Race Against Mind: An Alzheimer's Prevention Investigation

This episode goes deep on the exercise pillar. The four mechanisms connecting movement to brain health, including a 2026 UCSF study that identified a liver enzyme that repairs the blood-brain barrier and what it reveals about why consistency matters at a molecular level.We also get into why getting stronger is different from lifting consistently, what the SMART trial found when it measured both strength and aerobic capacity in the same participants, and why VO2 max may be the most important fitness number you are not tracking.Plus my parents as a natural experiment, where my own protocol stands after two years of deliberate changes, and four questions to audit whether what you are already doing is actually building what your brain needs.The research. The mechanisms. What I changed. What the data showed.Show Notes

For APOE4 carriers, knowing your risk is only useful if you know what to do with it. In this episode, Sarah walks through her path to developing a baseline, and discusses the labs that actually matter, fasting insulin, homocysteine, hs-CRP, Vitamin D etc. Sarah also discusses why standard functional medicine isn't specific enough for APOE4 biology, and how to interpret baseline data without losing your mind in the process.Whats in this episode: What APOE4 actually is, and what it isn'tWhy the "nothing you can do" frame is the most expensive mistake APOE4 carriers can makeThe research caveat problem: why so many studies don't apply to people like meHow I built my first baseline with blood work and cognitive testing before changing anythingWhy I started with Parsley Health and then moved to Dale Bredesen's PreCODE programWhat my PreCODE report revealed across metabolic, inflammatory, and cognitive domainsWhy my cognitive scores required more context than just a number on a page (ADHD, breastfeeding, medication status)Three practical takeaways for anyone at the beginning of this journeyWhy exercise leads Season 1, even though it wasn't where I startedShow Notes & References

Sarah is homozygous APOE4, the highest genetic risk profile for Alzheimer's disease. Her grandmother had it. Her mother was diagnosed at 58. When she got her own results, she didn't wait.In this first episode, she traces how a family legacy of Alzheimer's became a five-year personal research project and why the window for meaningful intervention is decades earlier than most people think. She breaks down what carrying two copies of APOE4 actually means, where the science is solid and where it falls short, and how she built a protocol around the pillars most likely to move the needle: nutrition, sleep, fitness, alcohol, and hormones. This is where it all starts.Show Notes & References