title: The effect of communicating the genetic risk of cardiometabolic disorders on motivation and actual engagement in preventative lifestyle modification and clinical outcome: a systematic review and meta-analysis of randomised controlled trials.
abstract: 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 aimed to understand 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. We included all randomised controlled trials (RCT) since 2003 investigating the impact of genetic risk communication on health behaviour to prevent cardiometabolic disease, without restrictions on age, duration of intervention or language. We conducted random-effects meta-analyses for perceived motivation for behaviour change and clinical changes (weight loss) and a narrative analysis for other outcomes. Within the thirteen studies reviewed, five were vignette studies (hypothetical RCT) and seven were clinical RCT. There was no consistent effect of genetic risk on actual motivation for weight loss, perceived motivation for dietary change (control v. genetic risk group standardised mean difference (smd) -0·15; 95 % CI -1·03, 0·73, P=0·74) or actual change in dietary behaviour. Similar results were observed for actual weight loss (control v. high genetic risk SMD 0·29 kg; 95 % CI -0·74, 1·31, P=0·58). 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. Of thirteen studies, eight were at high or unclear risk of bias. Additional larger-scale, high-quality clinical RCT are warranted.
authors.affiliation: 1Medical Research Council Epidemiology Unit,University of Cambridge,Cambridge CB2 0QQ,UK.
authors.forename: Sherly X
authors.initials: SX
authors.lastname: Li
authors.affiliation: 1Medical Research Council Epidemiology Unit,University of Cambridge,Cambridge CB2 0QQ,UK.
authors.forename: Zheng
authors.initials: Z
authors.lastname: Ye
authors.affiliation: 2Diabetes and Nutritional Sciences Division,King's College London,London SE1 9NH,UK.
authors.forename: Kevin
authors.initials: K
authors.lastname: Whelan
authors.affiliation: 3Department of Nutrition & Dietetics,Monash University,Level 1,264 Ferntree Gully Road,Notting Hill,VIC 3168,Australia.
authors.forename: Helen
authors.initials: H
authors.lastname: Truby
mesh_terms: D002318:Cardiovascular Diseases / Q000209:etiology / Q000235:genetics*; D003924:Diabetes Mellitus, Type 2 / Q000235:genetics*; D006801:Humans; D009765:Obesity / Q000235:genetics*; D012307:Risk Factors
keywords: Behaviour change; Cardiometabolic disorders; DTC direct-to-consumer; Genetic risk; RCT randomised controlled trial; SMD standardised mean difference; Systematic reviews; T2D type 2 diabetes