"Knowing something and then doing something are what matter. I agree! That said, data show that people who know they are ApoE4 are more likely to engage in preventative lifestyle change. If you want, check out the ethical considerations section. Also, this is a precision nutrition manuscript, i.e. it is based on an understanding of how ApoE4 alters metabolism and how to correct/compensate for those deficits. Knowledge is power. Anyway, sounds like you're doing absolutely stellar on your journey! Couldn't be happier for you! - Nick

Can you add a link to the paper referred to please.

@@janschwarz4194 It's already in the description. Look below the video.

@@janschwarz4194 Link is already there. See video description

You are not alone. And since the economic consequences are so devastating I would believe that before long there will be a treatment that aims at APOE4.

And what works best for you?

Research CDP Choline (Citicoline) looks very promising.

Good for you! Keep it up!

if you stop eating oil and fat the one cn handle carbs and sugar. Insulin resistance is caused by intramyocellular fat form ingested oil. The oil in the muscle cells turn off the insulin receptor

@@spoudaois4535 I had no idea! Thank you.

"now I can understand why my cholesterol is high" ... I'm not sure this paper explains any of that, nor does anything I've put out on omega-3s. Can you elaborate?

@@nicknorwitzPhD Sorry my comment might be not totally relevant just to the content of this video but I was just excited and grateful for the information on top of other things that you share. If I didn't read your article on Omega 3, I wouldn't go and do a gene test and would be oblivious to my E4 gene. So thanks again. This particular paper does not explain everything but I've read your other articles related to Omega 3 while being on keto: e.g. ketodietapp.com/Blog/lchf/what-you-need-to-know-about-omega-3-fats and ketodietapp.com/Blog/lchf/mediterranean-ketogenic-diet-for-alzheimer-s-prevention-new-scientific-paper-april-2021. Regarding cholesterol, this is one of those that I read: "The ApoE ɛ4 isoform is associated with higher total cholesterol levels, higher LDL-cholesterollevels and lower HDL-cholesterol levels" (Mahley RW, Rall SCJr. Apolipoprotein E: far more than a lipid transport protein. Annu Rev Genomics Hum Genet. 2000;1:507-537. www.annualreviews.org/doi/10.1146/annurev.genom.1.1.507, extracted from: academic.oup.com/biomedgerontology/article/74/1/99/5129099)

@@rosatyan The statement from the Mahley paper may not generalize to those who have an increase in LDL as the result of lifestyle change. The logic is that peripheral ApoE preferentially binds VLDL/HDL such that VLDL uptake is impaired at the liver. However, in the LMHR cohort there isn't a clear trend towards elevated LDL in ApoE4+ individuals. In fact, if anything, E3/4s have slightly lower LDL. Can't say much about 4/4s because population is too small.

Fibro is a catch all diagnosis that, sadly, doesn't usually mean much. The stereotype is that it's a label given to patients to "appease" them. Now, I'm NOT NOT NOT saying you're making anything up, but rather that pain disorders aren't well understood. I will also report, anecdotally, that I know three people who had fiber who ate clean keto (two medi-keto) for a month and it really did help (or so they reported). Placebo? Decreased inflammation? Honestly, does it matter?

@@nicknorwitzPhD Keto changed my life! I wish I knew about it sooner. Doctors had written off my A1C and inflammation values because they always showed up at the high end of "normal" or just out of range. Not enough inflammation to get autoimmune testing, but I was absolutely miserable for over 20 years. With a look at my genetics including ApoE4 - I get it now! Who knew the right nutrient dense protocol could improve my life so much? I wish there was more research being done on nutrition for Fibromyalgia. :)

Thanks Anil. Glad you're doing well! As for the debate, hopefully that happens. I've given him multiple opportunities to chat and he hasn't yet actually taken me up on them. Not sure if he intends to. Maybe he really is just that busy that he can't find any time over weeks. But he know's I'm game and he has my email. Currently, I have him blocked on Twitter because I think he's retweets lack insight, are unproductive, are intentionally inflammatory. But that's all a sidebar. "

you mean biolame. big pharma shill

I knew my status at age 23! No AD for me! Never too early!

@@nicknorwitzPhDhow to screen for it?

I'm a layman, but I think people focus on macros way too much. How about just eating a balanced diet with limited crap and exercising and being metabolically healthy. There's probably more truth to that than high carb vs low barb

I am, yes. I'm a homozygote actually (ApoE4/4). It's personal decision. In the paper, I discuss some of the pros and cons. Know yourself. I you're someone who will use that information as motivation to change behavior, then maybe you should get tested. If you're someone who will be bothered by the finding and would prefer not to know, then don't test. In future, we may have targeted therapies for ApoE4, but at present we remain mostly in the realm of speculation when it comes to precision for ApoE4. I, personally, am glad I know. Knowledge is power. But that's me, not you.

@@nicknorwitzPhD I am going to go ahead and be tested. I am already in a keto diet as it is the best for my mood but it would be good to know if there are more reasons to keep eating this way. Thanks for your reply

Thanks. Hoo you like it. Fun to write it.

@@nicknorwitzPhD Had to finish it today. It was a very nice read.

@@SchmittsPeter Thanks :)

I'm happy it is not paywalled

I'd disagree that ApoE4s "need" to be on a low-sat fat Ketogenic diet. That's a claim that, in my opinion, oversteps the literature. Keep in mind, I'm saying that as an ApoE4 who eats about 20% of kCal as saturated fat. I'm not saying E4s should eat a high sat fat diet, I'm just saying we actually don't think that saturated fat is harmful for E4s over the long term. Read the actual paper if you want as it provides guidelines. On the topic of eggs and hyperabsorption. If it is true hyperabsorption that also means one is probably taking up phytosterols which are potentially more atherogenic. Thus, certain seeds could feasibly be as "bad" as the eggs. Another comment is that sometimes pharmacological lowering of LDLc can result in hyper absorption phenomenon as a compensatory response. Is it adaptive? Not sure. Finally, if one hasn't been tested for hyper absorption it's possible it's not hyper absorption but a "lean mass hyper responder" phenotype. Leaner people tend to exhibit larger cholesterol increases on a carb-restricted diet. However, if you are quite lean and eating keto, I'm guessing that high LDL comes alongside high HDL and low triglycerides. No advice here, all just food for thought. And as a personal anecdote, when I thought I was a hyperaborber and did a controlled personally experiment in which I only reduced by cholesterol intake from 1800 mg to >300 mg all that happened is my LDL went up about 15 mg/dL. I did not change overall carb, protein, or fat intake. and saturated fat was even a bit lower because I was more or less trading egg yolks for olive oil and a tiny bit of lean protein. So, FWIW :)

@@nicknorwitzPhD According to Gene Food, my genetic data says that I am a hyperabsorber of cholesterol. When I ate a lot of eggs, my cholesterol and LDL-c were 553 mg/dL and 332 mg/dL. I did eat them with a lot of butter though. When I stopped eating eggs and butter, and ate pork belly instead, my values dropped to 223 mg/dL and 122 mg/dL. When I ate only fish and avocados, my values dropped to 168 mg/dL and 86 mg/dL. Thanks for letting me know about the phytosterols though. I didn't know that they could be potentially atherogenic since I heard some people taking phytosterol pills to lower their LDL.

@@sabby123456789 Got it. Hoping you've seen/are seeing an expert. That's impressive, dropping from 553 to 86 (all while LCHF) by only changing cholesterol intake and shifting fatty acid profile but not introducing carbs?

@@nicknorwitzPhD No carbs. If I eat them, my glucose goes up and won't come back down for several hours. Yeah, I have to be on a low cholesterol and low saturated fat diet for my hyperabsorption. Haven't been seeing a specialist since my doctor thinks I'm okay now because my cholesterol and LDL-c are in the safe range. I wish I could see a doctor who has advanced knowledge of lipids though. It seems conventional doctors are only concerned with standard lipid panels and don't know anything about testing for genetic conditions.

@@nicknorwitzPhD I am APOE4 and went on the Paleo diet to cure digestive issues and CFS. Overtime. My cholesterol went higher and higher until it hit 340. I was seeing a functional medicine doctor at the time who recommended a low fat, high carb almost vegan diet. Cholesterol markers actually went up higher!

I see your sad face but based on the information I have learned from research about APOE 4 and Alzheimer's my hope meter has gone up. As Dr. Norwitz states having APOE 4/4 does not mean you will get Alzheimer's. Let me tell you why I can say this confidently. My mother in law had late onset Alzheimer's when my husband learned there was no treatment being a scientist he started reading the research. That was 12 years ago. I have recently made an evidence video on APOE 4 and how to prevent Alzheimer's. My husband's name is Dennis N Crouse. Dr. Norwitz is on the right path with prevention and nutrition. However he needs to add you need an aluminum free diet. kzfaq.info/get/bejne/h8WEl5lymb7Zfnk.html