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In Episode 4 Dr. Perlmutter explains the vitally important concept of how our genes interact with the environment. Meaning, although our genetics are fixed, we have significant control over the expression of those genes with how we live our lives. This is a very powerful concept. He also points out that our genetic code developed over millions of years to suit our ancestor’s needs for survival. Often times, that evolutionary intent is at great odds with our modern world. This is easy to see in respect to how much our modern world has changed with respect to diet, movement, exposure to toxins, sleep and stress. If we can understand how our modern world is sending the wrong signals to our genes, then we can take steps to change how our DNA is expressed and change our health for the better.
With the above understanding of the interplay between genes and the environment, the following takeaways emerge:
- Our genes are not our destiny
- We can influence genetic expression through a process called “epigenetics”
- We can grow new neurons through a process called “neurogenesis”
- Our brains are capable of creating new connections through a process called “neuroplasticity”
Those notions become the basis for the most fundamentally important tools in our toolkit to prevent Alzheimer’s.
In the 1990’s, Dr. Perlmutter explains, a breakthrough occurred with the decoding the entire human genome. We became aware shortly thereafter the existence of a gene called “ApoE” which was intricately linked with the development of Alzheimer’s. There are 3 variations of the ApoE gene in the human genome. All of us inherit two copies, one copy from each of our parents. The variants are numbered 2 through 4. So there are the following possible combinations of ApoE: 2/2, 3/3, 4/4, 2/3, 2/4, 3/4. It’s the number of copies of the 4 variant, or alleles, which significantly increase the risk of developing the disease. But, it’s important to note, it is not deterministic. Meaning that even a person with two copies of ApoE4, what we would term a “4/4” or homozygous ApoE4, is not guaranteed of developing the disease. And, the converse is also true, lacking any copies of ApoE4 does not guarantee that a person will not develop Alzheimer’s, either. So, although the ApoE4 gene has been called, “the Alzheimer’s gene,” that is really a mischaracterization. There are other genetic causes for the disease, which run in families, and make the disorder much more likely. However, those, according to Dr. Bredesen, only account for about 5% of cases. The remaining 95% they can be broken down into those which are ApoE4 positive and ApoE4 negative. It turns out that about 2/3rd’s are ApoE4 positive and 1/3rd are ApoE4 negative. So while ApoE4 is an important risk factor to pay attention to, it is not the only thing and everyone, ApoE4 or not, should pay attention to the lifestyle and other factors which influence genetic expression.
Dr. Perlmutter goes on to explore the process of generating new brain cells, a process called neurogenesis. For many years, the dogma in medicine was that we could never grow new brain cells. We had what we had at around age 20 and from there we only lost them over time. This was a truly breakthrough finding. This leaves us with hope that we can stop, and even reverse, degenerative brain disease. The brain’s ability to grow new neurons has been documented up until the time of death.
The other concept is neuroplasticity, which is the ability of the brain to “re-wire” itself in order to improve its performance. Again, the old notion was that neurons could not make new connections past a certain point of development. Diet and exercise are two ways that we can help promote formation of new connections. And exercise includes both the kind we do with our muscles, as well as brain exercises. And this ability to change does not go away as we get older. Dominick D’Agostino, PhD goes on to examine how small molecules called ketone bodies, such as beta-hydroxybutyrate (BHB) have a profound influence over the epigenetics of gene expression. The use of a ketogenic diet is a key intervention in the ReCODE protocol developed by Dr. Bredesen. Another key ingredient in this process of neuroplasticity is to challenge the brain with new tasks. Learning to play music. Learning a new language. Learning to dance. Things that really are stimulating the formation of new connections and deal with novel information. Michael Merzenich, PhD has devoted his career to designing a software platform that allows individuals to do this on their own using software he developed for Posit Science called BrainHQ. There are many other brain games out there, but BrainHQ is the only one backed by over 100 peer reviewed research papers published in the scientific literature.
Stay tuned to this series for more of the latest information on how to reduce your risk of developing this devastating disease! Armed with the proper information, all of us have the ability to improve our brains, our health and our lives in general. I can honestly say, none of the information offered by the experts interviewed could be expected to cause harm. Lifestyle changes such as those discussed in this series promote health across the entire spectrum of an individual’s risk, not only for preventing cognitive decline, but also reducing the chances for heart attack, stroke or cancer — all of which happen to be the top causes of death in our society.
How can you get started? Let’s recap some of the recommendations from Dr. Perlmutter and the experts so far in this series:
- Eat a healthy nutritionally dense diet that helps reduce inflammation
- Bonus: Add intermittent fasting and consider exploring a ketogenic approach with guidance from your practitioner
- Exercise regularly using a combination of endurance, strength, and flexibility
- Exercise your brain by learning new things
- Manage your blood sugar
- Get good sleep
- Reduce your response to stress
- Eliminate exposure to toxins
- Nurture your microbiome
If you’ve found the information in the series worthwhile, consider owning a copy of it forever. Details on how to purchase the series are available when you sign up. There is a lot of valuable information available in the bonus materials for purchase.
