The ApoE4.Info Podcast: Episode 6

Dayan Goodenowe, PhD.: Clinical Strategies to Treat Dementia

Dr. Dayan Goodenowe joins Julie Gregory to announce the opening of his recovery and rehab clinic for dementia patients in Canada. He likens the therapeutic process used by his team as being similar to that used for addiction patients with the goal of improved mental acuity, mobility and mood. They intensively focus on nutrition, exercise, mindfulness and lifestyle management, and the importance of continuity of newly learned habits with supportive follow-up when patients return back home. He describes cognitive improvements that he has seen in his own family members who have used this approach. Dr. Goodenowe also describes an N=1 experiment that he ran on himself using high dose plasmalogens and other supplements to reverse the effects of acute stress with remarkable volumetric gains as evidenced by brain imaging. He discusses how he uses the ProdromeScan, a blood test, to guide treatment and assess progress. Finally, they discuss the upcoming launch of the ApoE4.Info MOD4 Project that will use the ProdromeScan to enable members to track their health progress over time.


Dementia recovery and rehab clinic: more information
ProdromeScan and supplements: Prodrome Sciences (Use code APOE4GROUP25 at checkout for 25% discount)
Breaking Alzheimer’s book: direct / Amazon


00:00:26 Julie

So welcome, Dayan – thank you so much for joining us again. We’re so excited to have you.

00:00:32 Dayan

Thank you, Julie. Happy to be here. It’s been many, many years now. We’ve been working together.

00:00:36 Julie

I know I was looking at that. Our community has actually been working with you for four years now.

00:00:44 Dayan

Pretty excited.

00:00:44 Julie

So it’s been our honor. And thank you so much. Yeah, you’ve been guiding lots of people and helping lots of people get better. So thank you. Since we last spoke, you have opened a dementia rehab and recovery program and I’m so excited to learn more about that.

00:01:04 Dayan

Well, this really comes. You know, I talk about it first in my book. So the last chapter of Breaking Alzheimer’s deals with this community based model of how the current infrastructure really isn’t designed to treat or to deal with complex diseases like dementia, right? And dementia prevention, recovery, rehabilitation. And most of the clinical work that we do around the world are really isolated. We take one agent, we look at B vitamins or we look at a drug and the purpose of those programs is to evaluate a particular agent, right, whether it be a drug or a lifestyle factor. And the goal is to isolate it from everything else. And the person in that type of trial really is a Guinea pig in it, right? It’s not really about that person. It’s about whatever agent you’re testing.

And we wanna flip that. There’s so many validated programs that work, and dementia recovery requires people who want to [get better] so we can focus on a caregiver and dementia individual that are serious about getting better, and we take an integrated approach and it’s really self focus on the individual.

So we do get advanced nutrition … So first of all we have a place for them to go. It’s a quiet, serene 10 acre facility, full facilities there with a lake in a peaceful environment, in Moose Jaw, Saskatchewan, which no one has ever heard of, but it’s very, very nice.

00:02:37 Julie

It’s in Regina, right?

00:02:40 Dayan

It’s near Regina, the city is actually called Moose Jaw.

00:02:43 Julie

Ohh Moose Jaw. Very very cool.

00:02:46 Dayan

Yes, the town that gets made fun of all the time in certain movies. But anyway, it’s not a medical program. We take a kind of a drugs of abuse model to this, right. So say you are a drug user and you want to get off of drugs, you can’t do it living in the wrong environment. So this allows people to come to a proper facility and it’s really them, it’s their program and it’s all designed for that individual to see themselves, the mobility, their cognition, their lifestyle, their diet and also prepare them to go back home.

So there’s three months where they can stay in facility. We do advanced blood work, obviously the supplementation protocols … so we look at dementia and brain structure recovery, and it is a recoverable situation and people do recover from cognitive impairment. That’s a fact.

OK, whether or not you have these big long randomized clinical trials that says this pill statistically improves cognition, that doesn’t change the fact that people do physically get better. It’s documented over and over and over again.

00:03:54 Julie

Yes, we see that all the time, absolutely.

00:03:57 Dayan

So the point is how do you do that in your personal life? It’s not about validating some drug company’s drug. And there are certain things that we know for a fact have contributing factors to that. So on the biochemistry side, we know the plasmalogens are contributing to mental health and brain restoration. There’s a huge amount of evidence of that. Proper B vitamin usage is another big issue, right? It’s just been there forever. People forget that it’s actually important to do it right. Your mitochondrial function. Those are basic biochemistry things that have an impact. And people need an ability to do that for themselves, so this is this is self-directed research.

00:04:42 Julie

You know what? I just want to jump in before you go any further because you have really hit the nail on the head. You need somebody who’s motivated to get better, and I love that your program is focused on that and that you also include a care partner because at the beginning they won’t be able to do all these strategies by themselves and they are gonna need someone to work with them. So I think that’s beautiful and …

00:05:11 Dayan

… and you want to prepare them to go home again!

00:05:13 Julie

Oh, I love that. So, yeah, this is the era of treatable dementia. That is huge. That is huge. Go on.

00:05:22 Dayan

Yeah, and so on the biochemistry side, that’s straightforward. Those are, you know, there’s no ambiguity there. Now what which particular piece will make the biggest contribution to an individual? That’s gonna be individual specific, but we know collectively these things will have impacts, but it’s just well known.

And then on the lifestyle side, you know the diet, obviously the time restricted eating, proper types of foods at proper  times. But you don’t need to be depriving yourself. You can have real meals. It just has to be with the right content. And also people don’t know how to cook, or they don’t know how to shop. So this facility is not a luxury camp. It’s a working camp, it’s boot camp. People, they go grocery shopping with us. And we get food and we cook food in the facility and the catering facility. They have their own room. They have their own privacy, all that stuff. It’s actually designed that way. And creating a daily lifestyle, because each day has to be reward driven, right? So you have to have a purpose.

So physiologically, skeletal muscle mass is one of the biggest things people need to deal with. They need to do resistance training. They need to incorporate into their lifestyle the rebuilding of skeletal muscle mass because of sarcopenia. That’s the biggest issue. It drives 99% of all diabetes, just loss of muscle mass, OK. And in the elderly, we mistreat these things. And so exercise and then the routine of your day gets into place.

And then the next part is the mindfulness part of it, because you have to have purpose. One of the problems with getting older is that people lose purpose. OK, a lot of the things that keep us healthy, we consider stressful or bad. Well, I can’t wait to not do that. But a lot of those things actually kept you alive. It gave you a reason to get up in the morning. So when we look at these things in the world where social activities and people involved in social activities have positive impacts on their health, it’s not the social activity itself. It’s getting up. It’s doing your hair. It’s getting dressed. It’s actually going out for a real meal rather than eating something at home. It’s all the things that surround that social environment that actually are the health inducing parts of the social interaction, you know, association with improved health.

So just like in a drugs of abuse kind of situation, you need to create new habits and then reinforce those habits. So in the facility you’re there for three months. And you have time to build a pattern in a relaxed environment. So we’ll do a cardiovascular test and we’ll put a 24 hour Holter monitor you because we know cardiovascular heart improves. We measure spirometry of your lung function. We’ll measure vision. We’ll measure auditory stimuli. We do real life stair climbing, like, can you can you climb up the set of stairs? What’s your mobility now? What’s your mobility later? Because if you’re gonna live a healthy life, you need to be able to do these things. And we call it the three M’s of a life worth living, right?

  1. You need mental acuity. You need to be able to understand the world around you and interact with it.
  1. You need mobility. You need to get up and go and do things. A human body is designed to be moving and one of the biggest predictors of frailty, or of death, is when people lose their ability to actually move in their environment. Humans have to move to be healthy.
  1. And the final thing is mood. You have to feel good about yourself. You have to. There has to be a reason. And that’s actually under-appreciated – people have to find a purpose in life and if you don’t have one you have to make one up because if you don’t have a purpose to live, you will not live much longer.

00:09:15 Julie

Right, we all need a reason to get out of bed in the morning and it’s easy when you’re working, right? But not so easy when you retire.

00:09:25 Dayan

Correct! And so then they have to have a plan for that.

So, we have a fieldhouse with exercise and track and field and places for people to go. But then while they’re here for three months, they have to say, OK, what am I gonna do when I go home? Where are you gonna get your hair done?  Where are you gonna go for exercise? Like, what are you gonna do with your day?

You’re gonna create a pattern – this is what my days deal with. And then you program that, you say, OK, let me prepare [a plan] for going home that I can read. And then we’ll have nine months where we follow up and check up and harass you basically for that time to get that pattern in your life and then we can do maintenance after that.

00:10:05 Julie

I love that. I love that you focus on the three things and you just keep it simple. Mental acuity, mobility and mood, and you just distill it down to that. But you’re right, that’s everything.

00:10:19 Dayan

And it’s for the person.

00:10:19 Julie

As you age, yes.

00:10:21 Dayan

So we we videotape the individual for their purpose. So we’ll do the 8S cog. We’ll do pegboards. We’ll do all the traditional classic validated clinical trial metrics, but they’re not for us – they’re for them. They can look at themselves and because people forget – this is what we’ve learned over the last few years – they start getting better, but they don’t really remember. They can’t really see the difference in themselves, and we see a lot of this when people stop doing something and then they regress. We find far more people recognizing improvement upon regression than improvement upon improvement – all the time, we see that.

00:10:59 Julie

I see that – you see that with my mother, yeah.

I’ve got a question. So do you have a cut off in terms of cognitive impairment?

00:11:11 Dayan

Not really. If you look at the clinical dementia rating scale, we’re going to be in that one to two, what we’re targeting.

People that are six months to 12 months from going into long term care, where the where the caregiver is saying, I’m almost at my wits end. I’m doing everything I can, OK? I don’t really want to put my my loved one into, you know, mental memory facility, but I’m gonna go crazy if I don’t myself. OK, so we want to find that group of people that are kind of in that six month to a year pre memory care. We want them mobile.

They should have some level of mobility, but we are flexible for things and that’s the target population because our goal is to get to people before they’re they’re getting into long term care. We reenergize them, restore health as much as we can and then create an environment that they can live for a very long period of time prior.

So we wanna prevent that long term care admission is really the biggest goal there.

00:12:15 Julie

And are you able to return people to live independently who weren’t able to do that before?

00:12:24 Dayan

Well, we’re just starting like we have anecdotal experience of people that aren’t in the program because the very first participants just came in at the beginning of August. And the second and third groups … it only holds 18 people and we only take we only take six people a month, so it’s not a warehouse facility, right – it’s an intimate facility.

So you get 6 people per month coming. And they’re there for three months. So basically every month, there’s six people coming in. There’s six people going home again, and then we’re offering … we’re working on a kind of a weekend day program here in the Temecula facility and Moose Jaw facility where people can come in for the day and then go home.

So our truncated process … the Moose Jaw facility is in house – you basically come and live there for three months and get things organized in your life. The other here in Temecula and Moose Jaw will also have like kind of like a weekend retreat model where people can come in for a day, get some stuff done, get some blood work done, get some supplements, get some assessments done and then kind of have a homework assignment, if you will, and then they can come back on a recurring basis.

And then we’ll have different levels of you know, cuz the goal is to help people, right? And so we have to understand, we have to tailor things for that individual because everyone’s life situation is slightly different.

00:13:54 Julie

Absolutely. So for the in-house facility, do you mind if I ask what the cost of that is?

00:14:00 Dayan

Yeah, it’s going to be for an entire year’s program. It’s going to be just under 100 grand. And so we are right now since we’re doing the opening, there’s a short term window where people can come in for 49 grand. It covers both the caregiver and the [care partner], so it’s actually very, very inexpensive. If anyone has ever had to put someone into a memory care facility like I have, this is an extremely discounted price.

We’ve been able to do it in a manner that is cost effective so that it fits people. And so for the first three or four months here, we’re gonna offer the discounted price because you know there are always gonna be some little things to work out and it’s all fully staffed and running, but by the end of December and early January, it’ll be back to the full …

00:14:47 Julie

Around it’s going to be 100,000 for the full year.

00:14:53 Dayan

Yeah, three months in facility, nine months at home, all your supplements, all your everything included, all supplements, food, lodging. Only thing’s not covered is your travel back and forth basically.

00:15:04 Julie

And that’s your support for the nine months afterwards as well. That sounds wonderful. I would imagine you have a waiting list. Am I correct?

00:15:14 Dayan

It’s getting there. It’s getting there. We’ve been very careful not to … like you’re really one of the first people that is kind of publicly … we sent it out to some of our doctors and and so we’re just kind of going slow because we’re getting …

00:15:24 Julie


00:15:26 Dayan

So we haven’t really gone large on this thing because we’re still working on it.

We’re doing some large clinical trial / community trial work that’s gonna plug into this program as well. But yeah, so that’s that’s kind of where it’s at. So yeah, your your timing is pretty amazing, Julie cuz … yeah, your timing is amazing on 2 fronts, not just this clinic.

I’m gonna be presenting real data on the first human taking high dose plasmalogens for 18 or 16 months, which is me. And you’ll be able to see the changes in my brain structure and function on advanced MRI. And so I’m going to be presenting that actually at the the Peptide World Congress on August 19th. So you’ll be able to see that we can actually restore brain structure and volume with plasmalogens using my own brain as an example.

00:16:13 Julie

Wow, do you mind giving us a little preview of that?

00:16:19 Dayan

Well, I don’t have any pictures to share either. But yeah, but the point is that certain cell bodies have increased quite dramatically, basically I’ve reversed over 10 years worth of natural atrophy in 16 months has been completely restored.

00:16:34 Julie

Wow! And when you say high dose, what, what kind it’s prodrome neuro I would assume …

00:16:39 Dayan

Neuro and Glia. So basically we have all this like I’ve been studying these molecules for so many years, right?

And so we’ve done all the animal work. So I’m at about 100 milligrams per kilogram dose. So I take what I took because I do everything on myself before I tell anyone else, and basically I don’t tell anyone anything. I said, “This is what I do. You know, work with our doctors. I always recommend that. We have a huge list of doctors out there that know exactly what they’re doing. But people want to do their own thing. So, like, we can share our own personal experiences. But I take about 5 mils of neuro in the morning and about 5 mils of Glia at night.

00:17:14 Julie

Wow. And that’s versus 1 mil, which is a pretty standard dose of the ProdromeNeuro.

00:17:18 Dayan

Neuro, you know, we have children with rare diseases taking high doses, but this is a pretty good dose. It’s at the upper limit of what we’ve done and I wanted to make sure I use myself as a Guinea pig over the course of a … I’ve been on that for quite a while actually, my dad and other people as well, so.

00:17:35 Julie

And did you feel changes in your own cognition? Did you measure any changes?

00:17:41 Dayan

Not in that regard. It’s just my own life. I’m actually physically stronger than I was in my 20s and 30s. I have better muscle mass. I have better recovery rates. I remember trivia better, so I know these things. I feel more in control of my life. It’s interesting, cuz when I started cuz, you know people, we think researchers … it’s like having a mechanic, right? They drive around in a broken down car. They fix everyone else’s car but their own, right? And so part of this process is my, you know, practicing what I preach and and doing that kind of stuff properly and it’s good cause I definitely had some some health improvements to make on my own. And you can see them happening. Which was great!

00:18:26 Julie

I love and respect that. And you say that your father has been on a similar regimen. Have you seen cognitive improvements there?

00:18:33 Dayan

Ohh yeah, like he said he can. He’s well, I got several family examples and my dad is 86, coming 87. He functions like he’s in his 60s. He’s fully mobile, fully drives. He does maintenance like he’s one of the more active people. I have a hard time keeping up with him. And so he’s a very, very physically active and strong 86-year-old.

00:18:59 Julie

That is beautiful. Was he always that healthy or do you feel like the program you’ve put him on has helped him get there?

00:19:06 Dayan

Ohh, he’s gotten better. He’s always been healthy for the most part.

00:19:09 Dayan

Yeah, but I you know, I used to … we’ve worked together. I’m just a farm boy from the prairies and so, but yeah, so it’s definitely helped. And then my aunt had serious memory loss. She was to the point she couldn’t remember the name of her son, and she now knows everybody. If my dad calls my uncle up, she can hear his voice across the room and say, you know, we’ll announce it and she goes out for dinner and she’s, you know, she still has mobility issues, but basically, she can recite everybody in her 50th wedding anniversary albums and stuff like that, so there’s clear, very clear, unambiguous restoration of memory and function that occurs, and we have lots of stories of this with our doctors and other people, so it is real. It happens and and it’s logical.

00:19:59 Julie

You have a clinical trial published. It is quite successful and it it shows improvement as well.

00:20:06 Dayan

In four months, we had a significant 75% of the people with the clinical dementia rating of two. Improving entire score in a four month period and an escalating dose. So it’s like I tell people all the time – no one thing ever is a silver bullet, OK? It has to be done with other things. You know your lifestyle. Like there, there is no magic to health, OK? It’s just common logical sense. But then it takes consistency and commitment to do things.

00:20:36 Julie

And that’s where you found that the drug rehabilitation model beautifully intercepted because it really does take commitment from the individual to adhere to this new lifestyle.

00:20:50 Dayan

We’re essentially addicted to dying. OK, death is an addiction. Like we we do things that we know exactly are bad for us.

00:20:55 Julie

That’s powerful.

00:20:57 Dayan

Right, like a heroin addict knows they’re a heroin addict. No heroin addict was like, hey, this heroin is good for me. Like, not a single person that’s a drug addict says, this is good stuff. OK, but they know it’s not good for them, but they can’t stop doing it.

00:21:11 Julie

They can’t break the pattern, they just can’t get out.

00:21:15 Dayan

And so if you have type 2 diabetes, you’re not eating, you’re not sleeping … you know that’s not good for you. Like, it’s not rocket science. Like people know health for the most part, but they can’t seem to break those patterns. So fundamentally it’s this inability to stop doing things that we know have negative consequences and so having that reprogramming and resetting and kind of creating a lifestyle that … people need help to get that organized and then but you have to want to, right?

00:21:49 Julie

You have to want to. That’s the most important thing, but I think another huge part of the magic is leaving your current environment and lifestyle and physically going somewhere else for three months. I think that’s super powerful too.

00:22:04 Dayan

It is. It just gets some new environment, clean, clutter free. They can focus on it. There’s not all the distractions of your everyday life, and heck, if you’re there for three months, if you wanna get something installed in your house, if you wanna get, you know, some fans and clean it up, and you can get your family members to start doing some stuff at home. So when you come back, it’s all cleaned up for you, right?

00:22:27 Julie

That is an excellent point. If you don’t mind, I want to dive a little bit deeper. So you mentioned a bunch of strategies that you’re using while people are at your clinic. Would you mind sharing what kind of diet you are using?

00:22:45 Dayan

So the first little while, we don’t want to change. It’s your life, right? So people, your diet and your food is pretty important. You start messing with people’s food and you’re gonna have trouble. And so the first week or so is just kind of getting into the groove of things, right, and then we’ll gradually change your morning to either no breakfast at all or something high protein / fat breakfast, one glycemic meal a day, which is your later meal. And taking time to prepare your meal. Basically, one main meal a day with some snacks. so it would be protein, fat snack like an egg and that comes in the breakfast and evening similar before bed because sometimes you know the fasting, it is … everyone’s different, right and so …

00:23:33 Julie

Ohh it’s tough if you’re insulin resistant, you can’t go to a long daily fast overnight.

00:23:39 Dayan

And if you can’t sleep, then you’re going have to wait. Like some people you can’t sleep if they’re super hungry, so give them something to eat at night that’s not glycemic. And then what we’ll do is we’ll actually shift them to our nutrient drinks like we have egg yolk, oil drinks that contain casein. Or whey in the morning and creatine. We can get a lot of these supplements into a nutrient drink format because that’s the other problem in the elderly, is that – like I take 20 pills a day, but you can’t do that. Kids can’t do that. The elderly can’t do that. The caregivers can’t be … there’s no way they can manage that level of load. So we need to simplify that.

So we’ve been able to develop nutrient drinks that contain egg yolk oil so has nice high quality phosphocholine and lipids.

It’ll have trehalose, which is a non diabetic sugar that helps actually reduce insulin reactivity. We use a whey protein for the mornings. You can use a casein protein at night which gives them better sleep, so there are very strategic, scientifically validated nutrients that we put in. But we put it in slowly.

00:24:45 Julie

And you figured out how to make them taste good, I would imagine.

00:24:49 Dayan

They do, actually. And some sweeteners aren’t that bad for you. You take maple syrup, for example. Maple syrup has a very, very low glycemic index. Like it actually is very little insulin sensitizing molecule. So you can sweeten things up a little bit with certain things. And yeah, it’s very nice. It’s kind of a custardy taste and you can blend it with anything you want to. You can make waffles with it, which I don’t recommend, but you can. Make anything you want with it.

00:25:20 Julie

So it sounds like you’re doing a small breakfast higher in proteins and fat. You’re doing the biggest meal of of the day at lunch when the sun is at its highest peak, which everybody says is something we should all be doing, and then you’re moving to a smaller dinner that’s also low-glycemic?

00:25:39 Dayan

Yeah, well, actually, no. I’m really going to two smaller meals. Then the evening meal is going to be a bit of a bigger meal because there’s cooking and there’s a time … and part of it’s your lifestyle, right? It’s kind of the reward of a day well done. And so you take your time, you relax, you’ve done all your running around for the day. Take the time to prepare a meal. OK, have a decent meal. Finish your day. You got a few hours after that and then it’s more of a satiating for bedtime. And so, you know, have that in that 4:00, 5:00, 6:00 range.

00:26:13 Julie

Got it.

00:26:18 Dayan

Have a kind of a decent decent meal and then kind of have two smaller high protein snacks during the day while you’re out there working.

00:26:25 Julie

Ohh before that and then you do the bigger meal at the end of the day when you’re ready to relax, which is a beautiful pattern for so many of us. I find that’s what I do, yeah.

00:26:34 Dayan

It’s for family time, right? So if you’re out doing things, you prepare the meal, you finish your day … it’s a reward for a day, and each day should be a milestone. Like each day has to feel that you’ve completed a milestone every single day, so there’s not this really, really long delayed gratification concept … like you should have that daily gratification of OK, I finished today. It was a good day.

00:26:58 Julie

I love that. I love having a meal be later in the day, a time when you’re coming together, celebrating the day and spending time with people that you love. So that’s great.

00:27:08 Dayan

And then you start coming down from the day there properly.

00:27:11 Julie

So for that bigger meal, you say it’s the higher glycemic meal then?

00:27:17 Dayan

Well, you’ll still have food like … you’ll have vegetables, basically good quality meat like salmon.

00:27:22 Julie

Sure. Yes.

00:27:23 Dayan

And that’s the other part that we try to get people like, teach people to go get good quality meat and salmon and steak and chicken and and have that good quality. You know, spend the money to get a decent … and so that’s the other part of the whole thing …

00:27:40 Julie

Teaching people how to get wild caught salmon and grass fed beef and …

00:27:43 Dayan

Right. And and have that as a reward. Cause people they really don’t feel that they’re worth it half the time. So there’s a lot of times what they do is they eat like crap because they don’t think they’re worth the extra $10 or $5 for a proper meal at the end of the day. Right? They do! This is a population of people that some of them start feeling that they’re just taking up space in this world. So you have to kind of fix that and say no, you’re valuable. You’re worth being alive. You have something to contribute here. And you’ve earned it basically and so … that’s the kind of concept when people kind of start and … it’s narcissistic, right? It’s about them. It’s like you have to think about yourself, and it’s like the old airplane, put the mask on yourself before you help others, right? Like if you wanna be helpful to your grandkids if you wanna be helpful to your kids. OK, then this is the way to do it.

00:28:43 Julie

Absolutely, they need to put themselves 1st and take take care of themselves.

So going back to that meal – vegetables, healthy proteins … do you restrict carbohydrates at all?

00:28:58 Dayan

Not really as long as it’s part of a balanced meal.

00:28:59 Julie


00:29:04 Dayan

And it’s gonna be part of that fat – the problem with carbohydrates is when they’re taken all by themselves. And your body does need carbohydrates. You still need it in your body. Your body shouldn’t go without it. Now keto is fine, like more of a time restricted process. And if you use keto specifically for a particular disorder, that’s a different situation, right? But for general health, I think … we can talk about this in much greater detail but … keto is very different. It’s hard to be true keto, to truly change the biochemistry of your body such that you’re not even using [carbohydrate], you’re using ketone bodies […] you have to, you have to block gluconeogenesis to actually get into true keto. And you gotta be very, very careful, because if you’re not doing that, then you’re doing muscle wasting, cause your body will use your protein to create sugar. And so keto has to be done carefully biochemically because keto can create sarcopenia.

00:30:15 Julie

And you’re talking about nutritional ketosis, because I would imagine with the fast that you’re doing in the time restricted eating people are clearly in a mild level of ketosis which is …

00:30:30 Dayan

Well, you’re mild, but you’re you’re in a fasting state. The trick is to be in fatty acid metabolism. OK, that’s the trick cause that’s what makes your steroids. That makes your hormones. It makes your plasmalogen’s. It makes. It’s being in the fasting state. So ketosis means that the body’s not actually making glucose anymore. It’s using ketone bodies. It’s a little bit different. We loosely use these terms and they have different meanings. And if you look at them really closely …

00:31:03 Julie

Sounds like you’re healing people that have an unhealthy metabolism, people that are insulin resistant, by just the time restricted eating, and the healthy meals that they’re being offered and you’re promoting metabolic flexibility as opposed to …

00:31:21 Dayan

Skeletal muscle mass. I’m a broken record on this skeletal muscle mass.

00:31:25 Julie

Well, I want to get into that next.

00:31:25 Dayan

Elderly have to build.

00:31:28 Julie

Yeah, but I I was going to say it sounds like you’re promoting metabolic flexibility. Where they’re naturally moving in and out of burning ketones and glucose as humans were designed to do.

00:31:39 Dayan

Correct, proper daily cycle, yeah.

00:31:40 Julie

Exactly, exactly. So yeah, the next thing I want to talk about is exercise, and I love that you’re a broken record about strength training because it is so important as we age. As a post menopausal woman in my 60s, I strength train almost every day. I love it and I absolutely need to at this point in my life because I find myself losing muscle mass.

00:32:09 Dayan

And you gotta be careful you don’t do it too much … I always tell people it’s recovering from resistance training that you get the benefit from it, not the actual doing of it.

0:32:20 Julie


00:32:22 Dayan

The doing of it is bad for you. The recovering of it is good for you.

00:32:25 Julie

That’s right. Because you’re breaking down the muscle fibers and the recovery is when the magic happens.

00:32:32 Dayan

And you want to give people time to do that. And so, yeah. So yeah, that’s absolutely true. Because […] diabetes and even cancer, OK. One of the things to happen with cancer is sarcopenia, right, like the people really lose muscle mass … or all of these situations with people getting these massive sicknesses. One of the first things you start losing is muscle mass, and it becomes very, very hard to get it back.

But the big point on the diabetes side is that your muscles are your primary utilizers of fasting triglycerides. OK, so fat is your storage molecule in your fat cells, and if your muscles deteriorate and don’t metabolize fatty acids, your fasting triglycerides are elevated. OK, this is why exercise has such a powerful effect, because … it’s actually that inability to metabolize the fatty acids coming off your fat cells in the fasting state that drives your metabolic syndrome situations and is driven because the balance of your body gets disrupted. OK, as your muscle mass goes down, if your muscles aren’t consuming the triglycerides, the fatty acids, OK, it blocks sugar from coming in, OK. And so that’s why your insulin goes up and your blood glucose goes up, because your muscles aren’t metabolizing the free fatty acids. OK. And why insulin is such a bad thing is because basically you’re forcing cells to take glucose that they don’t want. They’re saying, hey, I’m full. Don’t give me anymore, OK? And so that’s why I’m a broken record on that. But yeah, it’s important, it’s healthy, but you should rest a good day, like a real rest …

00:34:16 Julie

So do you recommend strength training every other day? Is that your ideal?

00:34:21 Dayan

And even taking two days off on the weekend, like, you don’t need to strength train every day. It should go heavy weights, and then rest.

00:34:29 Julie

See, I’m probably not doing as heavy of a weight. I’m fine going lighter. Yeah, and doing it more frequently.

00:34:38 Dayan

No, you should be at 10 reps you know in that range and …

00:34:40 Julie

Ohh yeah. Ohh no. Yeah, I’m I’m well past.

00:34:42 Dayan

Yeah, you should increase your weights until you can do about 10. You should do weights until you can’t do any … like you should do weights to exhaustion and then wait and and take a couple days off. As an anecdotal thing, like I’ve been kind of an athlete all my life. I use this six day routine. I’d have three different workouts and I do them twice a week for six days, right? And I wrote them legs and thighs. Biceps, whatever it is, I can’t remember. Right. And then I got working and I couldn’t do this big, fancy six day routine, right? And so I ended up saying I can’t do this. So I started working out just twice a week, Saturdays and Sundays. I got stronger working out twice a week than I did before when I was working out six days a week and that was my first big wake up call for me in my 30s.

00:35:40 Julie

I love that. And were you working out harder on those two days?

00:35:47 Dayan

About the same.

00:35:48 Julie

About the same.

00:35:50 Dayan

But I did less exercises, obviously. I would just do the core, biceps and triceps and bench presses. But that was shocking to me because after about a couple months I’m bench pressing more, I’m lifting more of my curls and I’m working out less. So I think we we have a lot of overworking.

00:36:12 Julie

Well, that’s probably me because I’m strength training five days a week and I’m doing at least 45 reps of everything and I am going to exhaustion, but I’m never sore. I’m one of those people that I’m very rarely sore, you know.

00:36:30 Dayan

Well, once, once you’re once you’ve got your biochemistry, you shouldn’t be. You should get. You should get a burn. You should feel it actually work.

00:36:36 Julie

Right. Oh, when I’m on my last rep, yeah, I’m done. I literally cannot do anything else. But you’re inspiring me to do less if I can get more of a benefit. And on the off days, I imagine you focus on aerobic exercise.

00:36:53 Dayan

Yeah, gentle walking like you can do a little bit of, you know, good hiking. And obviously if you if you wanna do some, you know, low impact cardio. Absolutely, yeah.

00:37:04 Julie

Like running if you feel like it, but I love interspersing, running with walking, and I love spending time in nature. I mean, independently. That is so healing.

00:37:14 Dayan

Hiking is awesome. Like you’re going up and down the hill. And you have this kind of varied behaviour – your balance gets better because you’re working, you’re on uneven surfaces …

00:37:25 Julie

And your senses are overwhelmed by the beauty and the wonder of nature, and nothing in a gym can replicate that.

00:37:28 Dayan

Yeah, absolutely, yeah.

00:37:34 Julie

Yeah, so that’s that is beautiful.

00:37:34 Dayan

Exactly right.

00:37:37 Julie

And you spoke about mindfulness, which I absolutely love. So many people lead their lives without really paying attention. They’re like on autopilot, and I think mindfulness has to be the core of any behavior change.

00:37:53 Dayan

Well, look, the reality, this is a stark cold reality – stress shrinks your hippocampus. Period. OK. Like it actually physically will shrink your hippocampus, which is your memory center. OK, so managing stress is critical to maintaining long term mental acuity. Like it really is. And actually I’m gonna present that cause I’m doing functional MRI and I can show you how the amygdala activity is dealt with by stress cause I’ve had a bit of a stressful year and it shows up on my MRI, so it’s kind of a wake up call for all of us who think that we’re impervious and we can say, hey, I got it all under control. You may think you have it under control, but you might not. So it is a reality – you have to take stress seriously and you have to learn how to let things go, and mindfulness is amazingly … and the documentation is quite strong in the clinical literature.

00:38:46 Julie

Very strong and it’s something once you understand the philosophy, you can practice it all day long. It’s just catching yourself when your minds wandering and you’re about to go on autopilot and do something you shouldn’t do. Ohh! It’s that aha! moment when you catch yourself, so yeah.

00:39:04 Dayan

And and then mindful awareness is where you get the views like that’s how you redirect your behavior. Say OK, you know what?

00:39:10 Julie

Yes. Yeah. Right. Ohh, that is beautiful. So are there other stress management strategies that you’re using with your participants?

00:39:19 Dayan

Well, they’ll be going through all the training that normally happen, like the Hazelden programs like the Betty Ford type stuff, like all the stuff that are important for self-awareness, self-confidence and life skills training is life skill training. We don’t take things for granted. Like we don’t assume people know how to cook or how to make a meal nutritious. We don’t assume anything … It’s really like a big bed and breakfast at the end of the day … it really is that kind of community setting.

00:39:57 Julie

Or summer camp for adults? Like, I’m like, sign me up. I’m ready to go. I love, I feel like you’re building self-confidence by teaching them to shop, teaching them to cook and prepare wholesome meals. Like you’re giving them their sense of worth back and it’s very sad in society, in Western society, people do not value elderly people. They have so much to give. So much wisdom. So that is beautiful.

00:40:27 Dayan

And we’re very agnostic. I don’t care what part of the program makes someone better. I just care that they get better. OK. It’s not about bragging about one piece of the puzzle … it’s not about the plasmalogen is the silver bullet or the exercise is the silver bullet. It doesn’t matter. The only thing that matters is that the person starts getting better, OK. And how they get better, you know, we’ll document it and we’ll back all this stuff and we wanna show people that this is real. But there’s not a hidden agenda. To the individual? They don’t care. They just want to get better. They want their life to get better, they want their home life. They want to be able to live at home. They want to be able to have a meaningful life. And so in each person, a piece of that protocol is going to have a greater contribution than another, and at the end, I don’t care which one was the biggest contributor.

00:41:22 Julie

Right. Well, that is beautiful. And it sounds like you also are teaching habits. You’re teaching them a healthier routine and sending them home with it so they can replicate it. And you haven’t had the clinic running long enough to know anything about success, but I know you’ll document all of that, hopefully publish it.

00:41:46 Dayan

Ohh yeah, we’ll do all that, and we have larger clinical trials where we’re doing the day program, where people come in, do assessments. Like that’s the trial of over 100 people starting pretty soon. So we’ll do all that work and we’ll do all the community work cause we wanna support these protocols. These are protocols to be emulated, right? Our doctor network … and we’ll work out the bugs.

Even our big, larger autism community, we have almost 800 autistic families now in our private Facebook group, and it’s not the science. It’s the daily implementation. Like how do you actually get an autistic child to take this kind of supplement, and what’s it gonna affect? Is it gonna give them constipation or are there other issues? Like it’s actually not the science – we have more than enough science. The hard part is using it and funding it.

00:42:43 Julie

I love that you recognize that because so many scientists and researchers are out here with their theories, but the devil is in the details and implementation. So to that end, I know you’re training practitioners, but I assume you’re also training health coaches.

00:43:01 Dayan

So it’s pretty well an open tent on our program … we have different levels of of access … we want to make sure we don’t leave anyone between the cracks, if you will. But yeah, it’s … find the right program for you. Obviously we have the early adopters, our high end doctors, the longevity and biohacking community, and they add our plasmalogen and our supplements and our testing into their existing protocols. OK, like we’re not here to tell people what to do. We’re here to help you do whatever you want to do, right, and whatever we can do to to help you succeed and reach your goals, we want to be able to provide services for that. And so you’ll have doctors like our advanced MRI stuff, people doing peptides and exosomes and intracranial ultrasound. And like, there’s a whole bunch of science level stuff that we are involved in, and then it comes down to the more practical side of things and it’s kind of, find your level. We can help you in in your path.

And sometimes maybe it’s just being part of community group like the ApoE4 group, right, where you guys are sharing, right. And we can find a piece we can contribute, and other people are contributing their piece of the pie and collectively, people find things that work for them. And they can find that person and that person’s life that closely emulates their own. And they can say, OK, I get some hints from somebody, and I can try this. And so we all have to be kind of mentors to people that can then self associate with us. Like me – I’m a 54-year-old, generally healthy man, and I wanna stay this way, right? So there’s gonna be other men in my age group, that’re gonna say, OK, like, OK, what’s going on? You know, I like this. I don’t like that. I think that’s a good idea. I think he’s an idiot on this one. Whatever. Right? That’s the conversation. And that’s what we all basically become, you know, mentors and students at the same time.

00:45:17 Julie


00:45:17 Dayan

In this process.

00:45:19 Julie

And that is a beautiful introduction to our MOD4 project that we’re very close to launching. And for those who aren’t aware, MOD4 stands for Metabolomic Open Access Dataset for the ApoE4.Info community, and we’ve created software on our website where we’ll be able to collect data using your ProdromeScan that will provide ApoE4 carriers (and others because we want a control) to basically track their health progress. And so we’ll be using your ProdromeScan. So can you remind our listeners what the ProdromeScan is?

00:46:03 Dayan

So the ProdromeScan is this 30,000 foot view of your core biochemical systems, and it’s really talking one-on-one with your body. So we deal with the membrane structure – plasmalogens, phosphocholines, the plasmalogen versus the phosphatidyl versions of those molecules, and when you have enough of them in the right proportion.

We look at the fatty acid distribution because there’s a lot of conversations about omega-9, omega-6 omega-3. We actually look at those ratios on the actual phospholipids that are in your body. Like we don’t take your blood and digest it into a soup and give you total fatty acids. You actually understand those fatty acids as they are existing in your membrane lipids.

There’s some gut metabolites called gastrointestinal tract acids that are highly associated with different cancers but also gut health. We look at those molecules.

Methyl transferase system, which is a big deal like your homocysteine system. But we look at it in greater detail, we look at your phosphocholine to ethanolamine ratios and sphingomyelins to ceramides to make sure because sometimes you can go on methyl homocysteine lowering programs, but not actually getting the outcome that you want.

Look at mitochondrial function. Peroxisomal like, that’s the big thing with inflammatory people, especially in today’s day of long COVID and people, you know, getting knocked down, they can’t get up again. All this issue we’re having with the the sudden death myocarditis situations that are out there – we were worried about that kind of stuff. So the mitochondrial function is critical to look at that, to make sure that’s working, and then there’s certain mitochondrial supplements that you can try that will help there. Peroxisomal function.

We just talked muscle mass, right. The biggest issue at the end is fasting triglycerides, right? It’s a simple little. 10 cent test I guess, but it’s critical – just because these are old tests doesn’t mean they’re not valuable. Sometimes these old tests are really the most valuable.

00:48:05 Julie

I love that you included some of the basics in the ProdromeScan. It has all these high level metabolomics and then you have some basics.

00:48:11 Dayan

Right. Because ohh, you would think, I have to get this super fancy test. But I went well, no, you don’t really need the fancy one.

00:48:20 Julie


00:48:21 Dayan

You need to get the core thing, and that’s really peroxisomal function, cholesterol regulation and transport, which is obviously very important for the ApoE4 community, and then sarcopenia type markers like creatinine and then your NAD type with uric acid – make sure that those molecules are in place … C reactive protein for inflammatory.

And there’ll be some other ones that you guys are now involved in. We’ll have other markers that will be available. We have to depend upon the the shipping requirements, but there’s a whole new suite of additional markers that will be available, and of course your blood samples are always biobanked, so we can do other things in the future.

00:49:01 Julie

Well that is wonderful. And I think just to kind of summarize, the ProdromeScan lets you assess your cellular health before symptoms show up. And that’s why your scan is so perfect for our community, because as you know, ApoE4 is not deterministic. We’re at risk for dementia and heart disease. And we want to know if things are moving in the wrong direction before things start to go wrong, and that’s where we think partnering with you is just amazing.

00:49:34 Dayan

The ProdromeScan test is designed to ask the question, why? Not what. It’s not about, what is your marker? It is, why is your biomarker the way it is? Because when you look at your blood work, that is a representation of … your body has chosen that as its best situation in your environment. So it’s the other way around. You have to question why is my homocysteine at 12? OK, it’s the “why” question. Cause the blood test is your body communicating to you – now you have to ask why, and then once you understand the why, then you need to change the why by changing the environment of the body. And the biomarkers will change afterwards. The biomarkers are not driving your health. Your biomarkers are a marker of your health.

So we’re looking at your equilibrium. So you need to look behind the curtain.

00:50:22 Julie


00:50:22 Dayan

That’s what it’s there for, is to say, OK. And then now you can now you can start interactively …

00:50:29 Julie

I love that and yeah, so we’re hoping that we’re going to get lots of people participating, repeating the ProdromeScan every six months or whenever it makes sense, and we’ve created a software platform where we can anonymously share this information with other members of the community. In addition to the ProdromeScan, we’re gonna collect the basics like their age and their height and their weight and their blood pressure. And some other basic biomarkers, if they want to share it, but also what their current diet looks like, what their exercise regimen looks like so that we can track … and their cognitive status – I should have said that – that’s most important. So that we can track people, we hope over a period of years. And we can see ApoE4 carriers that are doing better and we can ask the question, why? And we want to be able to look under the hood and this will be an open access dataset. So we’ll invite everyone to study us. Whoever wants to.

And we’re going to kick this off with a webinar, and you very graciously agreed to join us for that. And at that webinar you’ll be looking at pre and post ProdromeScan of two volunteers. And we’ve decided to use two different interventions for this initial kickoff webinar. And we’re currently looking for volunteers who are not fasting right now and who are not doing strength training. And so, if you’re an ApoE4 carrier and you wanna volunteer, please send an e-mail to, and you can volunteer for the project or you can learn more about it. And we should be kicking everything off in about 3 months and we hope you’ll join us for that.

And before we say goodbye, I just wanted to ask you, how can listeners learn more about your clinic, your rehab and recovery program?

00:52:30 Dayan

So basically if you go to, that’s where all the educational content is. There’s a page on the clinic there and there’s an e-mail link to ask for more information and see if you qualify for the program. And so that’s all available on

00:52:49 Julie

Ohh, fabulous! And I wanted to ask if there’s anything else we didn’t cover that you want to share with the community.

00:52:57 Dayan

Oh, there’s always 1000 things that we’re doing, but no, I think the biggest thing with ApoE4 is a cholesterol regulation situation that the book goes in great detail on the ApoE4 genotype and how the SNP actually … what it does.

And it’s not something people should be afraid of. The goal of all this stuff that we’re talking about is not to create an obsessive watching of your health. You should be able to find a pattern and a lifestyle that you say, OK, this is working for me, and then you shouldn’t have to be obsessing on it every month of your life.

00:53:32 Julie

I completely agree.

00:53:34 Dayan

And check on it every now and then.

00:53:34 Julie

I feel like I’m leading a joyful life, and I appreciate the awareness that I’m an ApoE4 homozygote. The book you’re referring to is Breaking Alzheimer’s. I think it’s available on Amazon. And at, I would imagine. OK, and I highly recommend that.

And before we say goodbye, I just want to say what a huge achievement this is. We are now reaching the era of treatable dementia. Your clinic is doing this. Are you familiar with Doctor Heather Sanderson?

00:54:10 Dayan

Yes, I’ve met her.

00:54:14 Julie

Yeah, so she’s got her clinic in California. She’s opening one in Kansas. And people with dementia are going to the senior care treatment center and they’re going home. So that is such amazing news for ApoE4 carriers. So, so grateful for your work that you’re making this possible and grateful for sharing your time with us today.

00:54:37 Dayan

Well, thank you, Julie. I’m looking forward to working with you.

00:54:39 Julie

Alright, alright, thank you so much, Dayan.

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