Key takeaways Two newly funded OSUCCC – James studies will examine how tailored eating plans may help reduce biological changes tied to colorectal cancer and breast cancer risk. One National Cancer Institute-funded study will test whether a blood-based inflammation marker can help guide diet changes for people at higher risk of colorectal cancer. A separate American Cancer Society-funded study will test whether a low-insulin eating pattern can improve blood sugar, insulin response, inflammation and other health markers in women at high risk for breast cancer. COLUMBUS, Ohio – Researchers at The Ohio State University Comprehensive Cancer Center – Arthur G. James Cancer Hospital and Richard J. Solove Research Institute (OSUCCC – James) have received two grants totaling nearly $4 million to test whether tailored eating plans can change biological processes tied to colorectal and breast cancer risk. The studies focus on separate cancers and diet-related pathways. One will test whether a blood marker can guide diet changes to reduce inflammation linked to colorectal cancer risk. The other will test whether a low-insulin eating pattern can improve measurable signs of health in women at high risk for breast cancer. Together, the grants support research into practical ways to lower cancer risk before the disease starts or returns. One study will test a blood-based metabolic score that measures diet-related insulin and inflammation linked to cancer risk across U.S. and global dietary patterns. Researchers hope the score could one day help clinicians use a simple blood test to guide personalized nutrition strategies for prevention. “The goal is not one-size-fits-all nutrition advice,” said Fred Tabung, PhD, a member of the OSUCCC – James Molecular Carcinogenesis and Chemoprevention Program and an associate professor in the College of Medicine’s Division of Medical Oncology. “We want to learn how a person’s biology can guide more precise prevention strategies.” “A lot of nutrition advice focuses on finding the right mix of fat, fiber and protein for weight or overall health. For cancer prevention, we are asking a different question: How do the foods a person eats affect processes in the body, such as metabolism, insulin and inflammation, that may influence cancer risk?” said Tabung. “Insulin and inflammation are normal and important. They become a concern when they stay elevated or unregulated over time. These studies are testing whether targeted nutrition changes can help bring those processes back into balance in people at higher risk.” Two studies focus on diet and cancer risk Tabung will serve as co-principal investigator with Mary Playdon, PhD, of the University of Utah on the colorectal cancer prevention study, which is a five-year, $3.21 million National Cancer Institute (NCI) grant. The second grant is a two-year, $599,500 American Cancer Society (ACS) grant focused on breast cancer risk. Tabung serves as principal investigator of this Ohio State-initiated study with Steve Clinton, MD, PhD, and Sagar Sardesai, MBBS, serving as co-investigators. “Food is one of the few cancer risk factors people may be able to change, but we need better tools to know which changes create systemic, long-term health benefits and cancer risk reduction,” said Tabung. “These studies are about moving nutrition research closer to the clinic, where it can support more personalized cancer prevention and care.” Blood marker may guide colorectal cancer prevention The NCI-funded study focuses on colorectal cancer, where diet quality and inflammation may play an important role. Researchers will test whether a blood marker can identify people whose usual diet is linked to higher inflammation, then study whether a targeted, plant-based eating plan can lower that inflammation. The study uses a biomarker called the reversed Empirical Dietary Inflammation Pattern (blood rEDIP), developed at the OSUCCC – James in partnership with the University of Utah. Biomarkers are measurable signs in the body — often identified through a blood test — that can help researchers understand risk or response to treatment. In this study, the rEDIP score gives a quantifiable measure of the inflammation-related impact of a person’s usual diet. Chronic inflammation is linked to increased cancer risk, though researchers do not know exactly why. By setting a baseline measurement of inflammation in patients, researchers hope to better quantify how impactful diet is or isn’t on cancer risk. The research team will collect blood and tissue samples from 200 adults undergoing colonoscopy in Ohio and Utah, to see how the rEDIP blood marker compares with signs of inflammation in the body and colon tissue. The team will then test a 12-week anti-inflammatory diet intervention program in a subset of 126 adults in Ohio and Utah, with high-risk adenomas, which are growths that can increase the chance of developing colorectal cancer. “If we can identify who has diet-related inflammation, we offer those people a more precise prevention plan. That could help clinicians move beyond broad advice such as ‘eat healthier’ — which can be overwhelming, confusing and interpreted many ways for the patient — and move toward tailored steps based on each person’s risk before cancer develops,” said Tabung. Low-insulin diet study targets breast cancer risk The ACS-funded study will focus on women at high risk of breast cancer and test whether a structured eating pattern can improve insulin response and other health markers including blood sugar, insulin, inflammation, cholesterol, blood pressure and quality of life. This study will use an eating pattern called reversed Empirical Dietary Index for Hyperinsulinemia (rEDIH). People who have hyperinsulinemia have too much insulin in the blood. High insulin levels can be tied to metabolic changes, inflammation and weight gain, which are all areas researchers are studying in relation to cancer risk. In an earlier ACS-supported single-arm study, Tabung and colleagues found that women at high risk of breast cancer were able to make meaningful diet changes. Early results also suggested possible improvements in blood sugar, cholesterol and inflammation. The new study will build on that work in a larger, six-month randomized-controlled trial. The trial will enroll 60 women at high risk for breast cancer. Researchers will compare the rEDIH eating pattern with the standard Dietary Guidelines for Americans. They will track changes in blood sugar, insulin, inflammation, cholesterol, blood pressure and quality of life. “Women at high risk of breast cancer often ask what they can do beyond screening,” Tabung said. “This study looks at whether a clear eating plan can improve measurable signs of health we believe matter for risk. The goal is to give patients and clinicians better evidence, not guesswork.” Prevention research could shape future care Cancer prevention is a major goal of modern cancer care. Screening can find cancer earlier, but prevention research asks another question: Can doctors help people lower risk before cancer starts? Researchers say these studies are important because they connect everyday choices, such as food, with measurable metabolic changes in the body. If successful, the work could help clinicians identify people who may benefit most from diet-based prevention support and make nutrition guidance more personal, practical and evidence-based. “We are trying to build a bridge between what we learn in the lab and what patients can use in real life,” said Tabung. “If we can show that specific eating patterns change the biology linked to cancer risk, that could open the door to more personalized prevention programs in high-risk clinics and survivorship care.” To learn more about participating in the breast cancer study, contact Robin Ralston, Robin.Ralston@osumc.edu. To learn more about participating in the colon cancer study, contact Fred.Tabung@osucmc.edu. For more information about patient care at the OSUCCC – James, visit cancer.osu.edu. ### MEDIA CONTACT: Amanda Harper amanda.harper2@osumc.edu | 614-685-5420 https://cancer.osu.edu/news