Hussein Yassine, M.D.: Deep dive into the "Alzheimer's gene" (APOE), brain health, and omega-3s

**Peter Attia** (0:11)
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Now, without further delay, here's today's episode.
My guest this week is Dr. Hussein Yassine. Hussein is an associate professor in the Department of Medicine at the Keck School of Medicine at USC. His lab has focused for almost a decade now on lipid metabolism and nutrition and the effect these have on cognition and the risk of developing Alzheimer's disease, paying specific attention to the APOE4 allele. Many of you listening to this podcast will no doubt be familiar with APOE4 genotypes. We've spoken about this at great length in a number of podcasts. This is really the deep dive into E4, what the implications are. I actually wanted to speak with Hussein after we were part of a journal club where he presented a couple of papers that he authored that were simply beyond fascinating. And it was definitely one of the deepest dives I'd ever seen into the inner workings of EPA and DHA's role in the brain. Now, we do get to that near the end of the podcast, but I realize that it's important for people to really understand a lot about the brain. And so I would consider this kind of a fundamental core coursework on brain biology. We really explain the architecture of the brain, the energy systems of the brain and what goes wrong. What are the various things that go wrong? Because it's not just one thing as a person develops Alzheimer's disease. And then we get into what APOE is, and then why we might have these three different variants or isoforms of it, E2, E3 and E4. And what turns out to be different, depending on which of those you have. The obvious thing, of course, is your risk for Alzheimer's disease, but why?
We have a little side tangent that goes into sort of the role of EPA in cardiovascular disease, with or without DHA, and then kind of bring it back to this discussion around the role of DHA in Alzheimer's disease, and also what some of the specific things that we understand to date, with respect to patients that have E4 and what they can do to reduce risk. I'm gonna give you a warning up front. Unfortunately, if you're anything like me, you're gonna come away from this episode, I think, frustrated that our state of knowledge is still so pedestrian. But nevertheless, this is a very important discussion, and I certainly learned a lot in it, and it will actually have an impact on how I think about taking care of my patients. So, without further delay, please enjoy my conversation with Hussein Yazin.
Hussein, thanks so much for making time to sit down today. I'm really looking forward to this. Obviously, I had the pleasure of doing Journal Club with you a few weeks ago, which is what made me realize we needed to do this for a much broader audience.
Let's kind of go back to the beginning a little bit though. I'm kind of curious as to what got you interested in this space. I know you grew up in Lebanon. Did you do medical school there as well as college?

**Hussein Yassine** (3:35)
Yeah, thank you, Peter, for the invitation. I'm happy to be part of your show. Yes, I grew up in Beirut, Lebanon. That's my medical school. And then shortly after, moved to the US to do some residency training, and followed by a fellowship.
And then I got to where I am right now.

**Peter Attia** (3:56)
Tell me a little bit about that path. Your fellowship was in what?

**Hussein Yassine** (4:00)
I trained in endocrinology.
I come from a family with strong heart disease and diabetes, so I decided to subspecialize in lipid disorders. And I studied lipids for a good of two to three years before I had the opportunity to study brain lipids, and I switched from blood lipids to the brain.

**Peter Attia** (4:23)
Well, this is a topic that I think a lot of people are interested in because I remember 10 years ago when you would check an ApoE genotype on somebody, it was a very unusual thing to do. Today, it's not as unusual. It's probably still not incredibly common that people are walking around knowing their ApoE genotype, but it certainly, I mean, it seems a log order more common than it was a decade ago, and I suspect a decade from now, that might be one of the genes that kind of everybody knows about themselves.