Hearing the words, “You have cancer,” is a life-altering moment. A diagnosis of multiple myeloma—a blood cancer that affects the bone marrow—is particularly daunting because it currently has no cure. In a recent groundbreaking study, researchers at Memorial Sloan Kettering Cancer Center (MSK) discovered for the first time that a high-fiber, plant-based diet may delay the progression to multiple myeloma, which disproportionally impacts the Black community twice as much as whites. The findings, presented at the 2024 American Society of Hematology (ASH) Annual Meeting in San Diego, offer a promising new way for cancer prevention and management through dietary intervention.
Led by Urvi A. Shah, MD, a myeloma specialist at MSK, the NUTRIVENTION clinical trial enrolled 20 participants diagnosed with precancerous blood disorders. Notably, forty-three percent of those enrolled in the trial were Black, Hispanic, or of mixed race, reflecting the study’s commitment to diversity. Additionally, 60 % of the participants had monoclonal gammopathy of undetermined significance (MGUS), and the other 40 % had smoldering myeloma (SMM). Both conditions are known precursors to multiple myeloma. Obese individuals with an elevated body mass index (BMI) are also at significantly higher risk of progression.
Participants in the trial followed a 12-week regimen of high-fiber, plant-based meals and engaged in 24 weeks of health coaching. The results were remarkable: two participants who had been experiencing disease progression before the study showed significant improvement in their disease trajectories.
None of the participants progressed to multiple myeloma during the one-year follow-up period.
Empowering Patients with Knowledge and Nutrition
“This study showcases the power of nutrition—specifically a high-fiber, plant-based diet—and unlocks a better understanding of how it can lead to improvements in the microbiome and metabolism to build a stronger immune system,” said Dr. Shah. “These findings further support how we as physicians can empower patients, especially those with precancerous conditions, with knowledge on reducing their cancer risk through dietary changes.”
Multiple myeloma is the second most common blood cancer (leukemia is first) and typically develops from precursor conditions such as MGUS and smoldering myeloma.
Research has shown that individuals with poor diets and a low intake of plant-based foods are at greater risk of developing multiple myeloma.
Unique Challenges for African Americans
Unfortunately, “African Americans face a disproportionate burden when it comes to multiple myeloma. Dr. Shah says, “There may be multiple mechanisms at play, including genetics, immune dysregulation, socioeconomic factors, dietary factors, and metabolic disorders like obesity and diabetes.”
Obesity, diabetes, and poor diets are more prevalent in Black communities compared to white populations, contributing to increased risks. Research by Dr. Shah indicates that 10-19 percent of multiple myeloma cases in the United States are attributable to excess body mass index (BMI).
Elevated BMI alone accounts for 2.1-3.3 percent more multiple myeloma cases among non-Hispanic Black Americans than non-Hispanic white Americans.
The NUTRIVENTION trial was designed to explore whether a dietary intervention could alter these odds. Those enrolled were encouraged to eat as much as they wanted, as long as their meals consisted of whole, plant-based foods such as fruits, vegetables, nuts, seeds, whole grains, and legumes.
Diet and Delayed Disease Progression or Transformative Results
Clinical trial partakers discovered that making the recommended diet changes led to the following significant health benefits:
- Weight loss: Participants lost an average of 8% of their body weight within 12 weeks.
- Improved quality of life: Many participants reported feeling healthier and more energetic.
- Better metabolic health: Improvements were observed in insulin resistance and inflammation.
- Gut microbiome health: A more diverse microbiome—a key factor in immune system strength—was noted.
Dr. Shah adds, “Four of 12 participants using prescription medications self-reported stopping them, saving a median of $65 per month.” The discontinued drugs were insulin, bupropion, potassium supplement, and hydroxychloroquine.
The trial’s findings were further validated by preclinical research in a smoldering myeloma mouse model. In the study, 44 percent of mice fed the recommended diet did not progress to multiple myeloma, compared to 100 percent progression in the group fed a standard diet.
These results encourage Dr. Shah and her team to proceed with multiple dietary clinical trials. NUTRIVENTION3, in particular, has 150 participants with precursor disorders. “We’re only beginning to understand the profound impact that nutrition can have on cancer prevention,” Dr. Shah emphasized. “This research represents a major step forward in showing how plant-based diets can serve as a powerful tool not only for managing weight but also for reducing cancer risk and improving overall health.”
Making Dietary Changes for Better Health
While diet alone cannot cure multiple myeloma, research increasingly suggests it plays a vital role in delaying progression and improving quality of life. Regarding diet, Dr. Shah recommends that “people try to get at least 80-90 percent of their calories from unprocessed plant foods.”
Acknowledging that that might sound a bit overwhelming, Francesca Castro, MS, RDN, CDN, Clinical Research Dietitian Nutritionist in the Myeloma Service at Memorial Sloan Kettering Cancer Center, assures that “dietary transitioning becomes much more manageable when you take a step-by-step approach and focus on one meal at a time.” She says, “I encourage folks to set realistic daily goals and gradually build from there. For instance, start with Meatless Mondays and expand as you feel more comfortable.” Once a day, Castro also encourages her patients to add legumes (like lentils, chickpeas, or black beans) to pasta, salads, or whole grains for a boost of protein, fiber, and micronutrients. She says, “It’s important to focus on progress, not perfection.”
Here are diet transition tips that Castro says have worked well for her patients:
- Start Small: Incorporate plant-based ingredients or meals you already enjoy, such as oatmeal, nut butter, stir-fried vegetables, or fresh fruit.
- Batch Cook: Prepare staples like beans, whole grains, tofu, or roasted vegetables in advance for quick and balanced meals.
- Learn and Explore: Utilize resources from the American Institute for Cancer Research (AICR) and the American College of Lifestyle Medicine (ACLM).
- Involve Family: Cooking and transitioning with loved ones can foster support and encourage a collective shift to healthier eating habits.
Healthy, Delicious Dishes Made Easy
For many Black people, integrating culturally relevant dietary strategies is essential.
Traditional ingredients like collard greens, okra, and black-eyed peas can provide crucial nutrients while honoring heritage.
The catch? Preparing these foods healthily—such as steaming them instead of frying them—maximizes their benefits.
“I always encourage patients to cook to their own flavor preferences and experiment with modifying their own recipes and making them plant-based,” says Castro. “One of our patients was Jamaican-American and predominately ate Caribbean food in the household. We found ways to modify one of her favorite recipes of ackee and saltfish by substituting the fish with hearts of palm.
Plant-based recipes to try:
Vegan Ackee and “Saltfish”: Jamaican-inspired, with hearts of palm replacing fish.
Chickpea-Stuffed Sweet Potato and Vegetarian Callaloo Soup: Nutrient-dense and flavorful dishes from MSK dietitian Karla Giboyeaux.
Apple Cinnamon Oatmeal Cups: Easy, portable breakfast packed with fiber.
Tofu Scramble: A protein-packed alternative to eggs, perfect for breakfast.
Pumpkin Spice Bread: A warm and comforting dessert.
Go to Sweet Potato Soul or Forks Over Knives for more culturally sensitive recipes.
