Is the Paleo diet right for you?

Your genes not only decide what you look like, they also decide which foods are best for you.  The major diseases of today – type 2 diabetes, heart disease, hypertension and obesity stem from a mismatch between our genes and our diet.  This means eating the wrong food for your genes increases your chances of developing these health problems.  On the other hand, eating a diet tailored to your genes will improve your health in a sustainable manner.  

A good example is the relationship between your TCF7L2 gene and refined carbohydrates.

Type 2 diabetes is more common in people with genetics that are incompatible with modern food and lifestyle.  People whose ancestors ate diets least similar to today's Western diet are at greatest risk for the condition, with a polymorphism within the TCF7L2 gene being the strongest genetic risk factor.

People with the ancestral allele(s) in this gene do not handle refined carbohydrates as well and may be better suited to similar diets such as pre-agricultural hunter-gatherers.  This is also called the Paleo diet, which became a trend amongst gym goers and the Cross Fit crowd.

So what is the Paleo Diet?

The Paleo diet reflects an eating pattern of our pre-agricultural ancestors and is characterised by the following:

• Emphasises vegetables, fruit, meat, fish and eggs

• Limits grains and added sugars

• High fat, protein and cholesterol

• Low carb and low glycaemic load

For people with diabetes linked to their TCF7L2 gene (which is often associated with lower BMI and not insulin resistance) the Paleo diet may offer benefits. 

Diets with a lower glycaemic load (GL) that limit desserts and milk reduce the risk of type 2 diabetes for this group. 

These dietary patterns and choices align with the Paleo diet. 


In contrast, for the majority of diabetes cases (which stem from being overweight and obesity with insulin resistance) the Paleo diet could be harmful. Because of the higher fat and protein content, the diet seldom meets dietary guideline recommendations. 

Here we are talking about the relationship between your APOE gene and dietary fat.

People with the APOE4 gene variant need to be particularly careful about following a Paleo diet as they can develop high cholesterol and cardiovascular diseases when the level of fat in their diet is too high. 

Genetic variation in the APOE gene strongly influences the risk of Alzheimer’s disease and cholesterol levels. 

There are three common types of the APOE gene. Each is associated with different levels of cholesterol in the blood and risk of dementia:

• APOE2: lower levels of cholesterol

• APOE3: normal cholesterol metabolism

• APOE4: higher risk for high cholesterol levels

Your heritage influences your likelihood of having E2, E3 or E4 and therefore your risk for high cholesterol and heart disease. 

One of the principles of functional nutrition that I like to repeat to my clients, is that you are not doomed by your genes! Your gene predisposition does not mean in any way that you will develop the disease associated with it. 

However by not adapting your diet to suit your genes and correct any imbalances, this will lead you on the wrong path. 

Research has shown that people from Nigeria have the highest frequency of the E4 allele (31%). However they have one of the lowest disease rates associated to its gene variant. So we have something to learn here from their diet.

The traditional Nigerian diet consists primarily of starchy root vegetables, grains and an abundance of fruits, while including very little animal meat. 

Adhering to a low-fat (especially low-saturated fat) and low-cholesterol diet allow people with the E4 genotype to thrive without high cholesterol and heart disease.  However, when people with E4 alleles consume a ‘Westernised’ diet, with higher cholesterol and sodium and low potassium, disease emerges.

The traditional Nigerian diet might present beneficial nutritional patterns for people with the APOE4 genotype. It also happens to perfectly align with heart healthy dietary recommendations by the American Heart Association.

So here are some guidelines for an APOE4 diet:

Gene Diet for APOE4:

• Strictly limit saturated fat to less than 7% of total calories.

• Limit dietary cholesterol to less than 200 g/day.

• Eat plenty of fruit and vegetables.

• Include an abundance of whole grains and complex carbohydrates in the diet.

• Choose fish and poultry instead of red meat.

• Get enough potassium (4,700 mg/d) while limiting sodium intake.

Cholesterol isn't the evil for us all.

Interestingly, a major update in the Dietary Guidelines for Americans in 2015 lifted the restriction on dietary cholesterol intake (originally 300 mg/day). 

This is because for most people, cholesterol may not be a big problem. 

In fact, cholesterol-rich foods can be beneficial for people with insulin resistance and metabolic syndrome.  However, for people with abnormal cholesterol metabolism, such as those with APOE4, this revised guideline does not apply; limiting fat, saturated fat and cholesterol-rich foods, such as eggs, shellfish, red meat and dairy, is critical for these people to minimise their risk of heart disease.

Genetic testing can shine light on the root causes of disease and helps us to more precisely formulate dietary, lifestyle and environmental changes to better optimise our health and prevent the development of degenerative diseases that represent the first cause of death in our society. 


So what's your best diet?  Get in touch and ask your genes here