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'Urban Garden' Helps Cancer Survivors Lower Risk of Recurrence

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 survivors' 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 leader Colleen Spees, PhD, MEd, RDN, FAND, an assistant professor and 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's 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 anticancer dietary patterns," Spees says. "Not only do our survivors have weekly access to fresh fruits, herbs, and vegetables [but] they [also] 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 United States and that number is expected to increase by 31% over the next eight years. Cancer survivors are at increased risk of 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," Spees says.

Growing HOPE allows cancer survivors to visit the garden several times per week to harvest. The produce changes with the seasons, and survivors attend cooking demonstrations led by chefs and dietitians to learn how to prepare dishes using the foods that have just been harvested. Dietetics 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 e-mail around the clock. Expert guest speakers regularly come to the garden and teach survivors about the current research, importance of anticancer dietary patterns, safe food handling, food preservation methods, and connections between the environment and illness.

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's hoping 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 also is developing new tools, videos, and applications to help in assessment and feedback. 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 her 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," Spees says. "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."

— Source: The Ohio State University Center for Clinical and Translational Science

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