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ArticleEuropean journal of clinical nutrition2026

The role of genetic variation in apolipoprotein response to diet among Brazilians with cardiovascular disease.

Angela C Bersch-Ferreira, Renato Hideo N Santos, Marcelo M Rogero, Rachel Helena V Machado, Josefina Bressan, Annie Seixas B Moreira, Cristiane K Amaral, Aline Marcadenti

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In one paragraph

Article in European journal of clinical nutrition, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01620398 (The Brazilian Cardioprotective Nutritional Program to Reduce Events and Risk Factors in Secondary Prevention for Cardiovascular Disease), which is not on this map. Not yet cited in PubMed.

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1 · What the graph read from it

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2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT01620398 nacompletednot on this map

The Brazilian Cardioprotective Nutritional Program to Reduce Events and Risk Factors in Secondary Prevention for Cardiovascular Disease

TypeinterventionalSponsorHospital do CoracaoRan2013 to 2017Enrolled2,534ConditionsCardiovascular DiseasesArmsBALANCE, Control diet
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4 · The record

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5 · Who and what money

Authors and funding

8 authors.

Angela C Bersch-FerreiraPROADI-SUS office, A Beneficência Portuguesa de São Paulo (BP), São Paulo, Brazil.
Renato Hideo N SantosHcor Research Institute, Associação Beneficente Síria (Hcor), São Paulo, Brazil.
Marcelo M RogeroDepartment of Nutrition, Faculdade de Saúde Pública da Universidade de São Paulo (FSP-USP), São Paulo, Brazil.ORCID http://orcid.org/0000-0003-0517-1645
Rachel Helena V MachadoHcor Research Institute, Associação Beneficente Síria (Hcor), São Paulo, Brazil.
Josefina BressanDepartment of Nutrition and Health, Universidade Federal de Viçosa (UFV), Viçosa, Brazil.
Annie Seixas B MoreiraClinical Nutrition Department, Universidade Estadual do Rio de Janeiro (UERJ), Rio de Janeiro, Brazil.
Cristiane K AmaralClinical Nutrition Outpatient Clinic, Instituto Dante Pazzanese de Cardiologia, São Paulo, Brazil.
Aline MarcadentiHcor Research Institute, Associação Beneficente Síria (Hcor), São Paulo, Brazil. marcadenti.aline@gmail.com.ORCID http://orcid.org/0000-0003-1994-4610

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

BACKGROUND/

objectivesData on the interaction between dietary patterns, single nucleotide polymorphisms (SNPs), and cardiometabolic markers remain limited in genetically admixed populations, particularly among individuals with established cardiovascular disease (CVD). This study aimed to evaluate how SNPs modulate the effects of dietary interventions on apolipoprotein concentrations (A-I, A-II, B, C-II, C-III, and E) in Brazilians undergoing secondary cardiovascular prevention. SUBJECTS/

methodsThis sub-study used data from the three-year multicenter BALANCE Trial, which enrolled individuals aged ≥40 with established CVD. Participants were assigned to either an intervention group (following the Brazilian Cardioprotective Diet with intensive monitoring) or a control group receiving general dietary advice. Apolipoproteins were measured via multiplex immunoassay, and SNPs were genotyped using the Axiom 2.0 Assay. GWAS and adjusted linear regression models assessed associations and gene-diet interactions related to apolipoproteins.

resultsA total of 266 participants (118 in the intervention group and 148 in the control group) were analyzed. After three years, significant SNP-diet interactions affecting log-transformed apolipoprotein concentrations were identified at a genome-wide significance threshold of 10⁻⁵. For each apolipoprotein evaluated, the following polymorphisms were associated: Apo A-I (rs11542163_T, rs11759163_T, rs13396579_C), Apo A-II (rs11197283_T, rs13185245_G, rs7666435_C), Apo B (rs13205819_G, rs926561_C), Apo C-II (rs143862519_TTC, rs674845_A, rs931606_G), Apo C-III (rs2247572_T, rs4506508_C, rs931606_G), and Apo E (rs4862401_G, rs6835179_G). Per-allele differences ranged from -0.65 mg/dL (Apo C-II, rs143862519_TTC) to +0.52 mg/dL (Apo B, rs13205819_G).

conclusionsOur findings show that genetic variants influence apolipoprotein responses to diet in Brazilians under secondary CVD prevention, supporting genotype-guided nutrition. CLINICAL TRIAL REGISTRY NUMBER: NCT01620398.

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