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Title: PER2 variants are associated with abdominal obesity, psycho-behavioral factors and attrition in the dietary treatment of obesity

Author
item GARAULET, MARTA - Universidad De Murcia
item CORBALAN-TUTAU, DOLORES - Universidad De Murcia
item MADRID, JUAN - Universidad De Murcia
item BARAZA, JUAN - Universidad De Murcia
item Parnell, Laurence
item LEE, YU-CHI - Tufts University
item ORDOVAS, JOSE - Tufts University

Submitted to: Journal of American Dietetic Association
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 11/17/2009
Publication Date: 5/22/2010
Citation: Garaulet, M., Corbalan-Tutau, D., Madrid, J.A., Baraza, J.C., Parnell, L.D., Lee, Y., Ordovas, J.M. 2010. PER2 variants are associated with abdominal obesity, psycho-behavioral factors and attrition in the dietary treatment of obesity. Journal of American Dietetic Association. 110(6):917-921.

Interpretive Summary: Persons with genetic differences in genes encoding regulators of the circadian rhythms may exhibit behavioral differences such frequent snacking and skipping breakfast. These individuals may also be prone to withdraw from weight-loss programs. We then sought to examine genetic variants in the PER2 gene, which regulates circadian clock genes, for associations with withdrawal from a weight-reduction program. 454 overweight/obese subjects (women= 380, men= 74), aged 20-65 years, who attended outpatient clinics specializing in obesity between January and December, 2008, were studied. Anthropometric, biochemical and dietary-intake variables were analyzed. Effectiveness of the program was assessed and a questionnaire of barriers to weight loss was considered. Results indicate that two specific variants of PER2 were associated with abdominal-obesity and participants who withdrew from treatment were significantly more obese and had more barriers to lose weight. They also showed reduced likelihood of “planning-eating in advance” and experiencing “stress with dieting” than those who completed treatment. Persons harboring the less common versions of either of the two PER2 variants displayed greater probability of dropping out of the program, more stress with dieting, and more frequent snacking and skipping breakfast than those lacking the more rare versions of these variants. In conclusion, the PER2 gene is implicated in attrition in weight loss treatment and may modulate eating behavior-related behaviors. These findings serve to unite personalized health care and nutrition based on a combination of measuring specific genetic variants and characterizing psycho-behavioral disposition.

Technical Abstract: The purpose was to test for association between polymorphisms in the circadian clock-related gene PER2 and attrition in patients prone to withdrawal from a behavioral weight-reduction-program based on the Mediterranean Diet. 454 overweight/obese subjects (women= 380, men= 74), aged 20-65 years, who attended outpatient clinics specializing in obesity between January and December, 2008, were studied. Anthropometric, biochemical and dietary-intake variables were analyzed. Effectiveness of the program was assessed and a questionnaire of barriers to weight loss was considered. Multivariate analysis and logistic regression models were performed. Results indicate that PER2 polymorphisms rs2304672C>G and rs4663302C>T were associated with abdominal-obesity (P<0.05). Participants who withdrew from treatment were significantly more obese and had more barriers to lose weight (P<0.05). They also displayed a lower likelihood of “planning-eating in advance” and experiencing “stress with dieting” than those who completed treatment. Frequency of rs4663307 minor allele was significantly greater in withdrawers than in those who successfully completed treatment (P<0.05). Logistic regression analysis showed that rs2304672 C>G minor allele carriers had a greater probability of dropping out, displaying extreme snacking, experiencing stress with dieting, eating when bored and skipping breakfast than non-carriers. In conclusion, PER2 is implicated in attrition in weight loss treatment and may modulate eating behavior-related phenotypes. These findings could represent a step towards personalized health care and nutrition based on a combination of genotyping and psycho-behavioral characterization.