Apoe 2/3/4 variants and diet page

[Dracil]

So I've been reading about apoe variants and how this may have a strong effect on what we should eat.

Stuff I've gleaned that may or may not be right
1) People have two copies of the genes, so you can be 2/2, 3/3, 3/4, 2/3, 2/4, etc.
2) 75% of the population have no 4 allele, and 2% have the 4/4 variant. Most people are 3/3. (This is specific to Europeans)
3) 4 is the most ancestral gene, 2 is the newest gene. There are claims that the 4/4 is much rarer now because our switch to a grain-based diet killed off most of the 4/4s. However, I have also read that the 4/4 genotype is actually even more ancient than paleo, and the diet would be more similar to other primates.
4) People are afraid of having 4/4 because that means a significantly higher risk of Alzheimer's, and the associated implications with insurance coverage and so forth
5) Having the 4 variant is associated with higher LDL, and I think especially the bad dense kind
6) However, this is because 4 variants have a harder time getting enough saturated fats in the brain, which is why the body needs to increase the LDL, however, this also increases plaque formation

From those points, are the following questions/comments
1) I have heard people comment that if you have the 4/4 variation you should lower your saturated fat intake because it'll be bad for your LDL numbers, but that doesn't make sense to me for the following reasons:
a) Given the general paleo/primal framework, it would seem to me that having the ancestral allele would make it even more important to be eating a non-grain diet, which means more protein and fat in general
b) If your brain is already not getting enough saturated fat, wouldn't reducing saturated fats just make it worse?
2) However, what does the additional plaque formation mean in regards to heart disease?
3) Apoe4 isn't the be-all-end-all, as there are those who were 4/4 or 4/3 (I forget which) who said their health/numbers improved going on a high fat diet and things sucked on a low-fat diet, but at the same time, there are those who found their numbers better going on a low-fat (esp. sat fat) diet.
4) As such, what should be the recommended diets for people of the various variations of the alleles (or if there should be any variations)? Not enough information is also a probable answer.

[peril]

Been taking a bit of an interest in this lately as my LDL numbers have skyrocketed. Haven't had the ApoE genotype test yet because I'm not sure what to do with the results. There is a lot of contradictory information out there, little of it concrete.

Do you have any evidence that high LDL resulting from the ApoE4 genotypes is necessarily artherogenic? Some of the reading that I've done points to ApoE4 inducing high LDL and high Triglycerides. Very easy to see this as being artherogenic. But if Trigs are low is there solid evidence of a danger?

[Dracil]

It mainly seems to be Dr. Davis who feels that those with Apoe4 should reduce their saturated fat intakes: e.g. The exception to low-carb | The Heart Scan Blog and http://www.trackyourplaque.com/blog/...t-fit-all.html

Others (I think Kruse?) have different opinions.

[Dig62]

What is the bottom line here? My mother has Alzheimer's as do her sisters and her mother had it also. I'm a bit concerned right now as to what my dietary strategy should be to avoid it myself, given that I have already been displaying symptoms of memory loss. Is this test something that doctors perform routinely, or do I need to ask for it myself? Is the paleo diet protective for the Apoe4 gene or do I need to undertake a special diet if I am gene positive?

[jturk]

What is the bottom line here? My mother has Alzheimer's as do her sisters and her mother had it also. I'm a bit concerned right now as to what my dietary strategy should be to avoid it myself, given that I have already been displaying symptoms of memory loss. Is this test something that doctors perform routinely, or do I need to ask for it myself? Is the paleo diet protective for the Apoe4 gene or do I need to undertake a special diet if I am gene positive?

At this point, I wouldn't base any particular dietary strategy on ApoE allele status. Not nearly enough evidence.

Remember that Alzheimer's is virtually absent amongst HGs, which is way it's included under the diseases of civilization umbrella. Nobody in dementia-free traditional cultures was deciding what they should eat based on genetic polymorphisms.

If you're already following a primal diet, then you're already doing all you can nutritionally to minimize your risk of AD. I wrote a couple posts recently about Alzheimer's and nutrition recently, if you're interested (I do Alzheimer's research for a living).

[Dracil]

I seem to recall that some HGs (Inuits?) did have plaque formations though. Supposedly the problem is if you have the variation, high-fat = plaques, and low-fat = Alzheimer's. But HGs were generally high-fat, so hence the first problem. However, despite the plaques, I think they didn't actually have any/more heart attacks, I think because they weren't getting a lot of inflammation.

[peril]

This seems to give rise to a number of issues. One that really strikes me is this. Is it not medical malpractice to prescribe statins to someone with the ApoE4 allele? Or to someone whose ApoE genotype hasn't been established?

[Dig62]

Peril, my mother was put on Lipitor four years ago and she didn't even have high cholesterol! Her doctor put her on it strictly as a 'preventative measure'. After being on it for two years she started to develop memory problems and now has Alzheimers, though I admit that it may be pure coincidence. Nonetheless I've gotten her off the Lipitor with her doctor's consent, and her cholesterol profile has remained good. Even if it doesn't help I figure it's one less pill for her to take and I'm all for that.

[robt]

Peril, my mother was put on Lipitor four years ago and she didn't even have high cholesterol! Her doctor put her on it strictly as a 'preventative measure'. After being on it for two years she started to develop memory problems and now has Alzheimers, though I admit that it may be pure coincidence. Nonetheless I've gotten her off the Lipitor with her doctor's consent, and her cholesterol profile has remained good. Even if it doesn't help I figure it's one less pill for her to take and I'm all for that.

The studies on APOE4 and high fat/cholesterol are not done in the context of a low carb diet. High fat + high carb may jack up cholesterol but not high fat alone.

[Aili]

At this point, I wouldn't base any particular dietary strategy on ApoE allele status. Not nearly enough evidence.

Remember that Alzheimer's is virtually absent amongst HGs, which is way it's included under the diseases of civilization umbrella. Nobody in dementia-free traditional cultures was deciding what they should eat based on genetic polymorphisms.

If you're already following a primal diet, then you're already doing all you can nutritionally to minimize your risk of AD. I wrote a couple posts recently about Alzheimer's and nutrition recently, if you're interested (I do Alzheimer's research for a living).

Good stuff! I wish to avoid AD and find all the above very interesting.