Savor Health

by Jacqueline Rogers, Dietetic Intern

The role of the microbiome in health is an exciting topic that we are learning more about each day. The human microbiome consists of all of the microbes and their genomes that live on and inside us. This includes largely fungal, viral, and bacterial material. In the digestive system alone, in what is referred to as the ‘gut microbiome’, there are 300-1000 different bacterial species that make up 39-100 trillion bacterial cells [i]. These microbiota affect many different bodily functions, including immunity [i,ii]. Disruption in function or composition of the gut microbiome leading to a less diverse and less stable microbiota is known as dysbiosis [i,iii]. Dysbiosis is influential in the development of different conditions and diseases, including cancers, because the disruption can result in impaired immune responses [i,iii]. An impaired immune response is also associated with poor response to cancer therapies, highlighting the important role that the gut microbiome plays in not only cancer onset and progression, but in the response to treatment as well [i].

In general, those with a more diverse microbiome prior to cancer treatment are more likely to respond positively to treatment and less likely to see cancer progression [i,ii,iii]. More specifically, there are certain microbiota whose presence or absence have been found to play a role in the body’s anti-cancer immune response [i]. Therefore, building a healthy diversity of specific microbiota prior to and following treatment is crucial. These specific microbes have been found to include certain species in the Faecalibacterium, Bifidobacterium, Clostridiales, and Ruminococcaceae genus [i,ii,iii]. Significant alteration in gut microbiota can be made through dietary change and adherence [i]. There are three categories with four dietary components that this article will focus on; fiber, prebiotics and probiotics, and polyphenols. Increased consumption of all have been shown to be able to promote beneficial changes to the microbiome in cancer patients that are either in pre or post treatment periods.

Probiotics

The first dietary component is probiotics. Probiotics are live microorganisms that are non-pathogenic and can help keep the gut healthy when given in optimal quantities [ii,iv]. Among sources are fermented dairy, vegetables, and soy foods [iv, v]. Probiotics contain high amounts of Lactobacillus, Lactococcus, Bifidobacterium, and Enterococcus [iv,v]. They help prevent toxin and carcinogen conversion, support the immune system, produce anti-inflammatory molecules, and prevent mutations [iv]. By doing so, probiotics and fermented foods have been linked to tumor development delay, anti-proliferation of cancerous cells, and significant reduction in adverse side effects of cancer treatments [iv].

Fiber and Prebiotics

Dietary fibers and prebiotics are categorized together because they are both resistant to digestion, and because all prebiotics are fiber [vi,vii]. This means that some fiber foods, although not all, contain prebiotic properties. Prebiotics are fermentable in the colon, and selectively stimulate the growth of healthy gut bacteria. They are found in various foods including fruits, vegetables, legumes, whole grains, nuts, and cereals [vi,vii,viii]. Increasing these dietary components have been found to increase levels of Faealibacterium prausnitzii, Clostridium cluster XVIa, lactobacilli, and bifidobacteria [vi,vii,viii]. Consumption of both fermentable fiber and prebiotics promote the production of metabolites known as short chain fatty acids (SCFAs) [vi,vii,viii]. SCFAs are crucial for the maintenance of gut microbiome health as they have anti-inflammatory and anti-neoplastic properties, both of which are essential for fighting cancer [vi,vii,viii].

Polyphenols

The last dietary component, polyphenols, are secondary metabolites that work as antioxidants [ix]. They come from plant-based sources including fruits, vegetables, nuts and seeds, beans, soy, herbs and spices, and cereals [ix]. Dietary polyphenols can further be subcategorized into flavonoids, stilbenes, lignans, phenolic acids, and more [ix]. Polyphenols adjust the microbiota composition through a prebiotic effect after they are broken down in the colon [ix]. They do so by preventing the growth of health-demoting microbes such as Bacillus spp., H. pylori, and others, while increasing health-promoting microbes including Lactobacillus spp., Bifidobacterium spp., and Akkermansia spp [ix]. Polyphenols are able to influence immune cells to better recognize tumor cells, giving them anti-tumor proponents. They also possess anti-inflammatory and antioxidant components [ix].

Foods the May Worsen Gut Health

A diet lacking in nutrients can also influence the gut microbiome. Consistently eating certain foods may contribute to dysbiosis by increasing bad gut bacteria species and decreasing good gut bacteria [i,ii,iii]. In contrast to the dietary components discussed above, this may lead to increased cancer progression and decreased treatment success [i,ii,iii]. Foods found to be detrimental to gut health include: processed foods, fried foods, foods high in saturated fats, antibiotic meats, alcohol, refined sugars, refined grains, and artificial sweeteners [x,xi].

References:

[i] Gopalakrishnan V, Helmink BA, Spencer CN, Reuben A, Wargo JA. The Influence of the Gut Microbiome on Cancer, Immunity, and Cancer Immunotherapy. Cancer Cell. 2018;33(4):570-580. doi:10.1016/j.ccell.2018.03.015

[ii] Lu K, Dong S, Wu X, Jin R, Chen H. Probiotics in Cancer. Front Oncol. 2021;11:638148. doi:10.3389/fonc.2021.638148

[iii] Cheng WY, Wu CY, Yu J. The role of gut microbiota in cancer treatment: friend or foe? Gut. 2020;69(10):1867-1876. doi:10.1136/gutjnl-2020-321153

[iv] Legesse Bedada T, Feto TK, Awoke KS, Garedew AD, Yifat FT, Birri DJ. Probiotics for cancer alternative prevention and treatment. Biomed Pharmacother. 2020;129:110409. doi:10.1016/j.biopha.2020.110409

[v] Zhang K, Dai H, Liang W, Zhang L, Deng Z. Fermented dairy foods intake and risk of cancer: Fermented dairy foods and cancer risk. Int J Cancer. 2019;144(9):2099-2108. doi:10.1002/ijc.31959

[vi] Spencer CN, McQuade JL, Gopalakrishnan V, et al. Dietary fiber and probiotics influence the gut microbiome and melanoma immunotherapy response. Science. 2021;374(6575):1632-1640. doi:10.1126/science.aaz7015

[vii] Enam F, Mansell TJ. Prebiotics: tools to manipulate the gut microbiome and metabolome. J Ind Microbiol Biotechnol. 2019;46(9-10):1445-1459. doi:10.1007/s10295-019-02203-4

[viii] Biswas V, Praveen A, Marisetti AL, et al. A Mechanistic Overview on Impact of Dietary Fibres on Gut Microbiota and Its Association with Colon Cancer. Dietetics. 2022;1(3):182-202. doi:10.3390/dietetics1030017

[ix] Cueva C, Silva M, Pinillos I, Bartolomé B, Moreno-Arribas MV. Interplay between Dietary Polyphenols and Oral and Gut Microbiota in the Development of Colorectal Cancer. Nutrients. 2020;12(3):625. doi:10.3390/nu12030625

[x] Rinninella, Cintoni, Raoul, et al. Food Components and Dietary Habits: Keys for a Healthy Gut Microbiota Composition. Nutrients. 2019;11(10):2393. doi:10.3390/nu11102393

[xi] Zhang N, Ju Z, Zuo T. Time for food: The impact of diet on gut microbiota and human health. Nutrition. 2018;51-52:80-85. doi:10.1016/j.nut.2017.12.005

Susan started Savor Health after losing a close friend to a brain tumor and, through that experience, becoming aware of the significant unmet nutritional needs of people with cancer.  Struck by the fact that her friend was told “nutrition doesn’t matter” and “eat whatever you want,” Susan read the evidence-based literature on the subject, interviewed oncologists, oncology nurses and oncology dietitians, as well as patients and caregivers, and found that, in fact, nutrition does matter in oncology. Armed with solid scientific evidence supporting the clinical and quality of life benefits of proper nutrition, Susan left Wall Street and created Savor Health, an AI-based provider of personalized and clinically appropriate nutrition solutions for cancer patients, their caregivers and health enterprises. Susan brings to Savor Health over 25 years of industry experience in healthcare and business as well as expertise in strategy, finance and management.

Susan is an outspoken and tireless advocate for cancer patients receiving proper nutrition and nutrition support before, during and after treatment. She strongly believes that the U. S. healthcare system requires new innovation to transform it into a more holistic and integrated system of care whereby multiple disciplines coordinate care together for the benefit of the whole patient. As part of this, her goal is for nutrition to be an integral component of such an integrated cancer care delivery system.  Susan’s commitment to the field of oncology extends beyond Savor Health to volunteer work at Memorial Sloan Kettering Cancer Center in pediatrics and as a runner for Fred’s Team to raise money for research at Memorial Sloan Kettering. Susan participated in the Cancer Moonshot in June of 2016 where she was a breakout session group “igniter” tasked with starting and leading discussion. Susan’s first book, the Meals to Heal Cancer Cookbook, was published in March 2016.

In addition to her role as CEO of Savor Health, Susan speaks nationally about the importance of ensuring proper nutrition in the cancer patient and on topics including leadership and startups. She has been a speaker at the Harvard Medical School’s Career Advancement and Leadership Skills for Women in Healthcare, ESMO World Congress on GI Cancer, BioPharm America, AARP Live @50+, Lake Nona Impact Forum, and IIR ePharma Summit.

Prior to starting Savor Health, Susan had a successful career on Wall Street as a healthcare services investment banker working at prestigious firms including Donaldson, Lufkin & Jenrette, Wasserstein Perella and Robertson Stephens. Susan earned a B.A. from Duke University and M.B.A. from the University of Virginia’s Darden Graduate School of Business.

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Marissa Buchan is a registered dietitian, with advanced practice certifications in Oncology Nutrition (CSO) and Clinical Research (CCRP). She received her Bachelor’s degree in Psychology from Duke University, and Master’s of Science degree in Clinical Nutrition from New York University. Marissa worked for 10 years at Memorial Sloan Kettering Cancer Center in both the clinical research and nutrition departments.  In addition to counseling patients before, during, and after cancer therapy, she spearheaded nutrition-research efforts for the bone marrow transplant service. She has co-authored over 20 articles and has a particular interest in the role of nutrition on the intestinal microbiota and its impact on patient outcomes. When Marissa’s not wearing her lab coat, she’s in her apron whipping up healthy and delicious recipes that you can find on her blog, Get Off Your Tush and Cook.

Marissa is Chief Operating Officer of Savor Health where she leads operations working with the technology, clinical, and business development teams and management. Prior to assuming the role of COO in March 2020, Marissa was Vice President, Clinical Research and Operations at Savor Health where she worked closely with Savor Health’s Chief Medical Advisor, Scientific Advisory Board, and Clinical Operations Team to evaluate, design and conduct clinical research.  She also counsels patients on oncology nutrition issues and contributes to the Company website’s clinical content.

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Dr. DeFrance has a unique background including clinical interventional cardiologist, chief medical officer, educator, outcomes researcher and entrepreneur. He has expertise in Lifestyle medicine in which he was board certified in 2020 and is highly interested in the prevention and reversal of chronic disease. Dr. DeFrance also has expertise in appropriate utilization of technology in medicine, healthcare economics, value-based metrics, and educational design and delivery. He worked as Chief Medical Officer for HealthHelp, one of the largest specialty benefit managers in the US, and led large teams of healthcare professionals in writing evidence based appropriate care guidelines and rule sets which improve the quality and safety of medicine for over 20 million people in the US while also creating sustained savings in healthcare. He has also designed clinical decision support systems that are currently in use helping to improve patient care.

In 2018 Dr. DeFrance founded MedMentor Education, a company that provides state of the art CME content using the latest in eLearning science and online delivery platforms. Dr. DeFrance is also the founder and President of Digimedica, a consulting and educational design and delivery company for healthcare professionals, hospitals, and universities. He is passionate about creating systems to optimize knowledge transfer and has won numerous awards for teaching excellence during his career. He is an expert in cardiovascular CT imaging and has taught more than 3,000 physicians how to perform and interpret cardiac CT nationally and internationally and has lectured extensively on this subject.

Dr. DeFrance has a stellar reputation in the medical field and continues work to improve the quality and safety of patient care in the US.

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Alyson is a registered nurse and is certified in oncology nursing (OCN) through the Oncology Nursing Society (ONS). She also has her certification as an ONS Biotherapy and Chemotherapy Provider. Alyson studied nursing at Thomas Jefferson University where she obtained her Bachelor’s of Science in Nursing (BSN). Since starting her nursing career in 2004, Alyson has had a strong dedication and commitment to oncology patients. She has worked inpatient specializing in Bone Marrow and Peripheral Blood Stem Cell Transplantation. Alyson currently works in outpatient oncology at the North Shore-LIJ Monter Cancer Center. Alyson is part of the clinical team at Savor Health where she counsels patients on oncology and oncology nutrition issues and contributes to website and other Savor Health content.

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Chelsey is a Registered Dietitian and Board Certified Specialist in Oncology nutrition (CSO). She completed her Dietetic Internship at Northwell Health, received her BS in Dietetics at the University of Wisconsin-Madison, and her MS in Nutrition at Stony Brook University’s School of Medicine. Chelsey works as an outpatient dietitian at Mount Sinai covering all of the downtown cancer services at Mount Sinai Beth Israel and Philips Ambulatory Care Center. Chelsey works with patients and families before, during and after treatment to optimize their nutrition through dietary counseling and support. Chelsey has experience counseling clients with a variety of diagnoses including breast cancer, lung cancer, prostate cancer, head & neck cancer, and more. Chelsey also enjoys sharing nutrition knowledge with her peers by running a monthly Employee Wellness program that showcases healthy topics, recipes and food demos.

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Michelle is a Registered Dietitian specializing in oncology. She works as a clinical dietitian at an ambulatory cancer center in New York City and is a consultant for Savor Health. She is passionate about educating oncology patients on the importance of nutrition during their fight against cancer and helping them to optimize their nutrition through all phases of treatment. Michelle received her Bachelor of Science degree in dietetics from the University of Wisconsin-Madison and her Master of Science degree in Clinical Nutrition from New York University.

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Denise Sievering is a Registered Dietitian who is board certified in Oncology Nutrition as well as Nutrition Support. A fluent Spanish speaker, Denise joined the Savor Health team to support Spanish speaking cancer patients and to continue to expand the Platform’s nutritional strategies and recommendations in Spanish. Denise holds a Bachelor of Science degree from Rutgers University, and completed her internship at New York Presbyterian Hospital (NYP). Denise started her career as a registered dietitian at NYP-Columbia University Medical Center, primarily covering inpatient Oncology units. Denise also holds a Master of Arts degree in Mental Health Counseling from New York University, and incorporates her advanced training in motivational interviewing and empathic listening in her patient encounters, particularly those whose lives have been forever changed by a cancer diagnosis. A New Jersey native, Denise now resides in sunny San Diego, CA where she works as a part-time outpatient Oncology dietitian at Scripps Health-MD Anderson Cancer Center, and also works as an inpatient dietitian at Kaiser Permanente. In her spare time, Denise can be found at a mom-and-pop taco shop, one of the many local craft breweries, and exploring her new city of San Diego with her husband and her rescue pup, Ripley.

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Karen is a Registered Dietitian, Board Certified Specialist in Oncology Nutrition and registered in New York as a Certified Dietitian Nutritionist. Fluent in Spanish, Karen joined the Savor Health team to support Spanish speaking cancer patients and to continue to expand the Platform’s nutritional strategies and recommendations in Spanish. Karen received her Bachelor of Science degree from Ithaca College and her Master of Science degree from Hunter College. She works as an outpatient oncology dietitian in New York. Karen often works with local community centers to host nutrition programs for cancer survivors and their families, leading classes on how to live healthier lifestyles throughout their continuum of care. The American Institute of Cancer Research selected to showcase one of her many programs at their conference in 2019. Karen has written for and lent commentary to various publications and truly enjoys teaching people how to eat better. She loves to cook and strongly feels that healthy food doesn’t have to taste bad.

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Allie is a Registered Dietitian and a Certified Specialist in Oncology (CSO). She joins Savor in 2023, bringing years of experience from the John Theurer Cancer Center in New Jersey, where she worked with patients with a variety of cancers. Her goal is to help people feel their best, both mentally and physically, when physical health challenges arise. She believes in the power of nutrition ever since the impact it made on her athletic career as a volleyball player during college. Allie graduated with her Bachelor of Science degree from University of Maryland-Baltimore County and has her Master’s degree in Human Nutrition from the University of Wisconsin Stout. She enjoys travelling, enjoying different cuisines, cooking, and hiking and other outdoor activities with her family and dog.

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Julia Penberg is a seasoned healthcare professional with more than 30 years of experience focusing on maximizing operational excellence, leading clinical program development and building strong cross-functional teams. Her previous roles include overseeing the performance of clinical managers and nurse practitioners across multiple markets within United Healthcare-Optum’s Medicare Advantage and dual-eligible special needs populations, payer outreach and program development at Mayo Clinic, ground level specialty hospital development and direct patient care as a family and dermatology nurse practitioner. Julia volunteered as an operating room nurse and nurse practitioner on several mission trips to Romania and was a support group leader for the Kansas City chapter of the International Myeloma Foundation. Her motivation throughout her career has been with wellness promotion, disease risk modification and ensuring the best patient experience across the health continuum. Ms. Penberg received an MBA from the University of Dallas; a MS in Nursing from the University of Kansas and a BS in Nursing from the University of Texas-Austin. She is board certified as a Family Nurse Practitioner.

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Alicia is a Registered Dietitian and Board-Certified Specialist in Oncology. She works as a clinical dietitian at an ambulatory cancer center in New York City and is a consultant for Savor Health. She received her BA in English from The George Washington University and MS in Nutrition from Brooklyn College. Alicia provides individualized nutrition counseling for patients during their medical, radiation and/or surgical cancer treatment and knows that it’s not a one-size-fits-all approach.

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Allie Werner is a Registered Dietitian at Fresenius Kidney Care where she provides medical nutrition therapy diet counseling to patients on Dialysis. She received her Bachelor’s Degree in nutrition from Indiana University and completed her Master’s Degree and dietetic internship at Loyola University Chicago. In her free time she enjoys spending time with friends and family, checking out the amazing food scene in downtown Chicago, and exercising on her Peloton bike.

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Immersed in the tech world for a decade, I've coded, led teams, and honed my skills in architecture and design. As a tech enthusiast, I've seamlessly woven through full-stack projects, fusing my love for code with the art of leadership.

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