The 2020 Lancet Commission Report estimates that up to 40% of Alzheimer's disease (AD) cases may be preventable through modifiable risk factor modification. The field of AD prevention has largely focused on addressing these factors through universal risk reduction strategies for the general population. However, targeting these strategies in a clinical precision medicine fashion, including the use of genetic risk factors, allows for potentially greater impact on AD risk reduction. Over the last decade, there has been an exponential increase in the evidence supporting nutritional interventions for AD risk reduction. However, in the area of precision nutrition, there remains many unanswered questions and the field is rich with opportunity for scientific exploration. Apolipoprotein E (APOE), and specifically the APOE ε4 variant, is one of the most well-established genetic influencers on late-onset AD risk. In this presentaion, we review an individualized clinical management approach toward AD risk reduction, and give an overview of the nutrigenomic impact of APOE ε4 carrier status on AD prevention interventions.