The Bredesen protocol’s “Ketoflex” approach to diet and eating for Alzheimer’s disease.Randall Smitham August 31, 2019 4 Comments
[Dale]: So then the 12/3 part of Ketoflex
12/3, a minimum of 12-hour fasts between when
you finish dinner and when you start breakfast
or brunch or lunch, if you are ApoE4 positive
you’re actually a better fat absorber, as
you know, so you want to make that 14 to 16
If you’re ApoE4 negative, 12 to 14 hours.
And be careful, if you have a very low BMI,
you can lose weight on this Ketoflex 12/3
diet and so you have to liberalize typically
once a week, have some sweet potatoes or something
that’s a little more carbohydrate-related.
And of course, in the book we talk about the
various things that you want to do with this
diet, but 12 hours, that gives you time for
autophagy, it gives you time essentially at
night to induce your ketosis, to clean out
your brain, of course, the glymphatic system,
you actually have a change in the architecture
of your brain as you’re sleeping, you’re actually
essentially sweeping this stuff out, it’s
kind of amazing, actually.
And so, if you’re eating with these very small
windows of sleep and very small windows of
fasting you’re actually doing yourself harm
and putting yourself at greater risk.
And then similarly, you want three hours before
bed after you finish your dinner.
You don’t want to eat right up until bedtime
because your insulin’s high, and again, that’s
hurting your cognition.
That’s again, giving you the same sort of
insulin resistance problem, storing fat, you’re
doing all the things that are not helpful.
So that’s the dietary approach.
And of course, you want to have organic.
There are toxins in our food, it’s unfortunate.
We’ve got a tremendous a life-long exposure
Of course, Bruce Ames, with whom you’ve trained,
developed the Ames Test, which allows us now
to look at carcinogens, but nobody has ever
told us, “Well, hey, what about dementogens?”
You’re exposed every day to various dementogens,
things like mercury, things like some of the
organics that are in some of the health and
beauty aids, and things like biotoxins.
If you’re living in a home that has leaks,
you are exposed to dementogens and you need
to know about that.
So that’s the Ketoflex 12/3.
We want it be…it’s a plant-rich diet that
Mark Hyman calls plant-rich as opposed to
plant-based, but either way it is a plant-rich
diet that can use some animal products, it’s
up to you.
You want to be vegetarian, that’s fine, you
don’t, that’s fine too.
That minimizes the toxins, you want to have
a high, typically 70% or so calories from
fat, and you can start out with using things
like MCT oil or coconut oil to get your ketones
We’re finding that people who have higher
ketone levels, 1.5 millimolar to 4 millimolar
more beta-hydroxybutyrate tend to do better
than those who are down lower.
[Rhonda]: ApoE4 positive or negative?
[Dale]: And ApoE4 positive or negative.
Now interestingly, for the ApoE4s what we
typically suggest, and this was actually originally
suggested by Julie G. who started the website,
You essentially start with using the MCT oil
to help you get your ketosis, but then switch
after a month or two to more monounsaturates
Now you can essentially balance, so you have
the best of both worlds.
You follow your LDL particle number, your
You want to keep it below 1,000 so you can
adjust how much MCT oil and how much of the
monounsaturates and polyunsaturates so they
have the best heart outcome, the best cardiovascular
outcome, at the same time have the best cognitive
Be careful, if don’t get your ketones up and
you get your carbs down you’re starving your
brain, and so then people will say, “Oh my
gosh, I just have no energy.”
So you want to use that.
You want to basically be changing over to
a more ketone-based metabolism for your brain.
And then, as you indicated, you want to go
back more toward the monounsaturates and polyunsaturates
to make it heart healthy.
[Rhonda]: So for this, for the ApoE4 positive
people you do recommend lowering the saturated
fat intake because of the LDL.
[Dale]: After you become insulin sensitive,
so after you want to drive yourself into insulin
sensitivity, so you’re able now to convert,
because it takes a few weeks, as you know,
to convert from a largely carbohydrate-based
metabolism to a largely fat-based metabolism.
So if you try to do it in a day you may end
up with so-called keto flu, and it takes some
time and you’re now producing, it’s a whole
set of things you’re producing, it’s going
to be less inflammatory, you’re lowering your
reliance on glucose, you’re becoming metabolically
flexible, and you’re now essentially developing
a use of the ketones and it does takes a few
And it’s helpful to do things like exercise
and things at that time to help you convert.
[Rhonda]: And then the fasting, the overnight
fasting of at least 12 hours, or like you
said, if you’re ApoE4 positive possibly even
increase that to 14 hours.