It was in graduate school at UNC-Chapel Hill that Nutrition Research Institute (NRI) Director Stephen Hursting first got interested in cancer research. After completing his MPH and working for two years as a research associate at Seattle’s Fred Hutchinson Cancer Research Center, Hursting came back to Carolina to pursue his PhD in nutrition and cancer with an emphasis on preventing cancer with nutrition interventions.

Over the past 15 years, Hursting’s lab has specifically focused on obesity. As a risk factor for cancer, the importance of obesity has emerged, with at least 15 different cancer types strongly associated with being obese. Approximately 30% of cancer deaths are now attributed to obesity. Hursting wants to understand why. What is it about obesity that drives these disparate cancers and worsens their prognoses? His lab continues to focus on this area, along with developing ways we can intervene to disconnect the link between obesity and cancer.

Questions the Hursting Lab Is Asking

Is the impact of obesity on cancer reversible?

More than 40 percent of the population in the United States is currently obese. An important but unanswered question is: Can we intervene to reduce the impact of obesity on cancer? Or is it that, once locked into place, the obesity-cancer link is a real challenge to break?

While it is a challenge, the Hursting lab has discovered that the impact of obesity on cancer is indeed reversible. Their research looks at the mechanisms that provide opportunities for this disconnect. They continue to emphasize mechanistic work addressing genetics and genomics, energy metabolism, inflammation, immune response and the microbiome, with the goal of understanding and interrupting the signals that drive the cancer process forward in the obese state.

Does obesity impact the process of cancer spread?

The deadly part of cancer is metastasis, or the spread of cancer to critical organs such as the lungs, liver, and brain. If we can detect cancer early and limit it to the local environment in which it starts, it can generally be a controllable disease. The reason that cancer is one of the leading killers in the world is that, too often, it is detected too late and has already spread to other organs.

In the past, Hursting’s research was very prevention focused. Now, his work also looks at ways to intervene in the later stages of cancer (when tumors have already developed). His work has found that while obesity impacts the process of cancer spread, there are ways to intervene. Much of the reason that obesity impacts cancer spread has to do with obesity-associated inflammation and impaired immune responses. Obesity suppresses the body’s ability to detect and defend against neoplastic growth, with the body in an immunosuppressed kind of state. This state, however, allows for opportunities to intervene and help the body defend against the cancer process. This includes an exciting area of cancer-therapy research called immunotherapy that aims to activate the body’s own immune defenses against cancer cells.

How can precision nutrition be applied to the nutrition and cancer field?

Many nutrition and cancer recommendations have been of the one-size-fits-all variety: maintain a healthy body weight and watch your sugar intake; increase your physical activity; limit the amount of red meat and processed foods you eat; limit your alcohol intake to low amounts. These are great recommendations, but they’re broad and do not account for individual differences. This is where Hursting sees the potential for precision nutrition approaches that address individual biological and socioeconomic differences to improve the effectiveness of prevention and treatment efforts. He is excited about a future where analyzing and understanding an individual’s genetics, microbiome, immunologic responses, and metabolic state allows practitioners to recommend individualized nutrition and physical activity guidelines based on that person’s unique predispositions.

According to Hursting, the NRI is emerging as a leader in the field of precision nutrition and cancer. His group, in partnership with colleagues at the NRI and the UNC Lineberger Comprehensive Cancer Center, is working to apply precision nutrition approaches to prevent primary cancers, control cancer metastases, and enhance cancer therapy responses.

Posted: April 21, 2022