The right diet for your APO E gene is what can truly heal your life.

For 16 years, Dora had been working with her primary care doctor to solve her cholesterol mystery. Despite trying many different medications, reading all the books about lowering cholesterol and following their advice, and even trying some of the popular diets, Dora was never able to bring her cholesterol level below about 400—double the recommended maximum level for good heart health.

When this lovely 75-year-old woman came to see me, she was not following any particular cholesterol-lowering program because she was stymied, as was her primary care doctor, about what approach to try next. Nevertheless, she was still determined to reduce her cholesterol levels. She had good reason.

As she told me while relating her medical history, nearly every immediate family member suffered from severe heart disease, and many had already died. Clearly, she faced multiple risk factors for heart disease, and perhaps even Alzheimer’s disease, since certain Apo E genotypes carry a higher risk for both. People with the Apo E 4/4, in particular, are more prone to Alzheimer’s disease, although Dora said none of her family members had exhibited symptoms.

I saw no hint of cognitive impairment in Dora, whose delightful sense of humor never failed to cheer me. Very no-nonsense and polite, she was also bright, aware, alert, and happy. She is also one of the most determined people I know. While her children were young, she worked nights as a telephone switchboard operator to support them, coming home in time to get them off to school and then sleeping during the day while they were gone. It was this same brand of perseverance that motivated her to solve the perplexing mystery of her cholesterol levels.

Once I explained that advanced cholesterol testing and an Apo E test could give her very detailed information, Dora eagerly agreed to have the tests done. The results showed extremely high total cholesterol and high LDL—not unexpected—as well as Apo E 4/4, passed to her from both of her parents.

Her test results of January 4, 2005, blew the top off the charts with a total cholesterol level of 489 and an LDL level of 381—both extremely high. Her HDL was 67, in the high range.

Now we had a very specific genetic road map, which we could use to structure her particular diet and exercise program. Since Dora had never been able to physically tolerate either drugs or botanical supplements typically used to lower cholesterol, we decided on a no-medicine approach using only diet and exercise in line with her Apo E 4/4. These top two integrative medicine tools would be a true test of the right program for her genotype.

I recommended a diet for Dora that would reduce all her cholesterol levels. She was to make the changes slowly so her body could adjust. First of all, it was important for her to avoid skipping meals, with breakfast, lunch, dinner, and three healthy snacks spaced three hours apart. She was to eat 1,600 to 1,800 calories a day, divided this way: 25 percent protein from plant sources and fish (very little red meat, limited to only once every 24 to 48 hours), 55 percent carbohydrates from low-glycemic foods such as whole grains, and 20 percent fat in monounsaturated and polyunsaturated forms. In addition, Dora was to begin walking on a treadmill every day, beginning with 10-minute sessions and slowly increasing the time.

A month later, Dora’s total cholesterol was 243, her total LDL was 160, and her HDL was 57. At the time of her third test, on March 11, 2005, her results had improved even further: total cholesterol of 214, total LDL of 142, and total HDL of 65. The final result: one very happy patient with exceptional results. A summary of her progress is as follows:

January 4

Total cholesterol: 489 mg/dL (Optimal: below 200. High: over 240)

LDL cholesterol: 381 mg/dL (Optimal: below 100. Very high: over 190)

HDL cholesterol: 67 mg/dL (Low: 40. High: 60)

After a month of Apo E 4/4 genotype diet and exercise protocol with no medications:

February 8

Total cholesterol: 243 mg/dL

LDL cholesterol: 160 mg/dL

HDL cholesterol: 57 mg/dL

March 11

Total cholesterol: 214 mg/dL

LDL cholesterol: 142 mg/dL

HDL cholesterol: 65 mg/dL

Five years later, Dora still comes to see me, and she’s doing well.