Personalised Nutrition in Obesity and Prediabetes: Do Genotypes Matter?

Area of Science:

• Nutrition Science
• Genetics
• Metabolic Health

Background:

• Obesity and prediabetes are significant global health challenges.
• Gene-diet interactions play a crucial role in cardiometabolic risk.
• Understanding these interactions is key to personalized prevention strategies.

Purpose of the Study:

• To systematically review evidence on gene-diet interactions in adults with obesity or prediabetes.
• To evaluate the impact of dietary patterns (Mediterranean, DASH), macronutrient quality, and energy restriction.
• To assess both single-variant and polygenic score approaches for gene-diet interactions.

Main Methods:

• Systematic literature search of PubMed for English language papers published within the last 5 years.
• Inclusion criteria required explicit statistical testing for gene-diet interactions and relevant cardiometabolic endpoints.
• Fewer than 200 studies were retained for analysis.

Main Results:

• General recommendations include restricting saturated fat and prioritizing carbohydrate quality, with significant genotype-dependent variations.
• Healthy dietary patterns showed reduced risk in individuals with high polygenic risk scores but limited benefit in low-risk groups.
• Specific gene variants (TCF7L2, APOA2) demonstrated genotype-specific responses to macronutrients and dietary antioxidants, impacting visceral adiposity and inflammation.

Conclusions:

• While some dietary changes (e.g., anti-inflammatory substitutions) benefit biomarkers universally, genotype-informed nutrition provides the most substantial risk reduction in high-risk populations.
• Clinical practice should integrate general dietary guidelines with targeted, genotype-specific nutritional strategies.
• Future research needs preregistered, genotype-stratified trials and locally trained polygenic scores to account for diverse ancestry and genetic architecture.