A Long-Term Follow-Up Study on Disclosing Genetic Risk Information (<b><i>APOE</i></b>) to Promote Healthy Lifestyles in Finland

Abstract

&lt;b&gt;&lt;i&gt;Aim:&lt;/i&gt;&lt;/b&gt; This observational follow-up study was designed to assess the long-term behavioural and clinical effects of receiving personal genetic risk information. The information disclosed was the carrier status of the apolipoprotein E (&lt;i&gt;APOE&lt;/i&gt;)&lt;i&gt;&lt;/i&gt;alleles, which differentially contribute to the genetic risk for cardiovascular disease (CVD) and Alzheimer’s disease. &lt;b&gt;&lt;i&gt;Methods:&lt;/i&gt;&lt;/b&gt; This study forms a continuum with a previous 1-year intervention (2010–2011) monitoring the effects of disclosing the carrier status of the &lt;i&gt;APOE ε4&lt;/i&gt;risk allele. The follow-up measurements, performed 5.5 years post-intervention, included clinical measurements (blood values and anthropomorphic parameters) and questionnaires (psychological and behavioural factors). The participants were healthy adult volunteers, aged 26–73 years (&lt;i&gt;n&lt;/i&gt; = 70) who had participated in the previous intervention, and received their &lt;i&gt;APOE&lt;/i&gt; allele status either at the beginning (former test group) or the end of the intervention (former control group). &lt;b&gt;&lt;i&gt;Results:&lt;/i&gt;&lt;/b&gt; Personal genetic risk information resulted in a moderate health-conscious change in diet and had a slight positive long-term effect on clinical factors, particularly the serum lipids. These improvements were subsequent to the disclosure of genetic information and occurred mainly in the &lt;i&gt;APOE ε4&lt;/i&gt;-positive members of the former control group, that is, those who were at increased genetic risk for CVD but had not been informed of their status before the end of the intervention. In contrast, changes in the values and health behaviour of the &lt;i&gt;APOE ε4&lt;/i&gt;-positive individuals in the former test group, who had already changed their health behaviour during the previous intervention as a result of being informed of their carrier status, varied more: some continued to improve, some remained at their previously improved level, and some relapsed slightly. Both groups had nonetheless displayed an improvement immediately subsequent to the disclosure of their personal genetic risk. &lt;b&gt;&lt;i&gt;Conclusion:&lt;/i&gt;&lt;/b&gt; Receiving information on increased personal genetic risk (carrier status of &lt;i&gt;APOE ε4&lt;/i&gt;)&lt;i&gt;&lt;/i&gt;for CVD provided the motivation for improvements in health behaviour. The resulting changes, while modest, in most cases remained visible even after a number of years.

Does personalised nutrition advice based on apolipoprotein E and methylenetetrahydrofolate reductase genotype affect dietary behaviour?

“…In line with our findings, previous studies have reported significant positive changes in health behaviour in participants informed of a high ApoE genetic risk in the context of CVD or AD ( Chao et al, 2008 ; Fanshawe et al, 2008 ; Hietaranta-Luoma et al., 2014 , 2018 ; Vernarelli et al, 2010 ). A significant effect of genotype-based personalised nutrition advice has also been reported for genes related to sodium intake ( Nielsen and El-Sohemy, 2014 ) and weight loss ( Arkadianos et al, 2007 ; Vranceanu et al, 2020 ).…”

“…Considering the attrition rate we observed after 10 days it is likely that the study would have been underpowered if the follow-up was extended. Previous studies have demonstrated significant dietary behaviour change 12 months after genebased personalised recommendations (Horne et al, 2020;Nielsen and El-Sohemy, 2014) and in the longest follow-up to date that these changes can be observed more than 5 years after the intervention (Hietaranta-Luoma et al, 2018). The aim of our study was to use genotyping to promote adherence to associated general dietary recommendations.…”

“…Comparisons have also been made between participants informed of a risk-associated genotype and those informed of a non-risk-associated genotype. Participants informed of an ApoE risk associated genotype have been reported to make greater changes to saturated fat intake ( Fallaize et al., 2016 ) and made and maintained moderate changes to dietary behaviour which resulted in slight improvements in clinical CVD markers 5.5–6.5 years after disclosure, ( Hietaranta-Luoma et al, 2018 ) compared to participants informed of a non-risk genotype. However, there was no significant difference in folate intake between participants informed of an MTHFR risk associated genotype and those informed of a non-risk associated genotype, following a recommendation to increase their folate intake ( O’Donovan et al, 2016 ).…”

Ethical Aspects of Genotype Disclosure: Perceptions of Participants in a Nutrigenetic Study in Finland

“…Those who were interested to participate were sent an information letter containing the study protocol and an overview of the APOE gene. The inclusion criteria have been mentioned in detail in another paper about ApoE4mot project [23].…”

Study protocol of brief intervention using gene polymorphism information for excessive drinking among Japanese college students and adults aged 20–30 years: a randomized controlled trial

“…No significant differences were noted in the results, but further studies and increased sample size suggested that genetic testing might be useful [15]. In addition, Hanna-Leena et al [14] reported a long-term follow-up study in 2018 on the disclosure of personal genetic risk information (APOE: apolipoprotein E) for cardiovascular diseases to promote a healthy lifestyle in Finland [16]. In conclusion, receiving information on increased personal genetic risk (carrier status of APOE ε4) for cardiovascular diseases provided the motivation for improvements in health behavior.…”