I feel you. Prior to learning my APOE status- 4/4, I had never even heard of it before. Alzheimer's wasn't even on my radar. It most definitely turned my life upside down. I’m sure you feel the same way.
I just wanted to throw out the idea that fish oil, like many possible ϵ4 interventions, is controversial. I've been all over the place with whether or not to supplement. I did. Then, I stopped. Now, I am again
I eat a healthy diet (like you) that is low in carbs-only veggies & fruit with Omega-3 rich proteins- and subsequently low in inflammation/oxidation. The concern is that fish oil/PUFAs are prone to oxidizing and our genotype makes that even more likely especially in the context of a typical Western diet.
Research to date has been mostly negative, showing ϵ4s do not get the same benefit as other genotypes.
Some newer research shows that ϵ4 mice can derive the same benefit with higher doses and additional antioxidants and nutrients. There are currently several studies underway testing the same concept on humans.
The isoform-specific pathological effects of apoE4 in vivo are prevented by a fish oil (DHA) diet and are modified by cholesterol http://www.ncbi.nlm.nih.gov/pubmed/22057027
"These findings suggest that a fish oil (DHA) diet could be used to attenuate the effects of apoE4 in AD."
Effects of Specific Multi-Nutrient Enriched Diets on Cerebral Metabolism, Cognition and Neuropathology in AβPPswe-PS1dE9 Mice http://www.plosone.org/article/info%3Ad ... ne.0075393
"The FC diet additionally restored neurogenesis in AβPP-PS1 mice, decreased hippocampal levels of unbound choline-containing compounds in wild-type and AβPP-PS1 animals, suggesting diminished membrane turnover, and decreased anxiety-related behavior in the open field behavior. In conclusion, the current data indicate that specific multi-nutrient diets can influence AD-related etiopathogenic processes. Intervention with the FC diet might be of interest for several other neurodegenerative and neurological disorders."
Some further digging revealed that the “FC” diet was a mouse version of Souvenaid- a patented mixture of nutrients that includes choline, uridine, monophosphate, high levels of omega-3 fatty acids, and various antioxidants and B vitamins.
In the meantime, here's some advice from the UCLA Alzheimer's Research Center specifically for ϵ4s.http://alzheimer.neurology.ucla.edu/Curcumin.html
“Data suggest that subjects with ϵ4 do not respond to DHA which may be due to oxidation. It is possible that Curcumin or other antioxidants may enable ApoE4 to respond to DHA. A combination of pure DHA with fish oil is recommended. 600-900 mg of DHA is recommended. You can start with a higher loading dose than drop down. Higher doses were used in the trial but there is saturation at 900 mg/day.” (Read the whole link; they suggest taking the fish oil on an empty stomach, 2-3 hours before meals, etc.)
Best of luck navigating these uncertain waters. Definitely do your own research. Trust me, we all know the frustration and fear. I've found incredible information and support learning from the dedicated people here.
Quick question: where did you come up with the idea that a high EPA/DHA ratio was best for ϵ4s? I've heard some cardiologists recommend that to treat CVD in ϵ4s and some neurologists (and researchers- like the UCLA team) recommend the opposite, high DHA:EPA ratio to prevent AD. Seems to be a little discrepancy there. Thanks for all of the amazing resources on safe salmon/sardines, etc. Priceless!