Found My Fitness with Dr. Rhonda Patrick – Dr. Dale Bredesen on Preventing and Reversing Alzheimer’s Disease

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Key Takeaways
  • The biggest risk factor for developing Alzheimer’s Disease? – Whether or not you have any copies of the ApoE4 gene
    • Everybody has 2 copies of the ApoE gene (1 from mom, 1 from dad) – it’s either ApoE2, ApoE3, or ApoE4
      • 75 million Americans have a single copy of ApoE4 
        • Their lifetime risk for developing Alzheimer’s Disease is about 30%
      • About 7 million Americans have 2 copies of ApoE4 
        • If you have 2 copies, your lifetime risk of developing Alzheimer’s Disease is over 50%
    • You can test your ApoE phenotype with 23andMe
  • In summary, the best ways to prevent Alzheimer’s Disease:
    • Eat a low inflammatory diet
    • Exercise
    • Limit your exposure to mold and other mycotoxins
    • Keep an eye on your copper and zinc levels
      • You don’t want your copper/zinc ratio to be too high
      • About a billion people on earth are deficient in zinc – you might want to supplement
    • Limit your exposure to mercury 
      • If you eat fish, make sure it’s wild caught, not farm raised
    • Eat organic to avoid toxins
  • To reverse cognitive decline. Dale recommends patients:
    • Follow a mild ketogenic diet
    • Fast for a minimum of 12 hours each night
  • Sleep is one of the ways you clear away amyloid plaques in the brain
  • Using the sauna is a great way to sweat out toxins that can lead to Alzheimer’s Disease (like cadmium, mercury, and BPA)
Intro
  • Follow Dr. Rhonda Patrick on Twitter and Instagram
    • You should also support her work on Patreon
  • 75 million Americans carry the ApoE4 gene
    • Having 1 copy of this gene increases the risk of Alzheimer’s disease 2-3 fold
    • Having 2 copies increases the risk 15 fold
    • You can see how many copies you have by getting a genetic test with 23andMe
  • “Cognitive decline is, at least for most of us, and especially early in its course, addressable. For the first time, hope and Alzheimer’s come together.”
What is Alzheimer’s Disease?
  • The literal definition is when you have amyloid plaques in the brain, and phosphorylated tau tangles
    • These ultimately lead to cognitive decline and dementia
  • Amyloid acts as a neurotoxin and has toxic effects
  • But why does amyloid form?
    • It’s an antimicrobial
    • It’s a protectant in a way – a response to things like pathogens
  • There are many people that produce the amyloid plaques, and don’t experience any cognitive decline
    • Why? – They don’t say
  • The types of Alzheimer’s Disease (AD)
    • Type 1 – Inflammatory (aka Hot) Alzheimer’s Disease
      • Caused by anything that increases inflammation in the body interacting with the amyloid plaque
    • Type 2 – Atrophic (aka Cold) Alzheimer’s Disease
    • Type 1.5 – has features of both Type 1 and 2
    • Type 3 – Toxic Alzheimer’s Disease
      • Many of these people have low serum zinc, high copper/zinc ratios, and low triglcygerics (we don’t know why)
        • Copper and zinc are competitive in their absorption
        • Too much of one, is associated with too little of the other
        • About a billion people on earth are deficient in zinc – you might want to supplement
        • People with copper piping, tend to be low in zinc (since it competes with zinc)
      • People with Type 3 tend to be younger (late 40s, mid 50s), are often women, and often ApoE4 negative
      • The above types all have amyloid plaques and tau tangles
ApoE4
  • Aka Apolipoprotein E
  • The most important genetic risk factor for Alzheimer’s Disease
  • Everybody has 2 copies of the ApoE gene (1 from mom, 1 from dad) – it’s either ApoE2, ApoE3, or ApoE4
    • 75 million Americans have a single copy of ApoE4 
      • Their lifetime risk for developing Alzheimer’s Disease is about 30%
    • About 7 million Americans have 2 copies of ApoE4 
      • If you have 2 copies, your lifetime risk of developing Alzheimer’s Disease is over 50%
    • If you’re a 3,3 (2 copies of ApoE3), your lifetime risk for developing AD is about 9%
  • People with ApoE4 have a “hair trigger for inflammation”
  • You can test your ApoE phenotype with 23andMe
Get a Cognoscopy
  • Dale recommends once you hit 45, you get what he calls a “cognoscopy” – it’s a term he made up
    • It’s basically just a series of blood tests to assess your overall health
  • “Alzheimer’s should be a rare disease. It should essentially decrease to a very low level with the current generation. You should be doing some testing to see where you stand, what are your risk factors – are you ApoE4 positive, do you have high homocysteine, methylation issues, inflammatory issues, nutrient issues, toxin issues, all these things, because they can all be addressed, and we can decrease the overall global burden of dementia”
  • What biomarkers should be measured with a “cognoscopy”?
    • hsCRP (high sensitivity C-Reactive Protein) – a marker of inflammation
    • Homocysteine – it’s a marker of methylation
      • If your homocysteine is high (greater than 7), you’re at risk for neurodegeneration
      • It’s been published that you’ll have a more rapid decline in your hippocampal volume if you have a high homocysteine
    • Fasting insulin
      • Optimally it should be less than 5
    • Hemoglobin A1C (HbA1c)
      • A marker of serum glucose over the last 2 months
    • Fasting Glucose
    • Your vitamin D levels
    • Pregnenolone, progesterone, estradiol, testosterone, and free T3 
    • BDNF – you can’t measure this, but if you haven’t been exercising, your BDNF is likely to be lower
    • Toxins
      • Mercury 
      • Organic toxins like DDE
      • Biotoxins – trichothecene, ochratoxin A, aflatoxin, gliotoxin – these are toxins produced by various mold species
    • Also consider or take note…
      • If you’ve had a history of head trauma
ReCODE
  • Dale has a protocol called ReCODE, which he advises his patients follow for the reversal of cognitive decline
  • What does the diet look like in this protocol?
    • It’s called the Ketoflex 12/3 diet
      • This involves being in a mild state of nutritional ketosis
        • Being in ketosis, seems to improve cognition, and many people do better with their cognitive decline
        • Use things like MCT Oil (Podcast Notes recommends this brand), Exogenous Ketones (we recommend this brand) , and coconut oil to raise your blood ketone levels
        • To be in a state of ketosis, you want your blood ketone levels to be greater than 0.5 mmol/L 
        • For more on ketosis, check out these Podcast Notes
      • To do this, you’d eat a very low carbohydrate, high fat diet
        • Fats are of the healthy variety – nuts, seeds, olive oil
        • 70% of calories should come from fat
      • Dale advises to “treat meat as a condiment”
        • If you eat beef, make sure it’s grass fed
        • Fish – make sure it’s wild caught, not farmed
          • Don’t have fish with high mercury contents – these are typically things like tuna (stay away from tuna sushi!!), swordfish
        • If you’re going to eat chicken, make sure it’s pasture raised
      • “12/3” – What does this mean? – A minimum of 12 hour fasts between when you start breakfast/lunch
        • 12 hours allows time for autophagy (death of weak cells)
        • If you are ApoE4 positive, Dale advises to fast for 14-16 hours
      • You can lose weight on the Ketoflex 12/3 diet, so once a week have a “cheat” meal or day
        • Have some sweet potatoes, and other higher carb foods etc.
      • Don’t eat 3 hours before bed
      • Eat organic to avoid toxins
      • “The bottom line is that we were not made as human organisms to consume the amount of simple carbs that we typically are exposed to.”
    • Other benefits to being in ketosis
      • Improved insulin sensitivity
      • You won’t have high blood glucose levels (and all the inflammatory processes associated with that)
      • Glucose gets spared to make NADPH, which is a precursor to glutathione (the body’s master antioxidant) which can repair damage
  • Each day we are exposed to toxins that could ultimately lead to dementia
    • Mercury
    • Organics in health and beauty aids
  • Another part of the protocol – use the sauna (see below)
Clearing Away Amyloid Plaques and Protecting Against Alzheimer’s Disease
  • People with Alzheimer’s disease are not clearing amyloid beta plaques via a process known as phagocytosis effectively
    • What does this mean? – Macrophages in our blood engulf harmful particles for clearance via a process known as phagocytosis
  • There’s evidence that when people who have ApoE eat more fish, they’re better protected against Alzheimer’s Disease
  • DHA (found in fish and fish oil – Rhonda recommends this brand of fish oil), is important for some glucose transporters on the blood-brain barrier
    • If you’re DHA deficient, those glucose transporters aren’t working well, and you’re not getting enough glucose into the brain – this is a hallmark of Alzheimer’s Disease
  • Type 1 and 1.5 Alzheimer’s Disease are the easiest to deal with and protect against
    • Just improve your diet, exercise, and sleep
    • Overall – do anything to reduce chronic inflammation
  • For Type 3 protection, Dale recommends really keeping an eye on exposure to mold (in both your living and work environments) and other mycotoxins
Sleep
  • Sleep is one of the ways you clear away amyloid plaques (which develop and cause dementia) in the brain
    • During sleep, your brain swells, and you squirt cerebral spinal fluid into the brain which clears out amyloid plaques and other junk
Use the Sauna
  • Sauna use has been shown to be very protective against developing Alzheimer’s Disease
  • One of the biggest benefits – detoxing
    • There are certain toxins that you sweat out – like mercury, BPA, and cadmium
    • “Using the sauna is a great way to reduce overall toxic burden. It’s really surprising how much toxic burden most of us are living with.”
  • After using the sauna, and getting all sweaty, Dale recommends using a non-emollient soap, like Castile soap, to prevent toxin repenetration
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