Dietitian Amylee Amos Talks “Alzheimer’s Diet,” APOE 4 + The Bredesen Protocol
We’re talking to brain health expert Amylee Amos MS, RDN about The Bredesen Protocol, a clinically-tested “Alzheimer’s diet” and how it can potentially slow and even reverse cognitive decline or prevent disease in APOE4 susceptible individuals.
Cognitive decline, or reduced brain functioning, is an unfortunately inevitable outcome of aging. A person’s risk of dementia doubles every 5 years, starting at age 65. By 90 years old, about 30% of people will develop the disease.
Smoking, being a woman, and genetic risk factors, like possessing a gene known as “APOE 4,” have all shown to increase a person’s risk of conditions like Alzheimer’s and dementia.
As it is Brain Awareness Week, I wanted to take this opportunity to share with you guys some lifestyle habits that support brain health and may reduce your risk of developing these conditions.
On this week’s episode of “The Sitch,” we’re talking to registered dietitian nutritionist, Amylee Amos, founder of the Amos Institute, a practice dedicated to helping patients implement strategies to slow and even reverse the symptoms of dementia and Alzheimer’s.
Using The Bredesen Protocol, developed by Dr. Dale Bredesen of the Buck Institute for Research on Aging, Amylee helps her clients adopt dietary and lifestyle habits that have been clinically shown to benefit Alzheimer’s patients.
Bredesen’s research has shown that a highly-individualized treatment protocol with certain similar components can produce improvements in brain functioning and markers of cognitive decline —and even regenerate the brain!
To develop these individual recommendations, each of Amylee’s patients receives comprehensive testing including measuring glucose response, insulin levels, inflammatory status, genetic variation, gut integrity, and the blood-brain barrier.
The Bredesen Protocol – An Anti-Alzheimer’s Diet
While the dietary interventions for her clients are high-individualized, there are certain recommendations that all patients follow.
A plant-based, mildly ketogenic diet
The main components of the protocol include:
- Whole, Predominantly Plant-Based foods
- Mild ketosis
- Complex carbohydrates
- 10-15 servings of non-starchy vegetables/day
- Healthy fats – mostly monounsaturated foods such as nuts, seeds, and olive oil
- Lean protein such as legumes and cold-water, low-mercury fish
- Low-glycemic fruit such as berries
- A 12-hour nightly fast + a 3-hour fast before bedtime
What the diet avoids:
- Highly processed foods such as protein/energy bars (which Amylee calls glorified candy-bars)
- Large amounts of meat and animal products
- Simple carbohydrates such as refined bread, crackers, pastries
- Simple sugar
- All non-nutritive sweeteners such as Splenda
- Gluten*
While the protocol does aim for a “mildly ketogenic” state, it is not your standard ketogenic diet and Amylee does not recommend that those with cognitive decline (or anyone) adopt that pattern of eating.
The Bredesen Protocol includes complex carbohydrates, fruit, and other foods that are typically avoided in a standard ketogenic diet and aims to reduce many foods that are common in a ketogenic diet such as meat and high-saturated fat animal products.
Still, the diet does include some animal products, including low-mercury fish.
Find out my secret to perfectly cooked salmon every time! >>
Amylee offered up the acronym “SMASH” to help us remember which fish fit the bill:
- Salmon
- Mackerel
- Anchovies
- Sardines
- Herring
Other components of the protocol include improving sleep, increasing physical activity, and “brain training” with games from companies like Brain HQ.
APOE 4 AND ALZHEIMER’S
We also discussed the benefits of the diet for people with a genetic risk factor for Alzheimer’s, the APOE 4 gene, which codes for a protein involved in fat metabolism.
People who possess one copy of the APOE 4 gene have an approximately 47% increased risk of Alzheimer’s while those with two copies of the gene have up to a 90% increase.
Amylee says that implementing components of the protocol earlier in life — before you’re seeing symptoms — may help fight the onset of Alzheimer’s in those who are genetically predisposed.
For more information on implementing an “Alzheimer’s diet” with The Bredesen Protocol, APOE 4, and how to test your blood to ensure you’re in a mildly ketotic state, watch the video above!
To learn more about The Bredesen Protocol, check out Dr. Dale Bredesen’s book, “The End of Alzheimer’s: The First Program to Prevent and Reverse Cognitive Decline.”
“What for so long has been a really devastating diagnosis, doesn’t have to be anymore.”
If you’re interested in working with Amylee, make sure to visit her website Amos Institute to learn about her services. And be sure to follow her on Instagram and Facebook where she shares daily tips for optimizing brain health.
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Weigh-in: Do you optimize your diet for brain health? Have you heard of the Bredesen Protocol or “Alzheimer’s diet” before?
*In the video, Amylee explains the reason gluten is excluded from the diet. She talks about the “transient” openings of the epithelial layer in the gut wall. Transient means the opening only lasts for a short period of time.
The study that this information comes from is an “in vitro” study, meaning it was conducted outside of the body on intestinal cells. What this means for the safety of gluten consumption in the general population (as opposed to with patients with GI conditions such as Celiac disease, non-Celiac gluten sensitivity, or impaired barrier function due to other chronic conditions) is still under investigation.
For now, I personally believe that gluten is safe and a nutritious part of the diet for the majority of healthy people.
Alisa Fleming says:
One side of my family has dementia issues, so this is definitely a book I need to check out! Thanks for sharing it.
Joanna says:
My first time hearing about it! This was so informative. Can’t wait to check the book out.
Angilina says:
Why is chicken not on this diet? Chicken breasts are low in saturated fat?
Jodi Robinson RD, CDE, PTS, RYT says:
I have never heard about this protocol before. Thanks for sharing all this info with us!
Erin says:
I was unaware of this- so incredibly interesting! Thanks so much for sharing this!
Katie Cavuto says:
How interesting! And what beautiful pictures
Catherine Brown says:
This sounds like a great eating plan and describes how I eat when I’m paying attention. So it sounds like, under this plan, you have a 9-hour window each day in which to eat. I wonder if I could eat that many servings of vegetables (along with the other groups) in that time period? I rarely ever measure my daily servings. Maybe something to build up to… curious to try it now!
Jen says:
I read the hours of fasting as a total of 12. The mention of 3 hours of fasting before bedtime just means that one should start the 12 hour fast 3 hours before going to bed. So, in other words, don’t eat at 9pm, go to bed at 10 pm, and then eat breakfast at 9am.
Instead, for example, finish dinner by 7pm if you are going to bed at 10pm. Then you’ll be set to have breakfast at 7am.
Whitney E. RD says:
Exactly!
Rebecca says:
Whitney your posts are always so well done and thorough. You are a true professional!
Charlene Pors says:
Nutrition is so important for the brain! Great information.
Abbie Gellman says:
Very interesting, hadn’t heard of this protocol before!
Katie Palmer says:
I think it’s irresponsible to give such incorrect figures on the risk increase that the APOE4 gene carries. Also irresponsible is supporting a protocol that has only been tested in 10 people, not received any peer review and asks vulnerable people to spend a lot of money on treatments that have not been tested in long term, large scale, well conducted trials.
Whitney E. RD says:
Hi Katie, in response to your comment – those figures are derived from research, which is linked in the text. The protocol was published in a peer-reviewed journal. And most of these recommendations can be carried out at little cost to a patient. I agree that this protocol is not a silver bullet, but it’s worth a try for the many people suffering from this devastating disease.
Danny says:
I began checking your linked sources, you claim “A person’s risk of dementia doubles every year, starting at age 65”, but both of the sources cited in the same line claim “Above the age of 65, a person’s risk of developing Alzheimer’s
disease or vascular dementia doubles roughly every 5 years”. That’s the first reference, and there’s already a substantial error. Also I’m not familiar with the Alzheimer’s Association, but claiming they’re owned by Big Pharma is a pretty bold claim, Ms. Amo’s services are at least $8,000 annually. https://amosinstitute.com/faq.html
S Thomas says:
The peer review process employed by the journal has been criticized by Jeffrey Beall, a university librarian and expert on predatory open access publishing, who also included the journal and its publisher on his list of “potential, possible, or probable predatory scholarly open-access journals” in July 2015.[7][8] Allegedly, journal editor Mikhail Blagosklonny responded by threatening to retract the papers of Beall’s colleagues at the University of Colorado.[9] It has been alleged that the journal has gamed their impact factor by requiring authors to provide references to other recent papers in the journal and does not conduct adequate peer-reviews of articles.[10]
Anna says:
I agree Katie Palmer, thank you for pointing out this disappointing article with false APOE4 statistics.
Daryl Vernon says:
It amazes that basic causality is overlooked. What could be opening guts transiently? What could be harming ability to take in varieties of nourishment that our near ancestors had little trouble with? There is one enormous category of environmental stress or pollution that is overlooked, and shielding therefrom, mitigating and agitating to eliminate this gargantuan problem should be at the forefront of anyone into public health. So what is doing us in? Dementia is striking younger and younger. It is obvious that it and a whole array of other “diseases of civilization” are attributable to human abuse of the electromagnetic spectrum.
Mary says:
what exactly are the complex carbs you should eat if you have already been diagnosed with Alzheimer’s?
Bill Kuhn says:
To stay in mild ketosis, thereby fueling your brain primarily using ketones rather than glucose, you need to limit your carbs, complex or simple, to definitely less than 100 grams a day, and that would require using MCT oil to stimulate ketone production, Generally, you would need to eat less than 50 grams a day, which you would get eating 15 servings of low GI fruits and vegetagles. So, no starches. Pretty much all of your energy calories would come from fat. These folks here claim that we should limit ruminant (cow and sheep) sources of fat, but there is some interesting data showing that some grass-fed beef and lamb can totally be a part of a healthy mildly ketogenic diet. The big deal is live on fat and eat lots of whole vegetables…
Margo says:
There’s no way you could be in mild ketosis if you eat 15 servings of fruit a day. Depending on the fruit you choose and the rest of what you consume in a day, you could very well eat too many carbs. Fruits can be very high in carbs. Strawberries I believe are the lowest you can get. But you still have to watch the portions closely.
The ketogenic eat of eating is high fat, moderate proteins and very low carbs (virtually all from vegetables, dairy and occasionally a little fruit). VERY CLEAN INGREDIENTS ARE KEY!
ALSO, mct oil is NOT necessary to put you in ketosis. To correctly follow A TRUE keto diet, you want no more than 20 total carbs a day. Max of 7 carbs per meal. Just eating clean ingredients and watching your carbs will put you in ketosis.
Doriela says:
Amylee, why does dr Dale Bredesen use a mild ketogenic form if fasting? What if someone with ahlzeimer were put on a full ketogenic fast? Is it bad?
Michael J Barker says:
I also want to know the answers to these two questions. There are several full keto proponents among Amazon’s top-selling Alzheimer’s treatment books. Does Bredesen advance a mild ketogenic diet because it is easier to follow, or because it is healthier?
Laura says:
Hi. Enjoyed watching, sad that the cost to work with Amos is so high. It makes me wonder how people that are truly interested could possibly have access to this protocol. Yes, you can do it yourself, but not to the level of having someone guide and personalize it to your specific needs. SIgh
Kathleen says:
When should this protocol be implemented? Does it help for someone in the throws of the disease? At what point does it make sense to start? Does it stop the progression or slow it down?
Thank You…
Bill says:
Not sure I would say it is bad, if you have a lot of weight to lose, it might be the ticket. But, Dr. Bredesen is very focused on getting all of the good stuff in whole vegetables, and if you are eating the recommended servings of vegetables, even if they are low GI vegetables, your ketosis will be mild as you will be consuming 50 or more grams of carbohydrate a day. In a full ketogenic diet, where you are keeping carbs to less than 20g a day or less, you would not have much room for even a big salad. When glucose is available to the body, it is the preferred fuel and the liver will not make ketones. So, mild ketogeingc so you can eat a whole bunch of whole vegetables and some fruits.
Sunny says:
Hi Amylee, love rh video! We need help. My husband was diagnosed with Alzheimer’s in April. In June we found the ReCODE Protocol and started follwing it. Then we connected with a functional medicine specialist trained by Dr Bredesen in July and began following their guidance. He was slightly overweight at 5’6” and 165. Now 4 months later he weighs only 140. He is very worried about his weight. We see our PCP tomorrow about this. He eats sweet potatoes and brown rice, and we do our best to stick to the Protocol guidelines of grass-fed beef, pastured chicken and eggs, and wild caught SMASH fish. The only time we stray is eating in restaurants when we don’t always know the sourcing of the meat. All fish we eat is wild caught. He’s been tested and is monozygotic APOE 4 for Alzheimer’s and cardiac issues. He is believed to have Type 3 Alzheimer’s. He fasts 14-16 hours between dinner and breakfast. The problem is the weight loss. His FMS wants him to consider going off the ketoflex diet and returning to his previous diet, then easing into keto again. I can’t find anything in the literature to support this idea. What would you recommend?
Bill says:
Well, I’m not Amylee, but am most interested and well read in the subject. Question, is your husband getting adequate fat calories? If he is not consuming carbohydrate for energy, he has no other option than to eat more fat. As in, a lot more fat. You might get an app, such as myfitnesspal, that you can use to count your macros and see how many calories he is eating per day. Or, you can just add more fat until the weight loss no longer happens. We are a very fat phobic culture and have been told by all the authorities that fat is something we need to avoid. But, if you are not eating carbs, you better eat fat, I use bulletproof coffee and the occasional fat bomb to make sure I get enough energy calories. but adding extra olive oil to your salad or doubling up on the kerrygold butter on your flax meal waffles will work, as well.
DMF says:
You can have a free 15 minute consult with the Apollo nutritionist. Email them! They advised to add more olive oil; nuts;avocado; and in limited amounts sweet potato and wild rice.
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Good luck to each and every one of that’s trying this herbal formula.
Amanda McCluskey says:
I am finding it hard to get a definite response about exactly what I can and can’t eat on this diet Are seeds and some grains such as quinoa allowed?
SK says:
I am also researching this diet. This is a good guideline: https://drlonsdorf.com/pdf/ReCODE-Report-MPI-Cognition-NUTRITIONAL-GUIDELINES.pdf
Quinoa is allowed but should be taken with caution because of its high glycemic index. One to two handful of nuts and a few tablespoons of seeds are allowed on this diet.
Brent says:
I have Bredesen’s book. It’s very good, very specific, and says which nutrients to take, one of which is phosphatatylserine for brain function. His book is his research from 30 years of his clinic. The gut biome is the key. The foods that cause unhealthy leaky gut syndrome he says is the cause. Buy the book, it answers ALL your questions. It is an answer to Alzheimer’s, and Bredesen has proven it.
Marla says:
The cost of “memory care” is about $10,000 A MONTH in Colorado so money well spent as far as I’m concerned. My Mother was just diagnosed with Alzheimer’s and we have started working with a functional medicine DR that has been trained in the Bredesen Protocol. Mainstream doctors offer NO HOPE. We now have hope.
Janet says:
I am currently whole food planted for 6 years, no added oil or salt for 5 years, VERY little oily plant foods except for 1T ground flax seed every day and occasionally restaurant food (once/month). For 6 months I’ve been flour & sugar free. I do eat a LOT of potatoes and sweet potatoes, green vegetable for breakfast, etc. I’ve not budged my cholesterol numbers which are not good, but my Calcium Scan score is 30 (not bad for a 76 yr old). I take Homocyst-X Plus which barely makes my homocysteine level ok by lab standards (not Bredesen standards). I still have high CRP. Are the potatoes a problem on the Keto Green diet?
Bpb says:
Good for you, Whtney, for your comment about gluten.
Syamala Pullakhandam says:
My mom is going through cognitive decline problems. I am not sure whether that can be classsified as Dementia or Alzhiemers. We are from India (part of Asia) where rice is predominantly used in meals. Do you have any diet plans for Indian ethnicity?
Sheryl Clark says:
Might this be effective for someone with Lewy Body dementia / disease?
Whitney E. RD says:
Possibly! Check out Amylee’s website to learn more.
Vera says:
I am listening to the audiobook and its useless to a layperson. Thanks for distilling it down to the bottom line. What do we eat?
Georgina says:
Just a thought, I know nuts are incredibly nutritious, however, should you have an allergy, would the alternatives be as helpful for reversing Alzheimers and what would the alternatives be? Thank you x
Dr. Stan Guberman says:
Have you looked into molecular mimicry foods that will increase the production of amyloid
They are: Lentil Tuna, Hazelnut, Cashew Vicilin, Scallops, Caseins,etc
Janette says:
What’s the best alternative to olive oil as I’m intolerant to it and eat a lot if saturated fats instead.
hentai says:
I do accept as true with all of the ideas you have introduced to your post.
They’re very convincing and will certainly work.
Nonetheless, the posts are too quick for newbies.
Could you please extend them a bit from next time?
Thank you for the post.
Adrian Vanessa says:
Having Alzheimer’s disease knocked my mother off her life and had her living like a mad person, I didn’t know how the better part of her life eluded her, my mind was completely splatted in two, She showed a severe decline in her mental and cognitive skills in the last few years and her quality of life had deteriorated greatly in the past 2 years where she was mostly bedridden. I am very glad my partner sought help and now she is free from all signs of psychosis. She was healed through the herbal medicines from Dr. Rohan (BRONGEE). I believe there is no act of kindness that is too small that is why I am sharing this testimony here. If you have anybody who is diagnosed with Alzheimer’s disease, I will advise you to opt out from western medication and go for BRONGEE herbal medicine. you will have every reason to be happy again just as I am. You can visit his blog to know more about this herbal medicine. https://herbalcureforalzheimeranddementia.blogspot.com/
He is well known for his groundbreaking treatments concerning the brain and mind issues..
S Thomas says:
Folks, I call B. S. on the claims of “peer-reviewed” research. Here is what has been written about the Journal “Aging,” in which Bredesen’s research was published:
” The peer review process employed by the journal has been criticized by Jeffrey Beall, a university librarian and expert on predatory open access publishing, who also included the journal and its publisher on his list of “potential, possible, or probable predatory scholarly open-access journals” in July 2015.[7][8] Allegedly, journal editor Mikhail Blagosklonny responded by threatening to retract the papers of Beall’s colleagues at the University of Colorado.[9] It has been alleged that the journal has gamed their impact factor by requiring authors to provide references to other recent papers in the journal and does not conduct adequate peer-reviews of articles.[10]”
S Thomas says:
Please do not give these people your money.
Tracy says:
https://www.ucsf.edu/news/2020/05/417431/pricey-protocol-not-proven-prevent-or-reverse-alzheimers-says-ucsf-neurologist
Please research before trying anything
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Zas says:
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tressa Collins says:
If you have one copy of spoe4 and 59 years old, is it to late to start protocol. I know it is just a risk gene
Ann says:
I’ve just read Dr. Bredesen’s book and recommend reading it to anyone on this thread who has questions about the protocol. There’s a LOT covered in it concerning genetics and medical conditions, such as leaky gut, and environmental/food toxins that contribute to the onset (not sure that’s the correct term) of Alzheimer’s. A majority of the foods that are safe to eat are there as well. The only information I can’t find, in the book or online, is specifics about condiments, such as vinegars, that are considered healthy to eat. They make a big difference in flavoring foods! I’m creating and compiling recipes for a friend who was recently diagnosed with early stage Alzheimer’s and need this information to make sure they’re compliant. Anyone have a more complete list, or know where to find it, than has been offered in the book?
uno online says:
I just read the Alzheimer’s Solution by Ayesha Sherzai and Dean Sherzai, and was super interested to hear another perspective. There were definitely more similarities than differnces.
Raquel Britzke says:
I’m really intrigued by the Bredesen Protocol and its potential to help with Alzheimer’s and cognitive decline. It’s great to see a focus on personalized nutrition and lifestyle changes. I look forward to tuning in to ‘The Sitch’ and hearing more from Amylee Amos!