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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 informative2–4, research on placebo and nocebo effects5–8 suggests that learning one’s genetic risk may evoke physiological changes consistent with the expected risk profile. Here we tested whether merely learning 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 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.

Background Health mindsets are mental frameworks that help people recognize, organize, interpret, and respond to health-relevant information. Although mindsets shape health behaviors and outcomes, no study has examined the health mindsets of ethnically and socioeconomically diverse Americans. Purpose We explored the content, cultural patterning, and health correlates of diverse Americans' health mindsets. Methods Two studies surveyed approximately equal numbers of African American, Asian American, European American, and Latinx American men and women of lower and higher socioeconomic status (SES). Study 1 (N = 334) used open-ended questions to elicit participants' mindsets about the definitions, causes, and benefits of health. Study 2 (N = 320) used Study 1's results to develop a closed-ended instrument. Results In Study 1, open-ended questioning revealed six overarching mindset themes: behavioral, medical, physical, psychological, social, and spiritual. The most prevalent mindsets were psychological definitions, behavioral causes, and psychological benefits. Participants mentioned more cause themes than definition or benefit themes, and mindset theme mentions correlated with worse health. Older participants mentioned more themes than younger, women mentioned more definition themes than men, and low-SES participants mentioned more cause themes than high-SES participants. In Study 2, closed-ended scales uncovered more complex and positive health mindsets. Psychological and spiritual benefit mindsets correlated with good mental health. African Americans and women endorsed the widest array of mindsets, and the spiritual benefit mindset partially explained the superior mental health of African Americans. Conclusions Many Americans hold simplistic, illness-focused health mindsets. Cultivating more complex, benefit-focused, and culturally appropriate health mindsets could support health. Keywords Mindset • Lay theories • Health disparities • Race paradox • Mental healthIn 1948, the World Health Organization urged people to replace their notion of health as "merely the absence of disease" with "a complete state of physical, mental, and social well-being" [1]. Seventy years later, studies suggest that Americans have not adopted this more complex and positive model of health [2,3]. Meanwhile, research increasingly demonstrates just how strongly people's thoughts and feelings about health affect their behaviors and outcomes. In recent years, for example, studies have shown that health mindsets shape a range of health-relevant variables, from the effects of exercise [4], to the impacts of stress [5], to the lengths of lives [6].Health mindsets are mental frameworks that help people recognize, organize, interpret, and respond to health-relevant information [7] [14], and the social and cultural construction of health and illness [15,16]. Similar to schemas and beliefs, health mindsets include cognitive, emotional, motivational, and  Alana L. Conner

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This paper investigates mindsets about the process of health behaviors—the extent to which people associate physical activity and healthy eating with appealing (pleasurable, fun, indulgent) versus unappealing (unpleasant, boring, depriving) qualities—to promote greater engagement. Study 1 (N = 536) examined how mindsets about physical activity and healthy eating relate to current and future health behavior. Study 2 (N = 149) intervened in actual fitness classes to compare the effects of brief appeal-focused and health-focused interventions on mindsets about physical activity and class engagement. Study 3 (N = 140) designed nutrition education classes that emphasized either the appeal or the importance of fruits and vegetables for health and compared its effects on mindsets about healthy eating and actual fruit and vegetable consumption. Holding more appealing mindsets about health behaviors predicts subsequent physical activity and healthy eating (Study 1). An intervention targeting mindsets about the appeal of physical activity promotes greater participation in fitness classes than emphasizing the importance of meeting activity guidelines (Study 2). Proposed version 2: Meanwhile, interventions targeting mindsets about the appeal of healthy eating increases in-class fruit and vegetable selection more than emphasizing the importance of eating nutritious foods (Study 3), however additional work is needed to sustain such changes in eating behavior. These studies suggest mindsets about the process of health behaviors can be influential and changeable factors in motivating physical activity and healthy eating.