Fall 2012

Centered on cancer prevention

As one of the world’s leading cancer prevention research institutions, the Hutchinson Center relies on its state-of-the-art Prevention Center to conduct exacting studies of nutrition and exercise and their relation to cancer risk

By Colleen Steelquist

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Sally von Bargen was once a self-described “jolly, overweight, grandmother type” who watched her mother struggle with breast cancer and witnessed her father’s final stages of heart disease and diabetes.

“I saw the tragedy and harsh reality of that,” she said of her parents’ weight-related health challenges. “The future I saw for myself loomed very large. I was motivated by my potential for those diseases.”

Sally von Bargen
Sally von Bargen
Overweight since childhood, von Bargen realized she was on a slippery slope toward weight-related illnesses, including cancer, heart disease and diabetes.

Last year, the 63-year-old Seattle resident signed up for Fred Hutchinson Cancer Research Center’s Vitamin D, Diet and Activity study, a yearlong project to test whether vitamin D supplementation affects weight loss efforts in overweight and obese postmenopausal women.

Von Bargen had no idea she was about to put her body to the test at one of the most comprehensive preventive study sites in the world—a place where researchers are pioneering ways to reduce the risk of cancer and other diseases. She wanted to do her part for science as a volunteer, and perhaps learn something about staying healthy along the way.

“I thought maybe I could change my life. Maybe I could be something I had never been before: physically fit and healthy. For me to even have a vision of having my weight within a healthy range was unknown territory,” she said.

On the first day of the study, von Bargen realized that the Hutchinson Center’s Prevention Center was not a typical fitness club or restaurant. Located in the Hutchinson Center’s Robert M. Arnold research building on South Lake Union, it is an exacting place, where what she ate was scrutinized, and how she moved—and how often she moved—was scrupulously recorded.

There were body fat and bone density scans during her time at the Center; blood draws and many other tests as well—a comprehensive approach to studying nutrition and fitness and their relation to decreasing the risk of diseases such as cancer that attracts visiting researchers from throughout the world.

“The Hutchinson Center is a strong leader in studies of diet, physical activity, obesity and cancer risk because of our scientific expertise and excellent facilities,” said Dr. Ross Prentice, director of the Public Health Sciences Division, the arm of the Hutchinson Center that studies large populations to find ways to reduce the risk of cancer and other diseases.

Dr. Ross Prentice
Dr. Ross Prentice

“Our research programs, such as the Women’s Health Initiative, have developed data resources on nutrition and physical activity biomarkers well beyond those found elsewhere in the U.S. or worldwide,” he said.

This is where von Bargen transformed her health en route to helping science. She committed to taking a daily study pill, cutting calories, working out, and more. Her study goal was to lose 23 pounds. She lost 75 pounds, nearly a third of her starting weight.

“I just worked the plan. I can say—unequivocally—that I will never gain that weight back again because now I know how to exercise and eat to be healthy,” she said.

She admits there were times on the treadmill when she wanted to throw in the towel. “I would literally say to myself, ‘It’s OK. This has a higher purpose.’ I would just close my eyes and think, ‘Twenty minutes for science,’ and the time would go by.”

The one-of-a-kind Prevention Center where von Bargen burned calories is a scientific laboratory, but not the kind with petri dishes or microscopes.

Instead, people of all ages and sizes jog on treadmills or pedal stationary bikes. Down the hall, there are walk-in freezers filled with scientifically customized, ready-to-heat meals for nutrition research. Here, scientists and study participants rub shoulders with yoga instructors, athletic trainers and chefs in the pursuit of applicable, evidence-based approaches to prevent cancer and other diseases.

It’s people like von Bargen who inspire Matt Van Doren, manager of the Exercise Research Center. “I love working with study participants and seeing the fruits of their labor. It’s great seeing the positive changes in people as they go from being sedentary to adopting a new, more active and healthy lifestyle,” he said.

Since the facility opened in 2001, more than 1,800 volunteers have taken part in exercise studies at the site—some of whom had never before set foot in a gym or ridden a bike.

The exercise center’s staff members coach volunteers through their exercises, and use technologies to measure everything from exercise tolerance to muscular function—even how many calories someone burns while at rest. The results: landmark studies linking exercise to cancer risk-factor reduction, and how exercise positively affects prognosis and quality of life in cancer survivors.

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Nutrition’s importance in reducing disease risk

Near the workout rooms, the enticing smell of tortilla soup fills a large, gleaming kitchen. The soup is the handiwork of the Human Nutrition Lab staff, which prepares precisely measured foods for the Hutchinson Center’s controlled feeding studies. For the COMIDAS (meals) study, research cooks

Louisa Hays and Sara Bennett of the Center's Human Nutrition Lab
Louisa Hays and Sara Bennett of the Center's Human Nutrition Lab
prepare traditional Mexican foods like albondigas (meatballs) and tortillas from scratch.

To better understand and reduce breast cancer disparities in Latinas, the COMIDAS study compares the metabolic response in young women of Mexican descent eating traditional Mexican foods versus typical American fare like hamburgers, pizza and mashed potatoes. It’s part of a larger National Cancer Institute-funded project studying health disparities of Latinas and breast cancer risk in the U.S.

Studies like COMIDAS are the mainstay of the Human Nutrition Lab, whose dieticians and research cooks prepared nearly 21,000 meals in the lab’s first eight years, and project to make another 34,000 meals in the next few years for current studies.

The lab’s huge commercial kitchen accommodates multiple studies with different needs running concurrently. Every component of every meal—even condiments—must be measured, labeled and stored for each participant for each day of each study.

An ad for the COMIDAS study caught Maria Blancas’ attention earlier this year. “I’ve always been really interested in the idea that the Mexican diet might positively influence our health,” said the 22-year-old, a recent University of Washington graduate who emigrated to the U.S. as a baby with her parents from Mexico.

The food, she said, was really good. And she paid the Mexican meals the ultimate compliment: “It tasted just like my mom’s cooking. I loved it all.” She even asked for the recipe for her favorite dish, tamales.

Dietary study participant Maria Blancas
Dietary study participant Maria Blancas
Like many Human Nutrition Lab studies, COMIDAS isn’t about weight loss, rather, it looks at dietary patterns and how they influence different metabolic processes and inflammation markers that might raise cancer risk. Controlled feeding studies are true experiments and allow researchers to test the direct effects of specific foods.

While eating patterns can be studied by asking people to self-report what they ate, such recollections can be inaccurate, said Kara Breymeyer, manager
of the lab.

“Controlled feeding is the gold standard of nutrition studies,” she said. “We work with the study investigators to develop the diets. We have confidence that we know what the participants ate.”

Breymeyer said most of the study participants are healthy and live independently, making it easier to generalize the results to the population at large. Each portion of food is weighed to the gram before it is given to participants and if something is uneaten, it’s returned and weighed again to accurately capture consumption.

Paying attention to these details ensures research integrity. When one participant on a carbohydrate-restricted feeding study absentmindedly ate a free sample of pasta at a market, the Center’s dietitians tracked down the pasta brand, determined how much was consumed, and analyzed the nutrients to account for the slip-up. Just like in any research lab, success depends on the minutiae.

Despite the demands, Breymeyer said volunteers work hard to follow the eating plans. “Definitely compliance is high because the study participants know they’re acting as sort of a test tube, if you will. We really impress on them that these studies are controlled so the research will have a high level of integrity,” she said.

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‘Feeling healthy’

The nutrition and exercise studies also make use of an in-house medical clinic, a third component of the Prevention Center. Clinicians meet with study volunteers to conduct interviews and physical exams and collect biospecimens, depending on a study’s needs.

Study medications are dispensed from an onsite pharmacy. Nearby, sophisticated scanners precisely measure bone density and body fat composition, important indicators for many of the studies.

Ultimately, all of these complex measurements and studies have a single purpose in mind: how to improve our overall health and reduce the risk of disease.

Consider von Bargen’s experience. Now toned and trim, she would love for everyone to know how good those once-elusive goals of fitness and a healthy weight feel.

“For the first time in my life, the whole conversation has shifted for me around food and exercise. It’s about me having control over my choices. Not willpower—just power,” von Bargen said. “I learned this exercise thing is kind of fabulous. I get off the machines and feel so alive. I look 10 to 15 years younger.

“But more importantly, I feel healthy. I know that I can do anything.”


 

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