The best diet for ApoE4s -Precision Nutrition - latest paper

Alzheimer's, cardiovascular, and other chronic diseases; biomarkers, lifestyle, supplements, drugs, and health care.
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TheresaB
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The best diet for ApoE4s -Precision Nutrition - latest paper

Postby TheresaB » Wed Apr 21, 2021 6:14 am

This paper was just released.

Precision Nutrition for Alzheimer’s Prevention in ApoE4 Carriers

Also, here's a short (less than 5 minutes) video abstract given by the author: Precision Nutrition for Alzheimer's Prevention in ApoE4 carriers - Video Abstract

According to LinkedIn, the primary author, Nicholas Norwitz holds a PhD from Oxford and is an MD candidate at Harvard.

Per the paper, precision nutrition is “an emerging approach for disease treatment and prevention that takes into account individual variability in genes, environment, and lifestyle for each person” [16]."

Much of the advice in the paper is what we've heard before, but this paper cites current research. It is reassuring to know this validates the path many of us have taken. He recommends a Low Carb diet with keto option, Mediterranean food choices, and certain supplements. For the "cliff notes" scroll down (it's page 14 of my downloaded PDF version) to Table 1 for the diet and keep scrolling to Table 2 for the supplements.

Regarding supplements, for me, this is the first time I've heard lithium recommended for ApoE4s. I've heard it recommended in general before, but not in the context of being specifically recommended for our genotype. I'd like to hear thoughts from others on their experience regarding lithium.
-Theresa
ApoE 4/4

circular
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Re: The best diet for ApoE4s -Precision Nutrition - latest paper

Postby circular » Fri Apr 23, 2021 9:07 am

I like they way they simplified and pulled the concepts together here and compared their approach with the FINGER, MAPT, ENLIGHTEN, and SPRINT-MIND studies.

You may have noticed Dr. Richard Isaacson as an author as well.
ApoE 3/4 > Thanks in advance for any responses made to my posts.

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Re: The best diet for ApoE4s -Precision Nutrition - latest paper

Postby NF52 » Fri Apr 23, 2021 12:24 pm

circular wrote:I like they way they simplified and pulled the concepts together here and compared their approach with the FINGER, MAPT, ENLIGHTEN, and SPRINT-MIND studies.

You may have noticed Dr. Richard Isaacson as an author as well.
"TheresaB wrote:
I agree with Circ's review!

Dr. Norwitz only graduated as valedictorian with a B.A. with honors from Duke in 2018 and managed to finish his PhD from Oxford in 2020, and is now taking post-doctoral work at Harvard Med School. I started reading this with some skepticism but ended up printing this out, re-reading sections and especially like the list of strategies and supplements on pp 14-15 and the careful references (179 of them, including many from 2020.)

Dr.Norwitz is extremely skillful in organizing and presenting information and honest about the unanswered or still open questions.

Thanks for finding and sharing this, Theresa!
4/4 and still an optimist!

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Re: The best diet for ApoE4s -Precision Nutrition - latest paper

Postby circular » Fri Apr 23, 2021 5:22 pm

NF52 wrote:… and honest about the unanswered or still open questions

Yes, I liked that too!
ApoE 3/4 > Thanks in advance for any responses made to my posts.

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Re: The best diet for ApoE4s -Precision Nutrition - latest paper

Postby mala » Sun Apr 25, 2021 4:19 pm

Thanks for posting this paper. I hadn't realized that B-vitamin success in reducing homocysteine was associated with omega-3 levels:

In the VITACOG randomized controlled trial, including 26% ApoE4 carriers, B-vitamin
complex supplementation slowed brain atrophy by 70% in those with high baseline Hcy,
but only in the tertile with the highest serum omega-3 levels. Correspondingly, high
baseline omega-3 levels were associated with decreased brain atrophy, but only in the
B-vitamin supplementation group and not with the placebo [160]. These data suggest
that the combination of omega-3 and sufficient B-vitamins might act synergistically to
slow cognitive decline. Data such as these suggest could also explain why omega-3
supplementation does not show benefits in all studies

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Re: The best diet for ApoE4s -Precision Nutrition - latest paper

Postby Whatnow » Sun May 16, 2021 10:14 am

One thing that struck me about this very interesting paper was the absence of any mention of Curcumin. I had thought that Isaacson believed it was useful. Has his opinion changed? Or, am I perhaps remembering incorrectly?
The other thing that struck me was the amount of Resveratrol they were recommending (2 gms!). Is anyone using quite that much?
Thanks.

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Re: The best diet for ApoE4s -Precision Nutrition - latest paper

Postby floramaria » Sun May 16, 2021 6:21 pm

TheresaB wrote:This paper was just released.
Precision Nutrition for Alzheimer’s Prevention in ApoE4 Carriers
Regarding supplements, for me, this is the first time I've heard lithium recommended for ApoE4s. I've heard it recommended in general before, but not in the context of being specifically recommended for our genotype. I'd like to hear thoughts from others on their experience regarding lithium.
Thanks for posting this, Theresa. Today I had time to relax and have a total Nerd Fest, slowly reading through this whole article. It is well-written and as you mention in your post, it has very good supporting evidence from current research for low carb and ketogenic diets as well as supplement recommendations.

As for supplements: I've been taking 5 mg lithium orotate off and on (mainly on) for several years now. First began after the outdoor dinner at the end of the low carb conference in San Diego; the person next to me described the benefits and I did some research after I got home. I've continued to take it because it seems like I've heard it mentioned in almost every health podcast since then. Quick glance at one notebook yielded these references: Ben Lynch ( for BDNF) Chris Shade (essential co-factor for B12 uptake), Dr Joseph Wright (to retain grey matter).
While the article describes its benefit as increasing amyloid beta clearance by inhibiting GSK3 beta, most references I've heard described it up-regulating BDNF. In recent ReCODE Training, increasing BDNF was listed as benefit of 5-10 mg lithium orotate, as well as reducing inflammation, anxiety and depression.

I can't isolate any particular benefit that I'm aware of from taking lithium orotate. Hopefully it is doing all those good things without my noticing! I have never had any problem associated with taking it.
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Re: The best diet for ApoE4s -Precision Nutrition - latest paper

Postby ethans24 » Fri May 21, 2021 9:19 pm

This is a very good read so far, I'm only a few pages in and I wanted to thank you for posting it before I forgot. I especially appreciate that it's free to read.
21 year old college student. 3/4

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Re: The best diet for ApoE4s -Precision Nutrition - latest paper

Postby Karlrad » Mon May 24, 2021 11:06 am

In my opinion, the best diet for APOE E4/4 would consist of specific fruits and leaves, such as Ficus sycomorus figs, Ziziphus spp. fruits, Moringa spp. leaves, etc. The spread of APOE E3 and APOE E2 mutations appear to have been due to infections, such as HHV-1 (herpes cold sores, encephalitis, Alzheimer's) HHV-3 (chickenpox, shingles, microstrokes, strokes, vascular damage), HHV-4 (mono, Burkitt lymphoma, immune dysfunction), etc. Studies have shown that people with the APOE E4 gene are much more susceptible to diseases from these extremely common pathogens. There are specific foods that inhibit HHV-1, etc. For example, 750 mg per kg Moringa oleifera leaf was highly effective at inhibiting HSV-1 in mice. Ficus sycomorus figs (this was called "The Tree of Life" in some cultures) were highly antibacterial to many known pathogens, contains many times the vitamin C as an orange, etc.

Large amounts of high-arginine grains, nuts, meats, etc. promote herpesviruses. Meat
that reaches the colon feeds Bilophila wadsworthia, etc. that creates TMA(O), ammonia, etc. that damages arteries in all people. Processed grains feed many gut pathogens that produce LPS, spores, etc.

Specific foods that feed Faecalibacterium prausnitzii A2-165 are especially beneficial for colon and blood-brain-barrier health. This bacteria produces butyrate, etc. and should make up greater than 5% of total colon bacteria. 1-kestose, fructooligosaccharides, and crossfeeding from resistant starches feed this key bacteria.

Grains, seeds, processed sugar, meat, etc. feed bacteria that cause gum disease that often migrate to the brain. This effects all APOE types.

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Re: The best diet for ApoE4s -Precision Nutrition - latest paper

Postby floramaria » Mon May 24, 2021 3:50 pm

Karlrad wrote:In my opinion, the best diet for APOE E4/4 would consist of specific fruits and leaves, such as Ficus sycomorus figs, Ziziphus spp. fruits, Moringa spp. leaves, etc. .
Welcome, Karlrad. Thanks for posting. This is an interesting take on the best diet for ApoE4’s.
Would the et certeras include any sources of protein? The idea that other ApoE alleles evolved because of 4’s susceptibility to the diseases you list is an interesting concept.
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