Nutritional genomics, inflammation and obesity

Corrêa, Telma Angelina Faraldo; Quintanilha, Bruna Jardim; Norde, Marina Maintinguer; Pinhel, Marcela Augusta de Souza; Nonino, Carla Barbosa; Rogero, Marcelo Macedo

doi:10.20945/2359-3997000000255

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review • Arch. Endocrinol. Metab. 64 (3) • May-Jun 2020 • https://doi.org/10.20945/2359-3997000000255 copy

Nutritional genomics, inflammation and obesity

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

The Human Genome Project has significantly broadened our understanding of the molecular aspects regulating the homeostasis and the pathophysiology of different clinical conditions. Consequently, the field of nutrition has been strongly influenced by such improvements in knowledge – especially for determining how nutrients act at the molecular level in different conditions, such as obesity, type 2 diabetes, cardiovascular disease, and cancer. In this manner, characterizing how the genome influences the diet and vice-versa provides insights about the molecular mechanisms involved in chronic inflammation-related diseases. Therefore, the present review aims to discuss the potential application of Nutritional Genomics to modulate obesity-related inflammatory responses. Arch Endocrinol Metab. 2020;64(3):205-22

Genetic polymorphism; Mediterranean diet; monounsaturated fatty acids; omega-3 fatty acids

Population	Inflammatory biomarkers	Mechanisms	Ref.
Obese subjects	TNF-α	M1 macrophages infiltration in the adipose tissue → ↑ TNF-α which binds to its receptor (TNFR1) → NF-kB and AP-1 activation → ↑ pro-inflammatory cytokines production.	( ²⁴24. Rogero MM , Calder PC . Obesity, inflammation, toll-like receptor 4 and fatty acids . Nutrients . 2018 ; 10 ( 4 ). pii: E432 . )
Obese subjects submitted to bariatric surgery	IL-6 and hsCRP	TNF-α and IL-1 → ↑ IL-6 which is produced from several sites, including adipose tissue. IL-6 induces hepatic synthesis of CRP and fibrinogen. Weight loss: ↓ IL-6 and CRP.	( ¹³⁰130. Furet JP , Kong LC , Tap J , Poitou C , Basdevant A , Bouillot JL , et al . Differential Adaptation of Human Gut Microbiota to Bariatric Surgery-Induced Weight Loss: links with metabolic and low-grade inflammation markers . Diabetes . 2010 ; 59 ( 12 ): 3049 - 57 . )
Obese women who underwent a 4-week caloric restriction (800 kcal/day)	hsCRP	Weight loss reduced gut permeability and LBP level, possibly reducing plasma hsCRP.	( ¹³¹131. Ott B , Skurk T , Hastreiter L , Lagkouvardos I , Fischer S , Büttner J , et al . Effect of caloric restriction on gut permeability, inflammation markers, and fecal microbiota in obese women . Sci Rep . 2017 ; 7 ( 1 ):11955. )
Healthy subjects and subjects with T2D submitted to an oral glucose tolerance test (OGTT)	hsCRP, IL-6, TNF-α, sICAM-1, sVCAM-1, and sE-selectin	Glucose load: ↑ biomarkers of low-grade inflammation in both groups. Subjects with T2D: higher increase in TNF-α and sE-selectin.	( ¹³²132. Derosa G , D’Angelo A , Salvadeo SAT , Ferrari I , Fogari E , Gravina A , et al . Oral glucose tolerance test effects on endothelial inflammation markers in healthy subjects and diabetic patients . Horm Metab Res . 2010 ; 42 ( 01 ): 8 - 13 . )
Healthy subjects who received an oral fat load	sICAM-1, sVCAM-1, hsCRP, sE-selectin, IL-6, TNF-α	Fat load: ↑ inflammatory biomarkers. Free fatty acids activate pro-inflammatory serine kinase cascades (IkB kinase and c-Jun N-terminal kinase) which stimulate adipose tissue to release IL-6.	( ¹³³133. Derosa G , Ferrari I , D’Angelo A , Salvadeo SAT , Fogari E , Gravina A , et al . Oral fat load effects on inflammation and endothelial stress markers in healthy subjects . Heart Vessels . 2009 ; 24 ( 3 ): 204 - 10 . )
Elderly subjects at high risk for cardiovascular disease	IL-6, IL-8, MCP-1	Long-term adherence to MedDiet reduced plasma inflammatory biomarkers probably due the inhibition of the NF-kB pathway activation by MedDiet polyphenols.	( ¹³13. Casas R , Urpi-Sardà M , Sacanella E , Arranz S , Corella D , Castañer O , et al . Anti-inflammatory effects of the Mediterranean diet in the early and late stages of atheroma plaque development . Mediat Inflamm . 2017 ; 2017 . )

Reference	Genes	Type of genetic variant	Study design	Population (n)	Phenotype	Diet	Interaction
Razquin et al. ( ¹³⁴134. Razquin C , Martinez JA , Martinez-Gonzalez MA , Bes-Rastrollo M , Fernandez-Crehuet J , Marti A . A 3-year intervention with a Mediterranean diet modified the association between the rs9939609 gene variant in FTO and body weight changes . Int J Obes . 2010 ; 34 ( 2 ): 266 - 72 . )	ADIPOQ	SNP (rs1501299 G>T)	RCT	Spain, high cardiovascular risk, adults (737)	Delta-Body weight	3-years intervention with the Mediterranean diet vs. Control diet	Men with the TT genotype had higher body weight gain (vs. G allele carrier) after the intervention. The Mediterranean diet canceled the effect of genotype on body weight gain.
Razquin et al. ( ¹³⁴134. Razquin C , Martinez JA , Martinez-Gonzalez MA , Bes-Rastrollo M , Fernandez-Crehuet J , Marti A . A 3-year intervention with a Mediterranean diet modified the association between the rs9939609 gene variant in FTO and body weight changes . Int J Obes . 2010 ; 34 ( 2 ): 266 - 72 . )	ADIPOQ	SNP (rs2241766 T>G)	RCT	Spain, high cardiovascular risk, adults (737)	Delta-Body weight	3-years intervention with the Mediterranean diet vs. Control diet	No interactions were found
Sánchez-Moreno et al. ( ¹³⁵135. Sánchez-Moreno C , Ordovás JM , Smith CE , Baraza JC , Lee YC , Garaulet M . APOA5 gene variation interacts with dietary fat intake to modulate obesity and circulating triglycerides in a Mediterranean population . J Nutr . 2011 ; 141 ( 3 ): 380 - 5 )	APOA5	SNP (rs662799 T>C)	Cross-sectional	Spain, overweight or obese, adults (1465)	BMI (kg/m ² ), body fat (%), Waist circumference (cm), hip (cm)	Macronutrient profile of the diet	Only TT carriers had a higher BMI, waist and hip circumferences when their diets were high in total fat and saturated fat.
Garaulet et al. ( ¹³⁶136. Garaulet M , Corbalán MD , Madrid JA , Morales E , Baraza JC , Lee YC , et al . CLOCK gene is implicated in weight reduction in obese patients participating in a dietary programme based on the Mediterranean diet . Int J Obes (Lond). 2010 ; 34 ( 3 ): 516 - 23 . )	CLOCK	SNP (rs4580704 C>G)	Non-RCT	Spain, overweight or obese, adults (454)	Weight (kg), BMI (kg/m ² ), body fat (%), waist and hip circumference (cm)	28-weeks hypocaloric Mediterranean diet advice and maintenance protocol	No interactions were found
Garaulet et al. ( ¹³⁶136. Garaulet M , Corbalán MD , Madrid JA , Morales E , Baraza JC , Lee YC , et al . CLOCK gene is implicated in weight reduction in obese patients participating in a dietary programme based on the Mediterranean diet . Int J Obes (Lond). 2010 ; 34 ( 3 ): 516 - 23 . )	CLOCK	SNP(rs1801260 A>G)	Non-RCT	Spain, overweight or obese, adults (454)	Weight (kg), BMI (kg/m ² ), body fat (%), waist and hip circumference (cm)	28-weeks hypocaloric Mediterranean diet advice and maintenance protocol	G allele carriers had higher BMI at baseline and were less successful in losing weight after the intervention period.
Garaulet et al. ( ¹³⁶136. Garaulet M , Corbalán MD , Madrid JA , Morales E , Baraza JC , Lee YC , et al . CLOCK gene is implicated in weight reduction in obese patients participating in a dietary programme based on the Mediterranean diet . Int J Obes (Lond). 2010 ; 34 ( 3 ): 516 - 23 . )	CLOCK	SNP(rs3749474 C>T)	Non-RCT	Spain, overweight or obese, adults (454)	Weight (kg), BMI (kg/m ² ), body fat (%), waist and hip circumference (cm)	28-weeks hypocaloric Mediterranean diet advice and maintenance protocol	No interactions were found.
Corella & Ordovas ( ¹³⁷137. Corella D , Ordovas JM . How does the Mediterranean diet promote cardiovascular health? Current progress toward molecular mechanisms: Gene‐diet interactions at the genomic, transcriptomic, and epigenomic levels provide novel insights into new mechanisms . Bioessays . 2014 ; 36 ( 5 ): 526 - 37 . )	FAIM2	SNP (rs7138803 G>A)	RCT	Spain, high cardiovascular risk, adults (7161)	BMI (kg/m ² ), body weight (kg), and waist circumference (cm)	4.8-years intervention with the Mediterranean diet vs. Control diet	No interactions were found
Hosseini-Esfahani, et al. ( ⁴⁵45. Hosseini-Esfahani F , Koochakpoor G , Daneshpour M , Sedaghati-khayat B , Mirmiran P , Azizi F . Mediterranean dietary pattern adherence modify the association between FTO genetic variations and obesity phenotypes . Nutrients . 2017 ; 9 ( 10 ). pii: E1064 . )	FTO	SNP(rs1121980 G>A)	Nested case-control study	Iran, adults (627 cases and 1,254 controls)	Obesity (BMI cut-off) and abdominal obesity (waist circumference and waist-to-hip ratio cut-offs)	Mediterranean diet score	No interactions were found
Hosseini-Esfahani, et al. ( ⁴⁵45. Hosseini-Esfahani F , Koochakpoor G , Daneshpour M , Sedaghati-khayat B , Mirmiran P , Azizi F . Mediterranean dietary pattern adherence modify the association between FTO genetic variations and obesity phenotypes . Nutrients . 2017 ; 9 ( 10 ). pii: E1064 . )	FTO	SNP(rs1421085 T>C)	Nested case-control study	Iran, adults (627 cases and 1,254 controls)	Obesity (BMI cut-off) and abdominal obesity (waist circumference and waist-to-hip ratio cut-offs)	Mediterranean diet score	No interactions were found
Hosseini-Esfahani, et al. ( ⁴⁵45. Hosseini-Esfahani F , Koochakpoor G , Daneshpour M , Sedaghati-khayat B , Mirmiran P , Azizi F . Mediterranean dietary pattern adherence modify the association between FTO genetic variations and obesity phenotypes . Nutrients . 2017 ; 9 ( 10 ). pii: E1064 . )	FTO	SNP(rs1781749 T>G)	Nested case-control study	Iran, adults (627 cases and 1,254 controls)	Obesity (BMI cut-off) and abdominal obesity (waist circumference and waist-to-hip ratio cut-offs)	Mediterranean diet score	Only G allele carriers had decreased odds for obesity and abdominal obesity when in the highest quartiles of the Mediterranean diet score.
Hosseini-Esfahani, et al. ( ⁴⁵45. Hosseini-Esfahani F , Koochakpoor G , Daneshpour M , Sedaghati-khayat B , Mirmiran P , Azizi F . Mediterranean dietary pattern adherence modify the association between FTO genetic variations and obesity phenotypes . Nutrients . 2017 ; 9 ( 10 ). pii: E1064 . )	FTO	SNP(rs3751812 G>T)	Nested case-control study	Iran, adults (627 cases and 1,254 controls)	Obesity (BMI cut-off) and abdominal obesity (waist circumference and wais-to-hip ratio cut-offs)	Mediterranean diet score	Only T allele carriers had decreased odds for obesity and abdominal obesity when in the highest quartiles of the Mediterranean diet score.
Hosseini-Esfahani, et al. ( ⁴⁵45. Hosseini-Esfahani F , Koochakpoor G , Daneshpour M , Sedaghati-khayat B , Mirmiran P , Azizi F . Mediterranean dietary pattern adherence modify the association between FTO genetic variations and obesity phenotypes . Nutrients . 2017 ; 9 ( 10 ). pii: E1064 . )	FTO	SNP(rs8050136 G>A)	Nested case-control study	Iran, adults (627 cases and 1,254 controls)	Obesity (BMI cut-off) and abdominal obesity (waist circumference and wais-to-hip ratio cut-offs)	Mediterranean diet score	Only A allele carriers had decreased odds for obesity and abdominal obesity when in the highest quartiles of the Mediterranean diet score.
Corella et al. ( ¹³⁸138. Corella D , Ortega-Azorín C , Sorlí JV , Covas MI , Carrasco P , Salas-Salvadó J , et al . Statistical and biological gene-lifestyle interactions of MC4R and FTO with diet and physical activity on obesity: new effects on alcohol consumption . PloS One . 2012 ; 7 ( 12 ): e52344 . )	FTO	SNP(rs9939609 C>A)	Cross-sectional	Spain, high cardiovascular risk, adults (7,052)	BMI (kg/m ² ), body weight (kg), and waist circumference (cm)	Adherence do the Mediterranean diet	No interactions were found
Roswall et al. ( ¹³⁹139. Roswall N , Ängquist L , Ahluwalia TS , Romaguera D , Larsen SC , Østergaard JN , et al . Association between Mediterranean and Nordic diet scores and changes in weight and waist circumference: influence of FTO and TCF7L2 loci . Am J Clin Nutr . 2014 ; 100 ( 4 ): 1188 - 97 . )	FTO	SNP(rs9939609 C>A)	Nested case-control study	Europe, adults (5,552 cases and 5,496 controls)	Delta-Body weight, and Delta-Waist circumference	Mediterranean diet score	No interactions were found
Razquin et al. ( ¹³⁴134. Razquin C , Martinez JA , Martinez-Gonzalez MA , Bes-Rastrollo M , Fernandez-Crehuet J , Marti A . A 3-year intervention with a Mediterranean diet modified the association between the rs9939609 gene variant in FTO and body weight changes . Int J Obes . 2010 ; 34 ( 2 ): 266 - 72 . )	FTO	SNP(rs9939973 G>A)	RCT	Spain, high cardiovascular risk, adults (776)	BMI (kg/m ² ), body weight (kg), and waist circumference (cm)	3-years intervention with the Mediterranean diet vs. Control diet	A allele carriers had the lowest body omozy gain (vs. GG genotype) after the intervention with the Mediterranean diet. This difference was not observed in individuals omozygou to the control diet intervention.
Hosseini-Esfahani, et al. ( ⁴⁵45. Hosseini-Esfahani F , Koochakpoor G , Daneshpour M , Sedaghati-khayat B , Mirmiran P , Azizi F . Mediterranean dietary pattern adherence modify the association between FTO genetic variations and obesity phenotypes . Nutrients . 2017 ; 9 ( 10 ). pii: E1064 . )	FTO	SNP(rs9939973 G>A)	Nested case-control study	Iran, adults (627 cases and 1,254 controls)	Obesity (BMI cut-off) and abdominal obesity (waist circumference and wais-to-hip ratio cut-offs)	Mediterranean diet score	Only A allele carriers had decreased odds for obesity when in the highest quartiles of the Mediterranean diet score.
Corella et al. ( ¹³⁸138. Corella D , Ortega-Azorín C , Sorlí JV , Covas MI , Carrasco P , Salas-Salvadó J , et al . Statistical and biological gene-lifestyle interactions of MC4R and FTO with diet and physical activity on obesity: new effects on alcohol consumption . PloS One . 2012 ; 7 ( 12 ): e52344 . )	MC4R	SNP(rs17782313 T>C)	Cross-sectional	Spain, high cardiovascular risk, adults (7,052)	BMI (kg/m ² ), body weight (kg), and waist circumference (cm)	Adherence do the Mediterranean diet	No interactions were found
de Luis et al. ( ¹⁴⁰140. de Luis DA , Izaola O , Primo D , Aller R . Association of the rs10830963 polymorphism in melatonin receptor type 1B (MTNR1B) with metabolic response after weight loss secondary to a hypocaloric diet based in Mediterranean style . Clin Nutr . 2018 ; 37 ( 5 ): 1563 - 8 . )	MTNR1B	SNP(rs10830963 C>G)	Non-RCT	Spain, obese, adults ( ⁸⁰80. Oki E , Norde MM , Carioca AAF , Ikeda RE , Souza JMP , Castro IA , et al . Interaction of SNP in the CRP gene and plasma fatty acid profile in inflammatory pattern: a cross-sectional population-based study . Nutrition . 2016 ; 32 ( 1 ): 88 - 94 . )	BMI (kg/m ² ), body weight (kg), fat mass (g), waist circumference (cm)	12-weeks intervention wih hypocaloric Mediterranean diet	The improvement of the anthropometric parameters after the intervention was higher among CC cariers (vs. G allele carriers).
Garaulet et al. ( ¹⁴¹141. Garaulet M , Smith CE , Hernandez-Gonzalez T , Lee YC , Ordovas JM. PPARga mma Pro12Ala interacts with fat intake for obesity and weight loss in a behavioural treatment based on the Mediterranean diet . Mol Nutr Food Res . 2011 ; 55 ( 12 ): 1771 - 9 . )	PPARG	SNP(rs1801282 C>G)	Non-RCT	Spain, overweight or obese, adults	Delta-Body weight	Behavioural treatment program for obesity based on a Mediterranean diet (duration varied according to patients need)	G allele carriers had less weight loss when fat intake was above 42.6% of total energy intake, in comparison do CC homozygotes.
Roswall et al. ( ¹³⁹139. Roswall N , Ängquist L , Ahluwalia TS , Romaguera D , Larsen SC , Østergaard JN , et al . Association between Mediterranean and Nordic diet scores and changes in weight and waist circumference: influence of FTO and TCF7L2 loci . Am J Clin Nutr . 2014 ; 100 ( 4 ): 1188 - 97 . )	TCF7L2	SNP(rs7903146 C>T)	Nested case-control study	Europe, adults (5,552 cases and 5,496 controls)	Delta-Body weight, and Delta-Waist circumference	Mediterranean diet score	Only when the Mediterranean diet score was high, there was a lower weight gain in TT omozygous, in comparison to C allele carriers.
Barchitta et al. ( ¹⁴²142. Barchitta M, Quattrocchi A, Adornetto V, Marchese AE, Agodi A. Tumor Necrosis Factor-Alpha -308 G>A Polymorphism, Adherence to Mediterranean Diet, and Risk of Overweight/Obesity in Young Women. BioMed Res Int. 2014 ;2014:742620. )	TNF	SNP(rs1800629 G>A)	Cross-sectional	Italy, women only, adults (380)	Overweight and obesity (BMI cut-off)	Mediterranean diet score	No interactions were found
Corella et al. ( ¹³⁸138. Corella D , Ortega-Azorín C , Sorlí JV , Covas MI , Carrasco P , Salas-Salvadó J , et al . Statistical and biological gene-lifestyle interactions of MC4R and FTO with diet and physical activity on obesity: new effects on alcohol consumption . PloS One . 2012 ; 7 ( 12 ): e52344 . )	FTO, MC4R	2-SNP GRS	Cross-sectional	Spain, high cardiovascular risk, adults (7,052)	BMI (kg/m ² ), body weight (kg), and waist circumference (cm)	Adherence do the Mediterranean diet	No interactions were found
Garaulet et al. ( ¹⁴³143. Garaulet M, Tardido AE, Lee YC, Smith CE, Parnell LD, Ordovas JM. SIRT1 and CLOCK 3111T> C combined genotype is associated with evening preference and weight loss resistance in a behavioral therapy treatment for obesity. Int J Obes (Lond). 2012 ;36(11):1436-41. )	CLOCK, SIRT1	2-SNP GRS	Non-RCT	Spain, overweight or obese, adults (1,465)	Delta-Body weight (kg)	40-weeks intervention with dietary advice to loose weight, based in the Mediterranean diet	Individuals with higher GRS lost less body weight than individuals with lower GRS after the intervention period
Frankwich et al. ( ¹⁴⁴144. Frankwich KA , Egnatios J , Kenyon ML , Rutledge TR , Liao PS , Gupta S , et al. Differences in weight loss between persons on standard balanced vs nutrigenetic diets in a randomized controlled trial . Clin Gastroenterol Hepatol . 2015 ; 13 ( 9 ):1625-32. )	APOA2, ADIPOQ, FTO, KCTD10, LIPC, MMAB, PPARG	7-SNP GRS	RCT	US, men only, adults ( ⁵¹51. Serra-Majem L , Roman-Vinas B , Sanchez-Villegas A , Guasch-Ferre M , Corella D , La Vecchia C . Benefits of the Mediterranean diet: Epidemiological and molecular aspects . Mol Aspects Med . 2019 ; 67 : 1 - 55 . )	proportion of individuals achieving at least 5% body weight loss	8-weeks and 24-weeks genetic-guided dietary advice vs. Standard dietary advice	No difference was observed between the interventions
Hosseini-Esfahani et al. ( ⁴⁵45. Hosseini-Esfahani F , Koochakpoor G , Daneshpour M , Sedaghati-khayat B , Mirmiran P , Azizi F . Mediterranean dietary pattern adherence modify the association between FTO genetic variations and obesity phenotypes . Nutrients . 2017 ; 9 ( 10 ). pii: E1064 . )	FTO	6-SNP GRS	Nested case-control study	Iran, adults (627 cases and 1,254 controls)	Obesity (BMI cut-off) and abdominal obesity (waist circumference and wais-to-hip ratio cut-offs)	Mediterranean diet score	The odds for obesity decreased across quartiles of the Mediterranean diet score only in individuals with GRS ≥ 6. No interaction was found for abdominal obesity traits.
San-Cristobal et al. ( ³⁶36. San-Cristobal R , Navas-Carretero S , Livingstone K , Celis-Morales C , Macready A , Fallaize R , et al . Mediterranean diet adherence and genetic background roles within a web-based nutritional intervention: The food4me study . Nutrients . 2017 ; 9 ( 10 ). pii: E1107 . )	ADRB2, APOA5, APOE, BCMO1, COMT, GC, GPX1, MTHFR, SLCA4, SOD2, TCF7L2, TPH2, VDR	14-SNP GRS	RCT	Europe, adults (1,263)	BMI (kg/m ² ) and waist circumference (cm)	6-month personalized dietary advice based in Mediterranean diet	No interactions were found.
Ding et al. ( ¹⁴⁵145. Ding M , Ellervik C , Huang T , Jensen MK , Curhan GC , Pasquale LR , et al . Diet quality and genetic association with body mass index: results from 3 observational studies . Am J Clin Nutr . 2018 ; 108 ( 6 ): 1291 - 300 . )	Near 158 genes associated with BMI	97-SNP GRS	3-Longitudinal cohorts (pooled)	US, adults (31,058)	BMI (kg/m ² )	Alternative Mediterranean diet score	Individuals in the highers tertile of the alternative Mediterranean diet score had lower increases in BMI per 10 risk allele increase of the GRS
Ding et al. ( ¹⁴⁵145. Ding M , Ellervik C , Huang T , Jensen MK , Curhan GC , Pasquale LR , et al . Diet quality and genetic association with body mass index: results from 3 observational studies . Am J Clin Nutr . 2018 ; 108 ( 6 ): 1291 - 300 . )	Near 102 genes associated with BMI and highly expressed in central nervous system	54-SNP GRS	3-Longitudinal cohorts (pooled)	US, adults (31,058)	BMI (kg/m ² )	Alternative Mediterranean diet score	Individuals in the highers tertile of the alternative Mediterranean diet score had lower increases in BMI per 10 risk allele increase of the GRS
Ding et al. ( ¹⁴⁵145. Ding M , Ellervik C , Huang T , Jensen MK , Curhan GC , Pasquale LR , et al . Diet quality and genetic association with body mass index: results from 3 observational studies . Am J Clin Nutr . 2018 ; 108 ( 6 ): 1291 - 300 . )	Near 56 genes associated with BMI and highly expressed in tissues other than the central nervous system	43-SNP GRS	3-Longitudinal cohorts (pooled)	US, adults (31,058)	BMI (kg/m ² )	Alternative Mediterranean diet score	No interactions were found
Hennein et al. ( ¹⁴⁶146. Hennein R , Liu C , McKeown NM , Hoffmann U , Long MT , Levy D , et al . Increased Diet Quality is Associated with Long-Term Reduction of Abdominal and Pericardial Fat . Obesity . 2019 ; 27 ( 4 ): 670 - 7 . )	Intergenic, long non-coding RNA, regulatory regions	4-SNP GRS	Longitudinal cohort	US, adults (1,677)	pericardial fat depots	Mediterranean diet score	Only individuals in the high-GRS cathegory had increased pericardial fat depot when Mediterranean diet score decreased during the follow-up period
Hennein et al. ( ¹⁴⁶146. Hennein R , Liu C , McKeown NM , Hoffmann U , Long MT , Levy D , et al . Increased Diet Quality is Associated with Long-Term Reduction of Abdominal and Pericardial Fat . Obesity . 2019 ; 27 ( 4 ): 670 - 7 . )	Intergenic, long non-coding RNA	2-SNP GRS	Longitudinal cohort	US, adults (1,677)	visceral fat depots	Mediterranean diet score	No interactions were found.
Hennein et al. ( ¹⁴⁶146. Hennein R , Liu C , McKeown NM , Hoffmann U , Long MT , Levy D , et al . Increased Diet Quality is Associated with Long-Term Reduction of Abdominal and Pericardial Fat . Obesity . 2019 ; 27 ( 4 ): 670 - 7 . )	FTO, ATXN1	3-SNP GRS	Longitudinal cohort	US, adults (1,677)	subcutaneous fat depots	Mediterranean diet score	No interactions were found.

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[1] Correspondence to: Marcelo Macedo Rogero Departamento de Nutrição, Faculdade de Saúde Pública, Universidade de São Paulo Av. Dr. Arnaldo, 715 01246-904 – São Paulo, SP, Brasil mmrogero@usp.br