Genetic Predisposition Impacts Clinical Changes in a Lifestyle Coaching Program

Abstract

Both genetic and lifestyle factors contribute to an individual's disease risk, suggesting a multi-omic approach is essential for personalized prevention. Studies have examined the effectiveness of lifestyle coaching on clinical outcomes, however, little is known about the impact of genetic predisposition on the response to lifestyle coaching. Here we report on the results of a real-world observational study in 2531 participants enrolled in a commercial "Scientific Wellness" program, which combines multi-omic data with personalized, telephonic lifestyle coaching. Specifically, we examined: 1) the impact of this program on 55 clinical markers and 2) the effect of genetic predisposition on these clinical changes. We identified sustained improvements in clinical markers related to cardiometabolic risk, inflammation, nutrition, and anthropometrics. Notably, improvements in HbA1c were akin to those observed in landmark trials. Furthermore, genetic markers were associated with longitudinal changes in clinical markers. For example, individuals with genetic predisposition for higher LDL-C had a lesser decrease in LDL-C on average than those with genetic predisposition for average LDL-C. Overall, these results suggest that a program combining multi-omic data with lifestyle coaching produces clinically meaningful improvements, and that genetic predisposition impacts clinical responses to lifestyle change.

Figure 1

Longitudinal changes for select clinical markers. Panels a,c,e, and g: Adjusted changes for the average participant in the entire study population. Panels b,d,f,h: Adjusted average differences from the ‘normal at baseline’ strata at baseline for each baseline strata over time in the program. In panels, the points represent the estimates from the GLMMs, and the vertical bars show the 95% confidence intervals. The solid lines connecting the points visually shows the trajectories over time and the dashed horizontal lines show the starting value of the entire population or corresponding strata.