The @RISK Study: Risk communication for patients with type 2 diabetes: design of a randomised controlled trial Effect of communicating genetic and phenotypic risk for type 2 diabetes in combination with lifestyle advice on objectively measured physical activity: protocol of a randomised controlled trial A randomized trial of the clinical utility of genetic testing for obesity: Design and implementation considerations Web-Based Risk Communication and Planning in an Obese Population: Exploratory Study Personalized Genetic Risk Counseling to Motivate Diabetes Prevention Information and Risk Modification Trial (INFORM): design of a randomised controlled trial of communicating different types of information about coronary heart disease risk, alongside lifestyle advice, to achieve change in health-related behaviour Behavioral Consequences of Testing for Obesity Risk The impact of individualised cardiovascular disease (CVD) risk estimates and lifestyle advice on physical activity in individuals at high risk of CVD: a pilot 2 × 2 factorial understanding risk trial Motivational interviewing and problem solving treatment to reduce type 2 diabetes and cardiovascular disease risk in real life: a randomized controlled trial Examining the impact of genetic testing for type 2 diabetes on health behaviors: study protocol for a randomized controlled trial Health Behavior Changes After Genetic Risk Assessment for Alzheimer Disease: The REVEAL Study Psychological impact of genetic testing for familial hypercholesterolemia within a previously aware population: A randomized controlled trial Impact of Positive Family History and Genetic Risk Variants on the Incidence of Diabetes Genetic testing for heart disease susceptibility: potential impact on motivation to quit smoking Is Information on Genetic Determinants of Obesity Helpful or Harmful for Obese People?—A Randomized Clinical Trial Genetic Predisposition to Weight Loss and Regain With Lifestyle Intervention: Analyses From the Diabetes Prevention Program and the Look AHEAD Randomized Controlled Trials Impact of Genetic Causal Information on Medical Students’ Clinical Encounters with an Obese Virtual Patient: Health Promotion and Social Stigma
Background Patients with type 2 diabetes mellitus ( T2DM ) have an increased risk to develop severe diabetes related complications , especially cardiovascular disease ( CVD ) . The risk to develop CVD can be estimated by means of risk formulas . However , patients have difficulties to underst and the outcomes of these formulas . As a result , they may not recognize the importance of changing lifestyle and taking medication in time . Therefore , it is important to develop risk communication methods , that will improve the patients ' underst and ing of risks associated with having diabetes , which enables them to make informed choices about their diabetes care . The aim of this study is to investigate the effects of an intervention focussed on the communication of the absolute 10-year risk to develop CVD on risk perception , attitude and intention to change lifestyle behaviour in patients with T2DM . The conceptual framework of the intervention is based on the Theory of Planned Behaviour and the Self-regulation Theory . Methods A r and omised controlled trial will be performed in the Diabetes Care System West-Friesl and ( DCS ) , a managed care system . Newly referred T2DM patients of the DCS , younger than 75 years will be eligible for the study . The intervention group will be exposed to risk communication on CVD , on top of st and ard managed care of the DCS . This intervention consists of a simple explanation on the causes and consequences of CVD , and possibilities for prevention . The probabilities of CVD in 10 year will be explained in natural frequencies and visualised by a population diagram . The control group will receive st and ard managed care . The primary outcome is appropriateness of risk perception . Secondary outcomes are attitude and intention to change lifestyle behaviour and illness perception . Differences between baseline and follow-up ( 2 and 12 weeks ) between groups will be analysed according to the intention-to-treat principle . The study was powered on 120 patients in each group . Discussion This innovative risk communication method based on two behavioural theories might improve patient 's appropriateness of risk perception and attitude concerning lifestyle change . With a better underst and ing of their CVD risk , patients will be able to make informed choices concerning diabetes care . Trail registration The trial is registered as NTR1556 in the Dutch Trial Register Type 2 diabetes ( T2D ) is associated with increased risk of morbidity and premature mortality . Among those at high risk , incidence can be halved through healthy changes in behaviour . Information about genetic and phenotypic risk of T2D is now widely available . Whether such information motivates behaviour change is unknown . We aim to assess the effects of communicating genetic and phenotypic risk of T2D on risk-reducing health behaviours , anxiety , and other cognitive and emotional theory-based antecedents of behaviour change . In a parallel group , open r and omised controlled trial , approximately 580 adults born between 1950 and 1975 will be recruited from the on-going population -based , observational Fenl and Study ( Cambridgeshire , UK ) . Eligible participants will have undergone clinical , anthropometric , and psychosocial measurements , been genotyped for 23 single-nucleotide polymorphisms associated with T2D , and worn a combined heart rate monitor and accelerometer ( Actiheart ® ) continuously for six days and nights to assess physical activity .  Participants are r and omised to receive either st and ard lifestyle advice alone ( control group ) , or in combination with a genetic or a phenotypic risk estimate for T2D ( intervention groups ) . The primary outcome is objective ly measured physical activity . Secondary outcomes include self-reported diet , self-reported weight , intention to be physically active and to engage in a healthy diet , anxiety , diabetes-related worry , self-rated health , and other cognitive and emotional outcomes . Follow-up occurs eight weeks post-intervention . Values at follow-up , adjusted for baseline , will be compared between r and omised groups . This study will provide much needed evidence on the effects of providing information about the genetic and phenotypic risk of T2D . Importantly , it will be among the first to examine the impact of genetic risk information using a r and omised controlled trial design , a population -based sample , and an objective ly measured behavioural outcome . Results of this trial , along with recent evidence syntheses of similar studies , should inform policy concerning the availability and use of genetic risk information . Current Controlled Trials IS RCT Background Obesity rates in the United States have escalated in recent decades and present a major challenge in public health prevention efforts . Currently , testing to identify genetic risk for obesity is readily available through several direct-to-consumer companies . Despite the availability of this type of testing , there is a paucity of evidence as to whether providing people with personal genetic information on obesity risk will facilitate or impede desired behavioral responses . Purpose We describe the key issues in the design and implementation of a r and omized controlled trial examining the clinical utility of providing genetic risk information for obesity . Methods Participants are being recruited from the Coriell Personalized Medicine Collaborative , an ongoing , longitudinal research cohort study design ed to determine the utility of personal genome information in health management and clinical decision making . The primary focus of the ancillary Obesity Risk Communication Study is to determine whether genetic risk information added value to traditional communication efforts for obesity , which are based on lifestyle risk factors . The trial employs a 2 × 2 factorial design in order to examine the effects of providing genetic risk information for obesity , alone or in combination with lifestyle risk information , on participants ’ psychological responses , behavioral intentions , health behaviors , and weight . Results The factorial design generated four experimental arms based on communication of estimated risk to participants : ( 1 ) no risk feedback ( control ) , ( 2 ) genetic risk only , ( 3 ) lifestyle risk only , and ( 4 ) both genetic and lifestyle risk ( combined ) . Key issues in study design pertained to the selection of algorithms to estimate lifestyle risk and determination of information to be provided to participants assigned to each experimental arm to achieve a balance between clinical st and ards and method ological rigor . Following the launch of the trial in September 2011 , implementation challenges pertaining to low enrollment and differential attrition became apparent and required immediate attention and modifications to the study protocol . Although monitoring of these efforts is ongoing , initial observations show a doubling of enrollment and reduced attrition . Limitations The trial is evaluating the short-term impact of providing obesity risk information as participants are followed for only 3 months . This study is built upon the structure of an existing personalized medicine study wherein participants have been provided with genetic information for other diseases . This nesting in a larger study may attenuate the effects of obesity risk information and has implication s for the generalizability of study findings . Conclusions This r and omized trial examines value of obesity genetic information , both when provided independently and when combined with lifestyle risk assessment , to motivate individuals to engage in healthy lifestyle behaviors . Study findings will guide future intervention efforts to effectively communicate genetic risk information Background A healthy diet , low in saturated fat and high in fiber , is a popular medical recommendation in preventing cardiovascular disease ( CVD ) . One approach to motivating healthier eating is to raise individuals ’ awareness of their CVD risk and then help them form specific plans to change . Objectives The aim was to explore the combined impact of a Web-based CVD risk message and a fully automated planning tool on risk perceptions , intentions , and saturated fat intake changes over 4 weeks . Methods Of the 1187 men and women recruited online , 781 were r and omly allocated to one of four conditions : a CVD risk message , the same CVD risk message paired with planning , planning on its own , and a control group . All outcome measures were assessed by online self-reports . Generalized linear modeling was used to analyze the data . Results Self-perceived consumption of low saturated fat foods ( odds ratio 11.40 , 95 % CI 1.86–69.68 ) and intentions to change diet ( odds ratio 21.20 , 95 % CI 2.6–172.4 ) increased more in participants allocated to the planning than the control group . No difference was observed between the four conditions with regard to percentage saturated fat intake changes . Contrary to our expectations , there was no difference in perceived and percentage saturated fat intake change between the CVD risk message plus planning group and the control group . Risk perceptions among those receiving the CVD risk message changed to be more in line with their age ( change in slopeindividual = 0.075 , P = .01 ; change in slopecomparative = 0.100 , P = .001 ) , whereas there was no change among those who did not receive the CVD risk message . Conclusion There was no evidence that combining a CVD risk message with a planning tool reduces saturated fat intake more than either alone . Further research is required to identify ways in which matching motivational and volitional strategies can lead to greater behavior changes . Trial Registration International St and ard R and omized Controlled Trial Number ( IS RCT N ) : 91154001 ; http://www.controlled-trials.com/IS RCT N91154001 ( Archived by WebCite at http://www.webcitation.org/62sBoGeOO OBJECTIVE To examine whether diabetes genetic risk testing and counseling can improve diabetes prevention behaviors . RESEARCH DESIGN AND METHODS We conducted a r and omized trial of diabetes genetic risk counseling among overweight patients at increased phenotypic risk for type 2 diabetes . Participants were r and omly allocated to genetic testing versus no testing . Genetic risk was calculated by summing 36 single nucleotide polymorphisms associated with type 2 diabetes . Participants in the top and bottom score quartiles received individual genetic counseling before being enrolled with untested control participants in a 12-week , vali date d , diabetes prevention program . Middle-risk quartile participants were not studied further . We examined the effect of this genetic counseling intervention on patient self-reported attitudes , program attendance , and weight loss , separately comparing higher-risk and lower-risk result recipients with control participants . RESULTS The 108 participants enrolled in the diabetes prevention program included 42 participants at higher diabetes genetic risk , 32 at lower diabetes genetic risk , and 34 untested control subjects . Mean age was 57.9 ± 10.6 years , 61 % were men , and average BMI was 34.8 kg/m2 , with no differences among r and omization groups . Participants attended 6.8 ± 4.3 group sessions and lost 8.5 ± 10.1 pounds , with 33 of 108 ( 30.6 % ) losing ≥5 % body weight . There were few statistically significant differences in self-reported motivation , program attendance , or mean weight loss when higher-risk recipients and lower-risk recipients were compared with control subjects ( P > 0.05 for all but one comparison ) . CONCLUSIONS Diabetes genetic risk counseling with currently available variants does not significantly alter self-reported motivation or prevention program adherence for overweight individuals at risk for diabetes Background Cardiovascular disease ( CVD ) remains the leading cause of death globally . Primary prevention of CVD requires cost-effective strategies to identify individuals at high risk in order to help target preventive interventions . An integral part of this approach is the use of CVD risk scores . Limitations in previous studies have prevented reliable inference about the potential advantages and the potential harms of using CVD risk scores as part of preventive strategies . We aim to evaluate short-term effects of providing different types of information about coronary heart disease ( CHD ) risk , alongside lifestyle advice , on health-related behaviours . Methods / Design In a parallel-group , open r and omised trial , we are allocating 932 male and female blood donors with no previous history of CVD aged 40–84 years in Engl and to either no intervention ( control group ) or to one of three active intervention groups : i ) lifestyle advice only ; ii ) lifestyle advice plus information on estimated 10-year CHD risk based on phenotypic characteristics ; and iii ) lifestyle advice plus information on estimated 10-year CHD risk based on phenotypic and genetic characteristics . The primary outcome is change in objective ly measured physical activity . Secondary outcomes include : objective ly measured dietary behaviours ; cardiovascular risk factors ; current medication and healthcare usage ; perceived risk ; cognitive evaluation of provision of CHD risk scores ; and psychological outcomes . The follow-up assessment takes place 12 weeks after r and omisation . The experiences , attitudes and concerns of a subset of participants will be also studied using individual interviews and focus groups . Discussion The INFORM study has been design ed to provide robust findings about the short-term effects of providing different types of information on estimated 10-year CHD risk and lifestyle advice on health-related behaviours . Trial registration Current Controlled Trials IS RCT N17721237 . Registered 12 January 2015 Objective : There is considerable hope that genetic susceptibility testing will motivate behavior that can prevent or reduce the risk of complex conditions such as obesity . This study examined potential behavioral consequences of such testing . Methods : Participants ( n = 249 ) were r and omly assigned to review one of four vignettes that asked them to imagine that they had been tested for their risk of becoming overweight or obese . The experimental factors were test type ( genetic versus hormone test ) and risk level ( increased versus average risk for obesity ) . Study measures included  behavioral intentions and perceived behavioral control related to eating a healthy diet  , as well as  weight locus of control .  Results : Participants assigned to the increased risk conditions indicated greater intentions to eat a healthy diet compared with participants assigned to the average risk conditions ( P < 0.02 ) . There were significant interaction effects of risk × perceived behavioral control ( P < 0.02 ) and risk × weight locus of control ( P < 0.003 ) on dietary intentions . Individuals with low perceived behavioral control or an external weight locus of control who were told to imagine they were at average risk expressed significantly lower intentions to eat a healthy diet . A three-way interaction of body mass index , family history of overweight/obesity , and assigned risk level found the greatest effects of risk feedback among those who either had a family history or a higher body mass index ( P < 0.007 ) . Conclusion : This study provides preliminary evidence that testing for susceptibility to obesity may motivate healthier behavior . However , some individuals may be susceptible to a false reassurance effect after receiving test results indicating a lack of increased risk Background There is currently much interest in encouraging individuals to increase physical activity in order to reduce CVD risk . This study has been design ed to determine if personalised CVD risk appreciation can increase physical activity in adults at high risk of CVD . Methods / Design In a 2 × 2 factorial design participants are allocated at r and om to a personalised 10-year CVD risk estimate or numerical CVD risk factor values ( systolic blood pressure , LDL cholesterol and fasting glucose ) and , simultaneously , to receive a brief lifestyle advice intervention targeting physical activity , diet and smoking cessation or not . We aim to recruit 200 participants from Oxfordshire primary care practice s. Eligibility criteria include adults age 40–70 years , estimated 10-year CVD risk ≥20 % , ability to read and write English , no known CVD and no physical disability or other condition reducing the ability to walk . Primary outcome is physical activity measured by ActiGraph accelerometer with biochemical , anthropometrical and psychological measures as additional outcomes . Primary analysis is between group physical activity differences at one month powered to detect a difference of 30,000 total counts per day of physical activity between the groups . Additional analyses will seek to further eluci date the relationship between the provision of risk information , and intention to change behaviour and to determine the impact of both interventions on clinical and anthropometrical measures including fasting and 2 hour plasma glucose , fructosamine , serum cotinine , plasma vitamin C , body fat percentage and blood pressure . Discussion This is a pilot trial seeking to demonstrate in a real world setting , proof of principal that provision of personalised risk information can contribute to behaviour changes aim ed at reducing CVD risk . This study will increase our underst and ing of the links between the provision of risk information and behaviour change and if successful , could be used in clinical practice with little or no modification Background Intensive lifestyle interventions in well-controlled setting s are effective in lowering the risk of chronic diseases such as type 2 diabetes ( T2DM ) and cardiovascular diseases ( CVD ) , but there are still no effective lifestyle interventions for everyday practice . In the Hoorn Prevention Study we aim ed to assess the effectiveness of a primary care based lifestyle intervention to reduce the estimated risk of developing T2DM and for CVD mortality , and to motivate changes in lifestyle behaviors . Methods The Hoorn Prevention Study is a parallel group r and omized controlled trial , implemented in the region of West-Friesl and , the Netherl and s. 622 adults with ≥10 % estimated risk of T2DM and /or CVD mortality were r and omly assigned and monitored over a period of 12 months . The intervention group ( n=314 ) received a theory-based lifestyle intervention based on an innovative combination of motivational interviewing and problem solving treatment , provided by trained practice nurses in 12 general practice s. The control group ( n=308 ) received existing health brochures . Primary outcomes was the estimated diabetes risk according to the formula of the Atherosclerosis Risk In Communities ( ARIC ) Study , and the estimated risk for CVD mortality according to the Systematic COronary Risk Evaluation ( SCORE ) formula . Secondary outcomes included lifestyle behavior ( diet , physical activity and smoking ) . The research assistants , the principal investigator and the general practitioners were blinded to group assignment . Linear and logistic regression analysis was applied to examine the between-group differences in each outcome measure , adjusted for baseline values . Results 536 ( 86.2 % ) of the 622 participants ( age 43.5 years ) completed the 6-month follow-up , and 502 ( 81.2 % ) completed the 12-month follow-up . The mean baseline T2DM risk was 18.9 % ( SD 8.2 ) and the mean CVD mortality risk was 3.8 % ( SD 3.0 ) . The intervention group participated in a median of 2 sessions . Intention-to-treat analyses showed no significant differences in outcomes between the two groups at 6 or 12-months follow-up . Conclusions The lifestyle intervention was not more effective than health brochures in reducing risk scores for T2DM and CVD or improving lifestyle behavior in an at-risk population .Trial registration Current Controlled Trials : IS RCT Background We describe the study design , procedures , and development of the risk counseling protocol used in a r and omized controlled trial to evaluate the impact of genetic testing for diabetes mellitus ( DM ) on psychological , health behavior , and clinical outcomes . Methods / Design Eligible patients are aged 21 to 65 years with body mass index ( BMI ) ≥27 kg/m2 and no prior diagnosis of DM . At baseline , conventional DM risk factors are assessed , and blood is drawn for possible genetic testing . Participants are r and omized to receive conventional risk counseling for DM with eye disease counseling or with genetic test results . The counseling protocol was pilot tested to identify an acceptable graphical format for conveying risk estimates and match the length of the eye disease to genetic counseling . Risk estimates are presented with a vertical bar graph denoting risk level with colors and descriptors . After receiving either genetic counseling regarding risk for DM or control counseling on eye disease , brief lifestyle counseling for prevention of DM is provided to all participants . Discussion A st and ardized risk counseling protocol is being used in a r and omized trial of 600 participants . Results of this trial will inform policy about whether risk counseling should include genetic counseling . Trial registration Clinical Trials.gov Identifier Risk information for Alzheimer disease ( AD ) may be communicated through susceptibility gene disclosure , even though this is not currently in clinical use . The REVEAL Study is the first r and omized clinical trial of risk assessment for AD with apolipoprotein E ( APOE ) genotype and numerical risk estimate disclosure . We examined whether APOE genotype and numerical risk disclosure to asymptomatic individuals at high risk for AD alters health behaviors . One hundred sixty-two participants were r and omized to either intervention ( APOE disclosure ) or control ( no genotype disclosure ) groups . Subjects in both groups received numerical lifetime risk estimates of future AD development based on sex and family history of AD . The intervention group received their APOE genotype . Subjects were informed that no proven preventive measures for AD existed and given an information sheet on preventative therapies under investigation . Participants who learned they were ϵ4 positive were significantly more likely than ϵ4 negative participants to report AD-specific health behavior change 1 year after disclosure ( adjusted odds ratio : 2.73 ; 95 % confidence interval : 1.14 , 6.54 ; P=0.02 ) . Post hoc analyses revealed similar significant associations between numerical lifetime risk estimates and self-report of AD-specific health behavior change . Despite lack of preventive measures for AD , knowledge of APOE genotype , numerical lifetime risk , or both , influences health behavior This trial tests the hypothesis that confirming a clinical diagnosis of familial hypercholesterolemia ( FH ) by finding a genetic mutation reduces patients ' perceptions of control over the disease and adherence to risk‐reducing behaviors . Three hundred forty‐one families , comprising 341 hypercholesterolemia prob and s and 128 adult relatives , were r and omized to one of two groups : ( a ) routine clinical diagnosis ; ( b ) routine clinical diagnosis plus genetic testing ( mutation search ing in prob and s and direct gene testing in relatives ) . The main outcome measures were perceptions of control over hypercholesterolemia , adherence to cholesterol‐lowering medication , diet , physical activity , and smoking .  There was no support for the main hypothesis : finding a mutation had no impact on perceived control or adherence to risk‐reducing behavior ( all P‐values > 0.10 ) . While all groups believed that lowering cholesterol was an effective way of reducing the risk of a heart attack , participants in whom a mutation was found believed less strongly in the efficacy of diet in reducing their cholesterol level ( P = 0.02 at 6 months ) and showed a trend in believing more strongly in the efficacy of cholesterol‐lowering medication ( P = 0.06 at 6 months ) . In conclusion , finding a mutation to confirm a clinical diagnosis of FH in a previously aware population does not reduce perceptions of control or adherence to risk‐reducing behaviors . The pattern of findings leads to the new hypothesis that genetic testing does not affect the extent to which people feel they have control over a condition , but does affect their perceptions of how control is most effectively achieved . Further work is needed to determine whether similar results will be obtained in population s with little previous awareness of their risks . © 2004 Wiley‐Liss , OBJECTIVE We aim ed to investigate the influence of positive family history ( FH+ ) of diabetes and 19 known genetic risk loci on the effectiveness of lifestyle changes and their predictive value on the incidence of type 2 diabetes  in the Finnish Diabetes Prevention Study ( DPS ) . RESEARCH DESIGN AND METHODS A total of 522 subjects with impaired glucose tolerance ( IGT ) were r and omized into the control ( n = 257 ) and intervention ( n = 265 ) groups . The mean follow-up was 6.2 years ( median 7 years ) , and the lifestyle intervention , aim ed at  weight reduction , healthy diet , and increased physical activity  , lasted for 4 years ( range 1–6 years ) . An oral glucose tolerance test ( OGTT ) and assessment of basic clinical variables were performed annually . RESULTS The effect of intervention on the incidence of diabetes was almost similar in subjects with FH+ compared with subjects with a negative family history ( FH− ) of diabetes during the entire follow-up . In the Cox model , including FH , genetic risk SNPs , and r and omization group , and adjusted for the effects of age , sex , BMI , and study center , only lifestyle intervention had a significant effect ( hazard ratio 0.55 , 95 % CI 0.41–0.75 , P < 0.001 ) on the incidence of diabetes . Further analyses showed that in addition to the baseline glucose and insulin values , 1-year changes in 2-h glucose and 2-h insulin achieved by lifestyle intervention had a significant effect on the incidence of diabetes . CONCLUSIONS These results emphasize the effectiveness of  lifestyle intervention  in reducing the risk of diabetes in high-risk individuals independently of genetic or familial risk of type 2 diabetes As genetic tests for common gene variants and multifactorial , lifestyle‐related conditions become available , it will be increasingly important to determine the psychological and behavioral impact of this emerging class of genetic tests . Our aim was to examine the potential impact of genetic testing for heart disease susceptibility on psychological predictors of smoking cessation .  Two hundred and sixty‐one smokers were asked to imagine that they had undergone a test for heart disease risk . They were r and omly assigned to a genetic test scenario ( low‐ or high‐risk result ) or an oxidative test scenario ( high‐risk result ) . Smokers in the genetic test‐high risk group reported greater intention to quit smoking than smokers in the oxidative test‐high risk group ( p = 0.009 ) ; 30 % of this was mediated by their holding stronger beliefs that quitting would reduce their heart disease risk ( outcome expectations ) ( p = 0.011 ) . The effect of genetic test‐high risk feedback on outcome expectations was greatest amongst smokers with no heart disease family history ( p = 0.038 ) . The results suggest that genetic testing for heart disease risk may enhance interventions design ed to improve health via increasing smoking cessation rates . Whether the findings hold true in studies that use real rather than hypothetical genetic tests remains to be seen Background and Objectives Although more and more genetic information is available , it is unclear whether this information is helpful for patients . Therefore , we assessed the positive and negative effects of informing obese people about the genetic etiology of being overweight . Design , Participants Two hundred ninety-four obese people were r and omized to 2 interventions ( a 1-session consultation for obese people on how to manage obesity either including genetic information or not ) ; their results were compared to a control group ( 116 ) . Subjects were assessed before and after consultation and 6 months later . Measurements Weight , scales on feeling guilty for being overweight , self-control , negative mood ( primary endpoint ) , body acceptance , restraint eating . Results Both types of consultations were considered helpful by the participants , and had comparable effects on body weight . The consultation with genetic information was rated superior in terms of leading to new insights ( advantage for consultation with genetic information , even 6 months later ; p = 0.046 ) . No negative effects ( e.g. , loss of self-efficacy/self-control , increase of body weight ; all p > 0.20 for interaction consultation × time ) were observed for informing obese people about the genetic etiology of being overweight . The consultation result ed in long-term improvement of negative mood if it included genetic information in the case of participants with a family history of obesity and if it included no genetic information in the case of obese people without a family history of obesity ( p = 0.03 for interaction of group , intervention , and time ) . Conclusions Consultations in obesity can be helpful in general . These consultations should include genetic information if people have a family history of obesity Clinical ly relevant weight loss is achievable through lifestyle modification , but unintentional weight regain is common . We investigated whether recently discovered genetic variants affect weight loss and /or weight regain during behavioral intervention .  Participants at high-risk of type 2 diabetes ( Diabetes Prevention Program [ DPP ] ; N = 917/907 intervention/comparison ) or with type 2 diabetes ( Look AHEAD [ Action for Health in Diabetes ] ; N = 2,014/1,892 intervention/comparison ) were from two parallel arm ( lifestyle vs. comparison ) r and omized controlled trials . The associations of 91 established obesity-predisposing loci with weight loss across 4 years and with weight regain across years 2–4 after a minimum of 3 % weight loss were tested . Each copy of the minor G allele of MTIF3 rs1885988 was consistently associated with greater weight loss  following lifestyle intervention over 4 years across the DPP and Look AHEAD . No such effect was observed across comparison arms , leading to a nominally significant single nucleotide polymorphism × treatment interaction ( P = 4.3 × 10−3 ) . However , this effect was not significant at a study -wise significance level ( Bonferroni threshold P < 5.8 × 10−4 ) . Most obesity-predisposing gene variants were not associated with weight loss or regain within the DPP and Look AHEAD trials , directly or via interactions with lifestyle Background Health care providers will increasingly encounter information about the genetics of obesity as genetics research progresses . Purpose This study explores whether information about the genetics of obesity reduces medical student stigmatization of obese patients , and how it affects rates of health behavior-related referral . Methods One hundred and ten third and fourth year medical students were r and omly assigned to read about genetic or behavioral mechanisms of obesity , or a control topic .  Students interacted with an obese virtual patient in a virtual clinic and completed a battery of measures . Results Rates of most health behavior screening recommendations ( weight loss , exercise , and diet consultations ) were lower among participants exposed to genetic causal information than control . The genetic causal information group exhibited less negative stereotyping of the patient than control , F(1,105 ) = 5.00 , p = 0.028 , but did not differ in anticipated patient adherence , F(1,105 ) = 3.18 , p = 0.077 . Conclusions Information highlighting genetic contributions to obesity may lead to both positive and negative outcomes . Communication about the genetics of obesity should discuss the multi-factorial and non-deterministic nature of genetic risk
This review found no clear or consistent evidence that genetic risk communication alone either raises motivation or translates into actual change in dietary intake or physical activity to reduce the risk of cardiometabolic disorders in adults .
Genetic risk prediction of chronic conditions including obesity , diabetes and CVD currently has limited predictive power but its potential to engage healthy behaviour change has been of immense research interest .
We aim ed to underst and whether the latter is indeed true by conducting a systematic review and meta- analysis investigating whether genetic risk communication affects motivation and actual behaviour change towards preventative lifestyle modification .