Lecture halls are familiar settings for Vincent Cryns, MD, Marian A. and Rodney P. Burgenske Chair in Diabetes Research and head, Endocrinology, Diabetes and Metabolism. But on October 16, 2017, he presented a talk to an audience that was far larger than any he had ever seen: the entire staff at the Verona, Wisconsin headquarters of electronic health records giant Epic Systems Corporation. 

“The audience was forty times bigger than the largest class I’ve ever taught,” said Dr. Cryns. “I absolutely loved the energy in the room.” 

Invited by CEO and founder Judith Faulkner to talk about his research after she heard him speak at a UW "Town and Gown" event, Dr. Cryns shared his team's efforts to use low-methionine diets to metabolically prime cancer patients prior to chemotherapy. 

He began by asking the audience, "What if we could use food to reprogram our genes to fight diseases like cancer and diabetes? Does that sound far-fetched?" 

His research group has been investigating how altering the intake of the amino acid methionine could shift cellular metabolism and gene expression in a way that leaves cancer cells more vulnerable to subsequent targeted chemotherapy. 

"Tumors require methionine for growth, but clinical trials of a low methionine diet in cancer have been disappointing. We reasoned that by discovering the underlying mechanisms we could make methionine restriction work better as a cancer therapy," said Dr. Cryns.

The work has resulted in two clinical trials of new treatments for aggressive triple-negative breast cancer. The trials are led by Ruth O'Regan, MD, professor and head, Hematology, Medical Oncology and Palliative Care. 

Dr. Cryns emphasized how a unique, collaborative environment at UW-Madison has brought together a multidisciplinary team of scientists, clinicians, and community partners to advance biomedical research from bench to bedside. Areas of expertise covered by team leaders include clinical trial management, nutrition, pathology, medical imaging, metabolomics, the molecular biology of circulating tumor cells, metabolism, and the perspective of cancer survivors.

A "food as medicine" approach also has direct implications for obesity, which is increasing markedly in every state. “I included the Wisconsin zip code-level obesity prevalence data from Health Atlas, which were generated from a surveillance tool from the Obesity Prevention Initiative. This work is part of the Wisconsin Partnership Program’s efforts to prevent childhood obesity, and it was wonderful to share it such a big audience of healthcare IT professionals,” said Dr. Cryns. 

He explained that although the association between obesity and type 2 diabetes is widely known, many people are unaware that cancer is an obesity-related disease. A recent Centers for Disease Control report stated that 13 different types or cancer are linked to obesity or overweight. This comprises 40 percent of all cancer cases in the United States.

During a September, 2017 Epic User Group meeting attended by thousands of health care leaders, Faulkner spoke about the potential of health care data for improved population health strategies by shifting from the concept of "electronic health records" to "comprehensive health records," which include social determinants of health. These factors could include data on diet, sleep, obesity, social isolation, and whether someone lives in an area that lacks access to healthy food such as fresh fruits and vegetables.

Resources:

• "Epic CEO Judy Faulkner is standing behind switch from EHRs to 'CHRs'," Healthcare IT News, October 6, 2017