[Multibilly]

Eat more fish and less meat?

by Multibilly on Sat Nov 19, 2016 6:05 pm

I was starting to go through some of the abstracts for the upcoming ASH meeting and came across this abstract that analyzes the impact of various Icelandic diets on the risk of developing MGUS, as well as the risk of MGUS transforming into multiple myeloma. Below is the conclusion published in this abstract:

Thordardottir, et al, "Dietary Pattern and Risk of Monoclonal Gammopathy of Undetermined Significance: A Population-Based Study," ASH 2016 Abstract 3257

Excerpt:

"Conclusion: Our findings suggest that high adherence to the old traditional Icelandic diet consumed during early and mid 19th century, including salted or smoked meat and fish, blood or liver sausage, rye bread, and potatoes decreases the risk of MGUS/LC-MGUS later in life. They additionally suggest an increased risk of progression to multiple myeloma and other lymphoproliferative diseases, with high adherence to a pattern with high meat and low fish intake. The mechanisms for these findings are unknown but our study suggests that food intake can alter the risk of developing MGUS/LC-MGUS as well as the risk of progression to multiple myeloma."

The data in this abstract could stand to be explained a bit more clearly and they unfortunately don't describe what makes up each and every diet pattern. But basically, the numbers in the first three columns of Table 1 are "odds ratios" (OR) for developing MGUS in the first place based on a particular diet. An OR = 1 means there is no identified risk one way or the other. An OR value < 1 is associated with lower odds, while an OR > 1 is associated with higher odds of developing MGUS. The numbers in the last two columns labelled with "Progression" analyzes the risk of transformation of MGUS to multiple myeloma or some other lymphoproliferative disorders in people that are 67 years and older) and utilizes "hazard ratios" (HR), which are simply measures of relative risk of progression in this case.

For those of us with MGUS or smoldering multiple myeloma, I think a couple of the key take­aways in this study can be found in the very last line of the table 1. That data indicates that there is a 34% (HR=1.34) higher risk that those on a pattern VI diet (high intake of meat and milk, low intake of fish) versus one of the other higher-fish / lower-meat diets will have their MGUS transform into multiple myeloma. Moreover, there is an 84% (HR=1.84) higher chance that those on the high-meat / low-fish diet will have their MGUS transform into one of a number of lympho­proliferative diseases (multiple myeloma, leukemia, lymphoma, etc) than those on the other diets.

Compare the aforementioned risk of progression to those on diets which include a higher intake of fish such as the pattern 1 diet (including salted or smoked meat and fish, blood or liver sausage, rye bread, and potatoes). Those on the pattern 1 diet had a 36% (HR =0.64) lower chance of progressing to multiple myeloma and a 27% (HR=0.73) lower chance of progressing to one of several lymphoproliferative diseases than the rest of those in the study with MGUS.

Literally, food for thought.

Additional potentially useful ASH 2016 links:

ASH 2016 abstracts about smoldering multiple myeloma
ASH 2016 abstracts about MGUS
All ASH 2016 multiple myeloma-related abstracts

[Johannes56]

Re: Eat more fish and less meat?

by Johannes56 on Thu Dec 22, 2016 4:45 pm

Hi,

Could it have to do something with vitamin D? Is there any known correlation between MGUS and vitamin D deficiency?

Johannes

[Johannes56]

Re: Eat more fish and less meat?

by Johannes56 on Fri Dec 23, 2016 11:24 am

Found this:

Ng, A, et al, "Impact of vitamin D deficiency on the clinical presentation and prognosis of patients with newly diagnosed multiple myeloma," American Journal of Hematology, July 2009 (abstract; full text pdf)

Abstract:

Vitamin D is a fundamental mediator of skeletal metabolism. It also has important nonskeletal actions. We hypothesized that vitamin D deficiency may play an important role in skeletal morbidity and clinical outcomes in multiple myeloma. We studied 148 newly diagnosed multiple myeloma patients from January 1, 2004 through December 31, 2008 who had a serum 25-hydroxyvitamin D [25(OH)D] obtained within 14 days of diagnosis. Subjects with vitamin D deficiency [25(OH)D level less than 50 nmol/L (20 ng/mL)] had higher mean values of serum C-reactive protein (CRP) (2.40 mg/L vs. 0.84 mg/L, P = 0.02) and creatinine (1.75 mg/dL vs. 1.24 mg/dL, P = 0.03) and lower serum albumin values (3.12 g/dL vs. 3.39 g/dL, P = 0.003) compared to subjects without vitamin D deficiency. The prevalence of vitamin D deficiency increased in parallel with International Staging System (ISS): 16% of subjects in Stage I, 20% in Stage II, and 37% in Stage III (P = 0.03) were vitamin D deficient. No differences were detected between the two groups in terms of skeletal morbidity. Association of vitamin D deficiency with higher serum CRP, serum creatinine and ISS stage at time of diagnosis suggests that vitamin D deficiency may portend poorer outcomes in subjects with multiple myeloma.