Patients facing cancer often ask their doctors a humbling question: What can I do to improve my chances against this disease?
Lifestyle changes such as improved diet, physical activity and other behavioral habits play a significant role in shaping cancer outcomes, from prevention and early detection, to treatment responses and long-term survivorship.
With that in mind, the UF Health Cancer Institute hosted the first daylong Lifestyle in Cancer Research Symposium on Dec. 3 at the Cancer & Genetics Research Complex, drawing more than 80 population and basic science researchers, clinicians, dietitians, exercise physiologists, digital health experts and others working in lifestyle medicine.
“We have a lot of strengths here, and when people come together, they realize how much potential there is,” said co-organizer Cora Best, Ph.D., R.D.N., an assistant professor of nutritional sciences in the UF College of Agricultural and Life Sciences and a Cancer Institute member. “Events like this help lay the groundwork for more effective, more connected work that ultimately benefits patients.”
The symposium featured two keynote addresses by external speakers on physical activity and food as medicine approaches. UF experts gave presentations on topics including the gut microbiota and GLP-1 weight loss drugs. Breakout sessions aimed to identify shared priorities and support new research partnerships, particularly between clinical teams and researchers. These collaborations can help clinicians answer questions that come up in practice while allowing researchers to contribute expertise in evaluation and evidence-building.
“Lifestyle is one of the most powerful but underused strategies that we can use to reduce the cancer burden,” said Dejana Braithwaite, Ph.D., associate director for population sciences at the UF Health Cancer Institute. “The goal is simple: small, achievable lifestyle changes could meaningfully reduce the cancer burden in our catchment area and across the state.”
It’s estimated that excess body fat increases the risk for as many as 13 to 15 cancers. These cancers account for over 40% of cancers diagnosed in the United States. At the same time, regular physical activity can lower the risk for about nine cancers.
Since 1991, overall cancer mortality rates have been declining, resulting in 3.8 million lives saved in the United States. Tobacco control and treatment breakthroughs have been key to those declines; now, gains in the lifestyle domain are needed to continue to reduce mortality, Braithwaite said.
“Approaches that address diet, activity and metabolic health will be critical to our continuing efforts to reduce cancer mortality rates,” said Braithwaite, who presented the multi-center study she’s leading, called Florida ASCENT, that aims to embed food access, diet quality and nutrition education into routine clinical cancer care and survivorship.
Harnessing data and integrating care
Breakout discussions highlighted UF’s strengths in lifestyle research, including digital health, implementation science and the use of electronic health records to standardize and enhance assessments of diet and physical activity. Attendees noted that more consistent data collection could help researchers better evaluate interventions and identify ways to tailor care.
“There’s so much opportunity to use the tools we already have, like smartphone apps and routine assessments, to standardize nutrition and physical activity data in the medical record,” Best said. “Even small changes in how information is collected could make a big difference in understanding what works for patients.”
One breakout session on exercise across the cancer continuum brought together research coordinators, oncology nutritionists, exercise physiology researchers and other researchers. The session generated the idea of incorporating physical activity or wellness interventions into the outpatient cancer infusion setting.
The idea exemplifies why it’s vital to integrate cancer care across multiple domains and contexts, said Danielle Jake-Schoffman, Ph.D., an associate professor in the UF College of Health and Human Performance who co-organized the symposium with Best.
“We have a lot of great programs available for exercise promotion and nutrition assistance, but they are not always integrated into the flow of care,” she said. “There are opportunities to identify people who can benefit and connect them to services.”
Jake-Schoffman’s research aims to translate behavioral recommendations into action in the real world. Much of her work focuses on using technology to increase the reach of interventions. She’s leading two projects with cancer survivors and community-based physical activity recommendations.
“It’s so valuable to make connections across the research and care continuum,” Jake-Schoffman said. “Working to close the research to practice gap holds a lot of potential impact.”
“Working to close the research to practice gap holds a lot of potential impact.” — Danielle Jake-Schoffman, Ph.D.
Community members as necessary research experts
Research can’t make any meaningful impact if it doesn’t take into account real-world needs. Carolyn Tucker, Ph.D., the UF Florida Blue Endowed Chair in Health Disparities Research, shared her successful community-based approach to conducting cancer and nutrition research.
“This approach requires involving community members as equitable partners in all aspects of research, including being co-authors on research publications, focusing on community empowerment by bringing resources to the community, and justly paying community members who are research partners and participants,” Tucker said. “It also includes discussing research findings with the participating community.”
Through the Community-Partnered Cancer Disparities Research Collaborative, Tucker has implemented this approach, leading a team of faith leaders and researchers who work to prevent and reduce cancers among East Gainesville residents. Tucker has also successfully implemented the approach through her Health-Smart Behavior Program, which promotes healthy eating, physical activity, and stress and depression management.
Expanding oncology nutrition support
The UF Health Cancer Institute is expanding access to oncology nutrition services. Jamie Levitt recently moved into a new role as an oncology-specific dietitian at UF Health, where she will promote better nutrition during cancer treatment.
“The UF Health Cancer Institute has understood the value of having an oncology-specific dietitian,” Levitt said. “We’re building this role and how we can best serve people, so to come here to connect and network is a huge piece, as is gaining continuing education. Getting to meet some of the research teams and learning how we could start incorporating data is extremely valuable.”
Best said it’s exciting to see momentum in the clinical realm to do more for the nutrition care of patients with cancer.
“We know nutrition can help people finish treatment, improve outcomes and support long-term survival, so building research partnerships around these initiatives is a great opportunity,” Best said.
“We know nutrition can help people finish treatment, improve outcomes and support long-term survival, so building research partnerships around these initiatives is a great opportunity.” — Cora Best, Ph.D., R.D.N.
GLP-1 drugs and cancer: An emerging frontier
Use of the popular class of weight loss drugs known as GLP-1s has expanded significantly, and even a small change in cancer risk could have widespread implications.
By harnessing the university’s unique big data capabilities, UF researchers and collaborators recently found that GLP-1s were associated with a lower risk of some obesity-associated cancers, but their use might be linked to an increased risk of kidney cancer.
UF’s access to real-world data through OneFlorida+ — a powerful multi-state resource of anonymous health records created by the UF Clinical & Translational Science Institute and the UF Health Cancer Institute — is crucial to unlocking insights on GLP-1s and cancer, said Yi Guo, Ph.D., chief data scientist for the UF Health Cancer Institute.
“Robust real-world evidence is urgently needed to comprehensively evaluate the impact of chronic GLP-1 exposure on various cancers and outcomes,” he said. “Future studies with larger sample sizes and longer follow-ups are needed to examine the impact of GLP-1s on cancer risk and survivorship outcomes.”
Moving concepts forward to transform care
The Cancer Institute plans to make the symposium an annual event and identify more resources to issue seed funding for pilot projects in lifestyle medicine. Engaging population scientists, clinicians, basic scientists and community members can make a difference in transforming cancer care.
“There are untapped opportunities to use UF’s unique strengths in fundamental, population and implementation science to leverage lifestyle, integrative medicine, nutritional, biobehavioral, engineering and informatics approaches to meaningfully reduce cancer risk and improve health outcomes across the state,” said Thomas George, M.D., FACP, FASCO, the institute’s interim director.
