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The effect of the apolipoprotein E genotype on response to personalized dietary advice intervention: findings from the Food4Me randomized controlled trial
Background: The apolipoprotein E (APOE) risk allele (É4) is associated with higher total cholesterol (TC), amplified response to saturated fatty acid (SFA) reduction, and increased cardiovascular disease. Although knowledge of gene risk may enhance dietary change, it is unclear whether É4 carriers would benefit from gene-based personalized nutrition (PN).
Objectives: The aims of this study were to 1) investigate interactions between APOE genotype and habitual dietary fat intake and modulations of fat intake on metabolic outcomes; 2) determine whether gene-based PN results in greater dietary change than do standard dietary advice (level 0) and nongene-based PN (levels 1â2); and 3) assess the impact of knowledge of APOE risk (risk: E4+, nonrisk: E4â) on dietary change after gene-based PN (level 3).
Design: Individuals (n = 1466) recruited into the Food4Me pan-European PN dietary intervention study were randomly assigned to 4 treatment arms and genotyped for APOE (rs429358 and rs7412). Diet and dried blood spot TC and Ï-3 (nâ3) index were determined at baseline and after a 6-mo intervention. Data were analyzed with the use of adjusted general linear models.
Results: Significantly higher TC concentrations were observed in E4+ participants than in E4â (P < 0.05). Although there were no significant differences in APOE response to gene-based PN (E4+ compared with E4â), both groups had a greater reduction in SFA (percentage of total energy) intake than at level 0 (mean ± SD: E4+, â0.72% ± 0.35% compared with â1.95% ± 0.45%, P = 0.035; E4â, â0.31% ± 0.20% compared with â1.68% ± 0.35%, P = 0.029). Gene-based PN was associated with a smaller reduction in SFA intake than in nongene-based PN (level 2) for E4â participants (â1.68% ± 0.35% compared with â2.56% ± 0.27%, P = 0.025).
Conclusions: The APOE É4 allele was associated with higher TC. Although gene-based PN targeted to APOE was more effective in reducing SFA intake than standard dietary advice, there was no difference between APOE âriskâ and ânonriskâ groups. Furthermore, disclosure of APOE nonrisk may have weakened dietary response to PN