard diet is not very healthy. So we try to say, “Hey. You can have that, and you can enjoy it, but it’s actually a really healthy version of it.” That’s what we try to teach people, is you can really have fun with this. You can really enjoy it. I think, Julie, I mean, they have incredible recipes as well. So, on those off days, there are tons of resources we can provide. I’ll let Julie also chime in because she has just a wealth of knowledge.
Julie Gregory: Yeah. Well, the other thing I wanted to mention, I love that you get your meals for five days, but I love to cook. That’s like a creative outlet for me. Our hope is that you will have learned on those five days what your plate should look like. You have the opportunity to cook meals for two days, which isn’t a hardship if you’re getting them delivered the other five days. It’s something to celebrate, do with your family. Our hope is that you eat KetoFLEX 12/3 every single day. Nothing tastes as good as being healthy feels with clear cognition. If you’re tempted to go off and have that red velvet cake or the Skittles because you’re looking for the colors, don’t do it. Go for the berries. You’ll feel amazing.
Jennifer Maynard: Yeah, and I think-
Dale Bredesen: Yeah, I mean … Sorry, go ahead.
Jennifer Maynard: I was going to say, and I think what will shock people is, when your body’s cleansed of that, and you’ve really taken a lot of that out of your diet. I think people will be shocked how much you taste, like I said, almost the chemicals in the food. You can taste how processed it is, and you won’t want [inaudible 00:29:41]-
Julie Gregory: Oops, I think Jennifer froze.
Dale Bredesen: Yeah. Jennifer, we lost you there for a sec. Okay.
Julie Gregory: Hopefully, she’ll be right back. Yeah.
Dale Bredesen: While we’re waiting for Jennifer to come back, I think she brought up … Jennifer, we lost you there for a minute. But I do want to bring up the issue of weight loss. We’ve heard so much about (how) Ozempic is bringing weight loss and things like this. Well, it turns out that by doing a plant-rich, mildly ketogenic diet, for many people, you will lose some weight. You’ll get into ketosis. You’ll burn fat. You do great. But one thing, some people then lose weight, and they want to gain some back. I think to me that’s one of the things the weekend’s for. Do some more fat bombs, and do some sweet potatoes.
Do some other things so that you then bring it back, and you don’t have quite as much weight loss. I know for some people, you want to kind of get in that right where you’re feeling right. For some people, they want to lose that weight. But for other people, they may have started with a BMI of 19 or something, and they don’t want to lose the weight. So, to me, that’s one of the values of having that weekend, which kind of allows you to have whatever variation you want to help you stay on track.
Julie Gregory: That is an excellent point. The last thing we want is for people to lose weight because that actually predisposes you to cognitive decline. Yes, we always encourage folks to lean into more fats; add an extra avocado, nuts, and seeds if you feel yourself starting to lose weight.
Dale Bredesen: Yeah. It’s critical to point out if you look at what Alzheimer’s is, as I mentioned earlier, it’s really driven by two things. By the inflammation part, by the innate immune system activation, and by the reduction in the energetics part. But overall, if you look at what it is, it is a network insufficiency. You have this amazing network of about 500 trillion synapses in your brain. You are now not supporting those well enough, and you’re demanding too much, which is where the inflammation part comes in. No question, we want to make it so that you’re not fasting too long. You want to get enough. You want to become insulin sensitive. You want to become metabolically flexible. You want to have those ketones and the glucose to go back and forth. You want to have the choline, the vitamin D, the B12.
All the things that make it so that the network is going to function optimally. That’s where there’s a little bit of a paradox here. We don’t want to be fasting so long that we’re actually losing that network, but we do want to be enough that we’re getting to be insulin sensitive. The way to be insulin sensitive, especially, is just not to eat a lot of high simple carbs. Those simple carbs really mess up your insulin sensitivity. That’s what’s happened with all the processed food that’s out there. Let’s take a question here from Jessica, who says, “Jennifer, are the weekly menus viewable before I order?”
Jennifer Maynard: Yeah. We try to load multiple weeks’ worth of menus on our website, so you can see what’s coming. We also run a seasonal menu, so we try to have whatever seasonal vegetables. There’s a small amount of fruit, but mainly seasonal vegetables. We try to use those in the dishes. You’ll see those ahead of time, and you can even pre-select which protein source you’re going to be following.
Dale Bredesen: Yeah. Then there’s another one here from Jan, who says, “My endocrinologist said I cannot do keto because it can cause heart problems due to nerve conduction issues. But I have terrible insulin resistance and do not want to take metformin.” Well, I have to say, of course, you want to talk to your practitioner. But by the way, I went through some heart conduction issues myself, and the keto actually was not an issue here. The issue turned out to be, in my case, magnesium, potassium, and taurine. Those are the big three for heart conduction. I would look into this further if I were you. The issue with keto is if you’re basically starving yourself. That’s not the purpose here.
Look into what a superb integrative cardiologist told me, which is to look at something called Electro-pH, which are really nice minerals that support heart conduction. I would check those things out, but again, of course, always talk to your provider. Then Deb here says, “I’m familiar with Farmer’s Fridge vending machines in the airports and wonder if adding your products to their selection would be good.” Of course, it would be great to see this available to everyone, but I don’t know if you are aware of these things or if you’ve talked to anyone about this.
Jennifer Maynard: Yeah. I mean, we’re always looking at collaborations to make things more accessible, even potential retail chains. There are definitely collaborations we look at, and we see whenever there’s a good fit. Being somebody that travels a lot, I do appreciate when there’s healthy food at the airports, and that is not easy to come by. I love Farmer’s Fridge. I love the concept. It’s actually my go-to if I’m traveling and I don’t have my own meals on me. It’s definitely something we can look at.
We are working on collaborations and partnerships right now. One of the biggest priorities for us is health insurance coverage, and we’re actually working with this team on that as well to work towards coverage of these meals for reimbursement by insurance. We’ve been able to do that with a lot of medical indications, and there’s a lot of great progress, especially with Medicaid and Medicare Advantage plans. Definitely, that’s a big step for us, as well as collaborations with retail partners, like the example you gave.
Dale Bredesen: Fantastic. Then there’s another person who says here, “Waiting for the vegan option. Excited about that.” Great. I think we’re all on it. We get it. I should say for optimal synaptic function, what is out there now, the pescatarian option and the flexitarian option, which are the two, are absolutely fantastic. If you are interested in optimal cognition, please don’t wait. But if you’re interested specifically in the vegan, we’ll get there, and we’ll get there. Please hang in there.
Julie Gregory: Dale, I just want to ask someone from our team if they could share a link in the chat. We just published a guide called KetoFLEX for Vegans and Vegetarians because we didn’t have that menu. It’s publicly available now, so if somebody could please share that link.
Dale Bredesen: That’s a great point, Julie. Thank you. Yeah. You can still do this on your own with the vegan part. Absolutely. Thank you. Apollo has over 100 guides that Julie has put together, with some interaction with Aida: just absolutely fantastic. Then someone asks, “Are these meals also shellfish free?”
Jennifer Maynard: We do have the shellfish separate. We do offer shrimp, as long as it’s not kosher. We do have a kosher halal kitchen, but it’s separate. Obviously, there’s no shellfish in that side of our food preparation. In our main food preparation, there is shrimp available, and then there’s regular fish. The place where we do shellfish free is in our kosher kitchen.
Dale Bredesen: Yeah. Then there’s another question which I think is a fantastic question because it really gets into the whole issue of personalized protocols. The person says, “For someone without cognitive issues but who has early-stage dry macular degeneration …” Which by the way, 11 million people in the US have macular degeneration. It’s very common, and it’s part of our Arc Project. We’ve been dealing with people with macular degeneration. “Is this diet appropriate? Is the lack of orange citrus foods an issue? That’s one food that’s actually recommended.” Here’s the point. The diet is the way to start. It’s arguably the most important part.
If you look at what we think of as the basic seven, the diet, exercise, sleep, stress, brain training, detox, and some targeted supplements. Those are the basic seven things. Then on top of those, we want to add for each person, do you have specific pathogens? Do you have Borrelia? Do you have P. gingivalis? Do you have mycotoxins? We want to address those, then. So, we have the basics, and then we have the specifics which make this personalized. They all start at the same point with the diet, and that’s where KetoFLEX 12/3 is so helpful. Now, if you’re going to be doing this for cognitive changes, there’s a set of things that we do. If you’re going to be doing this for dry macular degeneration, there’s a different set.
For example, you have to look at altitude. You have to look at blue light exposure. You have to look at mild stimulation with red light. You have to look at blood flow. Now blood flow, again, for both. There’s overlap, but the point is here, this is the place to start. There’s something called AREDS2, which people use for dry macular degeneration. As they pointed out, this makes it so that instead of losing 13 lines of vision, you lose 12, so you can see it’s not very helpful. Yes. What we’re developing is now for dry macular degeneration, just the way we did for cognitive decline, but it’s a separate set.
Starting at this place is absolutely fine because you still need to get that appropriate level of ketosis. You still need to get energetics. In fact, your macula is the area of greatest requirement when it comes to metabolism. Any time there is a light that is on, it’s like having a Ferrari that you’re driving at 220 miles an hour. You’ve got the firing of your ganglion cells, and you’ve got the firing of your rods and cones, so having that blue light decrease. There’s a whole set of things, but starting with this diet is no problem. Yes, adding some appropriate fruits that you’d like to this is no problem as well.
Maybe you could talk a little, Jennifer, about the fruits and vegetables in this, and maybe a little bit about some of the different things that you have. I found this to be very nicely varied. I don’t know how many unique meals you have over the year, but I thought each day was different. It wasn’t just about the Sloppy Joes that I loved. There were also great fish, great chicken, great beef, and great vegetarian options. I think there’s some tofu, as I recall, in some of these. There are all sorts of fantastic things. Maybe talk a little bit about the nice variability that you’ve put into this.
Jennifer Maynard: Absolutely. I mean, for us, we truly believe in the philosophy of eat the rainbow. Every color is a different phytonutrient spectrum, so those colors are really important to get a variety of phytonutrients as well. It’s one of the things even in our farming philosophy. Biodiversity is really important to get a lot of exposure, like I said to those different spectrums. Also, even in the way we farm, biodiversity in farming is really important. You want a diverse soil microbiome so that you get all that diversity. It makes the plant stronger; it produces more phytonutrients. So not only do we like to have the food biodiverse, but farms, either our own farms or farms that we collaborate with, not just mono-crop farms.
We are GMO-free. We focus very much on removing those toxins from the food system as well, so growing things organically. We source from farms that are growing organically and using those regenerative farming practices. That’s really important because we don’t want those synthetic chemicals in the body. We don’t put any added preservatives, pesticides, fillers, or artificial sweeteners, none of that. That’s part of that clean low inflammation baseline that we try to provide. We do like that, again, diversity. We do it also seasonally. Not only are you going to get… Like if it’s a salad or it’s a dinner, you’re going to get all sorts of different vegetables.
We’re very intentional with selecting different colors. We always try to say, get four to five colors on your plate if possible. We try to follow that philosophy, but also [inaudible 00:42:35] is important. We try to get stuff that’s harvested fresh and it’s at its prime. Not only does that give you good flavor, but that really broad phytonutrient spectrum. How we source our produce is really important, and making sure that each dish is very carefully balanced to have that difference. Julie gave a lot of great insights when we were designing this. She also loves the spectrum of color and gave us a lot of really good ideas. Even our salad dressings will have different vegetables and herbs and blends in them. We’re always trying to add that pop of color, something unique that you may not be getting. If we eat a lot of muted … The American diet is very muted, with browns and beiges and very little color. That’s one thing we try to change. Usually, what comes along with that is all the good stuff, the fiber, the phytonutrients, and the healthy fats. Those are all things that also help with insulin resistance. We, again, really try to bring that to the surface.
Dale Bredesen: Yeah, that’s a good point. Actually, the salad dressing is another thing that I found really delicious. Now someone’s saying here, “If I need to lose weight, is this an appropriate eating plan? I’m 81 and want to be proactive with cognitive health.” Fantastic. I should say we talk about everyone being proactive, so it’s a great point to me; this is the future. We should now be able to make cognitive decline optional by getting people started when they are asymptomatic or with the first symptoms. Really getting them so that they’re addressing these things appropriately. In doing that, absolutely getting yourself… If you look at what it takes to do that, the basic seven that I mentioned, the best way to start and the easiest way to start is to start with KetoFLEX 12/3.
It is a critical piece. To get you to be insulin sensitive, to get you to be in mild ketosis, have a phytonutrient plant-rich diet. By the way, with appropriate fiber, which improves your glycemic load, improves your lipid profile, improves your detox, improves your microbiome. I mean, it’s just striking how important this is. Of course, on the opposite side, it’s also striking how bad it is when you do it wrong. You end up with a leaky gut, a poor microbiome, poor lipid profile. One of the things that we found in our trial is that people who were on these various medications no longer needed them.
They were able to come off their anti-hypertensives, come off their anti-diabetes drugs like metformin and things like that, and be able to come off their statins because their lipid profiles became normal by doing the right thing. Yes, I think for the person who asked the question, absolutely, this is a great way to start. Yes, will it cause you to lose weight? If you’ve been doing the wrong things, as so many of us have been … I know that at all the various medical conferences that I would go to, the best thing that they would serve to get everybody to come would be pizza. When I was a resident, when I was at various universities over my career, it would be cookies or it would be pizza.
That’s the way people would get you to come to that particular lecture, which I realized was horrible. Of course the staying up, we won’t even go into staying up all night all the time. This is all things not good for your cognition. So absolutely, getting on KetoFLEX 12/3 is a fantastic way to start. Now Deborah asked, “My daughter is very sensitive to soy. First of all, is there soy? Do you have soy free, or do you make it very clear when there is soy in these?”
Jennifer Maynard: Yeah, absolutely. We do have some amounts of soy, mainly in the vegan products or meals. That’s because soy, for some people, is a healthy source of vegan protein. It’s always labeled on each individual dish, and any allergen is labeled on the dish. You have a full ingredient list, as well as the allergens. If you’re trying to avoid a certain tofu dish or a soy dish, you can also specify that. That should definitely be something. We don’t have soy in all of our dishes. When it’s soy, it’s very clear that there’s soy in the dish, whether it’s raw edamame or it’s tofu.
Dale Bredesen: Yeah. I loved the edamame as well. That was another good one. Then the olive oil. Julie, I know you are so focused on olive oil, and loving olive oil and getting that polyphenol count high. There’s a question here about the use of the olive oil. “Is it just to make the dressings for the veggies, or are other uses suggested?” You, I know, are so on top of this. Maybe you could talk a little bit about the olive oil here and the use of the olive oil.
Julie Gregory: That is an excellent question. First, I have to say, as Dale did, the dressings and the sauces are absolutely amazing, so bright. When you’re eating a whole food diet, that makes or breaks your meal. Every single one of them is compatible with this high polyphenol extra virgin olive oil. We encourage you to put as many as four tablespoons extra into the sauces and dressings. Stir it in. It will be absolutely delicious. In the instructions, we do tell you how to use the olive oil. It will also help you get into ketosis.
Dale Bredesen: Absolutely. Okay. Then there’s a question here about the grass-fed beef. As I understand it, yes, this is grass-fed beef. I guess the question is really about whether some of these can be grain finished. Do you know with the beef, is this … This is grass-fed beef, basically.
Jennifer Maynard: This is a full grass-fed beef.
Dale Bredesen: That’s huge.
Jennifer Maynard: So, these are pastured beef, essentially, without a grain finish.
Dale Bredesen: Yeah, that’s fantastic.
Jennifer Maynard: Yeah, 100% grass-fed.
Dale Bredesen: I think it is important to point out that, yeah, there are some that are kind of pseudo-grass-fed because they then switch away. This is truly grass-fed beef, which is fantastic.
Jennifer Maynard: Yeah. It’s one of the things that I really loved about working with Julie, and Dr. Bredesen and their team is just their attention to detail of the sourcing of the ingredients and really having healthier [inaudible 00:49:11]. Keto obviously can be a buzzword. I think when you do keto right, you can still have heart health and a lot of different components because we’re consuming this incredible olive oil, eggs, lean meats, the lean fish. Even if they’re a higher fat fish like a salmon or a sockeye salmon, it’s with the really high omega, really healthy sources of fat. I think that’s what’s really different than some of these buzzes that you hear. I mean, I’m always ready to cry when something I feel like gets really marketed. You go down the grocery store aisle now, and there’s keto cake mixes and keto … I’m just like…
So, I love that this is really a very pure source. It’s very low inflammation. It’s very high-quality proteins and fats, and that is really important for people that are going to do keto. This is not a typical keto diet. This is a very premium (one). I think that’s just really important because I have heard people very nervous about different parts of keto. This diet, I feel like, really takes a lot of that away. Which is the fiber, and switching people over still to vegetables, which are carbohydrates, but they’re very healthy carbohydrates. And focusing on the ones to avoid or limit. I have to say that because I think a lot of people are very nervous about that sometimes. When you see how different this diet is to what you see as processed foods in the grocery store, very different.
Dale Bredesen: Yeah, this is a very important point to make. We’ve had a number of people say, “Well, I don’t do a keto diet because that’s too much meat.” No. This is completely, it’s the difference between an old propeller plane and a jet plane. It’s just completely different. This is a plant-rich, mildly ketogenic diet. The whole point of this is this is the biochemistry that came out of the lab studies, which actually makes you form and keep synapses and reverse cognitive decline and prevent cognitive decline. I didn’t train as a nutritionist.
We’re coming straight from the lab to say, “Here’s what you actually have to do to make and keep your synapses.” By the way, the anecdotes have shown it, and the clinical trial has shown it. This is the optimal diet for cognitive health, and it’s not a typical keto diet. It’s not about eating sausage and ham and bacon and all that sort of stuff. This is a plant-rich, mildly ketogenic diet. Now one of the questions that come up here from Pamela says, “About how many calories per day on average for this particular meal plan?” Do you have a sense for total calories
Jennifer Maynard: I don’t know if Julie wants to hit on that. We do the eggs, the olive oil, the lunch, and the dinner. I mean, it can really range if people are adding different components to it, but I think Julie has a target of what … Because it’s very personalized as well. Is it male or female? Are they working out?
Julie Gregory: I don’t know the exact calorie count, but I do know the carb count was super important to us. Each day’s worth is less than 50 grams of carbs per day. Each meal is around 25. People mistakenly think that you can’t eat lots of vegetables when you have a low-carbohydrate diet. That just isn’t true because we’re easily getting six to nine cups or more every single day. But as far as the exact calorie count, it’s going to vary depending on if you choose to put two hard-boiled eggs in your salad that day and how much olive oil you put on it. It’s not intended to be a weight-loss diet. Everyone’s caloric needs are a little bit different. If you need to supplement so that you don’t lose weight, that is just fine. If it’s a little too much food for you, and you want to just save some, that is fine as well.
Dale Bredesen: I think that’s a really good point. Just use, I like Cronometer, whatever you like to call it. I found that very helpful. Really started using that when the pandemic started. We’re here for a while, and like, “Okay, let’s see what’s going on.” Of course, very quickly, I found out that I was low in choline intake. I found out other specifics that I was low in, and I found that very helpful. That will tell you obviously everything from all the different nutrients.
I think that you’ll be very pleasantly surprised to see how many good things will come from this. Now one of the things that was asked here is, what about oxalates? I know, again, you’ve worked so hard to get this optimal for cognition. I remember Aida actually talking about some of the oxalates and being relatively low here. There’s not going to be a ton of things that are going to give you high oxalates. Maybe you could speak to that for a moment.
Jennifer Maynard: Yeah. I mean, that was something again that the team really spent months making sure that some of the high oxalate vegetables are not included in the program. This is something that the team talked about very early on. Julie really made sure in every meeting it was discussed the balance between raw vegetables and cooked vegetables. If you talk about lectins and oxalate and things, some of those, if there’s a fermentation process or a cooking process, pressure cooking, some of those are removed anyway in the process.
It’s not just eliminating those vegetables, even though a lot of really high oxalate vegetables are not included in this. It’s also that balance of having a mix of raw and cooked, and that does impact how much actually ends up in the end product. We are low oxalate by design, so people can really … Just like we don’t have any gluten products, and we have beans, but they also go through a cooking process, our normal meals. Julie was really, really specific as we were designing this to make sure that we’re not adding obviously unhealthy toxins or different antinutrients and things into the meals.
Julie Gregory: Another important point, because there’s such a wide variety, there’s not an enormous amount of any one vegetable. As you mentioned, four to five different vegetables in each meal. That really helps if you’re sensitive to something.
Dale Bredesen: Yeah. Then the other thing was about eggs. It’s interesting. Again, we’ve always been taught, “Oh my gosh, eggs. Be careful.” What about cardiovascular disease, especially if I’m an ApoE4″ Ah, but these are not typical eggs. These are pastured eggs. As Jennifer said earlier, these are high omega-3 eggs. Julie, you as a 4/4; I’ve seen your lipid profile. It’s beautiful. I wish my lipid profile were as good as yours. You are eating these. You are getting the appropriate choline. You’re obviously not shooting up your LDL particle number and your oxidized LDL and things like that. Maybe you could speak to the issue of eggs, choline, and issues with omega-3s.
Julie Gregory: Yeah. I think it’s a little bit of an old-fashioned idea that eggs are high in saturated fat and they’re not healthy. I think what’s not healthy is combining it with bacon, sausage, and toast with jam, probably. Eggs themselves, I think, are one of the best health foods on the planet. I try to eat an egg or two every day. They’re that important to my diet. I do have a really nice lipid profile. It hasn’t driven my cholesterol up at all. It’s an excellent source of choline.
I also supplement choline because, as you mentioned, Dale, most people are deficient. I think men are supposed to get 550 milligrams a day and women 425. Almost nobody does that. If you’re a vegan or a vegetarian, you’re really deficient. That’s the reason we purposefully chose to include the eggs for the choline. It also is the basis of acetylcholine. You need that choline there in order to make that important neurotransmitter.
Dale Bredesen: Exactly. It is the most important neurotransmitter for memory, and it is one that is clearly low in people with cognitive decline. These things are all critical. I should mention that someone’s asking here about organic. Yes, these are pastured and organic and high in omega 3. You don’t want to just go and get ones that are standard old eggs. They’re not going to be high in omega 3, and they’re the ones that can actually give you some problems. They may, of course, also have everything from being pro-inflammatory to having antibiotics and all sorts of other issues. These are the right ones to have. Then, let’s see. Mercedes asks, “Okay. You’re giving us two meals a day. What about breakfast?” Now I know a lot of people, and I’m included in there; I’ve gone to two meals a day several years ago.
But I’m an old guy. That may be different. If you’re 25 or 30, or 35, it may be different. Again, to me, this gives you some freedom to decide, “Okay, what am I going to do? Am I going to have breakfast? I’m not going to have breakfast.” Now, Julie, you went into great detail in the book, The End of Alzheimer’s Program, talking about the period of fasting and how you typically have your first meal more like noon or one or somewhere in there. But for some people, they’re going to want to have three meals, and some people are going to want to have breakfast. Then they’re going to have to look carefully at what is their period of fasting. Jennifer, maybe if you could talk a little bit about the issue of when you’re sending out ten meals for Monday through Friday; what do you recommend that people do about breakfast?
Jennifer Maynard: The team discussed this, do we do breakfast, lunch, and dinner? Even before we were working on this program, we see that breakfast is the highest variability in the population in the U.S. Some people don’t eat breakfast. We actually just recommend you shift your meals. You still get those needed calories. Even though there’s research out there, should we be eating two large meals and more of a snack meal? That’s where the eggs add a lot of flexibility too. I eat breakfast very late, but I do eat breakfast. I eat breakfast around 11 or noon, but that’s for me. I think this is a very personalized component. If you’re working out in the morning, you might need something a little bit sooner. But I usually break my fast with an egg, and I eat almost entirely plant-based except for eggs.
I have the lowest cholesterol on the planet, and I eat almost two eggs a day. Eggs, for me, are huge. If you’re over 65, it’s a great source of adding protein. Some people will break their fast with eggs because they get six eggs. We give one extra egg: in case you’re eating two on certain days. That’s one thing that you can do. Julie recommends putting a lot of that olive oil on it so you get a little bit of extra fat and stay in ketosis. That’s what we see a lot of people doing. They’re really trying to optimize their ketosis and extend it into a little bit of a wider window. Keep that fasting going, and then they break it with the high fat so they’re still staying in ketosis until they switch completely over to the more plant-based lunch.
That’s something that we want to give people full flexibility to do, not kind of pre-designing a breakfast for them. I’m just giving how I personally consume my breakfast. We have other people that just are eating more of what would be a basic breakfast. They might even switch over to something that even has some vegetables in it, or an omelet or something like that. I’ll let Julie share, but that’s what we see a lot of people doing. Extending that fast a little bit, using the eggs as a late breakfast, and then switching over to the salad and extra leafy greens and everything with their lunch. Then the dinner is what usually has the higher either fish-based or flexitarian-based proteins.
Julie Gregory: Sure. I love this question, Mercedes. We do have a little instructional brochure that comes with each box. Our goal is for you to eat high-quality food less often. In KetoFLEX 12/3, the 12/3 refers to the minimum amount of time that we want you to spend fasting every day. We want you to spend a minimum of 12 hours, with at least three hours before bed. You should add that to your fast as well. Some people like me to extend their fast much longer. I can do 16 to 18 hours, and I get enough calories in there. At first, when you begin doing this, especially if you’re a little bit insulin resistant, it’s going to be very difficult to fast.
We have some educational guides provided on our website. There’s a link to our website from the brochure. If you click on the KetoFLEX 12/3 meals from our website, in the top, I think, right-hand corner, you can click the FAQs. We will direct you to an educational guide that will teach you how to extend your fast. You need to do it very slowly if you’re used to three meals a day, and there’s a little bit of insulin resistance there because we don’t want you to become hypoglycemic. As Jennifer mentioned, that’s where just having one hard-boiled egg can help tide you over until that lunch. Then eventually, maybe you will get to two meals a day.
Dale Bredesen: Yeah. I should mention breakfast, which we think of as breakfast cereal. This only began 100 years ago with Dr. John Kellogg. He’s the one that started this. He actually was ahead of his time, very interested in food as medicine. Which is now starting to sweep into Medicare and starting to sweep into the NIH. We look forward to people more and more understanding this. What Dr. Kellogg said, though, “We have to give something.” He started what became cornflakes, but something that has no sugar in it. The problem was that his brother then said, “Well, we should make this available to everybody.” Then Post added sugar, and Kellogg’s brother added sugar. Suddenly we had this thing where everyone’s eating all this sugary stuff and eating Froot Loops and Captain Crunch and this stuff, which is just horrible. If you want to destroy your cognition, have a classic American cereal breakfast every day.
This is what we want to get back to, is optimal cognition and optimal synaptic maintenance. I have one here from Ali, who’s asking about ApoE2 and 4. This is a very good point. Most of the people who have a single copy of ApoE4 are 43s because two is less common. By the way, as Julie said, the primordial gene was ApoE4. For 96% of our evolution as hominids, we were all APOE4/4. Just in the last 220,000 years, APOE3 appeared. Then just in the last 80,000 years, ApoE2 appeared. Now if you have, the so-called average risk is defined as the 3/3; as I mentioned, it’s about 9%. If you have two copies of 4, it’s up here. If you have one copy of 4 with a 3, if you have one copy of 4 with a 2, which is what Ali’s mentioning here, you still have some increased risk.
It’s not the same as 3/3, but you’re right; there is some relative protection compared to the 43s. That’ll be some protection, but it doesn’t bring you all the way back down to baseline. I know we’re running out of time here. It’s a few minutes after the hour, so we’ll wrap it up here. Lots of great questions. I look forward to doing this again and answering more questions because I think there are so many good questions about this. Again, looking for a reduction in the global burden of dementia. This is the future. This is what we are all interested in. This is a huge problem that will affect 45 million Americans, many, many times the number who have died from COVID-19. It actually dwarfs the pandemic numbers.
We’d like to bring that down as much as we can so that people can have optimal cognition and reduce their likelihood of developing cognitive decline. To Jennifer and Julie, thank you so much again for all the great work. We’ve got a few minutes of answering questions here, but you’ve been spending months and months and months and hundreds of hours getting this optimized, getting the right stuff. I know, Jennifer, you’ve been spending years of your life devoted to getting this as an optimal approach for people. Thank you so much for the hard work you’ve done, and we look forward to future discussions.
Jennifer Maynard: Thank you.
Dale Bredesen: Meanwhile, I’m going to go have some good Sloppy Joes. Thank you very much again, and thanks to everyone. Bye-bye.
Jennifer Maynard: Thank you, everyone. Bye.
Julie Gregory: Bye-bye.