Dr. Day is a cardiologist/electrophysiologist at the Intermountain Medical Center Heart Institute in Salt Lake City, Utah. He graduated from Johns Hopkins Medical School and completed his residency and fellowships in cardiology and electrophysiology at Stanford University. He is the former president of the Heart Rhythm Society and currently serves as the president of the Utah chapter of the American College of Cardiology.
How to Prevent Alzheimer’s Disease
My dear friend just learned this week that her father was diagnosed with Alzheimer’s Disease. The tragedy is that he is only 50 years old.
Does Alzheimer’s run in the family? Is there anything you can do now to prevent you from suffering the same fate? In this article I discuss the 10 things you need to do now to minimize your risk of ever suffering from this devastating condition.
Do You Have the Alzheimer’s Gene?
If you have a family history of Alzheimer’s Disease then there is a high chance that you have the “Alzheimer’s gene.” Specifically, half of all people with Alzheimer’s Disease have the ApoE4 gene. While this is the most important gene for Alzheimer’s Disease, there are also other “lesser” genes which may also be involved.
The ApoE gene controls cholesterol and lipid metabolism. There are 3 main forms of this gene, ApoE2, ApoE3, and ApoE4.
If you have the “ApoE2” form then you are protected against developing Alzheimer’s Disease. ApoE3 is the “normal” form of this gene and has no increased or decreased risk of Alzheimer’s Disease. Unfortunately, about 25% of Americans have at least one copy of the ApoE4 form which puts them at significant risk of high bad cholesterol (LDL) as well as heart disease and Alzheimer’s Disease.
We each have two copies of the ApoE gene. One from our mother and one from our father. If you have just one copy of the ApoE4 gene then your risk of Alzheimer’s Disease is increased 2-3 fold. Tragically, if you have 2 copies of the ApoE4 gene your risk of Alzheimer’s Disease is increased 20-30 fold. Not only does the ApoE4 gene put you at high risk of Alzheimer’s Disease, it also causes the disease to develop as early as age 30.
How Do You Know if You Have the ApoE4 Gene?
You can now know if you have the Alzheimer’s gene for a little over $100. You don’t even need your doctor to help you with this test. This is something you can order for yourself online.
Not only will you learn your Alzheimer’s gene status, you will also learn about thousands of other genes for cancer, obesity, autoimmune diseases, etc. Other than filling out a few online forms all it requires of you is some of your saliva in a test tube. To learn more, I describe the details of how to test your genes in a previous blog post.
Are Your Genes Your Destiny?
Do our genes determine whether or not we will develop certain diseases? Absolutely not! Our DNA is not our destiny.
Our genes just represent the seed. For a seed to grow it requires the right nutrients in the soil, water, and sunlight. The same is true for our genes.
If we can live a perfectly healthy lifestyle we can turn the ApoE4 gene off. This is done through a process known as epigenetics. In fact, only 25% of our health future is determined by our genes. The other 75% is completely up to us based on the decisions we make every day.
How Do You Silence the ApoE4 Gene?
Fortunately, even if you have the ApoE4 gene it doesn’t need to cause high cholesterol, heart disease, and Alzheimer’s Disease. While this often happens with our Western lifestyle, we have scientific evidence from 3 groups of people living an ancestral lifestyle who do not suffer any bad effects from the ApoE4 gene.
1. Pima People Living in Mexico
The Pima people reside in Arizona and Mexico. They were once known for their lean bodies, great athleticism, and health.
Unfortunately, after being driven from their native lands and way of life, the Arizona Pima people were given government rations of white flour, sugar, canned goods, and industrial oils to keep them from starving. A few generations later they now have one of the highest rates of obesity, diabetes, and Alzheimer’s Disease anywhere in the world.
In 1999, researchers studied a group of Pima people still following the traditional Pima diet and lifestyle in Western Mexico. Even among those Pima people with the ApoE4 gene, they saw no evidence of high cholesterol, heart disease, or Alzheimer’s Disease. The researchers concluded that this ancestral lifestyle protected the Pima people from the ravages of the ApoE4 gene.
2. Yoruba People Living in Nigeria
Later, in 2004, researchers evaluated two groups of people of African descent with regards to the ApoE4 gene and Alzheimer’s Disease. Of the two groups in this study, one group lived in Indianapolis, Indiana and the other Ibadan, Nigeria.
As expected, the ApoE4 gene increased the risk of Alzheimer’s Disease in African Americans living in Indianapolis. However, quite unexpectedly, the ApoE4 gene had absolutely no effect on the risk of Alzheimer’s Disease among the Yoruba people living in Ibadan, Nigeria.
Once again, the researchers concluded that the traditional diet and lifestyle of the Yoruba people living in Nigeria silenced the ApoE4 gene and protected them from developing Alzheimer’s Disease.
3. Sub-Sahara Africans
In 2014, researchers reviewed data published in 522 studies on the risk of dementia in Africa. As with the previous two studies, this study came to the same conclusion. In Sub-Sahara Africa, Africans who have the ApoE4 gene but yet still eat the traditional diet and follow the traditional lifestyle completely silenced the ApoE4 gene.
Are ApoE4 People the Canary in the Coal Mine?
In the past, canaries were used in coal mines to warn miners of impending danger. The build up of toxic gases in the mine, like carbon monoxide or methane, would kill the canaries long before the miners were affected.
In our modern Western way of life, people with a copy of the ApoE4 gene represent the canary in the coal mine. In other words, the Standard American Diet (SAD) and physical inactivity harms people with the ApoE4 gene long before people with the other forms of the ApoE gene.
For people with the ApoE4 gene, to escape the fate of the canary in the coal mine, they must give up the Standard American Diet (SAD) and embrace a physically active lifestyle. Indeed, studies have shown that for people with just one copy of the ApoE4 gene, a poor diet and lifestyle increases the risk of Alzheimer’s Disease by 11-fold!
How to Prevent Alzheimer’s Disease: 11 Strategies
If you have a family history of Alzheimer’s Disease then odds are that you also have the ApoE4 gene. If you have this gene or a family history of Alzheimer’s Disease, let me share with you 11 ways to prevent this tragic fate.
1. Exercise Faithfully
For people with the ApoE4 gene or a family history of Alzheimer’s, exercise is the single most important thing they can do to decrease this risk. While exercise is good for everyone, the benefits seem to be most pronounced in people with the ApoE4 gene.
It doesn’t matter what form of exercise you do as long as you do something physical every day for the rest of your life. In addition to exercise, make sure you minimize any sitting throughout the day.
2. Maintain a Perfect Weight
Following exercise, maintaining an ideal weight is absolutely critical for people with the ApoE4 gene or a family history of Alzheimer’s Disease. Unfortunately, I have found that most people have no idea what their ideal weight is. If you weigh more than your ideal weight this extra weight can turn the ApoE4 gene on.
People with the ApoE4 gene or a family history of Alzheimer’s need to have a body mass index (BMI) at least lower than 25 which is the bare minimum to no longer be considered overweight. To learn your own BMI, here is an excellent online BMI calculator.
3. Keep Your Mind Active
Countless studies have shown that stimulating your mind over a lifetime can help to prevent Alzheimer’s Disease. The same is true for people with the ApoE4 gene or a family history of Alzheimer’s.
4. Eat a Low Cholesterol Diet
New dietary guidelines in the U.S. will now stop recommending that people avoid cholesterol in the diet. While dietary cholesterol does not affect blood cholesterol levels in most people, this is not true for the 25% of Americans who possess at least one cope of the ApoE4 gene. For people with the ApoE4 gene, minimizing dietary cholesterol still matters!
5. Avoid Trans Fats and Minimize Saturated Fats from Animals
As with dietary cholesterol, saturated fats may no longer be dangerous to cardiac health as was once thought. Once again, this is true for most Americans, not those with the ApoE4 Alzheimer’s gene. For these people, minimizing saturated fats from animal products (meat and dairy) are critical to preventing dementia.
Trans fats are still rampant in processed foods, fast foods, bakery items, and restaurant foods. Anything processed or prepared could be loaded with trans fats. Even if the label says no trans fat this may not be the case due to loopholes in U.S. labelling laws. You have to read the ingredient list carefully. Trans fat for people with the ApoE4 gene are particularly dangerous.
6. Make 9 Servings of Fruits and Vegetables the Goal
The American Heart Association now recommends 9 servings of fruits and vegetables each day. While fruits and veggies are good for everyone, people with the ApoE4 gene or a family history of Alzheimer’s seem to benefit the most. Indeed, studies have shown that fruits and vegetables can decrease the risk of Alzheimer’s Disease by 76% in people with the ApoE4 gene.
7. Minimize Sugar
It goes without saying, if you want to protect your brain you need to minimize any added sugars or even foods that behave like sugar in the body. This includes fruit juice and 99% of breads, pastas, crackers, pastries, breakfast cereals, white rice, french fries, etc. If you enjoy these foods, you can be part of the 1% to eat the healthier options I have discussed in other blog articles.
Many researchers now feel that any elevation in blood sugar levels can be toxic to the neurons in our brains. Do your brain a favor and stick to lower glycemic foods to help maintain a healthy blood sugar level.
8. Use Supplements Wisely: B12, Fish Oil, Turmeric, and Vitamin D
Having the right amount of B12, turmeric/curcumin, and vitamin D can be protective of Alzheimer’s Disease in people with the ApoE4 gene or a family history of Alzheimer’s. However, people with the ApoE4 gene need to be very cautious with fish oil. Higher doses of fish oil in people with the ApoE4 gene can actually increase the risk of Alzheimer’s Disease.
I should point out here that eating fish has been shown to be very helpful in preventing dementia in many studies. However, for people with the ApoE4 gene there may not be as much of a benefit.
9. Avoid Smoking and Alcohol
Both smoking and alcohol activate the ApoE4 gene. Thus, for people with the ApoE4 gene, abstaining from smoking and alcohol are important in minimizing the risk of dementia.
10. Minimize Stress
11. Avoid too Much Iron and Copper
Iron and copper are critical micronutrients for health. However, when levels of copper or iron get too high in the body this can trigger dementia.
Does Alzheimer’s run in the family? Do you have the ApoE4 gene? What have you found that has been helpful in maintaining a healthy brain?
Do not self diagnose or treat based on anything you have read in this article. I am not recommending genetic testing or any supplements in this article. If you have a family history of Alzheimer’s Disease, please discuss with your physician which lifestyle changes would be most important to decrease your risk of Alzheimer’s.
Disclaimer Policy: This website is intended to give general information and does not provide medical advice. This website does not create a doctor-patient relationship between you and Dr. John Day. If you have a medical problem, immediately contact your healthcare provider. Information on this website is not intended to diagnose or treat any condition. Dr. John Day is not responsible for any losses, damages or claims that may result from your medical decisions.