Can Diet Slow the Progression of MGUS or Smoldering Myeloma?

People with precursor conditions to multiple myeloma, such as MGUS or smoldering myeloma, often wonder if lifestyle choices like diet could help prevent the progression to cancer. 

These conditions can linger for years without advancing to myeloma, offering researchers a crucial window to investigate preventive strategies. While there is not yet a cure for myeloma, experts are working to delay its onset. 

Urvi Shah, MD, a myeloma specialist at Memorial Sloan Kettering Cancer Center, explored this question in the NUTRIVENTION trial. Read highlights from the study below.  

“As we’re detecting cancers earlier – during the precancerous state – there is a greater opportunity to understand how lifestyle can modify the course of the disease and help patients live better. It is very anxiety-provoking when someone is told they have a precancerous state and there is nothing they can do. Our motivation is to see if we can empower patients to take steps to lower their risk.” - Urvi Shah, MD

If you are interested in contributing to this research, click here. 

High-Fiber, Plant-Based Diet’s Impact on Myeloma Precursors 

Dr. Shah led a clinical trial to investigate the potential benefits of a high-fiber, plant-based diet for patients with MGUS or smoldering myeloma. 

This motivation came from building on insights from prior studies suggesting that individuals with precursor conditions to myeloma who have a higher-than-normal body weight are at increased risk of developing the cancer. Additionally, factors such as diet and gut microbiome health may influence the progression of myeloma. 

The study involved 20 participants with MGUS or smoldering myeloma, all with a body mass index (BMI) of 25 or higher. Over the course of a year, participants closely adhered to a high-fiber, plant-based diet. On average, they lost 7% of their body weight within the first three months, and this weight loss was sustained throughout the study.

The dietary intervention produced significant health benefits. Participants showed improved insulin sensitivity, increased diversity in their gut microbiome, and reduced levels of inflammatory markers—factors that, when impaired, are linked to cancer progression. Additionally, they reported a higher quality of life, underscoring the positive impact of the diet. 

“We saw improvements in all spheres, including metabolism, microbiome, and immune system markers, and we also saw that two patients with progressive disease had the progression stabilize and slow down on the intervention. Even though it’s just two cases, to our knowledge, it has not been shown before in an intervention setting that you can improve diet and lifestyle and actually slow or change trajectory of the disease.” - Urvi Shah, MD

High-Fiber Diet Results from Mice Study

In a parallel study conducted at the Bellone laboratory at IRCSS San Raffaele Hospital in Milan, Italy, researchers investigated the effects of a high-fiber diet on mice with a precursor condition to myeloma. Remarkably, 40% of the mice on the high-fiber diet did not progress to multiple myeloma, compared to the control group, in which all mice developed the cancer.

The study also revealed other significant findings. A high-fiber diet reduced the exhaustion of cancer-killing T-cells. Additionally, the diet positively influenced gut bacteria, leading to an increase in short-chain fatty acids like butyrate, which are known to reduce inflammation.  

Although these results are promising, researchers emphasize caution. The small sample size of the clinical trial limits the ability to draw broad conclusions, and findings from animal studies do not always directly apply to humans. Larger studies are currently underway to confirm these results and further investigate the potential of dietary interventions in reducing the risk of myeloma progression. 

Key Takeaways

For patients with MGUS or smoldering myeloma, adopting a high-fiber, plant-based diet may offer a proactive way to improve health and potentially slow cancer progression. While more research on larger patient populations is needed, these findings highlight the critical role of diet and gut health in managing blood cancer risks. Remember to consult your healthcare provider before making significant dietary changes. 

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Sources: 

• Research Shows How Lifestyle Factors and Diet Affect Hematologic Care
• A High-Fiber Dietary Intervention (NUTRIVENTION) in Precursor Plasma Cell Disorders Improves Biomarkers of Disease and May Delay Progression to Myeloma
• High-Fiber NUTRIVENTION Study for Delaying Progression of Myeloma