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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

Lookup NU author(s): Dr Carlos Celis Morales, Dr Katherine Livingstone, Professor John Mathers


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Background: The apolipoprotein E (APOE) risk allele (epsilon 4) 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 epsilon 4 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 1-2); and 3) assess the impact of knowledge of APOE risk (risk: E4+, nonrisk: E4-) 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 omega-3 (n-3) 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 E4- (P < 0.05). Although there were no significant differences in APOE response to gene-based PN (E4+ compared with E4-), both groups had a greater reduction in SFA (percentage of total energy) intake than at level 0 (mean +/- SD: E4+, -0.72% +/- 0.35% compared with -1.95% +/- 0.45%, P = 0.035; E4-, -0.31% +/- 0.20% compared with -1.68% +/- 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 E4- participants (-1.68% +/- 0.35% compared with -2.56% +/- 0.27%, P = 0.025).Conclusions: The APOE epsilon 4 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 "risk" and "nonrisk" groups. Furthermore, disclosure of APOE nonrisk may have weakened dietary response to PN. This trial was registered at as NCT01530139.

Publication metadata

Author(s): Fallaize R, Celis-Morales C, Macready AL, Marsaux CFM, Forster H, O'Donovan C, Woolhead C, San-Cristobal R, Kolossa S, Hallmann J, Mavrogianni C, Surwillo A, Livingstone KM, Moschonis G, Navas-Carretero S, Walsh MC, Gibney ER, Brennan L, Bouwman J, Grimaldi K, Manios Y, Traczyk I, Drevon CA, Martinez JA, Daniel H, Saris WHM, Gibney MJ, Mathers JC, Lovegrove JA, Food4Me Study

Publication type: Article

Publication status: Published

Journal: American Journal of Clinical Nutrition

Year: 2016

Volume: 104

Issue: 3

Pages: 827-836

Print publication date: 01/09/2016

Online publication date: 20/08/2016

Acceptance date: 29/06/2016

Date deposited: 16/11/2016

ISSN (print): 0002-9165

ISSN (electronic): 1938-3207

Publisher: American Society for Nutrition


DOI: 10.3945/ajcn.116.135012


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Funder referenceFunder name
265494European Commission under the Food, Agriculture, Fisheries and Biotechnology Theme of the 7th Framework Programme for Research and Technological Development