Calling ApoE 4s


Hi there. Are there any ApoE 4s out there who are using the keto diet to prevent the CVD and Alzheimer’s we are more genetically susceptible to? (I am a 3/4) It would be great if folks could share studies they have found that support this way of eating for this genetic variant. I know the science is very new and sparse in this area. It is a particularly scary proposition when some medical experts are claiming that ApoE 4s need to avoid saturated fat at all costs (I believe this may be only true in the context of a high carb diet to begin with, but it still causes doubt and fear when I hear it.) I would love it if Carl and Richard could discuss it on the podcast some day.

(Dustin Cade) #2

I think the whisperings that Keto could help one avoid this dreaded disease, for me is a much more powerful reason to switch to the Keto lifestyle than weight loss or diabetes or anything else… we’ve all seen the devastating effects of Alzheimers and dementia…


Hi, I’m a ApoE 4/4 (scary). Also a DT2 (even scarier combination) I eat keto among doing other things to fend the dreaded results of those. IMO if you have insulin resistance that has such a great influence on Alzheimer’s risk that getting it down is the very first priority. I take into account the info on SFAs and ApoE 4s and try to get most of my fat from monounsaturated fats, but my first priority is to keep my blood glucose down and to reduce insulin resistance. The evidence is pretty good on ketosis and brain function.

One of the best places to find out about ApoE 4 and see all the latest science, along with lots of discussion, including on using keto diet among other methods is The best place to start is
An introduction to ApoE4, biochemistry, and possible prevention strategies

I hope it’s ok to post a link, if not, please let me know. This reply is rather late, but may help more than just the OP, now that more people are learning their genetics.


Hugely helpful - thanks! I have just discovered that site, but it’s so vast I didn’t really know where to begin, so appreciate those links. May I ask what you typically eat in terms of monounsaturated fats and how much saturated fat you allow in? This is what I find especially tricky.


My main mono fat food sources (per cronometer) are macadamia nuts, extra virgin olive oil, eggs (pastured) (I eat a lot of eggs) avocados and olives.

I probably eat more sat fats than I should still - debating about that. It’s a question of whether all sat fats are bad for Apoe4’s or only some and also my emphasis being on getting my insulin resistance down. Fine tuning can come later. So my sat fats currently come mostly from MCT oil, butter (pastured), eggs, coconut milk, macadamia nuts, and olive oil. Please don’t use me as an example of how much SFA is ok; I haven’t a clue. There are some long and extensive threads re sat fats on the Apoe4 website.

You may notice I don’t have any meats listed as sources. That isn’t because I’m a vegetarian, although I live with and cook for a pescatarian. Its partly because I eat a very wide variety of animals, fish and seafood, so they don’t show up well in cronometer. Also because per some sources, animal saturated fats may be a problem for Apoe4’s more than plant SFAs. Don’t know if true, but been eat somewhat leaner meats and then drowning in evoo.

Right now, by volume I eat @ 80% veg, mostly leafy greens. By percentage of calories, 80% fat.


Thanks again for taking the time to reply. Sounds like you have a clear strategy to mitigate your risk, which has inspired me in moving forward. Good luck reducing that IR!

(Michael Wallace Ellwood) #7

tagging @carl @richard

(Richard Morris) #8

I would love to know my APOe status, also my MTHFR status (just so I can give it it’s colloquial name on the podcast), heck I want to know as much about my genome as I can. I guess I should get a 23&me analysis done when I am in the states for Ketofest.


I’m telling everyone I know to get theirs done. Selfishly hoping you turn
out to have heterozygous polymorphisms on both of those genes like I do, so
I can benefit from your future thinking on it! :slight_smile:

(Richard Morris) #10

LOL … err thanks :slight_smile:

(Linda) #11

Are you saying you can’t get your APOe checked in Australia?

(Richard Morris) #12

I can, but I want to get the full 23&me genetic assay. As I understand it in Australia that is still sent away to the USA to be generated.

(Linda) #13

Ok, thanks. Are there special places in Australia or just your local pathology lab?

(Richard Morris) #14

Doctors can request individual tests against specific genes and for specific genetic disorders. As I understand it most path labs just take a buccal smear and send it to a handful of labs in Australia that can do the diagnostic.

My Doctor and I went through the list at my last checkup and she had maybe a dozen individual tests she could order for specific targets, but each was individually expensive.

What I really want is a DNA Sequence and analysis, which is something entirely different. That will cost several thousand of dollars.

But there is a half way step called Genotyping where my DNA can be sampled by a chip that can identify about 1 million of the 3 billion genes in human DNA for about $99 from 23&me in the USA and about $500 from some online direct to consumer companies in Australia. All of them send the samples to the same place Labcorp in the USA.

So that’s what I think I’m going to do until the cost of full sequencing comes down below $1000.

(Shannon Woollett) #15

Richard my daughter had 24andme. APOE only said 4 variant but did not say if she is 4/4 3/4 2/4 so she has to get full test done. Ask 23 if it gives you the full result. Maybe u have to pay more, I will send u a screen shot tonight when I get home… I am in Syd. When is n. Sydney meet up? Still on??? Forum for it? Regards, s

(Shannon Woollett) #16

Typo: 23 and me

(Shannon Woollett) #17

Richard a cardiologist did mine years ago, it was cheapish and I am 3/3… not sure cost now in Syd…

(Louise ) #18

@richard I recently had my DNA tested using - and thanks to a post on the forum, I downloaded the raw data and dropped into which generated the health report (costing only $5). What I see is fascinating (as I was double checking my APOE results again just now). 23&me here down under won’t send you the health report (for whatever government controlled reason). However, you could purchase the packs via Amazon and ship to @carl address. I think the ancestry dna lab is based in Sydney hence done locally.

As for my APOE - on the Promethease report, I have only one red flag for rs11591147 (altho the description says little about APOE).

My SNP for rs429358 (TT) has a ‘green is good’ rating which is a relief as my paternal grandmother (a DT2) had Alzheimers which was just awful to watch her decline.

(Linda) #19

Hi @Shaza
The Sydney meatup is this Sunday, BBQ at my place in Warrawee. Email us at for all the details.

(Linda) #20

Thanks Richard, I convinced my doctor to give me a pathology referral for testing APOe even though she didn’t have a clue what it meant or whether they will even accept it, but I’m going in the morning and I’ll see what they say.