Precision Nutrition for Alzheimer's Prevention in ApoE4 Carriers

• Published in: Nutrients 2021-04, Vol.13 (4), p.1362
• Main Authors: Norwitz, Nicholas G, Saif, Nabeel, Ariza, Ingrid Estrada, Isaacson, Richard S
• Format: Article
• Language: English
• Subjects: Alzheimer's disease; ApoE4; Apolipoprotein E4; Astrocytes; Blood-brain barrier; Clinical trials; Dementia; Dementia disorders; Diabetes; Disease prevention; Genetic diversity; Genetic variance; Genotype & phenotype; Glucose metabolism; Health risk assessment; Hypertension; Inflammation; Insulin; Insulin resistance; Lifestyles; Lipid metabolism; Lipids; Metabolic pathways; Metabolism; Microglia; Nutrient deficiency; Nutrition; Nutrition research; Overweight; Pathology; Pericytes; precision nutrition; Prevention; Risk analysis; Risk factors; Risk management
• ISSN: 2072-6643; 2072-6643
• DOI: 10.3390/nu13041362

The allele is the most well-studied genetic risk factor for Alzheimer's disease, a condition that is increasing in prevalence and remains without a cure. Precision nutrition targeting metabolic pathways altered by provides a tool for the potential prevention of disease. However, no long-term human studies have been conducted to determine effective nutritional protocols for the prevention of Alzheimer's disease in carriers. This may be because relatively little is yet known about the precise mechanisms by which the genetic variant confers an increased risk of dementia. Fortunately, recent research is beginning to shine a spotlight on these mechanisms. These new data open up the opportunity for speculation as to how carriers might ameliorate risk through lifestyle and nutrition. Herein, we review recent discoveries about how differentially impacts microglia and inflammatory pathways, astrocytes and lipid metabolism, pericytes and blood-brain barrier integrity, and insulin resistance and glucose metabolism. We use these data as a basis to speculate a precision nutrition approach for carriers, including a low-glycemic index diet with a ketogenic option, specific Mediterranean-style food choices, and a panel of seven nutritional supplements. Where possible, we integrate basic scientific mechanisms with human observational studies to create a more complete and convincing rationale for this precision nutrition approach. Until recent research discoveries can be translated into long-term human studies, a mechanism-informed practical clinical approach may be useful for clinicians and patients with to adopt a lifestyle and nutrition plan geared towards Alzheimer's risk reduction.