Experimental ‘urban garden’ helps cancer survivors’ lower
risk for recurrence, chronic illness

While there is substantial
evidence that diet and body weight can impact cancer development, recurrence,
and progression – for the estimated 14.5 million cancer survivors in the US,
there are few resources available to help them optimize their dietary patterns
and lifestyle behaviors after active cancer treatment is over. Now, new
research shows that cancer survivors who participated in a multifaceted urban
garden intervention improved their health behaviors, significantly reduced
their weight, and improved biomarkers of health – all major improvements
related to a reduced risk for developing a secondary cancer or illnesses like
diabetes or heart disease. The unique program is promising and could be used as
an evidence-based blueprint for other chronic conditions

To the casual observer, the three-acre plot of farmland
sitting in the middle of The Ohio State University agricultural campus isn’t
anything special. Except something special is happening among the tidy rows of
berries, kale and sweet peppers. Studies involving cancer survivors who harvest
there show that access to fresh produce, education and personalized health
coaching can improve survivor’s health while reducing their risk of future
cancer recurrence and comorbidities such as heart disease and diabetes.

There isn’t something magical in the soil at the Garden
of Hope, explains “Growing HOPE” project lead Colleen Spees, PhD,
RDN, a researcher at Ohio State’s School of Health and Rehabilitation Sciences
and James Comprehensive Cancer Center. Instead, it’s the combination of an
evidence-based curriculum paired with novel technology and a spirit-nurturing
environment that is literally changing the biology of the cancer survivors for
the better.

“After four months in our program, our survivors
decreased their weight, fasting glucose, non-HDL cholesterol, and increased
physical activity and skin carotenoids. In addition, they improved overall
adherence to anti-cancer dietary patterns,” said Dr. Spees. “Not only
do our survivors have weekly access to fresh fruits, herbs and vegetables, they
learn why we recommend these cancer-fighting foods and how to safely prepare
them. Participants also have access to nutrition experts both on and offsite that
provide additional support and guidance.”

There are currently more than 14.5 million cancer
survivors in the U.S. and that number is expected to increase by 31% over the
next 8 years. Cancer survivors are at increased risk for cancer recurrence and
other chronic diseases. Lifestyle behaviors, such as diet and physical
activity, are strongly linked to decreased risk of chronic disease and improved
health outcomes, but very little research has been conducted specifically in
this vulnerable population.

“We believe that our study is the first to implement
and test an integrated approach to overall patterns of diet and physical
activity while measuring the impact of adhering to evidence-based
recommendations for cancer prevention and survivorship,” said Dr. Spees.

Growing Hope

Dr. Spees’ belief that modifiable lifestyle behaviors can
play a significant role in reducing cancer is rooted firmly in her family’s
DNA. Literally. Her family is affected by an autosomal dominant gene mutation
that disrupts a tumor suppressor gene that normally protects the body against
cancer. After this mutation led to several deaths in her extended and immediate
family, Dr. Spees, a registered dietitian, looked for information on dietary
and behavioral interventions that could help her relatives and others improve
their odds. She found little data that translated bench research discoveries to
real world applications.

With the support of a TL1 training grant from Ohio
State’s Center for Clinical and Translational Science (CCTS), Spees went back
to school to earn a PhD, focusing on cancer, nutritional genomics and lifestyle
behaviors. Under the mentorship of Steve Clinton, MD, PhD, a researcher of
cancer-fighting foods, her expertise and research interests led her to the
Garden of Hope, where Spees saw an opportunity to conduct research and impact
the lives of cancer survivors.

“Dr. Clinton, The James, and JamesCare for Life
established the Garden of Hope in 2012 and began providing fresh produce to
survivors. It was the perfect “stage,” a living laboratory to engage
survivors in new ways that could improve their long term health,” said Dr.
Spees. After conducting a pilot study with encouraging results, she received a
grant from the American Cancer Society to see if she could expand the curriculum
and experiences for cancer survivors — and the seed for Growing HOPE took
root.

Growing HOPE allows cancer survivors to visit the garden
several times a week to harvest. The produce changes with the seasons, and
survivors attend cooking demonstrations led by chefs and dietitians on how to
prepare dishes using the foods that have just been harvested. Dietetic interns
from Ohio State are on hand to support survivors, assist with harvesting, and
answer questions. Cancer survivors participating in the program have access to
an eHealth coach (a dietitian) via Skype, instant message, text, or email
around the clock. Expert guest speakers regularly come to the garden and teach
survivors about the current research, importance of anti-cancer dietary patterns,
safe food handling, food preservation methods, and connections between the
environment and illness.

Dr. Spees shared the positive results from Growing HOPE
at Ohio State’s recent BRUTx healthcare innovation meeting and at the national
Academy of Nutrition and Dietetics Fall meeting, where she received the Award
of Excellence in Oncology Nutrition Research.

“I don’t think it’s a surprise that when you give
people information and empower them, you will see positive outcomes,” said
Dr. Clinton. “But what’s hard to measure — and as equally important — is
the experience that people have in the garden as the seasons change. The
psychosocial experience of sharing, being outdoors, watching the sunset,
hearing the birds, smelling the earth — it’s a reflection of the cycle of life
that gives people solace.”

Anne, a self-described foodie, Growing HOPE study
participant and breast cancer survivor, agrees. She can tell you all about the
creaminess of her butternut squash soup, the tart leaves of a rutabaga salad,
the surprising sweetness of a fresh picked beet. But for her, it isn’t just
about the food.

“Having cancer brings everyone to the same place.
The same fight. The Garden of Hope gives you a break from focusing on the
fight. I get excited thinking about who I will see there, what vegetables are
ripe, and what I’ll learn how to cook that night. Nobody has a bad day in the
Garden,” said Anne.

What’s Next on the Menu

With solid pilot data on hand, Spees is in the process of
applying for grants and seeking funding that would allow her to conduct a large
scale randomized controlled trial. She is hoping that she can take a closer
look at the complex interactions between genes and the environment, along with
evaluating additional biomarkers of health.

The Growing HOPE project is also developing new tools,
videos and applications to help in assessment and feedback. Dr. Spees has
partnered with software company Viocare, to create a secure web-based portal
where participants can track progress and access the health coach, recipes,
cooking videos, and evidence-based resources — all data that she and team can
track on the back end.

“We think this comprehensive approach is successful
because it allows people to choose what components of the intervention are best
for them, and the garden becomes their own “urban oasis.” The garden
is the glue that makes the pieces work together,” said Spees. “And if
this model works in cancer, it seems plausible that it could be replicated for
other chronic diseases and populations. Growing HOPE could be the blueprint for
other programs that combine team science and evidence-based medicine along with
a nourishing environment and support network.”

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