Peter Attia

makes it even more difficult.

So anyway, look, I don't want to offer advice from the peanut gallery because I'm in the peanut gallery for a reason on this, but that might be something worth considering.

Let's talk about Alzheimer's disease.

equally devastating, much longer tail, but in my mind seems somewhat easier to address through metabolic therapies because at least in the subset of those patients for whom an energetic crisis is at the core, and I don't think that that's all cases, I think that's also a very heterogeneous disease, but at least one subset of these people are probably in an energetic crisis.

What do we know about the current research and what's the current state of affairs for using ketogenic therapies?

If you have two copies.

There are a handful of genes in which you are destined to get it.

Unfortunately, at this point, PSCN1, PSCN2, APP.

But again, I mean, 25% of the population are heterozygous for APOE4.

Their risk is twofold higher.

I don't think anyone would consider that destiny.

Of those, would you say that the latter is the most important, that it's the alternative fuel source that is the most important?

Let's go back to, I haven't paid any attention to this, what's happening in clinical trials?

This is a much easier thing to test.

Has someone done the experiment where you take people in the earliest stages of dementia or in modest stages of MCI, mild cognitive impairment, who are progressing towards dementia and

and you randomize them to standard of care versus the exact same standard of care plus a KD.

Has that experiment been done cleanly in a randomized fashion?

Those experiments, like many things, are ongoing.

So patient selection is going to matter.

And what do you think is the state of the art with alpha GPC just in general for normal cognitive enhancement?