A high-fiber, plant-based diet (HFPBD) may delay progression of monoclonal gammopathy of undetermined significance (MGUS) and smoldering multiple myeloma (SMM) to multiple myeloma (MM). Researchers presented the findings of their pilot study at the ASH Annual Meeting.
“Poor diet quality, elevated body mass index (BMI), insulin resistance, microbiome dysbiosis, inflammation, as well as immune dysfunction have all been implicated in progression from MGUS and SMM to MM. Plant-based diets have been associated with reduced risk of MGUS and MM in epidemiological studies. Whether a dietary intervention can impact these modifiable risk factors and delay disease progression has not been investigated,” wrote the authors, led by Urvi A. Shah, MD, of the Myeloma Service at Memorial Sloan Kettering Cancer Center in New York, New York.
The researchers conducted a pilot study to test the feasibility of a HFPBD in 20 patients with MGUS/SMM and a BMI at or above 25. The intervention included 12 weeks of the HFPBD and 24 weeks of health coaching. The researchers found that the intervention was safe and feasible. It improved quality of life and modifiable risk factors, including BMI, insulin resistance, adiponectin-leptin ratio, microbiome profile, and inflammation. Two patients experienced a better long-term disease trajectory.
The researchers also conducted an in vivo study in a mouse model. A high-fiber diet delayed progression from SMM to MM and increased median progression-free survival from 12 weeks in the control group to 30 weeks in the intervention group. Notably, 40% of mice on the intervention did not progress to MM during the study period, compared with all mice in the control group.
Data from humans and mice indicated that the HFPBD affected the composition of gut microbiota, expanding butyrate-producing bacteria. Feces of mice on the high-fiber diet contained increased short-chain fatty acids. Analyses of human bone marrow and peripheral blood indicated that the intervention reduced inflammatory biomarkers.
“Together, our in vivo and clinical data support the beneficial anti-inflammatory role of a HFPBD providing a link between diet, microbiota, and immune modulation to delay disease progression in MGUS/SMM,” the authors concluded.
https://ash.confex.com/ash/2024/webprogram/Paper202224.html
Reference
Shah UA, Cogrossi LL, Derkach A, et al. A high-fiber dietary intervention (NUTRIVENTION) in precursor plasma cell disorders improves biomarkers of disease and may delay progression to myeloma. Abstract #671. Presented at the 66th American Society of Hematology Annual Meeting and Exposition; December 7–10, 2024; San Diego, California.
