(P09-002-23) Assessing Dietary Compliance of a Plant-Based Dietary Intervention in Patients With Precursor Plasma Cell Disorders - The Nutrition Prevention (NUTRIVENTION) Study

Objectives: Multiple myeloma (MM) is a plasma cell neoplasm often preceded by the premalignant conditions monoclonal gammopathy of undetermined significance (MGUS) and smoldering multiple myeloma (SMM). Obesity and dietary patterns rich in processed foods and low in plant-based foods are known risk factors for the development of MGUS/SMM and MM progression. The current standard of care, however, is monitoring disease progression without lifestyle intervention. Therefore, we designed a pilot dietary intervention with a whole food, plant-based diet (WFPBD) to improve diet quality and facilitate weight loss toward a healthful body mass index (BMI).

Methods: This is a pilot dietary intervention in 20 patients with diagnosed MGUS or SMM, following a non-energy-restricted WFPBD for 12 weeks. Patients received self-selected WFPBD meals (lunch/dinner) for 12 weeks, along with guidance for snacks and breakfast. Behavioral counseling was provided by health coaches and a research dietitian for 24 weeks. Patient compliance with the diet and BMI were measured through food records and weekly reported weights respectively, through 24 weeks and at the 52 week timepoint. WFPB dietary compliance was calculated by analyzing 72-hour food records and calculated as the percentage of kcal that were whole unprocessed plant foods out of the total kcal consumed.

Results: Of 23 patients enrolled, 20 completed the study intervention. 19 of 20 patients have completed the study through 24 weeks. The baseline demographics for 23 patients include median age 62 years (range 40-79), 43% male, 43% minorities (black, Hispanic, or other), 52% MGUS, 74% obese, and 26% prediabetic/diabetic. The study met both feasibility endpoints at 12 weeks with 93% dietary compliance and 7.4% BMI reduction. Additionally, fiber intake increased from baseline median of 18.6g to intervention median of 30.5g.

Conclusions: A whole food, plant-based diet is feasible for patients with MGUS/SMM with an elevated BMI, and facilitates improvement in BMI. Additional dietary indices will be analyzed to assess dietary quality to further support the impact of a WFPBD on risk reduction in MM.

Funding Sources: This research is supported through the NIH/NCI Cancer Center Support Grant, the Paul Calabresi K12 Award, the Allen Foundation Inc, and the Paula and Rodger Riney Foundation.