Alcohol use for APOE3/4?

[Kikiwebb]

This all seems very extreme. I think if you enjoy an occasional glass of wine to be social and to relax - (3-4 max a week women and 5-6 men) this is NOT going to give you AD! I have spoken at LENGTH with AD researchers at UofM... it can be part of a healthy lifestyle. BETER to abstain but a few glasses a week to be social is not going to move the needle.. being socially isolated and stressed much worse then a glass of Pinot *LIGHT DRINKING.. as long as you still get good sleep and keep it to once or twice a week.

[TheresaB]

Personal experience and opinions are all well and good, but what does the research say?

Dr Rhonda Patrick (fellow ApoE4) recently posted (July 2, 2024) on her Found my Fitness website this video discussion Episode #92 The Truth about Alcohol, An evidence-based scientific review

It comes with extensive show notes that include informative graphics. She elaborates on many issues regarding alcohol use, here is what Dr Patrick says about us:

Alcohol, APOE e4, and Alzheimer’s:

Some evidence suggests that the risk of dementia increases along with increasing alcohol consumption in people with one or more copies of the APOE e4 allele but not in people without this allele.
• Carriers who consumed alcohol less than once a month still had a 2.3 times greater risk of dementia than carriers who never drank, and carriers who drank several times per month had a 3.6 times greater risk.
• For adults with one or more copies of the APOE e4 allele, any alcohol was associated with a greater risk of cognitive decline, with 90% greater risk for two or fewer drinks per day, a 170% increase for two to five drinks per day, and a 730% increase for five or more drinks per day.

graphic 2.jpg

The interaction between midlife alcohol consumption and APOE status on dementia risk. Source: Alcohol drinking in middle age and subsequent risk of mild cognitive impairment and dementia in old age: a prospective population based study BMJ 2004. https://www.bmj.com/content/329/7465/539

In the video she also addresses:
*Alcohol, Alzheimer’s disease, and dementia (from a general population not ApoE4, perspective)
*Alcohol and gut health
*Alcohol and sleep
*Alcohol, longevity, and aging
*Alcohol and cardiovascular disease
*Alcohol and metabolic health
Her discussion points are actually more extensive, but those subjects are of particular interest to APOE4s.

Here are the time coded chapters (you can link directly to that time/discussion from the video's notes):
CHAPTERS:
00:00:00 Introduction
00:02:19 What does it mean to "have a drink"?
00:03:55 Drinking frequency definitions
00:06:55 How alcohol is metabolized
00:10:47 How genetics affect alcohol metabolism
00:12:41 Can alcoholism be inherited?
00:13:58 How food affects alcohol metabolism
00:15:57 Does age affect alcohol metabolism?
00:16:46 How alcohol affects nutrient absorption
00:21:22 How alcohol affects gut health
00:23:15 Alcohol elevates circulating LPS levels
00:26:09 Gut health & alcohol use disorders
00:30:49 Sick quitter & healthy user biases
00:33:57 How alcohol impacts the brain
00:37:53 Alcohol's effects on anxiety
00:42:09 Alcohol’s detrimental effects on brain volume loss
00:44:16 Alcohol facilitates thiamine deficiency
00:46:00 Alcohol promotes brain inflammation
00:47:16 Dementia & Alzheimer's disease risk
00:53:19 Alcohol’s impact on APOE4 carriers
00:57:28 Alcohol and brain health mechanisms
01:01:11 Is resveratrol in red wine beneficial?
01:05:50 Detailing the sleep stages
01:09:11 How alcohol impacts sleep
01:12:44 Alcohol worsens sleep apnea
01:14:10 Mitigating alcohol's impact on sleep
01:16:37 Hangover symptoms & causes
01:20:56 How congeners affect hangover severity
01:22:22 Treating hangovers with fruit
01:25:05 Zinc, vitamin B3, & hangovers
01:26:05 Managing hangovers with NSAIDs
01:26:46 "Hair of the dog” for hangovers
01:27:05 Liposomal glutathione, NAC, & hangovers
01:30:21 Does ZBiotics prevent hangovers?
01:32:43 Dihydromyricetin (DHM) for hangovers
01:33:41 Exercise & sauna for treating hangovers
01:34:47 Alcohol's effect on mortality risk
01:38:54 Is alcohol responsible for longevity in Blue Zones?
01:43:33 Alcohol & cancer risk
01:52:18 Genetics, alcohol, & cancer risk
01:55:10 Can quitting alcohol lower cancer risk?
01:57:15 Alcohol cancer-causing mechanisms
02:04:15 Alcohol & cardiovascular disease (CVD)
02:11:42 Alcohol & CVD mechanisms
02:15:55 Industry funding in alcohol research
02:17:54 Alcohol and type 2 diabetes risk
02:20:08 How alcohol affects blood glucose
02:22:58 Alcohol's impact on your waistline
02:26:04 Why alcohol facilitates weight gain
02:28:37 How alcohol impacts reproductive health
02:31:29 Fertility impacts of alcohol in females
02:37:27 How alcohol impacts fertility in males
02:39:03 Preconception alcohol risks
02:41:44 How alcohol affects testosterone in men
02:43:27 Pre-pregnancy alcohol consumption risks
02:47:49 Is red wine the healthiest option?
02:51:19 Headaches after drinking red wine
02:52:20 Alcohol & post-exercise recovery
02:56:08 Does alcohol "blunt your gains"?
02:58:45 The BEER-HIIT study
02:59:36 Can exercise lessen alcohol cravings?
03:02:34 FGF21, exercise, and alcohol intake
03:07:32 Alcohol damage control tactics

[Nords]

This all seems very extreme. I think if you enjoy an occasional glass of wine to be social and to relax - (3-4 max a week women and 5-6 men) this is NOT going to give you AD! I have spoken at LENGTH with AD researchers at UofM... it can be part of a healthy lifestyle. BETER to abstain but a few glasses a week to be social is not going to move the needle.. being socially isolated and stressed much worse then a glass of Pinot *LIGHT DRINKING.. as long as you still get good sleep and keep it to once or twice a week.

Wow, this thread is over nine years old. I’d forgotten about it.

@Kikiwebb, if this all seems very extreme to you, then choose your own path. If you’re happy with the advice of the Alzheimer’s researchers at UofM then you do you.

Maybe it’s worth asking the researchers if it’s safe to have that occasional glass when you’re older than 65, comfortable with the alcohol habit, "socially isolated", and dealing with a slight cognitive decline that’s possibly heading down a slope toward dementia. The entrenched habit of “an occasional glass” is what nearly killed my father, as described earlier in this thread:
https://forums.apoe4.info/viewtopic.php?p=16379#p16379

Why set yourself up for it? And for those of us who have a family history of dementia (especially exacerbated with two copies of APOE4), why would we take an even greater risk?

It’d be great if we could all stay on the “occasional glass” habit as we age, but that doesn’t seem to be happening. Older Americans are dying more from alcohol than from drug overdoses. Earlier in 2024, Paula Span (the NYT writer of the New Old Age column) added this research:
Public health officials are increasingly alarmed by older Americans’ drinking. The annual number of alcohol-related deaths from 2020 through 2021 exceeded 178,000, according to recently released data from the Centers for Disease Control and Prevention: more deaths than from all drug overdoses combined.
An analysis by the National Institute on Alcohol Abuse and Alcoholism shows that people over 65 accounted for 38 percent of that total. From 1999 to 2020, the 237 percent increase in alcohol-related deaths among those over age 55 was higher than for any age group except 25- to 34-year-olds.
[...]
Moreover, a 2018 meta-analysis found that binge drinking (defined as four or more drinks on a single occasion for women, five or more for men) had climbed nearly 40 percent among older Americans over the past 10 to 15 years.

Here’s a gift link to the article (and more links to the research) for those who don’t have a NYT subscription:
https://www.nytimes.com/2024/03/30/health/seniors-alcohol-consumption.html?smid=tw-share

[JD2020]

Public health officials are increasingly alarmed by older Americans’ drinking. The annual number of alcohol-related deaths from 2020 through 2021 exceeded 178,000, according to recently released data from the Centers for Disease Control and Prevention: more deaths than from all drug overdoses combined.
An analysis by the National Institute on Alcohol Abuse and Alcoholism shows that people over 65 accounted for 38 percent of that total. From 1999 to 2020, the 237 percent increase in alcohol-related deaths among those over age 55 was higher than for any age group except 25- to 34-year-olds.

I wonder to what extent Covid played a role. The lock downs were hard on a lot of people. Perhaps the older people were more socially isolated than other groups, and therefore, drinking more.

[Kikiwebb]

I think social isolation is so key. I did not mean to act inappropriately on this amazing website. I just have known a lot of people who carry the gene and are living in misery because they feel like they have to eat and be perfect. It just makes me sad. Life is supposed to be beautiful. I’m not saying, eat pizza and drink a bottle of wine every night but I feel like people also need to enjoy life and just balance a little bit. I have a friend who has two copies and has just gone off the deep end restricting everything. And she was the type of person that would only have one glass of wine at dinner anyways and would run 8 miles every day regardless . I just wonder what will be the advice in five years?

[Nords]

I just have known a lot of people who carry the gene and are living in misery because they feel like they have to eat and be perfect. It just makes me sad. Life is supposed to be beautiful. I’m not saying, eat pizza and drink a bottle of wine every night but I feel like people also need to enjoy life and just balance a little bit. I have a friend who has two copies and has just gone off the deep end restricting everything. And she was the type of person that would only have one glass of wine at dinner anyways and would run 8 miles every day regardless . I just wonder what will be the advice in five years?

And yet this forum is filled with people (including me) who are living in hope by striving for a sustainable routine of healthy habits, precisely to maximize their life enjoyment.

Until medical science starts routinely editing genomes to minimize the genetic risks, people can only control their reactions to their situations. Hopefully they'll find their own ways of adapting and can move from "living in misery" to "complaining happily" about their new habits.

[Kikiwebb]

awe beautifully said! I hate that last night when I went out for dinner (first time being social ion 2 weeks I had a terrible case of covid) I couldn't enjoy that darn glass of wine bc at 48, I was consumed with worry over AD!! This gene status has sucked the fun out of my life! ha!

Thank you to this amazing forum with honesty, science, patience and kindness.

[Kikiwebb]

OK, more deep thoughts on this topic. If the apoe4 gene is a cholesterol metabolism issue, why would small amounts of alcohol be an issue for carriers versus non-carriers. I did go to med school for a year, but unfortunately, I’m only a nurse practitioner. I don’t remember enough of the science to be able to figure out the mechanism with regards to the article you quoted above. This is just curiosity for me at this point.

[TheresaB]

OK, more deep thoughts on this topic. If the apoe4 gene is a cholesterol metabolism issue, why would small amounts of alcohol be an issue for carriers versus non-carriers.

First, ApoE4 is far more than a cholesterol metabolism issue. Granted, it used to be thought of as simply a lipid bucket, then a 2016 paper Direct Transcriptional Effects of Apolipoprotein E (V. Theendakara et al, 20 Jan 2016) revealed that APOE4 enters the nucleus and tells 1700 different genes what to do in areas associated with neurotrophins, programmed cell death, synaptic function, sirtuins and aging, and insulin resistance.

Second, research on alcohol’s effects on healthspan and lifespan is extensive, this applies to all APOE carriers – 2s, 3s, and 4s, but given the pleiotropic effects of ApoE4, it does seem that we are more sensitive to injurious insults so it stands to reason that we’d be more sensitive to the ill effects of alcohol, even small amounts. Once again referencing Dr Patrick’s video #92 The Truth About Alcohol: Risks, Benefits, and Everything In-Between | Dr. Rhonda Patrick posted on 2 July 2024, we know alchohol can contribute to:
• brain volume loss
• thiamine, (vitamin B1) deficiency —which can increase levels of iron in the brain
• neuroinflammation via gut-brain axis disruption
• impacting sleep and quality sleep is essential for cognitive health
• 1-3 drinks per day can double the risk of breast & colon cancer in men & women
• 5 drinks a week can be like smoking 10 cigarettes a week for women (oxidative stress)
• alcohol impacts waistline and visceral fat, which can contribute to harmful systemic inflammation

There's more reading in our ApoE4.info wiki: Alcohol Consumption

[Lizzy16]

OK, more deep thoughts on this topic. If the apoe4 gene is a cholesterol metabolism issue, why would small amounts of alcohol be an issue for carriers versus non-carriers. I did go to med school for a year, but unfortunately, I’m only a nurse practitioner. I don’t remember enough of the science to be able to figure out the mechanism with regards to the article you quoted above. This is just curiosity for me at this point.

Just wanted to say Nurse practitioners are highly skilled. You are never "only" a NP. And no, Im not a nurse