Preventing MGUS/SMM Progression to Multiple Myeloma with Dietary Interventions 

Multiple myeloma is the second most common form of blood cancer in the United States. Given its vast impacts, researchers are looking for ways to delay progression from monoclonal gammopathy of undetermined significance (MGUS) and smoldering multiple myeloma (SMM) to multiple myeloma.

Plant-based diets have been associated with reduced risk of MGUS and multiple myeloma in epidemiological studies. Based on these findings, a study presented at the 2024 American Society of Hematology Annual Meeting explored whether a plant-based diet high in fiber could delay progression from MGUS or SMM to multiple myeloma.

Examining a High-Fiber, Plant-Based Diet in Preventing Multiple Myeloma Progression

The researchers conducted a trial with 20 MGUS/SMM patients who had a BMI greater than or equal to 25. The patients followed a high-fiber, plant-based diet for 12 weeks and participated in health coaching for 24 weeks.

The researchers observed improvements to several modifiable risk factors in these patients, including:

• Metabolic profile (improved BMI, insulin resistance, and adiponectin leptin ratio)
• Microbiome profile (increased alpha-diversity and butyrate producers)
• Immunity (decreased inflammation and increased anti-inflammatory classical monocyte)

Additionally, a reduced long-term progression trajectory was observed in two patients.

The researchers also conducted a separate trial on mice presenting a pre-cancerous condition similar to MGUS. Forty percent of the mice that were fed a high-fiber diet did not experience progression to cancer during the study, while all mice in the control group progressed.

Overall, these findings suggest that a high-fiber, plant-based diet has the potential to delay progression from MGUS/SMM to multiple myeloma.

High-Fiber, Plant-Based Diets in Patients with MGUS/SMM

Patients can benefit from a diet primarily made up of whole foods that are low in processed sugars and saturated fats. Here’s what you can recommend to patients to help them incorporate more fiber into their daily lives:

• Fruits and vegetables, like berries, apples, pears, bananas, leafy greens, and cruciferous vegetables
• Legumes and beans, which can help provide protein in a plant-based diet
• Nuts and seeds to improve satiety and support metabolic health

While a high-fiber, plant-based diet won’t guarantee prevention of diseases like multiple myeloma, it appears to play a role in altering risk factors. With diligent screening of patients with MGUS/SMM, clinicians can intervene to mitigate the risk of progression to multiple myeloma.

References:

Shah, U. (n.d.). A high-fiber dietary intervention (NUTRIVENTION) in precursor plasma cell disorders improves biomarkers of disease and may delay progression to myeloma. ash.confex.com. https://ash.confex.com/ash/2024/webprogram/Paper202224.html

What is multiple myeloma? symptoms, causes, & prognosis. MMRF. (2024, May 29). https://themmrf.org/multiple-myeloma/

Key statistics for multiple myeloma. American Cancer Society. (n.d.). https://www.cancer.org/cancer/types/multiple-myeloma/about/key-statistics.html

Risk factors for multiple myeloma. American Cancer Society. (n.d.). https://www.cancer.org/cancer/types/multiple-myeloma/causes-risks-prevention/risk-factors.html

High-Fiber Foods. NCI. (n.d.). https://www.cancer.gov/about-cancer/treatment/side-effects/nutrition/high-fiber-foods