Transcription
All right. Let me catch you up on a crazy and unfortunate coincidence. Right after I started my PhD in neuroscience, literally studying the brain for a living, I found out that I'm one of the people most likely to develop Alzheimer's disease.
Because I carry not one, but two copies of the major risk gene variant for Alzheimer's, APOE4. And this skyrockets my Alzheimer's risk 10 to 15-fold. So, what we're going to talk about today, it's not just academic, it is deeply personal. And today, I'm here to tell you about the number one most important drink for brain health, no competition. It's DHA, the long-chain omega-3. DHA makes up 40% of the fatty acids in the brain's gray matter, the body of your neurons, the control centers of the brain. It makes what is you you. And DHA, it's not just structural in the brain. It influences how neurons talk to each other, how synapses fire. It controls inflammation, helps clear out brain waste. And without enough of it, you're planting the seeds of Alzheimer's disease.
And today, I'm going to prove that to you. But there's also good news, great news in fact, because when you understand the biology, you can act before it's too late. In fact, here's a secret. Those of us at highest risk for Alzheimer's disease also have a superpower, but one that needs to be used early. Stick with me because you're going to leave this video with real tools, real optimism, thinking like a neuroscientist. But I'm first going to have to put your 86 billion neurons to work. Let's go.
Without DHA, there is no physical brain. DHA is a core structural component of the brain. It supports learning, memory, and cognitive resilience. Alzheimer's disease, it begins long before symptoms. This is the opposite of what we might expect based on the data we reviewed so far. So, we have a paradox here. Maintaining very high levels of DHA consumption isn't optional. It's mission-critical.
Okay, this video is broken into four chapters. In chapter one, we're going to meet our star player, DHA. We're going to cover DHA's roles in the brain. And then in chapter two, we're going to get into the meat of it, the big fat metabolic shift. We'll explore the critical shift in lipid metabolism, one that happens very early in the Alzheimer's disease process. Chapter three, we're going to delve even deeper into biological mechanisms, the mechanisms involved in neurodegeneration and DHA metabolism, key pathways that shape the brain. And then in chapter four, I'm going to tell you about my personal protocol. All of what we discuss boils down to this. And I'm not just going to tell you what the science is, I'm going to tell you exactly what I do. This is my protocol I follow knowing my genetic risk and the biology we're going to walk through.
Also, if you want to dive even deeper like a sperm whale, check out the links below. You'll find detailed written versions of this video completely references, expanded insights, as well as other popular letters I've written on Alzheimer's disease, nutrition strategies, lifestyle tools, and emerging therapies. It's all rigorously evidence-based and curated to offer value that you won't find elsewhere. But with that, let's begin.
Meet DHA. Let's run through four essential functions of DHA in the human brain to prove to you it's not a one-trick pony or a one-trick dolphin as it were. DHA is a core structural component of the brain. DHA makes up a stunning, I already told you this but let's emphasize, 40% of the fatty acids in the brain's gray matter. It's vital to structural brain cell membranes and the myelin sheath that insulate neurons and allow them to fire. Essentially, it is essential to the brain's wiring system and body. Without DHA, there is no physical brain.
But let's move on to DHA actually enhances brain glucose metabolism even though it's a fatty acid. One of the hallmarks of Alzheimer's disease is brain glucose metabolism dysfunction because your brain needs to burn some sugar. And DHA can increase the expression of glucose transporters getting glucose into neurons so it can use it for energy. And it can help counteract this core dysfunction that develops in Alzheimer's disease. And three, DHA boosts brain levels of BDNF, brain-derived neurotrophic factor, which is a protein crucial for neuronal growth, repair, and plasticity. BDNF supports learning, memory, and cognitive resilience, and DHA supports BDNF. And four, DHA is anti-inflammatory. It exerts potent anti-inflammatory effects via many mechanisms. It tunes down inflammatory signaling pathways, and itself is a precursor to what are known as specialized pro-resolving mediators or SPMs. These are a new hot class of molecules like resolvins, maresins, and neuroprotectins, compounds that actively heal and protect the brain. But, more on that later.
Now, I want to bring you to chapter two, the big fat metabolism shift. Let's now look at how lipid metabolism shifts over time in the brain, particularly in APOE4 carriers, those at highest risk for Alzheimer's disease. Take a look at this graph. In Alzheimer's disease, you progress from normal cognition to mild cognitive impairment, MCI, to dementia. And what you see very clearly is lipid metabolism, the green line, is the first to decline. And only afterwards, down the domino chain, do we see the characteristic pathologies of Alzheimer's pop up, amyloid plaques, tau tangles, and finally, cognitive decline. These all happen after lipid metabolism dysfunction, and this suggests or is consistent with the idea that dysfunctional lipid metabolism is upstream, maybe one of the earliest drivers of Alzheimer's pathology.
So, bear with me here. If you optimize lipid metabolism early in life, before pathology takes hold, you might be able to prevent or delay or halt downstream degeneration. For APOE4 carriers, this is especially urgent. And let's pause to consider the logic here. What is APOE? APOE is a gene that codes for an apolipoprotein. These are deeply involved in lipid metabolism, lipoprotein. APOE4 is one of three major variants of the ApoE gene, ApoE2, ApoE3, ApoE4. Now, a quarter of people carry ApoE4. So, it's pretty common. But, ApoE4 is present in 65% 2/3 of Alzheimer's patients. Quick sidebar. If you want another example of a person or celebrity who's an ApoE4 homozygote other than me, Chris Hemsworth, or as you might know him, the mighty Thor, is another example. I actually have a letter coming to the Substack that mentions Chris Hemsworth and GLP-1s for Alzheimer's disease prevention. There's some really cool new literature. So, if you want another piece of content after this on Alzheimer's prevention, check that out. It's going to be linked below when it's ready.
And since ApoE is directly involved in lipid metabolism as an apolipoprotein, it's no surprise that those with the variant ApoE4 would be especially susceptible to slipping down that green slope faster and earlier. Make sense, right? That will put them at higher risk. Okay. Now, the rubber meets the road, or the kinesin meets the microtubules if you're a real neuro nerd. Sorry, I had to do that. Anyway, in a healthy brain, DHA, this fatty acid, has a long half-life, about 2.5 years in the human brain. That's the amount of time it takes DHA to decay by about half. But, in ApoE4 carriers, DHA is burned much more rapidly. Studies estimate that the whole body half-life of DHA in ApoE4 carriers like me is 77% shorter than in non-carriers, and you can see that clearly here. What you're seeing is effectively how long DHA lasts in the body. In an ApoE4 carriers, lifespan of DHA in the body is obliterated. The distribution's flattened like a pancake. And what this means is that ApoE4 carriers burn through DHA much more quickly and therefore are very vulnerable to DHA depletion.
But, here is the critical twist. Here's something you weren't expecting. I wasn't expecting it. Are you ready? ApoE4 carriers might actually harbor a secret advantage that can offset, at least partially, the consequences of inefficient DHA utilization later in life. Interestingly, in younger, healthy, cognitively normal APOE4 carriers, the brain shows increased DHA uptake, more DHA uptake into the brain, not decreased. This is the opposite of what we might expect based on the data we reviewed so far. So, we have a paradox here. How does the APOE4 brain incorporate more DHA, but end up DHA deficient in Alzheimer's disease? There is a way to make sense of this paradox, and I'm going to prove it, but let's first provide some proof, some human data.
In one study, researchers examined 22 adults aged 19 to 65 with varying APOE genotypes. They gave them radio-labeled DHA, so they could measure incorporation into the brain with what's known as an incorporation coefficient. And fascinatingly, APOE4 carriers most vulnerable to Alzheimer's disease showed a higher rate of DHA incorporation into the brain, particularly in regions most vulnerable to Alzheimer's disease, like the entorhinal cortex. The authors propose, and I agree, that this could represent a compensatory mechanism, a way for younger APOE4 carriers, cognitively healthy APOE4 carriers, to cope with accelerated DHA degradation by increasing uptake to maintain healthy brain levels, only if you give your body enough DHA.
And this finding actually aligns with other research showing early life cognitive advantages in APOE4 carriers. For instance, and I bet you didn't know this, APOE4 has been associated with higher IQ and greater educational attainment. But the advantage flips with age, a classic case of what's known as, ready for jargon? Antagonistic pleiotropy, where a trait that's beneficial early in life becomes detrimental later. It's kind of like a burn hot, die young ethos. But, if the core disadvantage in APOE4 carriers that increases the risk for Alzheimer's disease is increased DHA breakdown, in theory, this could be offset by consistently higher DHA intake throughout life. And that is the punchline. And that is where I'm placing my bet. For APOE4 carriers like me, maintaining very high levels of DHA consumption might be a viable strategy to counterbalance the accelerated metabolic loss breakdown of DHA and maintain healthy cognition as we age.
This also explains why DHA trials in people with Alzheimer's disease often show no benefit. It's not that DHA doesn't work. It's that it's being introduced too late after the superpower is gone. The transport and incorporation systems degrade with age. Your brain has effectively missed the boat. And that is why prevention, not treatment after cognitive decline has begun, is so critical. But, unfortunately, we cannot run 30-year randomized controlled trials. So, because of the limitations on the data we can actually collect, we need to reason through mechanism physiology from biologically first principles. And that is often the best approach we have. It's the best approach we have here and it's what we're doing right now.
But, let's dig a little deeper into the biochemical pathways involved in DHA metabolism. So, DHA and other polyunsaturated fats, omega-3 and omega-6 go into this class of fats called polyunsaturated fats. They're stored in membranes as phospholipids. Then there are enzymes called phospholipase A2s, PLA2s. These release the polyunsaturated fats, the omega-6 and threes, so that they could be used for metabolic pathways. And there are different types of PLA2s. Let's start with iPLA2 and sPLA2. These preferentially release EPA and DHA, omega-3s, leading to the creation of anti-inflammatory pro-resolving mediators like those we mentioned earlier, resolvins, protectins, and neuroprotectins. These heal the brain, decrease inflammation. By contrast, cPLA2 targets omega 6s, leading to the generation of primarily pro-inflammatory compounds like leukotrienes and thromboxanes. I'm just giving you examples, you don't need to know these terms. But here's the key point. ApoE4 shifts brain lipid metabolism towards the cPLA2 omega 6 pathway, favoring inflammation and oxidative stress, and accelerating brain breakdown. Brain breakdown, say that five times fast. Brain breakdown, brain breakdown, brain breakdown. I'm not going to do it. Anyway, this tilts brains towards neurodegeneration.
So, what's the takeaway? You want to tilt the balance back in favor of omega 3 pathways, and you can do this in large part by increasing omega 3 intake and levels in the brain. Well, what about omega 6 levels? Shouldn't we reduce those to improve balance? Brace yourself, this can get confusing. Here's the thing. In general, higher omega 6 levels are actually associated with better health outcomes in the broader population. This is circulating in the blood and also in tissue like fat tissue. But these data don't account for genetic differences like ApoE4, and is further complicated by the context in which omega 6 are consumed. So, for example, walnuts as a whole food, they're high in omega 6, but they also contain omega 3s, antioxidants, polyphenols, and other protective compounds. So, in a whole food form, omega 6 often travels in good company, which likely favors health over harm in most people. That said, we can't rule out the possibility of omega 6 overload, especially in ApoE4 carriers. So, the most honest answer I can offer you about the omega 6 question is we don't know.
But here is my practical approach. I prioritize my omega 3 intake, especially DHA. I also include healthy monounsaturated fats like extra virgin olive oil as a major fat source. And I avoid processed industrialized oils, like soybean oil, corn oil, grapeseed oil, where the omega-6 fats have been extracted, oxidized, damaged, heated cyclically. So, at a high level, personally, I focus on quality and context over quantity when it comes to omega-6. I don't avoid whole food sources, like walnuts or sesame. These foods offer a spectrum of nutrients that likely offset the theoretical downsides of omega-6 in theory. But, if someone chooses, out of abundance of caution, perceived abundance of caution, I should say, to lower omega-6 levels if you're apoE4, I think it's a defensible choice. But, I do completely avoid these industrialized oils rich in oxidized damaged omega-6 and their harmful derivatives, like 4-HNE. Other content for that. And, importantly, I monitor my omega-3 levels and my omega-6:3 balance using OmegaQuant to track my omega-3 index and 6:3 ratio. Both are perfect. So, it's like the old saying goes, if a tree falls in the forest and no one's around to hear it, does it make a sound? Well, if I eat walnuts loaded with omega-6 and my omega-6:3 ratio is still optimal, you fill in the rest. And if you want to try the service I use to measure my omega-6:3 ratio and omega-3 index, you can check the link below. There's also a discount code there for you. You can also listen to my two-part conversation with omega-3 expert and omega-3 index inventor, Professor William Bill Harris. Well, it sounds like you're pretty convinced that omega-3s are beneficial for our health. Unfortunately, nutrition normal doesn't necessarily mean optimal.
But, with that, let me get on to my personal protocol. As someone who carries two copies of apoE4, I take all this very seriously. So, here's what I do. I eat low-mercury fatty fish daily. Yes, daily. Primarily sardines and sockeye salmon. My favorite brands of sardines are Fishwife sardines preserved in lemon and extra-virgin olive oil. They're delicious, although a little bit pricier. Also, Wild Planet is a great budget-friendly option. Both of these are free of BPA in the tins, which is important, and sardines are a very low mercury fish. Because I always get that question, "What about your mercury levels?" Well, here's a fact, here's a statistic to make this stick in your brain. You need to eat 77 servings of sardines to equal the mercury in one serving of swordfish. So, sardines are actually pretty safe when it comes to mercury. In fact, my own levels, they're in the normal range, and they continue to do so despite eating fatty fish daily. I'm just selective about what fish I eat. And it's also important to note that the research shows more fish intake is linked to better cognitive outcomes, healthier brain aging, even after accounting for mercury exposure. This might be in part thanks to neuroprotective forms of selenium in fish. So, you might even want to be looking at the selenium to mercury ratio, but that's a whole different kettle of Well, that pun's too easy. Anyway, in addition to diet, I take a special form of DHA called lysophosphatidylcholine DHA, LPC-DHA. It's a specialized and really patented product that I really believe in. The actual brand I use is called XON Omega Max, and here's why. The lysophosphatidylcholine DHA uses a specialized transporter called MSF D2A to directly deliver DHA to the brain. This bypasses some of the barriers that limit absorption in APOE4 carriers like me. In fact, if you want proof of principle, in comparative studies, lysophosphatidylcholine DHA results in significantly more brain DHA levels. That's the orange bar, than standard supplementation. That's the red bar. Which instead, the standard supplements tend to build up in fat tissue instead. But, while I won't derail us talking about all the different carriers for DHA, I do want to provide deep rationale. So, if you want to go deeper about the products I use, you can see this content. If you want to try the product I use, this XON Omega Max, use the discount code stay curious, and the link is below. That'll get you 20% off.
Now, in terms of actual intake, I don't track my DHA day-to-day in a spreadsheet, but I do target a minimum level of 2,000 mg combined EPA DHA per day. Now, this is higher than is probably needed for most people to be generally healthy, but it's appropriate for APOE4 carriers like me. At least that's where I'm placing my bets. I want to be cautious, so I'm going for higher doses. And as a quick honorable mention, I also take microdose lithium orotate at 5 mg daily for its neuro protective effects. For more on that, I have a totally different video. See this video. The exact brand I use is called Pure Encapsulations. They're very reputable, but I don't have any affiliation or discount code for you on this one, so sorry about that. And for those of you over 40 or 45, you might also want to consider NAD boosting protocols for Alzheimer's prevention, which I've covered in depth in this content.
So, wrapping up, I know we've gone over a lot, but Alzheimer's disease, it begins long before symptoms, even before amyloid and tau start to accumulate. It begins with declines in brain lipid metabolism. And for those at highest risk, APOE4 carriers like me, this means DHA isn't optional. It's mission critical. And while we may never get perfect randomized controlled trials, the physiology makes some clear points. DHA supports brain and structural metabolic anti-inflammatory ways. All in all, I can't change my genes, neither can you, but I can be proactive and change what I do knowing my genetic background. I think that is empowering. What do you think? Stay curious. Thanks for learning with me.