Peter Attia and Rhonda Patrick are saying something that most neurologists still resist: Alzheimer's is not primarily a brain disease. It is a metabolic disease that expresses itself in the brain. The amyloid plaques we've spent decades targeting with drugs? They may be a symptom, not the cause. The real story begins in your blood sugar, your insulin sensitivity, and the integrity of the barrier that separates your bloodstream from your brain.
When 50 to 80 percent of Alzheimer's patients also carry a diagnosis of type 2 diabetes, that is not a coincidence. That is a signal. Chronically elevated blood glucose and insulin resistance disrupt the blood-brain barrier — that exquisitely selective filter that decides what gets into your brain and what stays out. When the barrier weakens, inflammatory compounds flood in, neurons begin to misfire, and the cognitive decline we call Alzheimer's begins years, sometimes decades, before any symptoms appear.
The genetic piece adds nuance. Carriers of two copies of the APOE4 allele face a ten-fold increase in Alzheimer's risk. But genetics is not destiny here. APOE4 affects how efficiently your brain clears amyloid, how well you metabolize DHA, and how permeable your blood-brain barrier becomes under metabolic stress. The gene amplifies the damage that poor metabolic health causes — it does not cause the disease in isolation. This distinction matters enormously for how we think about prevention.
Where experts genuinely disagree is on the relative weight of the amyloid hypothesis versus the metabolic model. The pharmaceutical industry has poured billions into amyloid-clearing drugs. Results have been, to put it gently, underwhelming. The metabolic research community is gaining ground, but the field moves slowly. Prevention is still treated as a secondary concern. That, I think, is the quiet scandal at the heart of this episode.
Here is what I find remarkable: Rhonda Patrick is perhaps the most cited researcher on sauna and dementia prevention. Her analysis of the Finnish cohort data shows a 66 percent reduction in Alzheimer's risk with frequent sauna use. And in this very episode, she is explaining exactly why that might work. Heat shock proteins clear misfolded proteins before they aggregate. Sauna reduces chronic inflammation. It improves insulin sensitivity. It strengthens vascular function — including, almost certainly, the blood-brain barrier itself. The intervention we offer at Contrast Collective is not separate from this conversation. It is embedded in it.
Treat your metabolic health as brain health. Full stop. Every meal that spikes your blood glucose unnecessarily is a small act of inflammation that your blood-brain barrier has to absorb. Every sauna session, every cold plunge, every bout of exercise is a direct investment in the cellular machinery that keeps your brain protected and clean. The genetics you carry inform your strategy — they do not determine your outcome. Start now, not when symptoms appear. The window for prevention is open far longer than most people realize, but it is not infinite.