BackgroundIn studies of gene–environment interactions and obesity, the term environment usually refers to individual behavioural factors that influence energy balance. However, evidence suggests that the built environments in which individuals live, work, and play are associated with obesity and may therefore be environmental triggers of genetic risk. No studies have explored whether individual response to such environmental determinants of obesity varies with genetic risk. We aimed to examine whether genetic risk of obesity modifies associations between various neighbourhood characteristics and body-mass index (BMI). MethodsOur sample included 245 532 adults aged 40–69 years from UK Biobank with cross-sectional data on neighbourhood exposures, BMI, potential confounders, and BMI-linked single nucleotide polymorphisms (SNPs). We derived a composite measure of residential neighbourhood environment based on proximity of fast-food stores, availability of physical activity facilities, and neighbourhood green-ness. We also examined each component separately. We constructed a genetic risk score (GRS) as the weighted average of 70 SNPs, where weights were published estimates of genetic effect sizes, scaled to account for the number of available SNPs. In adjusted mixed-effects regression models of neighbourhood environment–BMI associations we examined possible effect modification by genetic risk by testing GRS-by-neighbourhood measure interaction terms and estimating GRS-stratified associations. FindingsSome evidence of an interaction with genetic risk was observed for the composite measure (pinteraction=0·040); the magnitude of the main association with BMI was somewhat larger among people in the highest genetic risk quintile (0·12 lower BMI for each unit increase in composite score [95% CI −0·15 to −0·08]) compared with those in the lowest GRS quintile (β=–0·07; 95% CI −0·11 to −0·03). Less evidence of interaction was observed for the component neighbourhood exposures (fast-food proximity, availability of PA facilities, and neighbourhood greenness), but some results were sensitive (particularly fast-food proximity findings) to alternative model specification and GRS definitions. InterpretationThis preliminary analysis suggests that any gene–environment interaction is fairly weak. People at some levels of genetic risk of obesity might be more sensitive to some neighbourhood characteristics in combination. It is possible that obesogenic environments are so pervasive that low genetic risk affords limited protection. Results were sensitive to analytical decisions, and further examination of this possible gene–environment interaction is necessary. Measurement error in the neighbourhood exposures and UK Biobank's low response fraction remain potential sources of bias. FundingCommonwealth Scholarship Commission.
Read full abstract