Apoe Genotype Disclosure And Lifestyle Advice In A Randomized Intervention Study With Finnish Participants

Background: The APOE epsilon 4 allele is associated with higher risks of cardiovascular diseases and Alzheimer disease than epsilon 3 and epsilon 2.Objectives: We studied the effectiveness of dietary and lifestyle guidance and personal genetic risk information [epsilon 4 carrier (s4+); epsilon 4 noncarrier (epsilon 4-)] as motivators for a healthier lifestyle.Methods: A total of 188 healthy Finnish volunteers (82.4% women; mean +/- SD age: 51.0 +/- 5.6 y; BMI: 26.0 +/- 3.6 kg/m2; total cholesterol: 5.2 +/- 0.9 mmol/L) participated in our randomized intervention study. The participants were genotyped for APOE and divided into intervention (INT; INT epsilon 4+, n = 33; INT epsilon 4-, n = 57) and control groups (CTRL; CTRL epsilon 4+, n = 36; CTRL epsilon 4-, n = 62). Blood samples, measured observations, and questionnaire data were obtained at baseline and at 1 and 1.5 y. INT participants received their s4 carrier status at baseline. Monthly Internet-based guidance based on the Finnish Dietary guidelines was provided for all.Results: The proportion of SFAs in plasma over time fluctuated less in INT epsilon 4+ than in the other groups (P-interaction < 0.05; primary outcome). The lifestyle guidance increased vegetable consumption from 3.5 to 3.6 portions/d, improved the dietary fat quality score by 5.3%, increased the plasma n-3 (omega-3) FA proportion by 7.3%, and decreased the consumption of high-fat/high-sugar foods from 7.3 to 6.5 portions/wk and totaland LDL-cholesterol concentrations by 4.3% and 6.1%, respectively, in the entire participant population (P < 0.05; secondary outcome). Compared with the epsilon 4- participants, epsilon 4+ participants had 2.4% higher plasma n-6 (omega-6) FA, lower C-peptide (3.9 compared with 4.2 nmol/L x h) and sensitive C-reactive protein values, and decreased plasma malondialdehyde concentrations over time (P < 0.05; secondary outcome).Conclusions: Lifestyle guidance given to healthy Finnish participants yielded small but beneficial changes. The INT epsilon 4+ group did not seem markedly more responsive to the guidance than the other groups. This trial was registered at clinicaltrials.gov as NCT03794141.