Enhanced long-term dietary change and adherence in a nutrigenomics-guided lifestyle intervention compared to a population-based (GLB/DPP) lifestyle intervention for weight management: results from the NOW randomised controlled trial

Horne, Justine; Gilliland, Jason; O’Connor, Colleen; Seabrook, Jamie A.; Madill, Janet

doi:10.1136/bmjnph-2020-000073

Cited by 45 publications

(56 citation statements)

References 36 publications

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“…Our finding of significant differences in BFP between groups diminishing at the 12‐month follow‐up is intriguing, especially given that the GLB + NGx group made significantly greater dietary changes and adhered more closely to specific dietary advice compared with the standard GLB group at 12 months (31). There are multiple possible explanations for these findings.…”

Section: Discussionmentioning

confidence: 87%

Change in Weight, BMI, and Body Composition in a Population‐Based Intervention Versus Genetic‐Based Intervention: The NOW Trial

Horne

Gilliland

O’Connor

et al. 2020

Obesity

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The aim of this study was to compare changes in body fat percentage (BFP), weight, and BMI between a standard intervention and a nutrigenomics intervention. Methods: The Nutrigenomics, Overweight/Obesity and Weight Management (NOW) trial is a parallel-group, pragmatic, randomized controlled clinical trial incorporated into the Group Lifestyle Balance TM (GLB) Program. Statistical analyses included two-way ANOVA and split-plot ANOVA. Inclusion criteria consisted of: BMI ≥ 25.0 kg/m 2 , ≥18 years of age, English speaking, willing to undergo genetic testing, having internet access, and not seeing another health care provider for weight-loss advice outside of the study. Pregnancy and lactation were exclusion criteria. GLB groups were randomly assigned 1 to 1 (N = 140) so that participants received either the standard 12-month GLB program or a modified 12-month program (GLB plus nutrigenomics), which included the provision of nutrigenomics information and advice for weight management. The primary outcome was percent change in BFP. Secondary outcomes were change in weight and BMI. Results: The GLB plus nutrigenomics group experienced significantly (P < 0.05) greater reductions in percent and absolute BFP at the 3-month follow-up and percent BFP at the 6-month follow-up compared with the standard GLB group. Conclusions: The nutrigenomics intervention used in the NOW trial can optimize changes in body composition up to 6 months.

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Section: Discussionmentioning

confidence: 87%

Change in Weight, BMI, and Body Composition in a Population‐Based Intervention Versus Genetic‐Based Intervention: The NOW Trial

Horne

Gilliland

O’Connor

et al. 2020

Obesity

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“…In addition, with growing interest in the clinical application of PRS, disclosing one's polygenic risk for obesity may be useful to improve interventions that target individual ingestive behavior. Indeed, consistent evidence from randomized controlled trials reports positive dietary behavioral outcomes following disclosure of genetic information related to nutrition [41,42]. Future investigations that assess the relationships between genetic variants implicated in ingestive behaviors are warranted in order to better understand the role of genetics at the initial dietary action that impacts downstream obesity risk and to inform intervention approaches.…”

Section: Discussionmentioning

confidence: 97%

Diet Quality and Food Prices Modify Associations between Genetic Susceptibility to Obesity and Adiposity Outcomes

2020

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The role of the retail food environment in obesity risk is unclear, which may be due in part to the lack of consideration of individual differences in the responsivity to food cues. This cross-sectional investigation geo-temporally linked the CARTaGENE biobank (including genetic, dietary, lifestyle, and anthropometric data) with in-store retail food environment data to examine interactions between a polygenic risk score (PRS) for obesity and (1) diet quality (n = 6807) and (2) in-store retail food measures (n = 3718). The outcomes included adiposity-related measures and diet quality assessed using the 2010 Canadian-adapted Healthy Eating Index. A vegetable:soft drink ratio was constructed for each retail measure to assess the relative healthfulness of exposures. Generalized linear models adjusted for individual and neighborhood socio-demographic factors were used to evaluate main and interactive effects. Diet quality significantly modified the association between polygenic risk of obesity and body mass index, waist circumference, and body fat percent. A significant interaction was also observed between PRS and frequency of price discount of vegetables in relation to soft drinks on waist circumference. These results replicate previous reports of diet moderating polygenic risk of obesity and suggest that prices of low vs. high-energy density foods are an intervention target to address population obesity rates.

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“…This investigation was the first to assess HCP experiences with NGT. While previous research has evaluated public [24-26] and HCP perceptions [12, 22] of NGT and research participant behavioral responses to NGT results [3-7], evidence has lacked around the real HCP practice experience. It is particularly valuable to study the experience of HCPs who have already used NGT in practice, as they represent the early adopters of the technology, and their clinical experiences will help to inform future education, training material, and clinical practice guidelines for NGT.…”

Section: Discussionmentioning

confidence: 99%

“…The information obtained from nutrigenomics testing (NGT) provides a more precise understanding of an individual’s response to dietary intake, in turn enabling targeted nutrition recommendations based on DNA [2]. A consistent body of evidence indicates that behavioral modification can be achieved through NGT provided in research studies [3-7], underscoring the priority for appropriate clinical integration of NGT. NGT is also available through direct-to-consumer (DTC) sources, enabling independent consumer access to testing without the involvement of a healthcare professional (HCP) [2, 8].…”

Section: Introductionmentioning

confidence: 99%

Healthcare Professional Clinical Actions following Nutrigenomics Testing in Practice

Karamanoglu

Nielsen

2020

Public Health Genomics

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Background: Clinical demand for nutrigenomics testing (NGT) is increasing, underscoring the importance of assessing healthcare professional (HCP) competence and clinical actions with NGT in practice. While previous studies have explored HCP perceptions of NGT, no study has examined real HCP experiences with NGT in practice. Objective: The objective of this study was to evaluate the clinical experience of providing NGT among early adopter HCPs who have used NGT in their practice. We hypothesized that HCP clinical actions after NGT would differ according to HCP personal experience undergoing genetic testing (GT) as well as years in practice. Design: An online survey questionnaire was administered to HCPs (n = 70) who have provided NGT in practice. χ2 tests, tests for trend, and logistic regression were used to compare HCP characteristics with post-NGT outcomes. Results: HCPs with fewest years in practice (<5 years) comprised the lowest proportion of respondents (16%). Most HCPs reported good understanding of NGT results and 92% made genetic-based dietary recommendations to patients following NGT. HCP personal use of GT increased significantly with increasing years in practice (<5 years: 36%, 5–10 years: 53%, 11–20 years: 70%, and >20 years: 85%, p trend = 0.003). Requesting patient bloodwork because of NGT results increased significantly with HCP years in practice when HCPs with <5 years in practice were not considered (5–10 years: 19%, 11–20 years: 28%, and >20 years: 60%, p trend = 0.010). A near significant difference was observed where a greater proportion of HCPs who had personally undergone GT reported requesting patient bloodwork (personal use: 46% vs. no personal use: 23%, p-χ2 = 0.066). Conclusion: Early HCP adopters of NGT utilize the test results to provide genetic-based dietary recommendations to patients. Clinical action after NGT currently appears to be driven by HCP years in practice, but HCP personal use of GT may also be a factor.

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Enhanced long-term dietary change and adherence in a nutrigenomics-guided lifestyle intervention compared to a population-based (GLB/DPP) lifestyle intervention for weight management: results from the NOW randomised controlled trial

Cited by 45 publications

References 36 publications

Change in Weight, BMI, and Body Composition in a Population‐Based Intervention Versus Genetic‐Based Intervention: The NOW Trial

Change in Weight, BMI, and Body Composition in a Population‐Based Intervention Versus Genetic‐Based Intervention: The NOW Trial

Diet Quality and Food Prices Modify Associations between Genetic Susceptibility to Obesity and Adiposity Outcomes

Healthcare Professional Clinical Actions following Nutrigenomics Testing in Practice

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