Impact of Precision Nutrition Counseling for Active Duty Service Members at Risk for Metabolic Syndrome

OBJECTIVES: Metabolic Syndrome (MetS) is characterized by abdominal obesity, dyslipidemia, elevated fasting blood glucose (FBG), and hypertension; personalized nutrition counseling and wellness applications have demonstrated positive results for weight management when coupled with high levels of participant engagement and motivation. METHODS: In a prospective RCT RDs conducted personalized nutrition counseling using results of targeted sequencing, biomarkers, and expert recommendations to reduce risk for MetS. Treatment Group (TG) received six weekly sessions; Control Group (CG) received a pamphlet of expert recommendations upon randomization. A digital application provided real-time health data capture. Anthropometrics and BP were evaluated at baseline, 6, & 12 wks; biomarkers at baseline & 12 wks. Primary outcome was change in weight at 12 wks. Statistical analyses included descriptives and t-test or ANOVA; significance set at P < .05. RESULTS: 138 subjects enrolled from Nov 2019 - Feb 2021 between 2 sites [Northwest (NW) in WA; Southwest (SW) in TX]; 107 completed the study with n = 70 in the TG. Demographics: 66% male, mean age 31 yrs, 66% married, 49% Caucasian, non-Hispanic. There were no differences between TG and CG at baseline. High deleterious variant prevalence found for genes/SNPs associated with obesity (40%), cholesterol (38%), and BP (58%). 65% of subjects had 25(OH) D less than 30 ng/mL upon enrollment. In NW cohort primary outcome of change in weight at 12 wks was not significant p = .34. Significant difference at 6 wks noted for TG change in weight p = 0.02; fat mass p = .01; BMI p = 0.02; and % body fat p = 0.01. BP significant at 12 wks, both systolic (p = .04) and diastolic (p = .04). Change in 25(OH)D favored TG, p = 0.01. SW TG had greater reduction in waist circ p = .04 at 6 wks. Digital app had low adherence and poor correlation with ASA24 reference. CONCLUSIONS: Significant progress was achieved in the TG at 6 weeks although not sustained at 12 weeks. The concept of nutrigenomics was well-received in this cohort. FUNDING SOURCES: TriService Nursing Research Program.