A Study of a Plant-Based Diet and Dietary Supplements in People With Smoldering Multiple Myeloma (SMM)

Study Overview
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Brief Summary
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The purpose of this study is to look at how butyrate levels change in participants' stool after they are on a plant-based diet or dietary supplements (omega-3, curcumin or probiotics) for 2 weeks. All participants will have smoldering multiple myeloma (SMM). The researchers will compare how the different dietary changes affect butyrate levels in participants' stool.

Official Title
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Microbial Changes in Response to a Plant Based Diet and/or Supplements in SMM Patients: A National Multi-Arm Randomized Prospective Telehealth Study Via HealthTree

Conditions
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Multiple Myeloma, Smoldering

Intervention / Treatment
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* Dietary Supplement: Omega-3
* Dietary Supplement: Curcumin
* Dietary Supplement: Probiotic
* Other: Whole food, plant-based diet (WFPBD)


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Confirmed prior diagnosis of smoldering myeloma (anytime prior). However, confirmation of SMM diagnosis must be documented in their last local oncologist clinic note within 3 months prior to study enrollment. Age ≥18 years Willingness to comply with all study-related procedures Physically able to complete requirements for the study or has someone to assist with the requirements (such as meal preparation, stool shipment and survey completion) Interested in learning to cook plant based recipes Access to smart mobile phone or device with camera and ability to download Keenoa app Be residing within the United States for the study duration. English speaking or a family member or caregiver who speaks English and is able to assist with the surveys and phone based Keenoa app. Exclusion Criteria: Taking any supplements other than vitamin D, iron, vitamin B12, potassium, magnesium, calcium or those needed for a medical indication must be reviewed by PI. If patient is on a supplement (including curcumin, probiotic, omega3) they must stop these for 2 weeks prior to enrollment on study. Patients that already follow a whole foods plant based diet (ovo-lactovegetarian or processed junk food vegan diets are not excluded). This will be per research dietitian evaluation and discretion after nutrition screening. Legume allergy Severe allergies such as anaphylactic shock to peanuts and/or tree nuts, such as cashews Concurrent participation in weight loss/dietary trials or defined programs (that require specified diets/supplements on the program) Mental impairment leading to inability to cooperate Enrollment onto any other therapeutic investigational study Concurrent pregnancy Patients on full dose anticoagulation ≥ Grade 2 electrolyte (sodium and potassium) abnormalities as defined by CTCAEv5.0 (need to be resolved before enrolling on study) If in the opinion of the investigator there maybe any concerns regarding the ability of the patient to complete the study safely Current self reported heavy alcohol use (defined as >2 drinks per day or >14 drinks per week) Current self-reported illicit drug use (except inhaled marijuana, vaping or cigarette smoking. Oral marijuana/THC excluded or must stop >2 weeks prior.) Has a condition requiring antibiotics within 14 days of study intervention administration. Plan for travel during the study that would preclude adherence to prescribed diets History of active inflammatory bowel disease or major gastrointestinal surgery (not including appendectomy or cholecystectomy) within 3 months of enrollment or any history of total colectomy, or bariatric surgery (bariatric surgery which does not disrupt the gastrointestinal lumen, i.e. restrictive procedures such as banding, are permitted)

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Prevention
Allocation: Randomized
Intervention Model: Parallel Assignment
Interventional Model Description: This is a randomized, non blinded, telehealth based, national pilot study with 100 patients (25 per arm). Randomization will be stratified based on BMI (normal/elevated) and Mayo risk SMM criteria.
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Omega-3<br>For 2 weeks, patients will receive omega 3 fatty acid supplements 1640 mg (2 capsules) twice daily Qwell™ Omega 3 by The Veggie Doctor™. Each 820 mg omega 3 supplement capsule contains 700 mg Docosohexaenoic acid, 100 mg Docosapentaenoic acid, and 20 mg Eicosapentaenoic acid. No dietary changes will be made but data on dietary intake will be collected. | Dietary Supplement: Omega-3<br>* For 2 weeks, patients will receive omega 3 fatty acid supplements 1640 mg (2 capsules) twice daily<br>|
| Experimental: Curcumin<br>For 2 weeks, patients in the curcumin arm will receive Curcumin C3 complex 1000 mg with 5 mg BioPerine twice daily from Sabinsa pharmaceuticals. No dietary changes will be made but data on dietary intake will be collected. | Dietary Supplement: Curcumin<br>* For 2 weeks, patients in the curcumin arm will receive Curcumin C3 complex 1000 mg with 5 mg BioPerine twice daily<br>|
| Experimental: Probiotic<br>For 2 weeks, patients in the probiotic arm will receive Ultra-50 probiotics with 50 billion CFU per capsule (one capsule) twice daily from Vita Miracle pharmaceuticals. No dietary changes will be made but data on dietary intake will be collected. | Dietary Supplement: Probiotic<br>* For 2 weeks, patients in the probiotic arm will receive Ultra-50 probiotics with 50 billion CFU per capsule (one capsule) twice daily<br>|
| Experimental: Whole food, plant-based diet (WFPBD)<br>For 2 weeks, on the WFPBD arm, patients will receive 14 items weekly, prepared and shipped by U.S. based company, Daily Harvest once a week. The meals will have range from 2 breakfast, 11 lunch/dinners, 1 snack (provided Week 1), and whole grains items (provided Week 2). The meals will contain legumes, fruits, vegetables, whole grains, and plant-based fats that have undergone minimal processing. Detailed recommendations for additional meals outside those given by Daily Harvet meeting the standard of a WFPBD will also be given to supplement their individual daily calorie needs through the guidance of the research dietitian. Patients will receive a varied menu created by Daily Harvest and the study team on a weekly basis. | Other: Whole food, plant-based diet (WFPBD)<br>* Daily Harvest once a week. The meals will have range from 2 breakfast, 11 lunch/dinners, 1 snack (provided Week 1), and whole grains items (provided Week 2).<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| evaluate the change in Butyrate levels | To evaluate the change in stool butyrate levels, which is defined as the average of -1 and 0 week samples. Patient stool will be assessed for butyrate levels in batches by gas chromatography mass spectrometry. | at 2 weeks | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| evaluate the change in Butyrate levels | To evaluate the change in stool butyrate levels which is defined as the average of -1 and 0 week samples. Patient stool will be assessed for butyrate levels in batches by gas chromatography mass spectrometry. | at 1 week | 
| Adherence | To evaluate the dietary or supplement compliance at 2 weeks. ≥ 70% of meals or pills during the 2-week intervention period, by ASA dietary recalls at each visit and pill diaries. | at 2 weeks | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Plant-Based Diet, Dietary Supplements, 23-116