Genetic risk for primordial prevention of cardiometabolic disease

Abstract

The prevalence of obesity and type 2 diabetes (T2D) in children has risen dramatically. We hypothesized that providing child’s genetic risk information, to families at high T2D risk, would serve as a motivator to improve behaviors related to the development of risk factors for T2D. We conducted a pilot intervention study of parents (n=51) and their children (n=44) aged 2-8. Family’s physical activity, children’s eating behaviors related to obesity (CEBQ); and parent’s attitudes and motivations for lifestyle change were collected at baseline and 3-month follow-up (3MFU). At baseline, saliva samples were collected from children for genotyping of obesity and T2D risk variants identified in genome-wide association studies. Parents were on average 35±6 years old, BMI 31±7 kg/m2, 60% mothers, 31% black and 7% Latino. Children were 4±2 years with a BMI of 72±26 percentiles. At the risk disclosure session, anxiety (STAI-S) and depressive symptoms (POMS) of parents were measured immediately before and after disclosure of child’s risk; and a significant increase in tension (X =2.58, p=0.03) and anxiety (X =-2.98, p=0.002) was observed. Parents then received a quasi-motivational interviewing and behavioral education intervention. After receiving the intervention parents reported a significant increase in their confidence to change their family’s behaviors (X =-0.31, p=0.002) compared to pre-disclosure. This led to 100% of parents committing to a personalized diet or activity change. At 3MFU, children demonstrated a reduction in their desire to drink (X =1.52, p=0.002) and responsiveness to food (X =1.86, p=0.005). In parents, no elevation in depressiveness or anxiety remained. No change in BMI or physical activity was observed in either group. Our data suggest returning genetic risk results can motivate commitment to behavior change. Future work will test whether combining genetic risk with an established lifestyle intervention may facilitate lowering T2D risk.