Heredity and habit

Hey there, time traveller!
This article was published 07/10/2023 (1070 days ago), so information in it may no longer be current.

In a world inundated with health and wellness advice, the realms of genetics and personalized medicine are stepping into the limelight. Two genes of particular interest are APOB and APOE4, which impact cardiovascular and cognitive health risks as we age. Understanding these genes and their implications can provide you with valuable insights into your long-term health.

What are the ApoB and APOE4 genes?

Think of APOB as the “cholesterol courier.” The APOB gene helps create a protein, apolipoprotein B, that is integral in the formation of low-density lipoprotein (LDL) particles. Consider these particles as delivery trucks carrying cholesterol and fats through your bloodstream. A variant in this gene may predispose you to higher levels of LDL, commonly termed “bad cholesterol,” raising the risk of cardiovascular diseases.

APOB is considered a better risk assessment for heart disease than either LDL, HDL or triglyceride alone.

APOE, the “mindful guardian,” encodes the apolipoprotein E protein, which plays a crucial role in fat metabolism in the liver and serves as a janitor in the brain, helping to clear away waste. Specific variants of the APOE gene, in particular APOE4, have been associated with a higher risk of Alzheimer’s disease and other cognitive impairments.

The APOE4 gene is a variant of the APOE gene, which encodes a lipoprotein involved in cholesterol transport throughout the bloodstream and to neurons in the brain. This variant is associated with higher circulating levels of LDL and a two- to threefold increased risk for developing Alzheimer’s disease.

According to Peter Attia on the Found My Fitness podcast, the phenotype, or the amount of APOE that’s expressed, matters more than the genotype. The serum level of APOE was found to be more predictive of Alzheimer’s disease than the genotype 3. Having one copy increases the risk by around threefold. Having two copies of the APOE4 gene increases risk by around eight to 10 times. In the Disney+ docuseries Limitless, Chris Hemsworth discovered he had two copies of the gene APOE4, one from his mother, the other from his father.

How to get tested

The most straightforward way to learn about your genetic predispositions is through a blood test. Your health-care provider can recommend appropriate tests for APOB and APOE genotypes, often included in broader cardiovascular and neurological health panels.

Direct-to-consumer genetic testing kits like 23andMe and AncestryDNA have also become increasingly popular. While not as comprehensive as medical-grade tests, these kits claim to test for the variants and provide a summary for you.

How to reduce risk

I tested negative for both genes in my 23andMe report, but that doesn’t mean I’m in the clear. Lifestyle interventions still matter most.

Here are some of the common lifestyle interventions that can counteract your risks for both cardiovascular disease and Alzheimer’s disease and dementia:

• Prevent and manage high blood pressure – Tens of millions of North American adults have high blood pressure, and many do not have it under control.

• Manage blood sugar – Learn how to manage your blood sugar. Type 2 diabetes is a risk factor for both conditions.

• Maintain a healthy weight – Healthy eating and regular physical activity can help. Obesity is linked to both cardiovascular disease and dementia.

• Be physically active – Physical activity can improve thinking, reduce risk of depression and anxiety and help you sleep better.

• Quit smoking – Quitting smoking now may help maintain brain health and can reduce your risk of heart disease, cancer, lung disease and other smoking-related illnesses.

• Avoid excessive drinking – If you drink, do so in moderation. Heavy drinking is linked to a number of poor health outcomes, including heart conditions and brain damage.

• Get enough sleep – A third of adults report they usually get less sleep than is recommended. One study suggests sleep deprivation could increase your dementia risk by 20 per cent. How much sleep do you need? It depends on your age, but seven to nine hours per day is a general range to aim for.

Minimize risk: ApoB edition

• Dietary changes: APOB is influenced by cholesterol and triglyceride levels. Reducing carbohydrate intake can lower triglycerides, which in turn can reduce circulating APOB levels. However, it’s important to balance this with fat intake, as too much can still raise APOB. Ideally, you’d want to reduce saturated fat intake while also lowering carbohydrate intake.

• Statins: If lifestyle and dietary changes aren’t enough, medications like statins may be prescribed to lower cholesterol levels. This can be achieved through LDL-lowering drugs, which reduce circulating APOB.

• Frequent screenings: Regular blood tests and checkups will ensure you’re on the right path, allowing for timely adjustments to your lifestyle or medication.

Minimize risk: APOE4 edition

• Cognitive engagement: Activities like reading, puzzles and social interaction can stimulate your brain, keeping it agile. These activities are akin to sending your brain to the gym.

• Get your hearing tested: A loss of hearing is linked to early-onset dementia.

• Omega-3 and Curcumin: According to James O’Keefe on the Peter Attia Drive podcast, a high dose of omega-3 and well-absorbed curcumin can improve mental health and potentially reduce dementia in the long run.

• Metformin and rapalogues: Joan Mannick and Nir Barzilai discussed the potential of metformin and rapalogues in reducing the risk of Alzheimer’s disease. However, it’s still too early in the research to make any solid conclusions.

• Heat shock proteins and sauna use: Rhonda Patrick on the Tim Ferriss Show suggested that increasing heat-shock protein expression through sauna use could potentially reduce the risk of Alzheimer’s disease.

• Regular checkups: Screenings like MRIs and other neurological assessments can help monitor brain health and catch early signs of cognitive decline.

Finally, while these genes may provide us with heightened risk factors, they are not our destiny. Lifestyle choices and preventative measures can often mitigate genetic risks, providing you with the opportunity to live a healthier, longer life.

As clichéd as it is, genetics load the gun, but lifestyle pulls the trigger. Knowledge about your genetic makeup, particularly concerning these two genes, provides an empowering tool in your health-management arsenal. It enables you to tailor a more effective health strategy, much like how a seasoned politician fine-tunes their campaign based on voter demographics.

By understanding these genes and taking actionable steps, you’re not just hoping for a long, healthy life — you’re planning for it.

Mitch Calvert is a Winnipeg-based fitness coach who has helped more than 1,400 people transform their bodies and lives over the past decade. Visit mitchcalvert.com/calculator to get a free custom plan — complete with macros, calories and meal ideas — personalized for your age, body weight and goals.