There has been much debate over the APOE4 genes recently. If a high carb, low fat diet was bad for us, we must understand the reasons why a high fat diet can be helpful, in the right cases.
This it seems is based on your genetic makeup. Specifically, a gene called APOE. There are 3 different types of the APOE gene which I will discuss later.
As a human being, we are given 2 of these types of APOE genes at the same time, meaning that we actively carry 2 types of genes that are instructions for our bodies on how to make apolipoprotein E, which combines with fats to form lipoproteins.
APOE Gene Types
The three different types of APOE genes are as follows:
- APOE2 – Best suited to a High Fat / Low Carb Diet (saturated fats are good)
- APOE3 – Suitable For Both
- APOE4 – Best Suited For A High Monounsaturated Fat / Low Carb Diet (Avoid Saturated Fats)
Don’t freak out! Saturated fats will not kill you. If you feel good on a ketogenic diet, than there should be no reason to get your genetics tested. You should be getting your cholesterol checked as part of your regular medical checkup.
Because humans have two copies of each gene, these three isoforms code for six genotypes (E2/E2, E2/E3, E2/E4, E3/E3, E3/E4, and E4/E4). Your APOE genotype determines how your body metabolises cholesterol.
If you are consuming a high fat, low carb diet, you will increase your body’s production of cholesterol.
So how does the metabolism of cholesterol influence your body’s ability to handle cholesterol?
I spoke a little about lipoproteins before. These are made up of two components, cholesterol and fat.
When you increase your dietary fat, you increase your lipoprotein levels, which triggers the body’s cholesterol production to increase. This means that a high-fat diet is equivalent to a high cholesterol diet.
APOE 2 Carriers Thrive On High Fat
This means that APOE 2 carriers thrive on a high fat diet, as Cholesterol is an important part of the body’s ability to create hormones and function correctly.
However, research studies have shown that APOE4 carriers are most effected by high cholesterol, and benefit more from a low saturated fat diet, instead using monounsaturated fats, low carb diet, whereas APOE 2 carriers suit a high fat low carb diet, regardless of the saturated fats.
It appears that the effects of these genes are dose dependant. For example, the cholesterol levels of an APOE 2 / APOE 3 are naturally relatively low, whereas the APOE4 / APOE4 gene makeup is associated with a greater risk of high cholesterol.
One study shows that APOE4 carriers have up to 20 times greater risk of developing Alzheimer’s disease that non carriers. A full list of specific circumstances can be found here.
I recently had my genes tested, and I am a mix of APOE 3 and APOE 4, which means I might be better suited to a Mediterranean diet that utilises a little more monounsaturated fats.
As usual, I am not a doctor. I am purely writing about what I find in my research and from other reliable sources. If you are in doubt about what to do, you should always seek medical advice.
Sue Waters says
I am 68 – type 1 diabetic for 51 years – at present, no complications. I had the APOE gene tested about 5 years ago – result: APOE 4/4. I heard there were issues with it but didn’t really research it until recently. Cholesterol has always been normal, even low – ditto triglycerides. I have followed a number of protocols over the years but for many years eat mostly greens, veggies, soaked nuts/seeds, berries, modest amount of beef/chicken/fish but for a few years have eaten bacon (usually organic, uncured so no nitrites etc ). I know the issues about bacon but I’m celiac, and have food sensitivities to dairy/eggs so this worked for me. My cholesterol/lipids remained normal. Off and on I would follow protocols for intermittent fasting using coconut oil which we used exclusively for cooking. Lipids still normal but occasional rises in blood pressure. Then about 6-8 weeks ago I started a protocol based on Dr Bredesen’s work and Dr Terry Wahls work. I’ve read their books and each mentioned the APOE4 gene and issues with saturated fat. I still didn’t pay too much attention, although counting all the coconut I was eating plus more beef than usual there was quite a bit of saturated fat.
I check blood pressure regularly and suddenly it was increasing with higher numbers. Then one morning it was REALLY high – both numbers – and I had this eureka moment that it was caused by all the saturated fat. I stopped all of it – and in 3 days my blood pressure dropped and has remained in normal range. I am now consulting with my docs and just had comprehensive labs done which I haven’t gotten back. I have had lab tests done for years (b/c of T1DM) and all my lipids were normal. I have since learned quite a bit about this gene and the consequences, especially as it relates to dementia. Granted I am older and probably more at risk but I wish I had paid more attention to this, even 5 years ago would have helped. I am still following Wahls Protocol but have switched to olive oil (no more coconut products) and have greatly reduced the total amount of saturated fat in my diet. A little harder to maintain mild ketosis with intermittent fasting, but very doable. From the 2 books indicated above, and now several scientific papers I have read, there are clearly links with saturated fats and a host of issues for people with APOE 4.
Diana says
I am APOE4/3 and eat low saturated fat, (just nuts, seeds and dark choc), the only oils I use are olive, avocado and macadamia nut. I am mostly vegetarian, with occasional fish/seafood. I avoid high glycemic foods. The only grain I eat is a small amount of oat. My cholesterol is very high. Nothing I do seems to have any effect.
Adriana De la fuente says
I have a similar issue but its my ldl that is high. A1C is 4.9, bmi 20. Diet is healthy with low sat fat but I can’t seem to get my ldl down! as a apoe3/4 feeling pretty frustrated
FatForWeightLoss says
https://cholesterolcode.com/ is a great resource for this mysterious high LDL.
GH says
dark choc can be very high in sat fat, eliminate all sat fat if you are APOE4/3. Have your APOB status checked for your risk for heart disease.
Jim says
Also APOE3/4. I had same problem on keto – high LDL and doubling CAC score in 3 years. Check out Dr Eselstyn. A fairly savage vegan diet but it works. 23% drop in LDL in 3 months.