Dr Gundry's Protocol

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Dr Steven Gundry's Protocol

Dr Steven Gundry Wikipedia GundryMD is a practitioner who applies his background as a cardiothoracic surgeon to his current functional medicine approach, which he calls restorative medicine. As a surgeon, he developed an expertise in xenotransplantation (the process of transplanting organs between members of different species). Among his surgical inventions is the world's most widely used device to infuse heart tissue with a preservative solution. He is also a cum laude graduate of Yale University with special honors in human biological and social evolution. This background has given Dr Gundry unique insight into the body’s immune and genetic response.

In his practice, he tests multiple biomarkers to holistically optimize the functioning of the body, organs, and brain. Dr Gundry has been regularly testing and tweaking the diet and supplementation regimen of his patients since 2002. This testing includes the ApoE4 allele. He has followed thousands of ApoE4 patients.

He has specific dietary recommendation for carriers of the ApoE4 allele, which is discussed further in this post.

Dietary Advice for General Population

Detailed information on his dietary recommendations can be found in his books. The first book “Diet Evolution: Turn off the genes that are killing you-and your waistline-and drop the weight for good” was published in 2008 and discusses the disconnect between today’s modern diet and the food that human genes need for healthy living. Dr Gundry subsequently stated that “Diet Evolution” was a compromise between what he prescribed at the time and what the publisher thought would sell; therefore, it is not a complete guide to his dietary advice. His second book “Plant Paradox: The Hidden Dangers in "Healthy" Foods That Cause Disease and Weight Gain” was published in 2017 by a different publisher who provided Dr Gundry more freedom to address his findings. He has subsequently published related cookbooks and a book on Longevity, "The Longevity Paradox" see Books by Dr Gundry section below for details on each of his books.

For years, Dr Gundry has been compiling a list of acceptable and forbidden foods and providing this list to his patients. Originally called his “Matrix Diet” there are now two lists named after his second book:

  1. A Plant Paradox Foods List citing both a “Yes Please” list of acceptable foods followed by a “Just Say No” list of forbidden foods aimed at most of his readers.
  2. A Keto Plant Paradox Foods list which is provided to those who come to him with progressed health issues, i.e. severe diabetes, cancer, kidney failure, newly diagnosed dementia, Parkinson’s, or other neurological diseases that need to be placed in his “intensive care unit.”

Dr. Gundry’s “Yes” & “No” Lists can be found at this link: Dr. Gundry’s Print-Friendly “Yes” & “No” Lists

Dr. Gundry's food pyramid

Dr Gundry's food pyramid

can be used for guidance in implementing these lists.

These are the major points of the pyramid; additional information can be found at YouTube video - Dr Gundry's Food Pyramid

  1. Good fats, approved oils, and cruciferous vegetables (foundation of pyramid)
  2. Skip a meal
  3. Nuts, flour alternatives, lectin-free grains
  4. Resistant starches
  5. Wild-caught seafood
  6. Pastured poultry and Omega-3 Eggs (pastured poultry is okay for general population, but complete elimination is recommended for ApoeE4s)
  7. In-season fruits
  8. Southern European Cow’s milk, goat’s milk, sheep’s milk, and buffalo milk (in moderation for general population, but completely eliminated for ApoE4s)
  9. Red wine, champagne, dark spirits
  10. Grass-fed, pasture raised meat (in moderation for general population, but complete elimination is recommended for ApoE4s)

The pyramid also contains a list of food to avoid completely. Don't dismiss this. In his Plant Paradox book, he presents four rules, and rule #1 is "What you stop eating has far more impact on your health than what you start."

Advantages of Dr Gundry's Dietary Advice

The subject of lectins has been discussed numerous times on the ApoE4.info website. There are many who dismiss this dietary advice because, while there are studies, there’s no overwhelming scientifically collected evidence. Dr Gundry’s recommendation comes largely from his experience with tens of thousands of patients. Dr Gundry cites his own self-skepticism in Plant Paradox: “Believe me, twelve years ago I myself would have tossed this book out the window…” (page 70, hardcopy of "Plant Paradox"). So this skepticism is firmly based.
Perhaps the rationale for this has to do with the fact humans have been eating high lectin foods for a number of years without obvious consequence. In his Plant Paradox Book, Dr Gundry explains that today’s environment is a lot different than that of our grandparents. It’s not just the lectins, it's:
1. Our sensitivity to lectins has increased greatly due the recent introduction to chemical and other body disruptors, such as food additives, food preservatives, the introduction of NSAIDS pain pills in the early 1970’s, stomach acid reducers (Prilosec, Prevacid, Nexium) plastic food packaging/containers (like those containing BPA), petrochemical fertilizers introduced after World War II, herbicides, biocides, food that is now Genetically Modified (GMOs), skin-care products, hand sanitizers, on and on. These are compromising the body's ability to deal with lectins.
2. We eat a lot more lectins today than in the past, largely because the dietary guidelines changed in 1980 resulting in greater carbohydrate consumption. Also, some foods today have been modified and consequently contain more lectins than in the past.
3. Lectin silently and slowly causes the body to attack itself, so except for those that are particularly sensitive, there’s no immediate, “if I eat a tomato, my rheumatoid arthritis flares up” effect.
  • Incorporates fasting to give the gut a “mini-vacation” from the hard work of digestion as well as allowing the energy producing mitochondria in the brain and body a chance to rest and recharge. See Enhance autophagy, ketogenesis
  • Minimizes sdLDL (small dense LDL cholesterol) thus reducing the subsequent production of oxLDL (oxidized LDL cholesterol) which is the cholesterol that becomes “sticky” and problematic
  • Balances the Omega-3 (important for ApoE4s) to Omega-6 intake ratio through the consumption of wild caught fish, shellfish, omega-3 eggs, and grass-fed beef. See Fats, Omega -3(ω-3) & -6(ω-6), DHA and More, Omega-3 fatty acids and Provide synaptic structural components
  • Feeds the gut biome, which is important for many health concerns, but of particular interest to ApoE4s given the gut-brain connection. See Vagus Nerve. See GI health
  • Reduces the activation of the mTOR pathway and reduces IGF-1 through the limitation of animal protein. Both animal and human studies show that the lower the IGF-1, the longer and better (more healthily) a person lives.
  • Eliminates processed food thus reducing exposure to endocrine disruptors, also known as hormone disruptors, which are commonly found in plastics used for packaging, preservatives added to processed foods, and insecticides or herbicides sprayed on farmed food or on the food our animal protein source eats. See Hormone balance
  • Avoids “bad” oils, i.e. those high in Omega-6 content, or high in Polyunsaturated Unsaturated Fatty Acids (PUFAs). PUFAs look for oxygen atoms to bond to, thereby producing oxidation in the body. Also avoids oils derived from lectins, e.g. peanut, or are that he refers to as “estrogen bombs” e.g. soybean oil. See Fats, Omega -3(ω-3) & -6(ω-6), DHA and More and Omega-3 fatty acids
  • Emphasizes consumption of polyphenols, the beneficial plant chemical found in olive oil, tea, coffee, fruits, berries, and some vegetables. See Optimize antioxidants

Dietary Advice for ApoE4s

Dr Gundry further modifies his dietary recommendations for ApoE4s. These recommendations are not found in his books, but have been gleaned from ApoE4s who are his patients and from the YouTube video AHS16 - Steven Gundry - Dietary Management of the Apo E 4. Many posts in the ApoE4.info forums discuss Dr Gundry. See Dr. Steven Gundry with diet recommendations for ApoE4 for initial familiarization.

Recommendations for ApoE4s

  • Limit types of animal protein consumption in addition to his general recommendation of limiting total amount of animal protein He recommends ApoE4s only eat wild caught white fish, wild caught shellfish, and Omega-3 or pastured eggs (no grass fed beef, no pastured poultry).
  • Shellfish is the animal protein of choice due to its sdLDL lowering quality.
  • Eliminate cheese. He says it is not an ApoE4’s friend because cheese has the strongest correlation to production of oxidized particles of LDL levels.
  • Lower Triglycerides by lessening sugars, fruits, and seeded vegetables to reduce oxidized LDL.
  • Consume generous portions of polyphenol rich olive oil as well as polyphenols in Resveratrol, Grape Seed Extract, Tumeric, and Pomegranate Seed Oil and Extracts to further minimize the oxidation of small LDL particles.
  • While coconut oil is allowed for the general population, he does not recommend it for ApoE4s because it tends to elevate sdLDL. Dr Gundry himself explained, "Saturated fats compete for space within the Apolipoprotein 4's molecules ability to recycle cholesterol. No such problem exists if you don't carry the 4."
  • Supplement with fish oil. He cites that a high red blood count EPA + DHA (the two primary components of fish oil) corresponds with larger total brain and hippocampal volumes. He has stated that DHA in particular is what to emphasize, a person wants the most DHA per fish oil capsule that he/she can afford. While a good Omega-3 index for the general population is considered 8 to 10, Dr Gundry says the Omega-3 index for ApoE4s should be higher at 10 to 12.
  • Supplement with grape seed extract, at least 100 mg/day. Grape seeds are rich in antioxidants and a compound called oligomeric proanthocyanidin complexes (OPCs). Proanthocyanidins are a class of polyphenols that boost hepatic NAD metabolism and SIRT1. Without going into details, SIRT1 expression is critical to understanding the many faceted effects of the ApoE4 gene. See Increase SirT1 function
  • Supplement with turmeric. Best form is curcumin that is bioavailable. (Turmeric is the plant, curcumin is what is extracted from the turmeric). Curcumin has been found to activate SIRT1 and block the neurotoxicity of amyloid-beta in rat cortical neurons. In other words the curcumin was found to be neuroprotective. See Turmeric and curcuminarticle Turmeric and curcumin https://wiki.apoe4.info/wiki/Turmeric_and_curcumin. See Reduction of Aβ
  • Supplement with niacinamide (2x500 mg/day) (regular niacinamide, not no-flush niacinamide) for brain health.
  • Avoid whole grain bread and whole grain products. While his dietary advice recommends eliminating all major sources of lectins, which includes all grain products, of particular interest to ApoE4s is his opinion about the lectin Wheat Germ Agglutinin (WGA). This is not gluten, it is found in the bran, so while white bread contains gluten, it does not contain WGA. In “Plant Paradox” he addresses many ill effects of WGA, but during the Q&A dinner session with the ApoE4.info meet-up group in August 2016, he made of point of addressing wheat germ agglutinin and how it can bind to sialic acids on your blood vessels and to insulin receptors. When the wheat germ agglutinin binds to insulin receptors in the muscles a person gets sarcopenia (aging muscle loss) and when it happens in the brain, it blocks the effect of insulin. As discussed in the page on Insulin Resistance, there is a significant link to brain insulin resistance and Alzheimer's Disease. Dr Gundry thinks a lot of what we see as Alzheimer’s is is actually the accumulation through the years of wheat germ agglutinin.

Dr Gundry and Dr Bredesen

Although they derived their findings through very different means, there are numerous overlaps in Dr Gundry’s and Dr Bredesen’s protocols. This coincidence did not go unnoticed by the ApoE4 community. In 2016, the ApoE4.info group introduced Dr Gundry and Dr Bredesen to each other. They each gave a presentation at the Ancestral Health Symposium and were able to exchange thoughts with each other at the group dinners each evening. The two have become good friends. Dr Bredesen is quoted on the back cover of Dr Gundry’s book “Plant Paradox” and Dr Gundry is quoted in the "Praise for the End of Alzheimer's" section of Dr Bredesen's book.

On August 21, 2017, Dr Gundry posted a video, Dr Steven Gundry interviews Dr Dale Bredesen about "The End of Alzheimer's"the book that Dr Bredesen had just published. In the interview Dr Bredesen said, "In fact I'm actually starting phase one of your protocol right now myself, which I think is fantastic and actually fits very much with what we found in the test tube over the last 28 years on Alzheimer's disease."

Further information on Dr Gundry

Background information

Huffington Post Steven R. Gundry

Blog and Podcast

Dr Gundry's blog GundryMD Blog

Dr Gundry's podcast Dr Gundry's Podcast

Presentation on ApoE4 at AHS16

  • This link provides a synopsis of his presentation and a link to download his slides, AHS16 Schedule

Interviews and podcasts

Dr Gundry Abstracts and Posters to the American Heart Association

NOTE: The link does not go directly to the posters, use the search button and type in "Gundry" for access.

ApoE4.info forum discussions


Two ApoE4 patients' consultations with Dr Gundry. The format of the sessions are to go over our labs first, then ask questions.

Books by Dr Gundry

Gundry, Steven R. (2008). Dr. Gundry's diet evolution : Turn off the genes that are killing you-and your waistline-and drop the weight for good (1st ed. ed.). New York: Crown Publishers. ISBN 0307352110

Gundry, Steven (2017). The Plant Paradox: The Hidden Dangers in "Healthy" Foods That Cause Disease and Weight Gain (The Plant Paradox book 1)(1st ed.). Harper Wave. ISBN 978-0062427137

Gundry, Steven (2018). The Plant Paradox Cookbook: 100 Delicious Recipes to Help You Lose Weight, Heal Your Gut, and Live Lectin-Free. (The Plant Paradox book 2) Harper Wave. ISBN-10: 0062843370, ISBN-13: 978-0062843371

Gundry, Steven (2019). The Plant Paradox Quick and Easy: The 30-Day Plan to Lose Weight, Feel Great, and Live Lectin-Free (The Plant Paradox book 3) Harper Wave. ISBN-10: 0062911996, ISBN-13: 978-0062911995

Gundry, Steven (2019). The Longevity Paradox: How to Die Young at a Ripe Old Age (The Plant Paradox book 4) (1st ed). Harper Wave. ISBN-10: 0062843397, ISBN-13: 978-0062843395

Gundry, Steven (2019). The Plant Paradox Family Cookbook: 80 One-Pot Recipes to Nourish Your Family Using Your Instant Pot, Slow Cooker, or Sheet Pan (1st ed.). Harper Wave. ISBN-10: 006291183X, ISBN-13: 978-0062911834