human
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Background There is evidence that  physical activity ( PA )  can attenuate the influence of the fat mass- and obesity-associated ( FTO ) genotype on the risk to develop obesity . However , whether providing personalized information on FTO genotype leads to changes in PA is unknown . Objective The purpose of this study was to determine if disclosing FTO risk had an impact on change in PA following a 6-month intervention . Methods The single nucleotide polymorphism ( SNP ) rs9939609 in the FTO gene was genotyped in 1279 participants of the Food4Me study , a four-arm , Web-based r and omized controlled trial ( RCT ) in 7 European countries on the effects of personalized advice on nutrition and PA . PA  was measured objective ly using a TracmorD accelerometer and was self-reported using the Baecke question naire at baseline and 6 months . Differences in baseline PA variables between risk ( AA and AT genotypes ) and nonrisk ( TT genotype ) carriers were tested using multiple linear regression . Impact of FTO risk disclosure on PA change at 6 months was assessed among participants with inadequate PA , by including an interaction term in the model : disclosure ( yes/no ) × FTO risk ( yes/no ) . Results At baseline , data on PA were available for 874 and 405 participants with the risk and nonrisk FTO genotypes , respectively . There were no significant differences in objective ly measured or self-reported baseline PA between risk and nonrisk carriers . A total of 807 ( 72.05 % ) of the participants out of 1120 in the personalized groups were encouraged to increase PA at baseline . Knowledge of FTO risk had no impact on PA in either risk or nonrisk carriers after the 6-month intervention . Attrition was higher in nonrisk participants for whom genotype was disclosed ( P=.01 ) compared with their at-risk counterparts . Conclusions No association between baseline PA and FTO risk genotype was observed . There was no added benefit of disclosing FTO risk on changes in PA in this personalized intervention . Further RCT studies are warranted to confirm whether disclosure of nonrisk genetic test results has adverse effects on engagement in behavior change . Trial Registration Clinical Trials.gov NCT01530139 ; http:// clinical trials.gov/show/NCT01530139 ( Archived by WebCite at : http://www.webcitation.org/6XII1QwHz Background : As genetic testing for health risk becomes increasingly available , it becomes important to study the prospect i ve impact of testing on modifiable health behavior . Purpose : This study examines the impact of genetic testing for alpha-1 antitrypsin ( AAT ) deficiency , a condition that usually results in emphysema in individuals exposed to cigarette smoke . We evaluated whether AAT testing , performed in the home and with minimal contact ( reading material s including advice on cessation ) , results in quit attempts and abstinence . Methods : Identified smokers ( N=199 ) from a larger study of genetic testing were surveyed 3 months following receipt of their AAT genotype . The primary endpoint was the incidence of quit attempts . Results : Smokers who tested severely AAT deficient were significantly more likely to report a 24-hr quit attempt ( 59 % ) than were those who tested normal ( 26 % ) . Carriers had a 34 % quit attempt rate . Severely AAT deficient smokers were more likely than both carriers and normals to seek information on treatment , use pharmacotherapy for smoking cessation , and report greater reductions in their smoking . There were no group differences in 3-month abstinence rates . Conclusions : Knowledge of severe AAT deficiency , but not carrier status , may motivate smokers toward cessation . The AAT testing experience may have consequences for outcomes of other genetic conditions with modifiable health behaviors Background The high prevalence of physical inactivity worldwide calls for innovative and more effective ways to promote physical activity ( PA ) . There are limited objective data on the effectiveness of Web-based personalized feedback on increasing PA in adults . Objective It is hypothesized that providing personalized advice based on PA measured objective ly alongside diet , phenotype , or genotype information would lead to larger and more sustained changes in PA , compared with nonpersonalized advice . Methods A total of 1607 adults in seven European countries were r and omized to either a control group ( nonpersonalized advice , Level 0 , L0 ) or to one of three personalized groups receiving personalized advice via the Internet based on current PA plus diet ( Level 1 , L1 ) , PA plus diet and phenotype ( Level 2 , L2 ) , or PA plus diet , phenotype , and genotype ( Level 3 , L3 ) .  PA  was measured for 6 months using triaxial accelerometers , and self-reported using the  Baecke question naire . Outcomes were objective and self-reported PA after 3 and 6 months . Results While 1270 participants ( 85.81 % of 1480 actual starters ) completed the 6-month trial , 1233 ( 83.31 % ) self-reported PA at both baseline and month 6 , but only 730 ( 49.32 % ) had sufficient objective PA data at both time points . For the total cohort after 6 months , a greater improvement in self-reported total PA ( P=.02 ) and PA during leisure ( nonsport ) ( P=.03 ) was observed in personalized groups compared with the control group . For individuals advised to increase PA , we also observed greater improvements in those two self-reported indices ( P=.006 and P=.008 , respectively ) with increased personalization of the advice ( L2 and L3 vs L1 ) . However , there were no significant differences in accelerometer results between personalized and control groups , and no significant effect of adding phenotypic or genotypic information to the tailored feedback at month 3 or 6 . After 6 months , there were small but significant improvements in the objective ly measured physical activity level ( P<.05 ) , moderate PA ( P<.01 ) , and sedentary time ( P<.001 ) for individuals advised to increase PA , but these changes were similar across all groups . Conclusions Different levels of personalization produced similar small changes in objective PA . We found no evidence that personalized advice is more effective than conventional “ one size fits all ” guidelines to promote changes in PA in our Web-based intervention when PA was measured objective ly . Based on self-reports , PA increased to a greater extent with more personalized advice . Thus , it is crucial to measure PA objective ly in any PA intervention study . Trial Registration Clinical Trials.gov NCT01530139 ; http:// clinical trials.gov/show/NCT01530139 ( Archived by WebCite at : http://www.webcitation.org/6XII1QwHz Background There are few empirical data to inform the debate surrounding the use and regulation of direct-to-consumer ( DTC ) genome-wide disease risk tests . This study aim ed to determine the long term psychological , behavioural , and clinical impacts of genomic risk testing for common disease . Methods The Scripps Genomic Health Initiative is a prospect i ve longitudinal cohort study of adults who purchased the Navigenics Health Compass , a commercially available genomic test . Web based assessment s were administered at baseline , short ( 3 months ) , and long term ( 1 year ) follow-up . Results 2240 participants completed either or both follow-ups and a subset of 1325 completed long term follow-up . There were no significant differences from baseline in anxiety ( p=0.50 ) , fat intake ( p=0.34 ) , or exercise ( p=0.39 ) at long term follow-up , and 96.8 % of the sample had no test related distress . Longitudinal linear mixed model analyses were consistent with results of cross-sectional analyses . Screening test completion was associated with sharing genomic test results with a physician ( 36.0 % shared ; p<0.001 ) and perceived utility of the test ( 61.5 % high perceived utility ; p=0.002 ) , but was not associated with the genomic risk estimate values themselves . Conclusions Over a third of DTC genomic test recipients shared their results with their own physician during an approximate 1 year follow-up period , and this sharing was associated with higher screening test completion . Genomic testing was not associated with long term psychological risks , and most participants reportedly perceived the test to be of high personal utility PURPOSE Markers of genetic susceptibility to tobacco-related cancers could personalize harms of smoking and motivate cessation . Our objective was to assess whether a multicomponent intervention that included feedback about genetic susceptibility to lung cancer increased risk perceptions and rates of smoking cessation compared with a st and ard cessation intervention . EXPERIMENTAL DESIGN Our design was a two-arm trial with eligible smokers r and omized in a 1:2 ratio to Enhanced Usual Care or Biomarker Feedback ( BF ) .  Surveys were conducted at baseline , 6 , and 12 months later . The setting was an inner city community health clinic . African-American patients who were current smokers ( n = 557 ) were identified by chart abstract ion and provider referral . All smokers received a self-help manual and , if appropriate , nicotine patches . Smokers in the BF arm also were offered a blood test for genotyping the GST(3 ) gene ( GSTM1 ) , sent a test result booklet , and called up to four times by a health educator . Prevalent abstinence was assessed by self-report of having smoked no cigarettes in the prior 7 days at the 6- and 12-month follow-ups and sustained abstinence , i.e. , not smoking at either follow-up or in-between . RESULTS Smoking cessation was greater for the BF arm than the Enhanced Usual Care arm ( 19 % versus 10 % , respectively ; P < 0.006 ) at 6 months but not at 12 months . CONCLUSIONS Smokers agreed to genetic feedback as part of a multicomponent cessation program . Although the program increased short-term cessation rates compared with st and ard intervention , genetic feedback of susceptibility may not benefit smokers with high baseline risk perceptions Nutrigenetics research is anticipated to lay the foundation for personalized dietary recommendations ; however , it remains unclear if providing individuals with their personal genetic information changes dietary behaviors . Our objective was to evaluate if providing information for a common variant in the fatty acid desaturase 1 ( FADS1 ) gene changed omega-3 fatty acid ( FA ) intake and blood levels in young female adults ( 18–25 years ) . Participants were r and omized into Genetic ( intervention ) and Non-Genetic ( control ) groups , with measurements taken at Baseline and Final ( 12 weeks ) . Dietary intake of eicosapentaenoic acid ( EPA ) and docosahexaenoic acid ( DHA ) was assessed using an omega-3 food frequency question naire .  Red blood cell ( RBC ) FA content was quantified by gas chromatography . Implication s of participation in a nutrigenetics study and awareness of omega-3 FAs were assessed with online question naires . Upon completion of the study , EPA and DHA intake increased significantly ( p = 1.0 × 10−4 ) in all participants . This change was reflected by small increases in RBC % EPA . Participants in the Genetic group showed increased awareness of omega-3 terminology by the end of the study , reported that the dietary recommendations were more useful , and rated cost as a barrier to omega-3 consumption less often than those in the Non-Genetic group . Providing participants FADS1 genetic information did not appear to influence omega-3 intake during the 12 weeks , but did change perceptions and behaviors related to omega-3 FAs in this timeframe Background Proponents of consumer genetic tests cl aim that the information can positively impact health behaviors and aid in chronic disease prevention . However , the effects of disclosing genetic information on dietary intake behavior are not clear . Methods A double-blinded , parallel group , 2∶1 online r and omized controlled trial was conducted to determine the short- and long-term effects of disclosing nutrition-related genetic information for personalized nutrition on dietary intakes of caffeine , vitamin C , added sugars , and sodium . Participants were healthy men and women aged 20–35 years ( n = 138 ) . The intervention group ( n = 92 ) received personalized DNA-based dietary advice for 12-months and the control group ( n = 46 ) received general dietary recommendations with no genetic information for 12-months .  Food frequency question naires were collected at baseline and 3- and 12-months after the intervention to assess dietary intakes . General linear models were used to compare changes in intakes between those receiving general dietary advice and those receiving DNA-based dietary advice . Results Compared to the control group , no significant changes to dietary intakes of the nutrients were observed at 3-months . At 12-months , participants in the intervention group who possessed a risk version of the ACE gene , and were advised to limit their sodium intake , significantly reduced their sodium intake ( mg/day ) compared to the control group ( −287.3±114.1 vs. 129.8±118.2 , p = 0.008 ) . Those who had the non-risk version of ACE did not significantly change their sodium intake compared to the control group ( 12-months : −244.2±150.2 , p = 0.11 ) . Among those with the risk version of the ACE gene , the proportion who met the targeted recommendation of 1500 mg/day increased from 19 % at baseline to 34 % after 12 months ( p = 0.06 ) . Conclusions These findings demonstrate that dis 
    Output:
    
agent
Several studies of good quality demonstrated changes in lifestyle habits arising from the provision of genetic interventions .
The most promising lifestyle changes were changes in nutrition .
Conclusions : It is possible to facilitate behaviour change using genetic testing as the catalyst .
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Background There is evidence that  physical activity ( PA )  can attenuate the influence of the fat mass- and obesity-associated ( FTO ) genotype on the risk to develop obesity . However , whether providing personalized information on FTO genotype leads to changes in PA is unknown . Objective The purpose of this study was to determine if disclosing FTO risk had an impact on change in PA following a 6-month intervention . Methods The single nucleotide polymorphism ( SNP ) rs9939609 in the FTO gene was genotyped in 1279 participants of the Food4Me study , a four-arm , Web-based r and omized controlled trial ( RCT ) in 7 European countries on the effects of personalized advice on nutrition and PA . PA  was measured objective ly using a TracmorD accelerometer and was self-reported using the Baecke question naire at baseline and 6 months . Differences in baseline PA variables between risk ( AA and AT genotypes ) and nonrisk ( TT genotype ) carriers were tested using multiple linear regression . Impact of FTO risk disclosure on PA change at 6 months was assessed among participants with inadequate PA , by including an interaction term in the model : disclosure ( yes/no ) × FTO risk ( yes/no ) . Results At baseline , data on PA were available for 874 and 405 participants with the risk and nonrisk FTO genotypes , respectively . There were no significant differences in objective ly measured or self-reported baseline PA between risk and nonrisk carriers . A total of 807 ( 72.05 % ) of the participants out of 1120 in the personalized groups were encouraged to increase PA at baseline . Knowledge of FTO risk had no impact on PA in either risk or nonrisk carriers after the 6-month intervention . Attrition was higher in nonrisk participants for whom genotype was disclosed ( P=.01 ) compared with their at-risk counterparts . Conclusions No association between baseline PA and FTO risk genotype was observed . There was no added benefit of disclosing FTO risk on changes in PA in this personalized intervention . Further RCT studies are warranted to confirm whether disclosure of nonrisk genetic test results has adverse effects on engagement in behavior change . Trial Registration Clinical Trials.gov NCT01530139 ; http:// clinical trials.gov/show/NCT01530139 ( Archived by WebCite at : http://www.webcitation.org/6XII1QwHz Background : As genetic testing for health risk becomes increasingly available , it becomes important to study the prospect i ve impact of testing on modifiable health behavior . Purpose : This study examines the impact of genetic testing for alpha-1 antitrypsin ( AAT ) deficiency , a condition that usually results in emphysema in individuals exposed to cigarette smoke . We evaluated whether AAT testing , performed in the home and with minimal contact ( reading material s including advice on cessation ) , results in quit attempts and abstinence . Methods : Identified smokers ( N=199 ) from a larger study of genetic testing were surveyed 3 months following receipt of their AAT genotype . The primary endpoint was the incidence of quit attempts . Results : Smokers who tested severely AAT deficient were significantly more likely to report a 24-hr quit attempt ( 59 % ) than were those who tested normal ( 26 % ) . Carriers had a 34 % quit attempt rate . Severely AAT deficient smokers were more likely than both carriers and normals to seek information on treatment , use pharmacotherapy for smoking cessation , and report greater reductions in their smoking . There were no group differences in 3-month abstinence rates . Conclusions : Knowledge of severe AAT deficiency , but not carrier status , may motivate smokers toward cessation . The AAT testing experience may have consequences for outcomes of other genetic conditions with modifiable health behaviors Background The high prevalence of physical inactivity worldwide calls for innovative and more effective ways to promote physical activity ( PA ) . There are limited objective data on the effectiveness of Web-based personalized feedback on increasing PA in adults . Objective It is hypothesized that providing personalized advice based on PA measured objective ly alongside diet , phenotype , or genotype information would lead to larger and more sustained changes in PA , compared with nonpersonalized advice . Methods A total of 1607 adults in seven European countries were r and omized to either a control group ( nonpersonalized advice , Level 0 , L0 ) or to one of three personalized groups receiving personalized advice via the Internet based on current PA plus diet ( Level 1 , L1 ) , PA plus diet and phenotype ( Level 2 , L2 ) , or PA plus diet , phenotype , and genotype ( Level 3 , L3 ) .  PA  was measured for 6 months using triaxial accelerometers , and self-reported using the  Baecke question naire . Outcomes were objective and self-reported PA after 3 and 6 months . Results While 1270 participants ( 85.81 % of 1480 actual starters ) completed the 6-month trial , 1233 ( 83.31 % ) self-reported PA at both baseline and month 6 , but only 730 ( 49.32 % ) had sufficient objective PA data at both time points . For the total cohort after 6 months , a greater improvement in self-reported total PA ( P=.02 ) and PA during leisure ( nonsport ) ( P=.03 ) was observed in personalized groups compared with the control group . For individuals advised to increase PA , we also observed greater improvements in those two self-reported indices ( P=.006 and P=.008 , respectively ) with increased personalization of the advice ( L2 and L3 vs L1 ) . However , there were no significant differences in accelerometer results between personalized and control groups , and no significant effect of adding phenotypic or genotypic information to the tailored feedback at month 3 or 6 . After 6 months , there were small but significant improvements in the objective ly measured physical activity level ( P<.05 ) , moderate PA ( P<.01 ) , and sedentary time ( P<.001 ) for individuals advised to increase PA , but these changes were similar across all groups . Conclusions Different levels of personalization produced similar small changes in objective PA . We found no evidence that personalized advice is more effective than conventional “ one size fits all ” guidelines to promote changes in PA in our Web-based intervention when PA was measured objective ly . Based on self-reports , PA increased to a greater extent with more personalized advice . Thus , it is crucial to measure PA objective ly in any PA intervention study . Trial Registration Clinical Trials.gov NCT01530139 ; http:// clinical trials.gov/show/NCT01530139 ( Archived by WebCite at : http://www.webcitation.org/6XII1QwHz Background There are few empirical data to inform the debate surrounding the use and regulation of direct-to-consumer ( DTC ) genome-wide disease risk tests . This study aim ed to determine the long term psychological , behavioural , and clinical impacts of genomic risk testing for common disease . Methods The Scripps Genomic Health Initiative is a prospect i ve longitudinal cohort study of adults who purchased the Navigenics Health Compass , a commercially available genomic test . Web based assessment s were administered at baseline , short ( 3 months ) , and long term ( 1 year ) follow-up . Results 2240 participants completed either or both follow-ups and a subset of 1325 completed long term follow-up . There were no significant differences from baseline in anxiety ( p=0.50 ) , fat intake ( p=0.34 ) , or exercise ( p=0.39 ) at long term follow-up , and 96.8 % of the sample had no test related distress . Longitudinal linear mixed model analyses were consistent with results of cross-sectional analyses . Screening test completion was associated with sharing genomic test results with a physician ( 36.0 % shared ; p<0.001 ) and perceived utility of the test ( 61.5 % high perceived utility ; p=0.002 ) , but was not associated with the genomic risk estimate values themselves . Conclusions Over a third of DTC genomic test recipients shared their results with their own physician during an approximate 1 year follow-up period , and this sharing was associated with higher screening test completion . Genomic testing was not associated with long term psychological risks , and most participants reportedly perceived the test to be of high personal utility PURPOSE Markers of genetic susceptibility to tobacco-related cancers could personalize harms of smoking and motivate cessation . Our objective was to assess whether a multicomponent intervention that included feedback about genetic susceptibility to lung cancer increased risk perceptions and rates of smoking cessation compared with a st and ard cessation intervention . EXPERIMENTAL DESIGN Our design was a two-arm trial with eligible smokers r and omized in a 1:2 ratio to Enhanced Usual Care or Biomarker Feedback ( BF ) .  Surveys were conducted at baseline , 6 , and 12 months later . The setting was an inner city community health clinic . African-American patients who were current smokers ( n = 557 ) were identified by chart abstract ion and provider referral . All smokers received a self-help manual and , if appropriate , nicotine patches . Smokers in the BF arm also were offered a blood test for genotyping the GST(3 ) gene ( GSTM1 ) , sent a test result booklet , and called up to four times by a health educator . Prevalent abstinence was assessed by self-report of having smoked no cigarettes in the prior 7 days at the 6- and 12-month follow-ups and sustained abstinence , i.e. , not smoking at either follow-up or in-between . RESULTS Smoking cessation was greater for the BF arm than the Enhanced Usual Care arm ( 19 % versus 10 % , respectively ; P < 0.006 ) at 6 months but not at 12 months . CONCLUSIONS Smokers agreed to genetic feedback as part of a multicomponent cessation program . Although the program increased short-term cessation rates compared with st and ard intervention , genetic feedback of susceptibility may not benefit smokers with high baseline risk perceptions Nutrigenetics research is anticipated to lay the foundation for personalized dietary recommendations ; however , it remains unclear if providing individuals with their personal genetic information changes dietary behaviors . Our objective was to evaluate if providing information for a common variant in the fatty acid desaturase 1 ( FADS1 ) gene changed omega-3 fatty acid ( FA ) intake and blood levels in young female adults ( 18–25 years ) . Participants were r and omized into Genetic ( intervention ) and Non-Genetic ( control ) groups , with measurements taken at Baseline and Final ( 12 weeks ) . Dietary intake of eicosapentaenoic acid ( EPA ) and docosahexaenoic acid ( DHA ) was assessed using an omega-3 food frequency question naire .  Red blood cell ( RBC ) FA content was quantified by gas chromatography . Implication s of participation in a nutrigenetics study and awareness of omega-3 FAs were assessed with online question naires . Upon completion of the study , EPA and DHA intake increased significantly ( p = 1.0 × 10−4 ) in all participants . This change was reflected by small increases in RBC % EPA . Participants in the Genetic group showed increased awareness of omega-3 terminology by the end of the study , reported that the dietary recommendations were more useful , and rated cost as a barrier to omega-3 consumption less often than those in the Non-Genetic group . Providing participants FADS1 genetic information did not appear to influence omega-3 intake during the 12 weeks , but did change perceptions and behaviors related to omega-3 FAs in this timeframe Background Proponents of consumer genetic tests cl aim that the information can positively impact health behaviors and aid in chronic disease prevention . However , the effects of disclosing genetic information on dietary intake behavior are not clear . Methods A double-blinded , parallel group , 2∶1 online r and omized controlled trial was conducted to determine the short- and long-term effects of disclosing nutrition-related genetic information for personalized nutrition on dietary intakes of caffeine , vitamin C , added sugars , and sodium . Participants were healthy men and women aged 20–35 years ( n = 138 ) . The intervention group ( n = 92 ) received personalized DNA-based dietary advice for 12-months and the control group ( n = 46 ) received general dietary recommendations with no genetic information for 12-months .  Food frequency question naires were collected at baseline and 3- and 12-months after the intervention to assess dietary intakes . General linear models were used to compare changes in intakes between those receiving general dietary advice and those receiving DNA-based dietary advice . Results Compared to the control group , no significant changes to dietary intakes of the nutrients were observed at 3-months . At 12-months , participants in the intervention group who possessed a risk version of the ACE gene , and were advised to limit their sodium intake , significantly reduced their sodium intake ( mg/day ) compared to the control group ( −287.3±114.1 vs. 129.8±118.2 , p = 0.008 ) . Those who had the non-risk version of ACE did not significantly change their sodium intake compared to the control group ( 12-months : −244.2±150.2 , p = 0.11 ) . Among those with the risk version of the ACE gene , the proportion who met the targeted recommendation of 1500 mg/day increased from 19 % at baseline to 34 % after 12 months ( p = 0.06 ) . Conclusions These findings demonstrate that dis 
    Output:
    