What is a whole food plant based diet? Will it help improve my myeloma?

A whole food plant based diet is just like the name suggests a lot of whole foods and a lot of plant forward diet. So whole foods means unrefined unprocessed foods. It doesn't have to be raw. It can be cooked in any preparation. But it's it's not processed.

Plant based means its the majority of the calories and the foods come from plant ingredients, such as beans, nuts, seeds, legumes, fruits, vegetables. So that's predominantly what the foods groups include in a whole food plant based diet.

So a plant based diet is really trying to have you have the base. So when you think of a food pyramid, the mainstay of your diet, be fruits and vegetables, whole grains as well.

And then as you head up the the pyramid, getting away from things like red meat, again, the American Cancer Society is recommends red meat no more than once per week.

It also thinking about substances, how much alcohol you consume. There are guidelines and recommendations about that as well that women should not have more than one alcoholic beverage per day and men no more than two. Less is more in that regard.

But going back to your question, a plant based diet is just trying to have two thirds or the majority of your diet come from fruits and vegetables.

How would a plant based diet be beneficial to a myeloma patient?

The American Institute of Cancer Research and the American Cancer Society that just talk about diets in general for cancer prevention do mention eating plenty of fruits, vegetables and whole grains to reduce the risk of cancer.

And many of these foods are known to decrease their risk of cancer individually as well.

In myeloma, we don't have data specifically for one food group or not, but there are a couple of studies that point towards this.

So the Epic Oxford study, which looked at over 61,000 individuals who developed about 65 cases of myeloma because myeloma is rare, the numbers are small.

But what they showed is that the meat eaters compared to the fish eaters, compared to the vegetarians and vegans, the vegetarians and vegans had a 77% relative risk reduction compared to the meat eaters. So there was a significant reduction in the myeloma in just based on just overall dietary patterns.

In myeloma, specifically, there was a study looking at the nurses health database that looked at pre-diagnosis dietary patterns with the overall risk of mortality or death from myeloma.

And what it showed was that a healthy, overall, healthy diet based on the alternative healthy eating index is associated with a 15 to 24% reduction in mortality for every standard deviation increase,

whereas a western inflammatory diet is associated with an increased risk of death by one standard deviation for about 15 to 24% for everyone, standard deviation decrease.

That is showing that there is an impact of diet on outcomes once myeloma is diagnosed, too.

There have been smaller studies that have looked at individual food components like fruits, whole grains, vegetables, cruciferous vegetables, and all of them consistently show that increased plant, these increased plant foods are associated with a decreased odds of developing myeloma.

In the United States, only about 5% of the U.S. population meet their fiber requirement.

So I think we talk about protein as this, we need to get enough protein. But I think what we really need to be talking about is where are we getting our fiber from and are we meeting those requirements.

What is your research around a plant based diet?

So, we started out by just reviewing the literature and saw that there is so much data, our wealth of data already around plant based diets and reduced risk of myeloma. But we don't know what once a patient develops these precursor disorders MGUS or smoldering myeloma., we don't know what diet factors could do to

the risk of developing myeloma and being able to modulate these risk factors and reduce the odds, I think would be great for patients. And so we have a study that's opening actually this month, maybe next week, which is going to be looking at a whole food plant based diet in patients with MGUS and smoldering myeloma with an increased BMI over 25.

And we're going to look at the patients over a year and look at things like inflammation, insulin resistance, BMI changes and microbiome. So we want to see if there is an impact on any of these things or all of these things and hopefully even myeloma markers. But that as you know can take time to change.

In abstract 4771, presented at Ash 2023, Doctor Shah and colleagues detailed results from the first dietary intervention trial conducted in patients with plasma cell disorders. This research was selected as an Ash Scholar Award. Past research revealed that overweight patients with monoclonal gammopathy or smoldering myeloma are twice as likely to progress to myeloma. Additionally, research has shown that myeloma patients have imbalanced microbiomes, and it is known that an intervention of whole food plant based diets can improve modifiable biomarkers.

These factors are the rationale for studying if losing weight with a whole food plant based diet would reduce progression for participants with MGUS or smoldering myeloma. For more information, read the references article.