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Poor Fat-Soluble Handling

When genes affecting fat absorption, conversion, and transport are compromised, fat-soluble nutrients don't work the way textbooks say they should.

What this pattern means.

Fat-soluble nutrients (vitamins A, D, E, K, omega-3s, cholesterol) require special handling. They need to be absorbed with fat, transported by lipoproteins, and often converted from precursor forms.

The problem

Standard nutrition advice assumes average genetics:

  • • "Eat carrots for vitamin A" → BCMO1 poor converters can't use carotenoids
  • • "Take flax oil for omega-3" → FADS1/2 slow converters can't make EPA/DHA
  • • "Get 20 min of sun for vitamin D" → VDR variants may need higher levels
  • • "Reduce saturated fat" → Only critical for APOE4 carriers

Following generic advice with these variants can lead to deficiency despite "doing everything right."

Genes in this pattern.

APOELipid transport

E4 variant affects cholesterol transport, brain lipid delivery, and fat-soluble vitamin handling

E4 = different lipid metabolism; may need different dietary fat approach
BCMO1Beta-carotene → Vitamin A

Converts plant carotenoids to retinol. Poor converters can't get vitamin A from plants effectively.

A379V and R267S reduce conversion by 30-70%

FADS1

Omega fatty acid conversion

Converts plant omega-3 (ALA) to EPA. Slow variants need preformed EPA/DHA from fish.

Multiple SNPs affect conversion efficiency

FADS2

Fatty acid desaturation

Works with FADS1 in omega-3 and omega-6 conversion pathway

Variants affect both omega-3 and omega-6 metabolism

MTTP

Lipoprotein assembly

Assembles lipoproteins for fat transport. Affects absorption of dietary fats.

Variants affect fat absorption efficiency

ABCA1

Cholesterol efflux

Moves cholesterol out of cells. Important for HDL formation and reverse cholesterol transport.

Variants affect HDL levels and function
VDRVitamin D receptor

How cells respond to vitamin D. Variants may need higher D levels for same effect.

Fok1, Bsm1, Taq1 affect receptor function

Common signs.

  • •Vitamin A deficiency despite eating carrots/sweet potatoes
  • •Low DHA despite taking flax oil or chia seeds
  • •Dry skin, eyes, or mucous membranes
  • •Night vision problems
  • •Cognitive issues despite 'healthy' diet
  • •Low vitamin D despite sun exposure
  • •High cholesterol that doesn't respond to standard advice
  • •Poor absorption of fat-soluble vitamins (A, D, E, K)
  • •Fatty liver or gallbladder issues
  • •Hormone imbalances (hormones are made from cholesterol)

The BCMO1 example.

This is the "I eat tons of carrots but I'm still vitamin A deficient" gene.

Good BCMO1

  • • Efficiently converts beta-carotene to retinol
  • • Can get vitamin A from plant sources
  • • Carrots, sweet potatoes, and leafy greens work
  • • Vegetarian/vegan vitamin A sources are adequate

Poor BCMO1

  • • 30-70% reduced conversion
  • • Accumulates beta-carotene (may get orange skin)
  • • Can't rely on plant sources for vitamin A
  • • Needs preformed retinol: liver, eggs, dairy

~45% of people have at least one BCMO1 variant that reduces conversion. Many have no idea their "healthy" plant-based vitamin A sources aren't working.

Strategies for this pattern.

🥚

Preformed Vitamin A

If BCMO1 is slow, get retinol from liver, egg yolks, or cod liver oil—not just beta-carotene from plants.

🐟

Direct EPA/DHA

If FADS1/2 are slow, get omega-3s from fish or algae oil. Plant ALA won't convert efficiently.

🫀

Optimize Bile Flow

Fat-soluble nutrients need bile for absorption. Bitter foods, adequate fat, ox bile if needed.

🔬

Test, Don't Guess

Check vitamin A (retinol), D (25-OH), omega-3 index, and lipid panel. Functional levels, not just deficiency cutoffs.

🥑

Fat Quality Matters

Focus on whole food fats. Oxidized seed oils may be harder to handle with this pattern.

⚖️

Consider Saturated Fat

APOE4 carriers may need to limit saturated fat more than others. But E2/E3 may do fine with it.

The vegetarian challenge.

This pattern creates real issues for plant-based diets.

Plant sources rely on conversion

  • • Vitamin A: Beta-carotene → retinol (BCMO1)
  • • Omega-3: ALA → EPA → DHA (FADS1/2)
  • • Vitamin D: Sun → D3 → active form (multiple genes)

If conversion genes are slow, plant sources alone may lead to deficiency.

Options for plant-based eaters

  • • Algae oil for direct DHA (bypasses FADS)
  • • Consider eggs if not vegan (preformed retinol)
  • • Test levels regularly to catch deficiencies early
  • • May need vitamin A and D supplementation in active forms

Go deeper.

APOE

The major lipid transport gene affecting cholesterol and brain health.

VDR

How your cells respond to vitamin D.

Bile

Fat absorption requires bile. No bile = no fat-soluble nutrients.

"Generic nutrition advice assumes average genetics. With this pattern, you need to know your conversions aren't average."
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