Learning one’s genetic risk changes physiology independent of actual genetic risk

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Millions of people now access personal genetic risk estimates for diseases such as Alzheimer’s, cancer and obesity1. While this information can be informative2,3,4, research on placebo and nocebo effects5,6,7,8 suggests that learning of one’s genetic risk may evoke physiological changes consistent with the expected risk profile. Here we tested whether merely learning of one’s genetic risk for disease alters one’s actual risk by making people more likely to exhibit the expected changes in gene-related physiology, behaviour and subjective experience. Individuals were genotyped for actual genetic risk and then randomly assigned to receive either a ‘high-risk’ or ‘protected’ genetic test result for obesity via cardiorespiratory exercise capacity (experiment 1, N = 116) or physiological satiety (experiment 2, N = 107) before engaging in a task in which genetic risk was salient. Merely receiving genetic risk information changed individuals’ cardiorespiratory physiology, perceived exertion and running endurance during exercise, and changed satiety physiology and perceived fullness after food consumption in a self-fulfilling manner. Effects of perceived genetic risk on outcomes were sometimes greater than the effects associated with actual genetic risk. If simply conveying genetic risk information can alter actual risk, clinicians and ethicists should wrestle with appropriate thresholds for when revealing genetic risk is warranted.

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Fig. 1
Fig. 2: Receiving genetic risk information for exercise capacity alters cardiorespiratory physiology, running endurance and subjective experience.
Fig. 3: Receiving protective genetic risk information for satiety increases physiological and self-reported satiety.

Data availability

Data is available on the Open Science Framework at the following link: https://osf.io/gz57m/?view_only=71292e851b754bacbd89dc07c8113829.


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This research is supported by the Foundation for the Science of the Therapeutic Encounter, the National Science Foundation GRFP Grant No. DGE-11474 and the National Institutes of Health DP2 AT009511 and U54EB020405. The funders had no role in the conceptualization, design, data collection, analysis, decision to publish or preparation of the manuscript. We thank Y. Rosenberg-Hasson, the Clinical Translational Research Unit, Human Immune Monitoring Center, Human Performance Lab and Protein and Nucleic Acid Facility at Stanford University for assistance in the collection and processing of biological samples. We thank colleagues C. Dweck, H. Markus, K. Hall and G. Walton for comments on versions of this manuscript.

Author information

B.P.T. and A.J.C. conceived and designed the study. B.P.T., A.S., S.L.D. and A.J.C. designed protocol details. B.P.T. and D.Z.B. were responsible for consenting participants, running participants through the protocol and debriefing participants. A.S. was responsible for processing physiological data, B.P.T. and D.Z.B. were in charge of data management and J.P.G. was in charge of data analysis. B.P.T. wrote the first draft, and all authors contributed critical revisions of the manuscript.

Correspondence to Bradley P. Turnwald.

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Supplementary Methods, Supplementary Notes, Supplementary Figures 1–3, Supplementary Tables 1–11, Supplementary References

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Turnwald, B.P., Goyer, J.P., Boles, D.Z. et al. Learning one’s genetic risk changes physiology independent of actual genetic risk. Nat Hum Behav 3, 48–56 (2019) doi:10.1038/s41562-018-0483-4

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