Ever wonder if you are going to get a dreaded disease that you have a family history of?  That was the case for me with Parkinson's disease.  My grandfather had Parkinson's, and sometimes I wondered if I had the same genetic markers that predisposed my grandpa to getting the disease. About a month ago I got an email from 23andme letting me know that they were going to be changing their website, and that if I wanted access to locked genetic information, I would have to access it before those changes came.  The locked information included genetic markers for Parkinson's, Alzheimer's and breast cancer.  I had previously decided to keep that information locked, because I know that diet, exercise and stress management are key factors involved in gene expression.  As a nutritional consultant I'm pretty confident that my diet is good, I exercise regularly, and while my life can be pretty stressful, I do have regular practices that I use to manage it.  

I changed my mind though when I realized I would lose access to that information.  I gave a huge sigh of relief when I found out that I don't have any of the known Parkinson's markers, but was surprised to find that I have the APOE 4 gene.  APOE 4 carriers are prone to high LDL cholesterol and Alzheimer's.  The reason the E4 variation is associated with higher risk for high LDL is because the Apolipoprotein E (the protein produced by the gene) binds with VLDL, which reduces the clearance of LDL from the blood, resulting in higher blood levels of LDL.  Ideally you want low LDL, so having a genetic variation that predisposes you to higher LDL increases your risk for certain diseases, such as cardiovascular disease.  The connection between APOE 4 and Alzheimer's is not well understood at this time.


1. Known risk factors:
There are many known risk factors for Alzheimer's including family history, having the APOE 4 gene, high blood pressure, high cholesterol, diabetes, obesity, stroke, depression, smoking and traumatic brain injury (Source).  
Besides the genetic marker, I have no other risk factors for Alzheimer's.  A good reason not to worry.

2.  A healthy gut microbiome:
Research into the area of the microbiota-gut-brain axis has exploded in recent years, and includes the effects of the microbiome on Alzheimer's (Source).  Since my area of specialization as a nutritional consultant is teaching people how to eat to support a healthy microbiome, I feel pretty confident that I'm addressing my microbiome.  I eat a Paleo, gut-healthy diet that includes animal proteins, lots of vegetables, some fruit, healthy fats like fats from grass-fed animals, coconut oil and olive oil, as well as some nuts and seeds, and fermented foods.  

3.  Occasional ketosis as prevention:
A 2008 study showed that glucose transport across the blood brain barrier is impaired in an Alzheimer's brain (Source).  When brain cells are deprived of glucose they need another fuel source, which can be obtained from ketone bodies.  There are different ways for the brain to get ketones.  One is to eat a very low carbohydrate, moderate protein, high fat diet (also known as a ketogenic diet), which will cause your body to shift from glucose metabolism to fat metabolism.  When you metabolize fat, you start producing ketones, which are a great fuel for brain cells.  The other way is to supplement with medium chain triglycerides (MCTs), which rapidly get metabolized into ketones. A double blind, placebo controlled study has shown that MCT supplementation improves memory in Alzheimer's patients (Source).  It's important to note that no dietary changes were made in the study, but that the changes happened with supplementation alone.

A ketogenic diet that is high in saturated fat could be problematic for someone like me who has the APOE 4 gene variation.  I never recommend a diet low in fats, but at the same time I don't necessarily want to eat a high fat diet if I can't metabolize fats well. I decided on a modified ketogenic diet with MCT supplementation.  Right now I'm eating a very low-carbohydrate diet, moderate protein, moderate fat with the addition of MCT oil supplementation daily.

My long-term plan is to go back to a Paleo, gut-healthy diet, with occasional periods of ketosis.  Some of those periods might look like the one I'm in right now that uses a modified ketogenic diet, but some of those periods might be a 3-4 day fast, which also induces ketosis.

Have you considered a preventative approach to your brain health?  Have you reversed symptoms of a neurological condition using diet?  What has worked for you? Or what hasn't?

Happy, Healthy Eating!