Projects
Overview
Each year over 1.6 million new cases of cancer are diagnosed in the United States. Nutrition and energy balance form important cornerstones of cancer prevention because they are linked to the etiology of many human cancers. Nutrition is a complex exposure to study due to our complex food supply, inherent challenges in assessing self-reported diet, limitations in existing food and nutrient databases and the multiple economic, cultural, social and behavioral predictors of food intake. These complexities require a comprehensive research program that includes methodological work to improve upon dietary self-report, novel methods to characterize food intake, innovative intervention strategies and applications to large cohorts with well-characterized and adjudicated clinical outcomes. These multiple research strategies comprise the work of the Neuhouser Lab. The research program includes intervention trials conducted in the Fred Hutch Prevention Center and Human Nutrition Laboratory as well as community-based interventions in the Seattle community and beyond. In addition, the lab uses data and biorepository specimens from large existing cohorts including the Women’s Health Initiative (WHI) and the Carotene and Retinol Efficacy Trial (CARET) to test etiologic questions related to nutrition, biomarkers, energy balance and cancer risk. The Neuhouser Lab also actively participates in large, national collaborations such as NCI’s Transdisciplinary Research in Energetics and Cancer (TREC); these collaborations bridge basic sciences, clinical research and population sciences.
Our Leadership Model
Dr. Neuhouser works closely with a wide array of clinicians and scientists, with collaborations spanning the array of science from bench-to-bedside-to communities. She and her team epitomize the belief that the whole is more than the sum of its parts and that everyone’s ideas are valued.
Current Projects
Assessing Diet, Appetite and Physiology Throughout Weight Loss (ADAPT)
The ADAPT study is interested in learning why weight loss stops and if body and brain changes can predict halted weight loss, known as an involuntary weight loss plateau.
The study lasts about 18 months and includes in-person visits at the University of Washington South Lake Union campus and Fred Hutch.
Learn More About ADAPT
The EAT-Well Study (Effects on metabolism of AlTering protein within a WELL balanced diet)
The EAT-WELL is a randomized cross-over experimental feeding trial testing two healthy diets - one with no red and processed meat and one with red and processed meat and whether altering these protein sources has metabolic effects on the metabolome and the gut microbiome.
The Seattle Dietary Biomarker Development Center (Seattle DBDC)
Diet is one of the major cancer risk factors that is modifiable. The Seattle DBDC is a collaboration with partners at NIH, USDA, and other funded Centers. The central mission of the Seattle DBDC is to advance the science of measuring complex dietary exposures by rigorous identification and validation of dietary biomarkers. The need for these biomarker centers is because inconsistent evidence and measurement error in dietary self-report have prevented broad nutrition-focused population interventions and public health policy initiatives from moving forward in a consistent manner. The Seattle Dietary Biomarker Development Center will use two phases of controlled feeding studies for metabolomics discovery of USDA's MyPlate foods, food groups and dietary patterns. Blood and urine samples collected during the feeding studies will be assayed using untargeted LC-MS metabolomics and comparison to both benchmark biomarkers and self-reported diet will be accomplished using data and archived biospecimens from three, diverse independent cohorts; the Cancer Prevention Study-3, the Hispanic Community Health Study/Study of Latinos and the Women's Health Initiative.
The Fresh Study
In the Frequency of Eating and Satiety Hormones Study (FRESH) we are conducting a randomized cross-over trial of 3 eating occasions/day to 6 eating occasions per day in relation to biomarkers of satiety, inflammation and insulin resistance – biomarkers that are susceptibility markers for cancer risk. We are also measuring sleep patterns and self-reported satiety in both treatment arms. Learn more about the Fresh Study
Nutrition and Physical Activity Assessment Study
The Nutrition and Physical Activity Assessment Study (NPAAS) focuses on the use of objective biomarkers of dietary intake and physical activity and their use in regression calibration models to understand better the relationship between diet, physical activity and chronic disease risk in postmenopausal women. Our work in this area has been expansive and supports that there is systematic measurement error of self-reported diet and physical activity. The biomarker calibrated measures that correct for this systematic error are providing robust associations of risk for many cancers, cardiovascular disease and diabetes that are typically not apparent with uncorrected self-report. We are currently evaluating metabolomics for candidate dietary biomarkers.
Carotene and Retinol Efficacy Trial (CARET)
CARET was a landmark randomized, double-blind, placebo-controlled trial of the cancer prevention efficacy and safety of a daily combination of 30 mg of beta-carotene and 25,000 IU of retinyl palmitate in 18,314 persons at high risk for lung cancer. We studied two high-risk populations: 4,060 men with extensive occupational exposure to asbestos, and 7,965 men and 6,289 women with at least 20 pack-years of cigarette smoking history. CARET began in 1985 with two pilot studies and expanded to U.S. six sites beginning in 1988. The design projected active intervention until 1997, encompassing 110,000 person-years of follow-up for the 18,314 randomized participants. The CARET intervention was halted in January 1996, 21 months ahead of schedule, with the twin conclusions for definitive evidence of no benefit and substantial evidence of a harmful effect of the intervention on both lung cancer incidence and total mortality. This was a major landmark finding for cancer prevention – that smokers should not use dietary supplements with high-dose beta-carotene. During the CARET intervention, extensive data were collected on diet, smoking, health history and clinical measures of vital signs, weight, and serial blood collections were performed. Lung tissue was collected from a subset of participants. Total and site specific cancer outcomes were collected and adjudicated. In 2005, CARET stopped active follow-up of participants for health status and thereafter, cancer incidence and mortality data through 2013 were collected from select cancer registries and the National Death Index (NDI). The extensive CARET biorepository and database are available for ancillary studies. Learn more about CARET and procedures for collaboration.
Diet and Genetic Risk for Prostate Cancer
This study investigates comprehensive measures of diet and dietary supplements with a focus on antioxidants measured by both self-reported and blood based biomarkers of intake in relation to prostate cancer risk among 12,000 participants in the Carotene and Retinol Efficacy Trial (CARET). We also measured polymorphisms in oxidative stress regulatory genes and whether any diet gene interactions modify associations of diet and nutritional biomarkers with prostate cancer risk.
Health, Eating, Activity, and Lifestyle (HEAL) Study
The HEAL Study is a multicenter, multiethnic cohort of female breast cancer survivors residing in three SEER registry catchment areas – Seattle-Puget Sound (WA), Los Angeles County (CA) and North Central New Mexico. Women completed a baseline interview within 12 months of diagnosis and an additional interview that also included a blood draw, anthropometry and diet and dietary supplement questionnaires 24 months later. Outcomes were obtained from participant medical records review and vital status records.
Collaborative Projects
Prostate Active Lifestyle Study
PI: Dr. Jonathan Wright
This study, led by Dr. Jonathan Wright, associate professor in the Department of Urology, medical director of the University of Washington medical Center Urology Clinic and affiliate researcher with Dr. Neuhouser at Fred Hutch, investigates how controlled interventions in diet and exercise – resulting in weight loss – affect the short- and long-term outcomes for men with low-grade prostate cancer on active surveillance.
PALS study participants travel to Fred Hutch, where the study is based, for regular meetings with a nutritionist and an exercise physiologist. A combined diet and exercise program that is based on the Diabetes Prevention Program may affect markers (or “biomarkers”) of prostate cancer progression. Gathering this information may help Drs. Wright, Neuhouser and other researchers understand how obesity affects prostate cancer progression and may help lead to a program that can reduce the risk of prostate cancer progression and improve long-term survival and quality of life. Learn more about the PALS Study
TREC Training Course
PI: Melinda Irwin
A growing number of studies have examined observational associations and interventional effects of diet, physical activity and obesity on various biological, psychosocial, and behavioral outcomes associated with cancer. These studies have focused on healthy populations, high risk populations and those diagnosed with cancer. However, even with the growing number of scholarly publications in this field, many of the studies suffer methodological limitations, and this research to date has not led to sufficient implementation of weight management and/or physical activity interventions/programs in the clinic or community. Recognition of the complex, multidimensional relationship between energy balance and cancer has motivated the development of new transdisciplinary training models, as the training of scientists and clinicians in energy balance and cancer research is critical.
To meet this need, in collaboration with Dr. Melinda Irwin (PI, Yale University) and other researchers, we developed the Transdisciplinary Research in Energetics and Cancer Research Education Program (TREC Training Workshop) and provide an annual, in person 5-day transdisciplinary research in energy balance and cancer training course early career investigators (i.e., junior faculty and postdocs). Cohorts will span a diverse array of academic backgrounds (i.e., basic, clinical and population cancer research) and in collaboration with the wider community of TREC-inspired scientists will enhance the ability to produce innovative and impactful transdisciplinary research in energetics and cancer and clinical care. Learn more about the TREC Training Course
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