Dr. Rhonda Patrick is one of the health influencers I trust the most as an evidence-based researcher. In her work, she emphasizes the importance of knowing your type for a particular gene linked to the risk of dementia: APOE. She recently highlighted research linking the benefits and risks of alcohol use to APOE genetic status:
While light alcohol consumption has been associated with a decreased risk of AD in general [127], this relationship does not appear to hold in ApoE4 carriers. Consumption of any amount of alcohol may increase the risk of AD for ApoE4 carriers [128,129,130]. In one study, both light and moderate alcohol consumption were associated with improvement in learning and memory for non-carriers, but with a decline in learning and memory for carriers [129]. Other studies found that ApoE4 carriers who consumed alcohol one or more times per month had a higher risk of AD than those who never consumed alcohol [128] and the risk of AD for carriers increased with increasing amounts of alcohol consumption [130] These data suggest that alcohol consumption should be limited, especially in ApoE4 carriers.
In summary:
Alcohol normally lowers the risk of dementia and enhances memory.
But, if you have one or two copies of the “bad” ApoE4 gene, any amount of alcohol appears to increase the risk.
How can you know if you have this gene? First, you’ll need to get your 23andme done. Second, you can run your raw data through Patrick’s genetic risk profiler to highlight specific areas of concern, including APOE status. Those with two copies of the Apoe4 gene have an 8-10x increased risk of dementia, whereas those with one copy are at a 2-3x risk. These are not rare variants. About 25% of the population has one copy of the higher-risk gene, and 2-3% of the population has two copies. Patrick says this complication is why so many alcohol studies show contradicting results if they do not control for Apoe4 status.
I am a carrier of a single Apoe4 gene and based on her advice I have reduced my drinking from 5-7 drinks per week (which is neuroprotective for those without the gene) to 1-3 drinks per week. The research also suggests that what is effective in the long term is also beneficial in the short term, and I have found I am sharper and have more energy with less alcohol consumption. I particularly notice its impact on my sleep, which may be due to my Apoe4 status.
Patrick’s hypothesis is that Apoe4 carriers have a reduced capacity to repair brain damage. In a person without these genes, alcohol appears to work like weightlifting: a little bit of brain damage stimulates the repair mechanisms to overcompensate. In a person with ApoE4, it just causes brain damage, and likely cumulative brain damage over time*. She also recommends that people with this gene avoid any contact sport where concussion might be a risk. She also cites research showing that with good weight management, frequent exercise, and minimal alcohol consumption, carriers can effectively reduce their risk to that of a person without genetic risk factors.
*It’s possible there is still an ideal low dose of alcohol that would be beneficial, but it would be very low, less than one drink a few times a week.
Alcohol Addiction
Anyone with an alcohol or other addiction problem should know about the Sinclair method, arguably the most effective treatment to change behavior. It utilizes a drug called naltrexone which binds to opiate receptors without providing any kind of high. The method is very simple:
Take 50 mg naltrexone 2 hours before drinking.
Drink as much as you want. No abstinence required.
Repeat.
Do not take naltrexone at any other time, only before drinking.
By binding to opiate receptors, naltrexone helps the brain unlearn addictive behavior by blocking the pleasure it provides. It may also work for a wide variety of behavioral addictions as well, including compulsive gambling and perhaps sex-type addictions. It seems to be a powerful way, with a completely safe cheap generic drug, for anyone to reprogram their brain away from undesired behaviors. Since it’s not a controlled substance, many doctors are willing to prescribe it. In low doses, it can be used to treat a wide variety of conditions, perhaps even depression and anxiety. Out of curiosity, I did use a low-dose regimen for a time (chopping 50 mg pills into tiny slivers) but saw no beneficial effect on mood. But if you have a difficult condition like fibromyalgia or chronic fatigue, low-dose naltrexone is cheap and easy to try.
Holiday Health Reminder
Our bodies are pretty amazing at maintaining weight. But most weight gain happens slowly, over the years, and most of that, about 1 pound per year (ignore the headline, read the article), happens during the holidays. We seem to give ourselves permission during this time to overeat and override the body’s setpoint. It’s way easier to not gain weight by declining and throwing away extra food than to lose weight later. From Halloween to Easter, I feel like I am constantly putting extra junk food in the trash can.
With that, I wish you all a Merry Christmas and a prosperous 2023! I will be taking most of the rest of the month off, so I may have time to finish a few more posts.