DietCompLyf Study – Creation of a unique biobank of patient samples with associated diet and lifestyle data

Researchers: Dr Anthony Leathem and Dr Miriam Dwek

Location: University College London, University of Westminster, London

Dates:  1997 – 2014     Status: Complete

Funding: £5,137,022

Research Theme: Prevention

Aims

The DietCompLyf (DCL) study was a pioneering observational research project aimed at understanding the impact of diet and lifestyle on breast cancer recurrence and survival.

Type of Study: Multi-centre prospective cohort

Participants: 3,390 women with grade 1 to 3 breast cancer, recruited 9–15 months post‑diagnosis from 56 UK hospitals

Duration: Participants actively followed up for 5 years

Initiated at University College London (UCL) by our founder Dr Anthony Leathem and continued at the University of Westminster by Dr. Miriam Dwek. Participants provided blood and urine samples and completed diet and lifestyle questionnaires for up to 5 years.

Early Findings

The DCL study was designed to investigate associations between phytoestrogens – naturally occurring plant compounds with oestrogenic properties – and other diet and lifestyle factors with breast cancer recurrence and survival. Early study findings were published in scientific journals (see publications below). Furthermore, 1000 DNA samples from the DCL biobank have contributed to over twenty-five studies by the Breast Cancer Association Consortium (BCAC) to identify new breast cancer susceptibility genes.

The DietCompLyf biobank was transferred to the University of Southampton in late 2025 and will be a key resource for the ABC Discover 2 programme (2025-2030) to accelerate the multi-omics driven programme of precision medicine and discovery of novel biomarkers to improve outcomes for breast cancer patients.

Background

Diet has been found to influence hormone production and metabolism which in turn could affect the incidence of hormone-related cancers. Phytoestrogens are plant-based compounds that are similar to the hormone oestrogen and have a wide range of metabolic effects. Consumption of soy-containing foods, known to be rich in phytoestrogens, is thought to be a protective against breast cancer in Asian populations. Although there is mounting evidence of the positive influence of phytoestrogens on primary breast cancer risk, little research had been conducted in humans as to the effects of phytoestrogens on secondary breast cancer recurrence and survival.

The DietCompLyf study was supported by the National Cancer Research Network and succeeded in its aim to enrol over 3,000 breast cancer patients from fifty-six centres across the UK. Each patient participated from one-year post-diagnosis of primary breast cancer and was on active follow-up for 5 years. Data collected annually included blood and urine samples, which formed the Biobank, and detailed lifestyle data including 7-day food diaries, food frequency questionnaires (FFQ), lifestyle, and general health questionnaires.

Potential benefit for patients

The biobank will assist the discovery of early detection and other biomarkers that can inform clinicians on the best form of treatment at an early stage to improve patient survival. Biomarkers are biological molecules that alter during disease conditions, often months or years in advance of clinical symptoms becoming noticeable. The earlier these biomarkers are detected, the quicker individuals at risk can be identified, monitored, or receive treatment. Secondary spread breast cancer is currently difficult to detect early due to vague or variable symptoms depending on where the secondary tumours have spread.

In ABC Discover 2, biomarkers will be measured in the DCL biobank samples and be used to evaluate the ability of the miONCO-Dx early cancer test to detect early recurrence.

Project Results and Impact

The resulting resource of linked biological samples and diet and lifestyle data across a longitudinal study of 5 years comprise one of the largest collections of its kind in the UK.

• 3,390 women were recruited to the DCL study.
• Over 23,000 blood and urine samples were added to the DietCompLyf biobank.
• 1000 DNA samples were shared with the Breast Cancer Association Consortium (BCAC). This forum of international investigators is combining information from multiple studies to identify gene mutations that give rise to breast cancer. This will help improve risk prediction and classification of gene variations in patient groups. Over twenty-five published BCAC studies have acknowledged the DCL biobank DNA samples and Against Breast Cancer.
• Cadherin-5 has been identified as a potential biomarker that differentiates between those who develop secondary cancer and those that do not. Further research will be needed to assess this as a detection candidate (Fry et.al)
• Serum immunoglobulin A1 (IgA1) in breast cancer patients has a different pattern of glycosylation (sugar expression) compared to healthy patients. This may be another useful biomarker that differentiates between those who develop secondary cancer and those that do not (Lomax-Browne et.al). Further research will be needed to assess this as a detection candidate.

Publications

DCL study results:

The DietCompLyf study: a prospective cohort study of breast cancer survival and phytoestrogen consumption. Swann R, Perkins KA, Velentzis LS, Ciria C, Dutton SJ, Mulligan AA, Woodside JV, Cantwell MM, Leathem AJ, Robertson CE, Dwek MV. Maturitas. 2013 Jul;75(3):232-40.

Significant changes in dietary intake and supplement use after breast cancer diagnosis in a UK multicentre study. Velentzis LS, Keshtgar MR, Woodside JV, Leathem AJ, Titcomb A, Perkins KA, Mazurowska M, Anderson V, Wardell K, Cantwell MM. Breast Cancer Res Treat 2011 Jul;128(2):473-82.

Adherence to WCRF/AICR guidelines for cancer prevention in participants of the DietCompLyf breast cancer survival study. Brennan et al (conference poster).

Associated publications:

Lignans and breast cancer risk in pre- and post-menopausal women: meta-analyses of observational studies. Velentzis LS, Cantwell MM, Cardwell C, Keshtgar MR, Leathem AJ, Woodside JV. Br J Cancer 2009 May 5;100(9):1492-8.

Dietary patterns and breast cancer risk: a systematic review and meta-analysis. Sarah F Brennan, Marie M Cantwell, Chris R Cardwell, Louiza S Velentzis, Jayne V Woodsid, The American Journal of Clinical Nutrition, Volume 91, Issue 5, May 2010, Pages 1294–1302.

Do phytoestrogens reduce the risk of breast cancer and breast cancer recurrence? What clinicians need to know. Velentzis LS, Woodside JV, Cantwell MM, Leathem AJ, Keshtgar MR.Eur J Cancer. 2008 Sep;44(13):1799-806. doi: 10.1016/j.ejca.2008.05.019. Epub 2008 Jul 7.

Cadherin-5: a biomarker for metastatic breast cancer with optimum efficacy in oestrogen receptor-positive breast cancers with vascular invasion. Fry SA, Robertson CE, Swann R, Dwek MV. British J Cancer. 2016 Apr 26;114(9):1019-26.

Serum IgA1 shows increased levels of α2,6-linked sialic acid in breast cancer. Lomax-Browne HJ, Robertson C, Antonopoulos A, Leathem AJC, Haslam SM, Dell A, Dwek MV. Interface Focus. 2019 Apr 6;9(2):20180079.