Physicians' Academy for Cardiovascular Education

Adherence to healthy diets can overrule genetic predisposition for obesity

Improving adherence to healthy dietary patterns, genetic risk, and long term weight gain: gene-diet interaction analysis in two prospective cohort studies

Literature - Wang T, Heianza Y, Sun D, et al. - BMJ 2018;360:j5644

Main results

Conclusion

This study showed that improving adherence to healthy dietary patterns can attenuate the effect of genetic predisposition to long-term changes in BMI and weight increases, particularly in individuals at high genetic risk. Thus, especially in people genetically predisposed to obesity improving adherence to a healthy diet is important and beneficial for weight management.

Editorial comment

In their editorial article [6], Ells et al. discuss the limitations of the Wang et al. study, which include unmeasured confounders, like physical activity, the non-randomized adherence to healthy diet, a possible reverse causality, the lack of generalizability and clear underlying biological plausibility, and the small effect size of the genetic predisposition. Moreover, they highlight the challenges of eating healthy in environments that promote obesity, and they conclude: ‘Genetic predisposition is no barrier to successful weight management and no excuse for weak health and policy responses. Through evidence based and cost effective interventions at both individual and societal levels, governments and populations must act to ensure universal healthy diets within health promoting food environments and food systems. This must become the new normal. Only then will we begin to curb and ultimately reverse the global epidemic of obesity.’

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