precision nutrition impact on health-related behavior change

Conditions: Metabolic Syndrome

Summary: a prospective, randomized, controlled trial enrolling up to 150 service members (sms) from two sites; joint base lewis mcchord (jblm) in the northwest and joint base san antonio (jbsa)-lackland in the southwest. a baseline genomic profile (70 genes/80 single nucleotide polymorphisms \[snps\]) augmented by common serum biomarkers specific to diet-related chronic disease (metabolic syndrome, cardiovascular disease \[cvd\], vitamin d deficiency) risk will be created. subjects will be randomized to either personalized nutrition counseling or standard nutrition education for 6 weeks. this interval matches service-run healthy weight initiatives such as the army's current fit for performance program. to promote self-care and engagement, a digital app will be utilized for 2 weeks for real-time health data capture with continuous feedback and will be validated with in-person rd interviews. physical activity and injury data, sun exposure, and family history will help elucidate unique individual responses. participant follow-up at 12 weeks will evaluate changes in anthropometrics and metabolic, cardiovascular, and vitamin d biomarkers.

precision nutrition leverages the specificity of molecular and phenotypic differences in personalizing diet and lifestyle interventions. specific aims: 1) examine the effectiveness of gene-based nutrition counseling on health-related behavior change in service members as measured by body weight, body mass index (bmi), blood glucose, lipids, 25-hydroxyvitamin (oh) d, %body fat (bf), waist circumference, and blood pressure; 2) evaluate the feasibility of a digital application to accurately capture diet, activity, and sleep behaviors; and 3) describe military-unique characteristics in demographics, diet, and lifestyle for northwest army and southwest air force cohorts. a baseline genomic profile will be created from 70 diet-responsive genes and 80 variants following amplicon sequencing on an illumina miseq platform and will be informed by serum biomarkers specific to diet-related chronic disease risk (i.e. metabolic syndrome, vitamin d deficiency) for each subject. risk variants were selected if minor allele frequency \> 5% and at least two published papers verified the link to the phenotype of interest. treatment group receives gene-based nutrition counseling for six weekly sessions; controls receive evidence-based nutrition pamphlets, all content directed at preventing metabolic syndrome. a digital app provides real-time health data capture with continuous feedback and is verified by in-person dietitian interviews. both groups will also use study resources independently for six weeks, returning for final body composition and serum biomarkers after the twelve-week intervention. the control group receives the genomic profile with dietary recommendations upon study completion. data analysis will examine between-group and by-cohort differences on primary anthropometric and biomarker outcomes.

Eligibility criteria:
inclusion criteria: * active duty army or air force * age 18-45 * able to read and comprehend english * assigned to jblm or jbsa-lackland, * remaining on station for 5 months * consider self generally healthy * history of or currently out of compliance with military fitness standards * willing to submit 2 blood samples including one for gene testing * willing to undergo 1 dexa scan (jblm only) * willing to participate in 6 weekly nutrition counseling sessions if assigned to treatment group exclusion criteria: * currently diagnosed with an eating disorder * pregnant * current physical training profile (ie limitation) * pending deployment in next 5 months * pending retirement in next 5 months * pending permanent change of duty station in the next 5 months * currently has a pacemaker (contraindicated for bioelectrical impedance analysis)

Keywords: nutrition military nutrigenomics