Thomas DeLauer … Please pin this comment. - Nick (and thanks for making this important video) Dear all, I want to be clear APOE4 function is so poorly understood we CANNOT make definitive statements or give absolute advice to those who carry the allele(s). Neither I nor Thomas meant for this video to be absolute statements, but simply extrapolations from what n = 1 experiments I (an APOE4 homozygote, medical trainee, and Ketone PhD researcher) have done on myself, combined with a review of the current literature, mostly in cells and model organisms. The hard literature isn’t there… this is a “better safe than sorry” approach. Also, please see a HANDOUT!!! at this link: www.dropbox.com/s/hrsei52zbag9akh/Keto_E4s_Handout_Jan17_2020.pdf?dl=0 (this link was updated on Jan 17, 2020 given new data) Thomas and I don’t mean to be dogmatic, but really wanted to provide a concise resource for those, like myself, who carry this genetic burden. Contrary to popular belief, I do think this is an “actionable” gene and that, even if you are a homozygote like me, you can reduce to eliminate your increased risk. If you have the gene(s), feel free to contact me directly and I can direct you to further resources. Also, a BIG thank you to the world’s most brilliant, compassionate, and knowledge doctor with regards to nutrition, Dr. Vyvyane Loh, for supporting this content.
Hi Nick, I hope you're doing well and staying healthy! I worry about docs and health care providers. You are all are doing great work! I wanted to ask one more Apoe4 question.... what about alcohol? I know lots of long lived folks (Sardinians) drink moderate amounts of red wine every day... not sure how that translates to Apoe4 folks. I tried to find research regarding Apoe4 in places like Sardinia and wasn't successful, i.e. do they have any and how do they fare. I know for sure more than moderate is bad for any individual... period. Sorry if this question comes at a bad time. Be well.... thanks a lot!!
Appreciate the info and the disclaimer. The research is scant, which is odd for a gene variant that affects ~100 million Americans and probably over a billion people around the world. Of course, Drs. Gundry and Bredesen have their own protocols on the appropriate diet for APOE4. Gundry says no fatty fish and instead advocates a moderate amount of wild white fish, along with the shellfish. But I can't give up my salmon and mackerel. It's impossible to easly replace the naturally sources Omega 3s that you point out are so important. Have to be careful with too much liver (iron overload, for one thing). I personally think 1/2 lb per week should be fine.
I don't have APOE but I really respect that you'd go out of your way to make a video like this for those who do It shows you sincerely care about the wellbeing of your audience, and that's awesome man
I’m glad you’re delving into the importance of genetics - one size doesn’t fit all for diets. It’s all about the fine tuning. Hope we get to see videos about variants of FTO, PPARA, ADIPOQ, and other keto-related genes. Especially ACAT1...people with the less common variant of this gene have trouble metabolizing ketones and feel exhausted on a high fat diet.
It's good to know if you are homozygous (two alleles) or heterozygous (one allele). You get one allele from your mom and one from your dad. APOE3/4 is more common (20-25% of the population) than APOE4/4 (2-3% of the population). 4/4 is more pathogenic in terms of AD and CVD. APOE2/2 is also very rare. 2/2 is a genetic gift and the risk of dementia and CVD go way down in this subset of the population. The most common phenotype is 3/3 and these people are at "normal" risk.
I struggled with keto too much, I just felt exhausted. We're supposed to enjoy the food we eat and with keto that's close to impossible. That's why I tried the *Agoge diet* and it works great.
There is a fantastic discussion specifically on ApoE4 on Dr. Paul Saladino's podcast with Dr. Tommy Wood. Food for thought from the time our ancestors descended from the canopy 8 million years ago until approximately 200 000 years ago we only carried the ApoE4 allele, during this time we were predominantly eating meat, especially bone marrow. It's only in the presence of assaults from inflammation, endotoxins, sugar, excess insulin, etc. that the LDL becomes oxidized and dangerous.
Thank you for caring about those of us who have ApoE 4/4. I really appreciate the time you have taken to devote to this subject. However, I would argue that ApoE 4/4 folks should NOT consume MCT/coconut oil (especially), palm oil. cocoa butter and NO animal based foods (containing cholesterol and saturated fats) ...these foods directly cause elevations (MCT/coconut oil sends LDL and triglycerides through the roof in ApoE4 people). Advising ApoE4s that they can eat, even in moderation, MCT and animal products is very poor advice. I have tracked my blood work over 10 years and I am here to tell you that it has been my experience that the more closely I, as an ApoE4/4 person, adhere to a whole food, plant based diet - the more optimal my blood work markers are. ApoE 4s should really eliminate foods with cholesterol and saturated fats; added sugars, processed foods, foods containing preservatives, etc. Coconut oil was the worst culprit of all for me. Never in my life have I had high triglycerides until I consumed coconut oil. My LDL too remained continually well elevated while consuming animal based foods - all and any animal based foods. Please, please do not advise ApoE4s that it's ok to consume MCT/coconut oil and animal foods (even sea food). For example, read "The End of Alzheimer's" by Dr. Dale Bredesen. This is just one, for the lay person, source to support what I am saying.
Hey Katherine, Dr Bredesen does actually recommend animal products - specifically oily fish, seafood and eggs - for those with the APOE4 gene. He does however recommend reducing saturated fats (which yes includes Coconut) in favour of those MUFAs and PUFAs (but that can include fish). And everyone will be different depending on whether they have one or two E4 alleles and what other genes they carry that influence lipid metabolism and other aspects of their diet and lifestyle. For some, MCT won't increase LDL, but if it does raise it, it is obviously advised to abstain. Exactly what each person needs to avoid/consume in order to keep their blood levels optimal will vary considerably. It's also worth noting these guys DO have coconut oil on the "avoid" list, so are not recommending E4 carriers eat coconut oil.🖤🧠
What is conflicting is that those with Alzheimer's are meant to do better on keto as the brain is less able to fuel itself on glucose and thus ketones are a better choice of energy
@HummusLad the research on APOE4 and keto seems to come down to the source of fat. For example saturates seem to be the issue. However a keto diet full of omega 3 and leafy rich vegetables, Berries and plant based proteins etc it can be very health promoting. You may be interested in the Metabolic Health Summit and Metabolic Mind (organisation) who are sharing good research on this. The other nuance is exogenous ketones for alzheimer's disease. This pathway is different and could perhaps provide an alternative fuel source for the neurones even in an APOE4 demographic.
Thomas, thank you! I have TWO APOE4 variants, and I only recently learned that this is very unusual and it increases my risk of Alzheimer's 12-fold. I have been following along with your other videos this year in my quest to lose weight and get healthier. Do you know if there are any other protocols to follow for those who have the double APOE4?
And, Thomas, I was SO SORRY to miss you at the Manitou Incline today! Oh my gosh! I did it 52 times last year, and I haven't been able to this year because I had foot surgery! I hope you enjoyed it! A group of us up there follow you!!!
If you have the APOE4 SNP, because your whole body is prone to dislipedemia, the standard keto diet isn't a good idea at all. You want to be eating a low fat diet. Another possibility instead of keto is a low calorie, moderate protein weight loss diet. You can do this by using protein shakes to replace a meal, as it isolates the protein your body needs from other macronutrients. The protein creates a feeling of satiety without alot of added carbs or fat. Add a bit of fruit like strawberries or blueberries, and a non-nutritive sweetener like stevia, etc. The point is keep the calories low, but don't deprive your body of nutrients. Soy protein is probably the best to use because it has a more robust amino acid load than whey and it has a relatively complete amino acid profile, but hemp would also be a good choice. Pea and rice protein might also be OK but make sure it is sourced from a place with low heavy-metal contamination in the soil.
I have the ApoE4 allele. I absolutely do not like the ApoE4 foods. I will instead continue to eat saturated fat like everyone else, and then have my doctor give me cholesterol lowering medications. Medications may be unnnatural, but if you had familial hypercholesterolemia, you would still need to take cholesterol medications no matter how unnatural they may be.
Great advice; I will add (having this gene) taking some supplements: one that I believe would be of help is Moringa. Really a Superfood!!..It lowers blood sugar, contains Calcium (that we need since dairy should be avoided), helps with insomnia (sleep really important), and also lowers cholesterol. Has more benefits as well....Holy Basil is worth looking into as well: losts of benefits including protection against "diabetes," and reduces LDL and helps with sleep as well (among other benefits.) I was wrongly taking too much of the MCT oil for the ketones - however - be careful since it is with coconut oil and a saturated fat. To go into ketosis I prefer to eat two meals a day..eating "early 2nd meal of the day ending at about 4 pm. The next morning break your "fast" and eat breakfast 16 - 17 hrs later at about 9 - 9:30 a.m. Check with your doctor (hopefully with someone credible who understands food's importance and also "insulin resisance." They should check our "fasting insulin" in our blood work, but do not! Sugar is not our friend!!!
Have you done a video on people doing Keto who have Familial hypercholesterolemia (FH) is a genetic condition associated with very high levels of cholesterol in the blood, specifically low-density lipoprotein (LDL), or "bad" cholesterol.?
I have this genetic cholesterol and my endocrinologist had prescribed Juxapid first go around which caused my liver enzymes to soar but it did bring my levels down perfectly in seven weeks. My doctor had to withdrawn me from the medication now 2 years later he prescribed Repatha pushtronix and it is amazing cholesterol levels are perfect and lost weight from keto diet also 80 lbs. Talk to your doctor about this medication may work for you also. Only 50,000 people in USA has this type of cholesterol I am told God Bless.
I’m a rare bird, have lipid issues due to RB1 gene deletion. Keto helps some things but I need to customize it. I have sensitivities to foods allergist can’t figure out. Drs pretty much give up on me or force meds which make me sicker (cause seizure activity or adverse reactions). Finally writing this stuff down for my genetic specialist because I can’t remember it all anymore. Been in ketosis and week and off very low dose statin for a few weeks and it’s already back at 300.
My grandmother passed from heart disease and my dad passed from heart disease and Stage 5 Parkinson’s disease also having prostate cancer years ago. I’m 33 and 330lbs. Gained over 90 lbs out of grief since my dad passed last year. I need your help..... What is a great diet to turn my life around considering my family history? Thank you so much.
Hi John. This is a great start! Keto is not a diet, per say. It's an eating lifestyle to achieve optimal, natural human health, optimizing powerful body mechanisms within you. The main proponent is eliminating sugar from your life (carbohydrates covert to sugar in your body). Sugar is what feeds and causes disease. (Not salt, cholesterol, or fat) (after completely cutting sugar and savory carbs like fries, pasta and grains, from your life and replacing them with healthy fats- you won't even miss the sugar. Your cravings and desire just stops! You'll stay full and won't even have to calorie count) Achieving ketosis is the way to go for you. It has changed the lives and regained the health of so many. Watch as many Thomas videos as you can, also Dr Berg and Dr Ken Berry. They're so informative and enjoyable to watch. Best of luck to you!
When you start keto don’t be shy with the salt. That’s my best advice. Look in to The Salt Fix on YT and learn about that guy’s work. It does wonders for curbing carb cravings. Get Redmond’s Real Salt. It has a good amount of iodine as well. To get healthy your thyroid has to work and iodine is essential.
please see my comment and HANDOUT above www.dropbox.com/s/p1371llshl5ih7p/Keto_E4s%20V5_Thomas.pdf?dl=0 Also see our videos on Medi-Keto and this HANDOUT www.dropbox.com/s/uncq64bbrmb57gp/Ketogenic-Mediterranean%20Handout_V2.pdf?dl=0
Thank you so much for sharing this. It’s no wonder I’ve been struggling with Keto! I did a genetic test and found out I have 1 variant of the APOE4 gene mutation. I knew the benefits of keto should help prevent Alzheimer’s but had no idea I could actually be adding fuel to the fire eating tons of coconut oil, red meat and Dairy. A few weeks ago I cut out dairy and red meat and immediately started feeling better and had substantial weight loss. I added back those things and started feeling like crap again. Just watched this video and it all makes sense! Thank you so much, now I have an actionable dietary intervention that helps me stay Keto and get the benefits.
I would be interested to see a video on the possibility of an omega-6 deficient diet. I noticed in myself that cutting out almost all big sources of omega-6 fats caused some strange issues with my mood, energy levels and particularly with my skin. Once I added a few mostly omega-6 sources back into my diet, without changing anything else, the issues resolved. Also, while eliminating nearly all omega-6 sources, I was going hard into omega-3 (EPA & DHA from boatloads of fish oil and fish, and ALA from macadamias), so it may have just been that my ratio was unbalanced in the opposite way from what most experience. Omega-6 fats are still essential, so they cannot be cut out completely; they play a huge role in immunity as inflammation is actually a healing process. If one does not have the correct nutrients to trigger inflammation, then the immune response may be dulled. I have not seen anyone speak about this topic which may become more prevalent in the keto community since omega-6 fats are often considered to be "public enemy #1".
Justin S keto and carnivore people avoid pork too much in my opinion. Thiamine is high in pork and so many people are deficient, especially diabetics. People are too scared of omega 6 and miss out on other good nutrients.
I am now tired of fish, shellfish, avocados, and olive oil. Replacing some of the fish I eat with 5 or 6 eggs a day provides me much better satiety, but I am not supposed to eat that much because of APOE4. I already stopped eating butter, coconut oil, and fatty meat, and if I have to reduce the amount of eggs I eat, my diet is going not going to be enjoyable. What should I do?
Even if statins have side effects, it will lower your cholesterol and you can live a happier life with less dietary restrictions so you will not have to keep avoiding saturated fat which tastes better than olive oil.
This diet definitely keeps my glucose and LDL low. But it is not tasty and not satisfying at all, and because of this, I have a very poor compliance rate to it.
Can you eat more nuts and seeds if you supplement with higher doses of Omega 3 (krill oil). If so what would an effective dose be? I really hate fish and shellfish, besides salmon.
I don't like this diet at all, but I'm just doing it for the sake of my ApoE4 status. Olive oil just isn't as tasty as animal fat and this may be an unpopular opinion, but I've never understood what is so awesome about the flavour of it. I used to eat chicken thighs with skin and cooked vegetables with chicken fat and it tasted great. Now I have to eat lean beef, lean chicken, and vegetables with olive oil and the flavour just is not as enjoyable. I enjoy nuts, but they say not to eat too many of those because it can cause inflammation in E4s. I used to enjoy eating, but now I don't, even if it keeps my blood markers good.
Olive oil is awesome. Please, try to find an extra virgin olive oil, not just olive oil. Way more expensive, but a lot healthier and has better taste. Don't give up on olive oil without trying the better brands.
@panno1103 I don't like extra virgin olive oil too, and I used ones in metal cans, dark glass bottles, and Kirkland. All the real stuff. EVOO just isn't as good as animal fat to me. Animal fat tastes much better. Eating lean meat with olives, avocados, and those oils just does not taste as good as eating meat with the fat of butter, chicken, pork, and beef. And I cannot eat healthy carbs either. I can only eat animal fat and healthy carbs in moderation, so I am stuck with this diet of mostly: Lean meat Oily fish Egg whites Low fat dairy Avocados and oil Olives and oil Non starchy vegetables. I don't like this diet but it's the only one that prevents my glucose and cholesterol from going up
If i just want to add extra fat to my diet at the end of the day is it better to eat some nuts like macadamia/wall nuts or just add olive/coconutoil to my salad?? Thank you so much
Basically with any diet, you have a 50/50 chance at success. If you have a beef allergy, or are sensitive to some vegetables you will know. Keep it simple.
Give up and just do fasting, its less restrictive to your live style this is why its so annoying to jump back on the bandwagon and why you want a video made. Although if you must I’m assuming taking MCT oils everyday plus KETO supplements would increase the speed of you being keto adapted
Hi Thomas, Can you make a video about people who seem to genetically be predisposed to super high triglycerides? I used to eat normal amounts of carbs BEFORE keto and had triglyceride levels between 800 and 1100. Even in Keto, I’ve only been able to come down to 270. What is it with people like me whose triglycerides skyrocket from just sniffing carbs?
My husband has the same! Trigs are always around 800, but since starting keto they skyrocketed to 1900! But, he always has low ldl! I'm guessing it must be genetic, but not sure if he should stop keto or not. He's lost 20 lbs and his blood sugar is back to normal and now totally off of metformin! Btw, he's Apoe3/4. I'm Apoe4/4.
Thomas it would be fantastic if you made a video with a meal plan for those with egg white and casein (milk protein) intolerances. Or other intolerances as opposed to allergies.
Bet you three months on strict keto and it would be above 60. Three months on keto got me from 40s to 134. Bet it's even higher now but haven't checked recently ;)
@@dwaconsulting1609 If you do go/are low-carb/keto, focus on unsaturated fats because unsaturated fats activate PPARa much more strongly than saturated fats and PPARs promotes HDL production. Therefore more unsaturated and less saturated fats (the latter of which also decreases ApoA production) will boost your HDL. Since you don't want to overload the Omega-6s: these are some ideal fat sources... fatty fish, macadamia nuts, olive oil, avocado.
@@nicknorwitzPhD you are awesome thank you for the advise...I know o have to stay away from coconut oil, and eggs which i love bit the dr did say i could eat like 1 per day... I have a question about your ldl... did it raise as well or were you able to keep that normal??
@@dwaconsulting1609 I disagree about the eggs. Eggs are great! Your dietary cholesterol doesn't really impact your blood cholesterol. Furthermore, the cholesterol found in eggs (the ester form) isn't the form found in arterial plaques. If you actually look at what's in a plaque, you'll see the form of cholesterol is the form that is found in red blood cell membranes, which tells us plaques are clots! This is something that most doctors know but don't think about deeply. As for you question about my LDL, yes it did increase initially, BUT that may have to do with me eating tons of cheese and being ApoE4 homozygous. Interestingly, despite my poor genetics, my HDL/total cholesterol ratio didn't get worse with all that cheese (like a pound per day). I'm now on Medi-Keto and blood markers are best they've ever been.
C519 to G mutation in exon 4 - this is the family gene mutation that causes my and half my siblings high LDL - do you have anything specific to this mutation as it seems more related to High LDL than just the inflammation gene...its kind of hard to follow for a lay person, not versed in science/study writing/reading, interpretation...(i do not mean your presentations hard to follow) i mean the science itself. Thanks for your content and contributions they are helpfiul
Hi Thomas! I love your videos and all the valuable information you provide!! I just watched the Netflix movie "The Game Changers". I would love to see a a video with your thoughts and response to the information provided in this film. Thanks!!
That video is already in the works ;) Promise... production team just putting together but it will be up. Spoiler: “The Game Changers” is NOT a documentary that argues eating plant-based is healthy. It is a documentary that argues a plant-based diet and plant proteins can support growth and elite-level athletic activity.
I had a huge jump in my cholesterol after going keto and so I started reading Dave Feldman's stuff on hyper-reponders. I pretty much convinced myself that I must be APOE4 based on all of that. Nope, I'm APOE2/3. I'm definitely relieved! Good video as usual.
Wish we had a firmer answer for you. Each one of us is different. If you want a rule of thumb, I think for most people it's good to have at least a 1:2 ratio of saturated fat to monounsaturated fat sources (that doesn't mean a ratio of 1:2 SAT:MUFA). What I mean by this is for every steak you have, have an avocado. For every cheese meal you have, have some olive oil or macadamia nuts.
Not by the looks: customercare.23andme.com/hc/en-us/articles/236409067-Conditions-NOT-included-in-23andMe Specifically: "Repeats, insertions, rearrangements or deletions" APOE4 is a deletion of 19q13.32, the long (q) arm of chromosome 19.
Derek Myers yes it does as that’s where I found out my APOE allele. It will be either APOE 2, 3 or 4. 4 is the not desirable one:( which I have. Boo However that’s where you make the changes in diet to help prevent issues in the future.
Ryan Jensen well i hope you’re talking about the organic grassed finished chicken and the cage free grass organic eggs !! Thomas has really nice videos about affordable keto shopping from Aldi they’re amazing you should check them out
@@ryanjensen5897 super tight budget here too, antibiotic-free chicken is the best we can afford at my house as well. Clean keto is great but just doing the best you can is still better than no keto. After a while I don't eat as much so maybe it will balance out my budget 😂
Just take a statin and eat saturated fat. If you cannot tolerate statins, take a other cholesterol lowering medication. Avoiding both carbohydrates and saturated fat is a miserable way to live, even if it keeps you healthy.
I'm going out on a limb and say that he means to report you to the ADL [anti-defamation league] for holding up the A-OK sign. Which they say means "White Power".
albie071 yes get checked. I just found out my mother had it a couple of years ago. She is now in memory care. I just happened to do the DNA test years ago and really didn’t know anything about the APOE 4 gene back then. I just found out I have it this year. It gives you a higher risk of getting Alzheimers, however does not mean you’ll get it! I cut out all sugar a while back. 23 & Me does give this in your health genetics, yet they did ask if you wanted to open your results. It’s tests for cancer gene etc as well. Take care of yourself:)
Having APOE4 only meant higher risk, it's not 100% guarantee. Not everyone who is APOE 4 will get Alzheimer. It's important to know that because sometimes there can be a negative placebo effect where a mental expectation results in it actually happening.
@@maxng1977 True. Doesn't mean you shouldn't take action. It's like wearing a helmet. Even if you may not crash your bike, better safe than sorry. Those of us with APOE4 are simply driving on a more dangerous road filled with pot holes so the helmet is extra important.
![Optimizing brain health: Alzheimer's risk factors, APOE, & prevention strategies [AMA 46 sneak peek]](http://i.ytimg.com/vi/ELK-k7DO1Is/mqdefault.jpg)
Thomas DeLauer … Please pin this comment. - Nick (and thanks for making this important video)
Dear all, I want to be clear APOE4 function is so poorly understood we CANNOT make definitive statements or give absolute advice to those who carry the allele(s). Neither I nor Thomas meant for this video to be absolute statements, but simply extrapolations from what n = 1 experiments I (an APOE4 homozygote, medical trainee, and Ketone PhD researcher) have done on myself, combined with a review of the current literature, mostly in cells and model organisms. The hard literature isn’t there… this is a “better safe than sorry” approach. Also, please see a HANDOUT!!! at this link: www.dropbox.com/s/hrsei52zbag9akh/Keto_E4s_Handout_Jan17_2020.pdf?dl=0 (this link was updated on Jan 17, 2020 given new data)
Thomas and I don’t mean to be dogmatic, but really wanted to provide a concise resource for those, like myself, who carry this genetic burden. Contrary to popular belief, I do think this is an “actionable” gene and that, even if you are a homozygote like me, you can reduce to eliminate your increased risk. If you have the gene(s), feel free to contact me directly and I can direct you to further resources.
Also, a BIG thank you to the world’s most brilliant, compassionate, and knowledge doctor with regards to nutrition, Dr. Vyvyane Loh, for supporting this content.
Thanks for the clarification & for sharing your research!
Hi Nick,
I hope you're doing well and staying healthy! I worry about docs and health care providers. You are all are doing great work!
I wanted to ask one more Apoe4 question.... what about alcohol? I know lots of long lived folks (Sardinians) drink moderate amounts of red wine every day... not sure how that translates to Apoe4 folks.
I tried to find research regarding Apoe4 in places like Sardinia and wasn't successful, i.e. do they have any and how do they fare.
I know for sure more than moderate is bad for any individual... period.
Sorry if this question comes at a bad time.
Be well....
thanks a lot!!
Appreciate the info and the disclaimer. The research is scant, which is odd for a gene variant that affects ~100 million Americans and probably over a billion people around the world. Of course, Drs. Gundry and Bredesen have their own protocols on the appropriate diet for APOE4. Gundry says no fatty fish and instead advocates a moderate amount of wild white fish, along with the shellfish. But I can't give up my salmon and mackerel. It's impossible to easly replace the naturally sources Omega 3s that you point out are so important. Have to be careful with too much liver (iron overload, for one thing). I personally think 1/2 lb per week should be fine.
I don't have APOE but I really respect that you'd go out of your way to make a video like this for those who do
It shows you sincerely care about the wellbeing of your audience, and that's awesome man
I’m glad you’re delving into the importance of genetics - one size doesn’t fit all for diets. It’s all about the fine tuning. Hope we get to see videos about variants of FTO, PPARA, ADIPOQ, and other keto-related genes. Especially ACAT1...people with the less common variant of this gene have trouble metabolizing ketones and feel exhausted on a high fat diet.
Been watching your videos for a while now. Just found out I have APOE3/E4. Mad respect to you for making this video.
This video is not for everybody...but it IS exactly for my mum. Thank you so much!
please see my comment and HANDOUT above
www.dropbox.com/s/p1371llshl5ih7p/Keto_E4s%20V5_Thomas.pdf?dl=0
It's good to know if you are homozygous (two alleles) or heterozygous (one allele). You get one allele from your mom and one from your dad. APOE3/4 is more common (20-25% of the population) than APOE4/4 (2-3% of the population). 4/4 is more pathogenic in terms of AD and CVD. APOE2/2 is also very rare. 2/2 is a genetic gift and the risk of dementia and CVD go way down in this subset of the population. The most common phenotype is 3/3 and these people are at "normal" risk.
Hi, do you happen to know the best way to test for this? … Thank you in advance 🙏
I struggled with keto too much, I just felt exhausted. We're supposed to enjoy the food we eat and with keto that's close to impossible. That's why I tried the *Agoge diet* and it works great.
Agoge diet works great, I've been using it for about 3
Damn I got Apoe4 been losing wait on carnivore. Got two more months to go then I’ll switch over to this style of diet. Going to miss red meat.
There is a fantastic discussion specifically on ApoE4 on Dr. Paul Saladino's podcast with Dr. Tommy Wood. Food for thought from the time our ancestors descended from the canopy 8 million years ago until approximately 200 000 years ago we only carried the ApoE4 allele, during this time we were predominantly eating meat, especially bone marrow. It's only in the presence of assaults from inflammation, endotoxins, sugar, excess insulin, etc. that the LDL becomes oxidized and dangerous.
There's not a lot of bone marrow in animals
Thank you for caring about those of us who have ApoE 4/4. I really appreciate the time you have taken to devote to this subject. However, I would argue that ApoE 4/4 folks should NOT consume MCT/coconut oil (especially), palm oil. cocoa butter and NO animal based foods (containing cholesterol and saturated fats) ...these foods directly cause elevations (MCT/coconut oil sends LDL and triglycerides through the roof in ApoE4 people). Advising ApoE4s that they can eat, even in moderation, MCT and animal products is very poor advice. I have tracked my blood work over 10 years and I am here to tell you that it has been my experience that the more closely I, as an ApoE4/4 person, adhere to a whole food, plant based diet - the more optimal my blood work markers are. ApoE 4s should really eliminate foods with cholesterol and saturated fats; added sugars, processed foods, foods containing preservatives, etc. Coconut oil was the worst culprit of all for me. Never in my life have I had high triglycerides until I consumed coconut oil. My LDL too remained continually well elevated while consuming animal based foods - all and any animal based foods.
Please, please do not advise ApoE4s that it's ok to consume MCT/coconut oil and animal foods (even sea food). For example, read "The End of Alzheimer's" by Dr. Dale Bredesen. This is just one, for the lay person, source to support what I am saying.
Hey Katherine, Dr Bredesen does actually recommend animal products - specifically oily fish, seafood and eggs - for those with the APOE4 gene. He does however recommend reducing saturated fats (which yes includes Coconut) in favour of those MUFAs and PUFAs (but that can include fish). And everyone will be different depending on whether they have one or two E4 alleles and what other genes they carry that influence lipid metabolism and other aspects of their diet and lifestyle. For some, MCT won't increase LDL, but if it does raise it, it is obviously advised to abstain. Exactly what each person needs to avoid/consume in order to keep their blood levels optimal will vary considerably. It's also worth noting these guys DO have coconut oil on the "avoid" list, so are not recommending E4 carriers eat coconut oil.🖤🧠
What is conflicting is that those with Alzheimer's are meant to do better on keto as the brain is less able to fuel itself on glucose and thus ketones are a better choice of energy
@HummusLad the research on APOE4 and keto seems to come down to the source of fat. For example saturates seem to be the issue.
However a keto diet full of omega 3 and leafy rich vegetables, Berries and plant based proteins etc it can be very health promoting. You may be interested in the Metabolic Health Summit and Metabolic Mind (organisation) who are sharing good research on this.
The other nuance is exogenous ketones for alzheimer's disease. This pathway is different and could perhaps provide an alternative fuel source for the neurones even in an APOE4 demographic.
Thanks so much for this video. I have 2 copies so APOE 4/4. Good to know that I can still do keto.
I am a double apoe4 this is so helpful, please post more about it.
Thomas, thank you! I have TWO APOE4 variants, and I only recently learned that this is very unusual and it increases my risk of Alzheimer's 12-fold. I have been following along with your other videos this year in my quest to lose weight and get healthier. Do you know if there are any other protocols to follow for those who have the double APOE4?
And, Thomas, I was SO SORRY to miss you at the Manitou Incline today! Oh my gosh! I did it 52 times last year, and I haven't been able to this year because I had foot surgery! I hope you enjoyed it! A group of us up there follow you!!!
Always making sure everybody is covered. Excellent video, Thomas! #ForwardThinking
If you have the APOE4 SNP, because your whole body is prone to dislipedemia, the standard keto diet isn't a good idea at all. You want to be eating a low fat diet.
Another possibility instead of keto is a low calorie, moderate protein weight loss diet. You can do this by using protein shakes to replace a meal, as it isolates the protein your body needs from other macronutrients. The protein creates a feeling of satiety without alot of added carbs or fat. Add a bit of fruit like strawberries or blueberries, and a non-nutritive sweetener like stevia, etc. The point is keep the calories low, but don't deprive your body of nutrients. Soy protein is probably the best to use because it has a more robust amino acid load than whey and it has a relatively complete amino acid profile, but hemp would also be a good choice. Pea and rice protein might also be OK but make sure it is sourced from a place with low heavy-metal contamination in the soil.
I have the ApoE4 allele.
I absolutely do not like the ApoE4 foods.
I will instead continue to eat saturated fat like everyone else, and then have my doctor give me cholesterol lowering medications.
Medications may be unnnatural, but if you had familial hypercholesterolemia, you would still need to take cholesterol medications no matter how unnatural they may be.
Excellent! Finally someone addressing DNA problems.
Blood pressure and fatty liver videos presented like his would be awesome too
Will chicken work as a substitute for steak? Great info. I have printed the PLAN and posted on my ref my refrigerator!
Great advice; I will add (having this gene) taking some supplements: one that I believe would be of help is Moringa. Really a Superfood!!..It lowers blood sugar, contains Calcium (that we need since dairy should be avoided), helps with insomnia (sleep really important), and also lowers cholesterol.
Has more benefits as well....Holy Basil is worth looking into as well: losts of benefits including protection against "diabetes," and reduces LDL and
helps with sleep as well (among other benefits.) I was wrongly taking too much of the MCT oil for the ketones - however - be careful since it is with
coconut oil and a saturated fat. To go into ketosis I prefer to eat two meals a day..eating "early 2nd meal of the day ending at about 4 pm. The next morning break your "fast" and eat breakfast 16 - 17 hrs later at about 9 - 9:30 a.m. Check with your doctor (hopefully with someone credible who
understands food's importance and also "insulin resisance." They should check our "fasting insulin" in our blood work, but do not!
Sugar is not our friend!!!
Have you done a video on people doing Keto who have Familial hypercholesterolemia (FH) is a genetic condition associated with very high levels of cholesterol in the blood, specifically low-density lipoprotein (LDL), or "bad" cholesterol.?
I have this genetic cholesterol and my endocrinologist had prescribed Juxapid first go around which caused my liver enzymes to soar but it did bring my levels down perfectly in seven weeks. My doctor had to withdrawn me from the medication now 2 years later he prescribed Repatha pushtronix and it is amazing cholesterol levels are perfect and lost weight from keto diet also 80 lbs. Talk to your doctor about this medication may work for you also. Only 50,000 people in USA has this type of cholesterol I am told God Bless.
GodIsLove thank you for the suggestion!
I’m a rare bird, have lipid issues due to RB1 gene deletion. Keto helps some things but I need to customize it. I have sensitivities to foods allergist can’t figure out. Drs pretty much give up on me or force meds which make me sicker (cause seizure activity or adverse reactions). Finally writing this stuff down for my genetic specialist because I can’t remember it all anymore. Been in ketosis and week and off very low dose statin for a few weeks and it’s already back at 300.
My grandmother passed from heart disease and my dad passed from heart disease and Stage 5 Parkinson’s disease also having prostate cancer years ago. I’m 33 and 330lbs. Gained over 90 lbs out of grief since my dad passed last year. I need your help..... What is a great diet to turn my life around considering my family history? Thank you so much.
John Wilson subscribe to this guy and start from the beginning. His information has changed my family’s life
Hi John. This is a great start! Keto is not a diet, per say. It's an eating lifestyle to achieve optimal, natural human health, optimizing powerful body mechanisms within you. The main proponent is eliminating sugar from your life (carbohydrates covert to sugar in your body). Sugar is what feeds and causes disease. (Not salt, cholesterol, or fat) (after completely cutting sugar and savory carbs like fries, pasta and grains, from your life and replacing them with healthy fats- you won't even miss the sugar. Your cravings and desire just stops! You'll stay full and won't even have to calorie count) Achieving ketosis is the way to go for you. It has changed the lives and regained the health of so many. Watch as many Thomas videos as you can, also Dr Berg and Dr Ken Berry. They're so informative and enjoyable to watch. Best of luck to you!
When you start keto don’t be shy with the salt. That’s my best advice. Look in to The Salt Fix on YT and learn about that guy’s work. It does wonders for curbing carb cravings. Get Redmond’s Real Salt. It has a good amount of iodine as well. To get healthy your thyroid has to work and iodine is essential.
please see my comment and HANDOUT above
www.dropbox.com/s/p1371llshl5ih7p/Keto_E4s%20V5_Thomas.pdf?dl=0
Also see our videos on Medi-Keto and this HANDOUT
www.dropbox.com/s/uncq64bbrmb57gp/Ketogenic-Mediterranean%20Handout_V2.pdf?dl=0
Thank you so much for sharing this. It’s no wonder I’ve been struggling with Keto! I did a genetic test and found out I have 1 variant of the APOE4 gene mutation. I knew the benefits of keto should help prevent Alzheimer’s but had no idea I could actually be adding fuel to the fire eating tons of coconut oil, red meat and Dairy. A few weeks ago I cut out dairy and red meat and immediately started feeling better and had substantial weight loss. I added back those things and started feeling like crap again. Just watched this video and it all makes sense! Thank you so much, now I have an actionable dietary intervention that helps me stay Keto and get the benefits.
Dr.s Saeed 23 and me
I would be interested to see a video on the possibility of an omega-6 deficient diet. I noticed in myself that cutting out almost all big sources of omega-6 fats caused some strange issues with my mood, energy levels and particularly with my skin. Once I added a few mostly omega-6 sources back into my diet, without changing anything else, the issues resolved. Also, while eliminating nearly all omega-6 sources, I was going hard into omega-3 (EPA & DHA from boatloads of fish oil and fish, and ALA from macadamias), so it may have just been that my ratio was unbalanced in the opposite way from what most experience. Omega-6 fats are still essential, so they cannot be cut out completely; they play a huge role in immunity as inflammation is actually a healing process. If one does not have the correct nutrients to trigger inflammation, then the immune response may be dulled. I have not seen anyone speak about this topic which may become more prevalent in the keto community since omega-6 fats are often considered to be "public enemy #1".
Justin S keto and carnivore people avoid pork too much in my opinion. Thiamine is high in pork and so many people are deficient, especially diabetics. People are too scared of omega 6 and miss out on other good nutrients.
I am now tired of fish, shellfish, avocados, and olive oil. Replacing some of the fish I eat with 5 or 6 eggs a day provides me much better satiety, but I am not supposed to eat that much because of APOE4.
I already stopped eating butter, coconut oil, and fatty meat, and if I have to reduce the amount of eggs I eat, my diet is going not going to be enjoyable.
What should I do?
Even if statins have side effects, it will lower your cholesterol and you can live a happier life with less dietary restrictions so you will not have to keep avoiding saturated fat which tastes better than olive oil.
This is awesome? Is it safe to take CBD if you have an APOE4 allele?
This diet definitely keeps my glucose and LDL low.
But it is not tasty and not satisfying at all, and because of this, I have a very poor compliance rate to it.
Quick question: is this also connected to familial hypercholesterolemia? (Genetic high cholesterol)
no, I have apoe4 and no familial hypercholesterolemia
Can you eat more nuts and seeds if you supplement with higher doses of Omega 3 (krill oil). If so what would an effective dose be? I really hate fish and shellfish, besides salmon.
Update: It has now been confirmed that oleic acid in olive oil activates sirtuins! (sirt1 etc)
What does this mean
I don't like this diet at all, but I'm just doing it for the sake of my ApoE4 status.
Olive oil just isn't as tasty as animal fat and this may be an unpopular opinion, but I've never understood what is so awesome about the flavour of it.
I used to eat chicken thighs with skin and cooked vegetables with chicken fat and it tasted great.
Now I have to eat lean beef, lean chicken, and vegetables with olive oil and the flavour just is not as enjoyable.
I enjoy nuts, but they say not to eat too many of those because it can cause inflammation in E4s.
I used to enjoy eating, but now I don't, even if it keeps my blood markers good.
Olive oil is awesome. Please, try to find an extra virgin olive oil, not just olive oil. Way more expensive, but a lot healthier and has better taste. Don't give up on olive oil without trying the better brands.
@panno1103 I don't like extra virgin olive oil too, and I used ones in metal cans, dark glass bottles, and Kirkland. All the real stuff.
EVOO just isn't as good as animal fat to me.
Animal fat tastes much better.
Eating lean meat with olives, avocados, and those oils just does not taste as good as eating meat with the fat of butter, chicken, pork, and beef.
And I cannot eat healthy carbs either.
I can only eat animal fat and healthy carbs in moderation, so I am stuck with this diet of mostly:
Lean meat
Oily fish
Egg whites
Low fat dairy
Avocados and oil
Olives and oil
Non starchy vegetables.
I don't like this diet but it's the only one that prevents my glucose and cholesterol from going up
If i just want to add extra fat to my diet at the end of the day is it better to eat some nuts like macadamia/wall nuts or just add olive/coconutoil to my salad?? Thank you so much
Thank you so much Thomas..
Your videos now is helping me with my med school 😃😘😘😘
Homozygous ApoE4 here but also FUT2 just to really throw a wrench in the works. Going to apply this, maybe even go full carnivore.
Basically with any diet, you have a 50/50 chance at success. If you have a beef allergy, or are sensitive to some vegetables you will know. Keep it simple.
Thank you for another great video! Keep 'em comin'!
Do a video like how to restart keto diet after a break (more than one month).
Just stop eating carbs.
The same way you started before. Seems pretty cut and dry to me.
Give up and just do fasting, its less restrictive to your live style this is why its so annoying to jump back on the bandwagon and why you want a video made. Although if you must I’m assuming taking MCT oils everyday plus KETO supplements would increase the speed of you being keto adapted
What about no fat plain no sugar Greek yogurt?
A question you probably get asked 10 times a day. How many weeks a year do you think you’re doing keto?
thank you for this x
Thanks Thomas!
I'm homozygous Apoe4. Thank you for clarifying the fats for us. I did not see the link for Butcher Box after the video. What is your discount code?
EVERYONE talks about Apoe4. I am Apoe2. Can someone do a podcast on E2?
This is real helpful. Thanks
Baste fashy DeLauer
Shhh, I spoke to the ADL. They had an emergency meeting and ended up clearing him of all charges.
Hi Thomas,
Can you make a video about people who seem to genetically be predisposed to super high triglycerides? I used to eat normal amounts of carbs BEFORE keto and had triglyceride levels between 800 and 1100. Even in Keto, I’ve only been able to come down to 270. What is it with people like me whose triglycerides skyrocket from just sniffing carbs?
My husband has the same! Trigs are always around 800, but since starting keto they skyrocketed to 1900! But, he always has low ldl! I'm guessing it must be genetic, but not sure if he should stop keto or not. He's lost 20 lbs and his blood sugar is back to normal and now totally off of metformin! Btw, he's Apoe3/4. I'm Apoe4/4.
Thomas it would be fantastic if you made a video with a meal plan for those with egg white and casein (milk protein) intolerances. Or other intolerances as opposed to allergies.
re casesin: mdlingo.com/cheese-mutant-cows-opioids-constipation/
what about chicken ?
Baste and Rojo Pillado
DOes this apply to a person with high APOE -b lipid levels?
I have the complete opposite genetic disorder... my good(hdl) cholesterol is very low and doctor says I'll never be able to get it no where near 60
Bet you three months on strict keto and it would be above 60. Three months on keto got me from 40s to 134. Bet it's even higher now but haven't checked recently ;)
@@nicknorwitzPhD that's good to know Nick... thank you... mine is currently 36...
@@dwaconsulting1609 If you do go/are low-carb/keto, focus on unsaturated fats because unsaturated fats activate PPARa much more strongly than saturated fats and PPARs promotes HDL production. Therefore more unsaturated and less saturated fats (the latter of which also decreases ApoA production) will boost your HDL. Since you don't want to overload the Omega-6s: these are some ideal fat sources... fatty fish, macadamia nuts, olive oil, avocado.
@@nicknorwitzPhD you are awesome thank you for the advise...I know o have to stay away from coconut oil, and eggs which i love bit the dr did say i could eat like 1 per day... I have a question about your ldl... did it raise as well or were you able to keep that normal??
@@dwaconsulting1609 I disagree about the eggs. Eggs are great! Your dietary cholesterol doesn't really impact your blood cholesterol. Furthermore, the cholesterol found in eggs (the ester form) isn't the form found in arterial plaques. If you actually look at what's in a plaque, you'll see the form of cholesterol is the form that is found in red blood cell membranes, which tells us plaques are clots! This is something that most doctors know but don't think about deeply. As for you question about my LDL, yes it did increase initially, BUT that may have to do with me eating tons of cheese and being ApoE4 homozygous. Interestingly, despite my poor genetics, my HDL/total cholesterol ratio didn't get worse with all that cheese (like a pound per day). I'm now on Medi-Keto and blood markers are best they've ever been.
Nice short video 👍
C519 to G mutation in exon 4 - this is the family gene mutation that causes my and half my siblings high LDL - do you have anything specific to this mutation as it seems more related to High LDL than just the inflammation gene...its kind of hard to follow for a lay person, not versed in science/study writing/reading, interpretation...(i do not mean your presentations hard to follow) i mean the science itself. Thanks for your content and contributions they are helpfiul
Hi Thomas! I love your videos and all the valuable information you provide!!
I just watched the Netflix movie "The Game Changers". I would love to see a a video with your thoughts and response to the information provided in this film. Thanks!!
That video is already in the works ;) Promise... production team just putting together but it will be up. Spoiler: “The Game Changers” is NOT a documentary that argues eating plant-based is healthy. It is a documentary that argues a plant-based diet and plant proteins can support growth and elite-level athletic activity.
That movie is so unscientific it’s ridiculous. I can’t wait for Food Lies to come out.
@@KekeeBlack Drop me your email. I can send you something... my Oxford email can be found at link at bottom of show notes
as promised! th-cam.com/video/xERfacShcJ4/w-d-xo.html
I have one allele of APOE4 so I'm gearing my retirement to rotting in a nursing home.
Rich not true! It’s just a slightly higher risk and I have it too! Just take care of yourself and you’ll be fine.
please see my comment and HANDOUT above
Have you seen the work of Dr Bredersen th-cam.com/video/Sq7uVZ_0D3U/w-d-xo.html
I had a huge jump in my cholesterol after going keto and so I started reading Dave Feldman's stuff on hyper-reponders. I pretty much convinced myself that I must be APOE4 based on all of that. Nope, I'm APOE2/3. I'm definitely relieved! Good video as usual.
@Dr.s Saeed Via 23 and Me and then I downloaded the data to Found My Fitness.
Would this be done with routine blood work or is it a specific test to find out ?
You'd need a specific genetic test.
Nick Norwitz thank you for replying
I have some genetic mutaation but ain't sure if it is this hope this works
Thomas should we keep saturated fat below a certain amount of grams per day?
Check out Shawn Baker md. Interesting info on quantity of saturated fats
Duke Silver 🤣....what?
Duke Silver BWAHAHAHAH🤣🤣 what the hell are you referring to? Dude, reread your original post!🤣🤣
@Duke Silver FUNNY! I love the Parks and Recs ref!
Wish we had a firmer answer for you. Each one of us is different. If you want a rule of thumb, I think for most people it's good to have at least a 1:2 ratio of saturated fat to monounsaturated fat sources (that doesn't mean a ratio of 1:2 SAT:MUFA). What I mean by this is for every steak you have, have an avocado. For every cheese meal you have, have some olive oil or macadamia nuts.
I love your videos. My blood test came up Ketones are 5. Is that good?
Is it possible to see if we have this from our 23&Me report?
Not by the looks: customercare.23andme.com/hc/en-us/articles/236409067-Conditions-NOT-included-in-23andMe
Specifically: "Repeats, insertions, rearrangements or deletions"
APOE4 is a deletion of 19q13.32, the long (q) arm of chromosome 19.
Derek Myers yes it does as that’s where I found out my APOE allele. It will be either APOE 2, 3 or 4. 4 is the not desirable one:( which I have. Boo
However that’s where you make the changes in diet to help prevent issues in the future.
Hey Thomas, great video mate. What your take on the documentary The Game Changer on Netflix.
How do you know if you have apoe4s?
23&me DNA test is how I found that I have apoE3/4
I have high Apo (a) cholesterol, is this the same thing?
No it's not at all. In fact, good news for you, ApoA is a protein marker of HDL "good" cholesterol. You want high ApoA.
Chicken?
I want to get back on keto but I've been eating seeds and rice because it's cheap
Ryan Jensen eating healthy made me spend 4 times more than before ! So i quit the alcohol and it balanced my budget
@@ak_247aaa4 I ind that chicken is basically the only meat I can handle
Edit: the only meat I can aford. Eggs get nasty after some time.
Ryan Jensen well i hope you’re talking about the organic grassed finished chicken and the cage free grass organic eggs !!
Thomas has really nice videos about affordable keto shopping from Aldi they’re amazing you should check them out
@@ak_247aaa4 Well so far I've been looking for antibiotic free chicken.
@@ryanjensen5897 super tight budget here too, antibiotic-free chicken is the best we can afford at my house as well. Clean keto is great but just doing the best you can is still better than no keto. After a while I don't eat as much so maybe it will balance out my budget 😂
Just take a statin and eat saturated fat.
If you cannot tolerate statins, take a other cholesterol lowering medication.
Avoiding both carbohydrates and saturated fat is a miserable way to live, even if it keeps you healthy.
You don't sound like an infomercial for butcher box gives you credablity.
I TURNED YOU INTO THE ADL TOM!
ADL?
I'm going out on a limb and say that he means to report you to the ADL [anti-defamation league] for holding up the A-OK sign. Which they say means "White Power".
It's a very nonsensical accusation for a keto-diet and nutrition channel.
@@nikolaylifshaz8860 it's typical that you would refer to me and my people as "they".
Oh goodness. I checked the ADL and they’re very clear it’s all about context. Clearly no applies applied context here.
Nice 666 hand sign
ILLUMINATI CONFIRMED
I’ve got the APOE4 🧬. My mother has Alzheimer’s too:(
albie071 yes get checked. I just found out my mother had it a couple of years ago. She is now in memory care. I just happened to do the DNA test years ago and really didn’t know anything about the APOE 4 gene back then. I just found out I have it this year.
It gives you a higher risk of getting Alzheimers, however does not mean you’ll get it! I cut out all sugar a while back. 23 & Me does give this in your health genetics, yet they did ask if you wanted to open your results. It’s tests for cancer gene etc as well.
Take care of yourself:)
Please see my comment and handout above www.dropbox.com/s/p1371llshl5ih7p/Keto_E4s%20V5_Thomas.pdf?dl=0
Having APOE4 only meant higher risk, it's not 100% guarantee. Not everyone who is APOE 4 will get Alzheimer.
It's important to know that because sometimes there can be a negative placebo effect where a mental expectation results in it actually happening.
Nick Norwitz thank you I printed it:)
@@maxng1977 True. Doesn't mean you shouldn't take action. It's like wearing a helmet. Even if you may not crash your bike, better safe than sorry. Those of us with APOE4 are simply driving on a more dangerous road filled with pot holes so the helmet is extra important.
More genetic vids
Hahahahaha the SJW fascist are gonna have a field day with that thumbnail :p