If you’ve spent any time reading about APOE4, you’ve probably encountered passionate advocates for every dietary approach imaginable. Some promote strict ketogenic diets. Others advocate plant-based eating. Still others favor Mediterranean-style nutrition. Rather than tell you what you should eat, I’m going to share what I do.

I do not follow a strict ketogenic diet – for a good reason!

I have no excess weight to lose, and maintaining a healthy weight has become just as important to me as maintaining healthy glucose levels. At 5’7″, I currently weigh approximately 120 pounds and have no desire to lose additional weight.

That said, I do follow what many would describe as a KetoFlex approach. Through intermittent fasting and careful food choices, I typically achieve blood ketone levels above 0.5 – 0.7mmol/L at some point during the morning. For me, this provides some of the metabolic flexibility and ketone production I am seeking without requiring a highly restrictive ketogenic diet.

If I were significantly overweight, my approach would almost certainly be different. In that situation, I would have no hesitation embracing a far more ketogenic eating pattern to improve metabolic health and reduce insulin resistance.

My food choices are guided by a few simple principles:

The staples in my pantry, listed below, form the foundation of my current eating pattern.

Dr. Nick Norwitz, a Harvard trained MD with a PhD from Oxford, is also an APOE4/4. He co-authored an article about Precision Nutrition for Alzheimer’s Prevention in APOE4 Carriers you can access here.

In summary, I focus primarily on a whole food mediterranean diet (nothing boxed or with a long ingredient list), no added sugar, lower glycemic index (for instance, I don’t eat grapes!) and my beverages include:

A Personal Note About Food Choices

The foods listed on this page reflect my main personal dietary go-to’s based on my genetics, health goals, laboratory results, age, preferences, and what I have learned along the way. They are not intended as recommendations for everyone.

Each of us brings a unique combination of genetics, medical history, lifestyle factors, food sensitivities, and personal goals. What works well for me may not be appropriate for you.

I encourage you to use this information as a source of ideas and education rather than a prescription. Whenever possible, make dietary decisions in partnership with qualified healthcare professionals who understand your individual circumstances. My BMI is a big reason I’m not chasing ketones more frequently.

I’ve read Dr. Gundry’s books and am familiar with his theories regarding lectins and the avoidance of many foods that are otherwise considered healthy.

My personal view is that the lectin issue is often overstated when applied to the general population. While some individuals may have specific sensitivities and benefit from limiting certain foods, I do not believe most people need to avoid nutrient-dense foods solely because they contain lectins.

As for me, I continue to eat nightshade vegetables. They’ve never caused any noticeable issues, and my consistently low inflammation markers suggest they are not problematic in my case.