A Study of a Plant-Based Diet and Dietary Supplements in People With Smoldering Multiple Myeloma (SMM)

Inclusion Criteria:

• Confirmed prior diagnosis MGUS or of smoldering myeloma (anytime prior). However,confirmation of diagnosis must be documented in their last local oncologist clinicnote within 6 months prior to study enrollment.

• Age ≥18 years

• Willingness to comply with all study-related procedures

• Physically able to complete requirements for the study or has someone to assist withthe requirements (such as meal preparation, stool shipment and survey completion)

• Interested in learning to cook plant based recipes

• Access to smart mobile phone or device with camera and ability to download Keenoaapp

• Be residing within the United States for the study duration.

• English speaking or a family member or caregiver who speaks English and is able toassist with the surveys and phone based Keenoa app.

Exclusion Criteria:

• Taking any supplements other than vitamin D, iron, vitamin B12, potassium,magnesium, calcium or those needed for a medical indication must be reviewed by PI.If patient is on a supplement (including curcumin, probiotic, omega3) they must stopthese for 2 weeks prior to enrollment on study.

• Patients that already follow a whole foods plant based diet (ovo-lactovegetarian orprocessed junk food vegan diets are not excluded). This will be per researchdietitian evaluation and discretion after nutrition screening.

• Legume allergy

• Severe allergies such as anaphylactic shock to peanuts and/or tree nuts, such ascashews

• Concurrent participation in weight loss/dietary trials or defined programs (thatrequire specified diets/supplements on the program)

• Concurrent use of prescription weight loss (such as semaglutides and tirzepatides)and/or therapeutic myeloma drugs such as daratumumab, lenalidomide, etc.) within 12weeks of consent

• Mental impairment leading to inability to cooperate

• Enrollment onto any other therapeutic investigational study

• Concurrent pregnancy

• Patients on full dose anticoagulation

• ≥ Grade 2 electrolyte (sodium and potassium) abnormalities as defined by CTCAEv5.0 (need to be resolved before enrolling on study)

• If in the opinion of the investigator there maybe any concerns regarding the abilityof the patient to complete the study safely

• Current self reported heavy alcohol use (defined as >2 drinks per day or >14 drinksper week)

• Current self-reported illicit drug use (except inhaled marijuana, vaping orcigarette smoking. Oral marijuana/THC excluded or must stop >2 weeks prior.)

• Has a condition requiring antibiotics within 14 days of study interventionadministration.

• Plan for travel during the study that would preclude adherence to prescribed diets

• History of active inflammatory bowel disease or major gastrointestinal surgery (notincluding appendectomy or cholecystectomy) within 3 months of enrollment or anyhistory of total colectomy, or bariatric surgery (bariatric surgery which does notdisrupt the gastrointestinal lumen, i.e. restrictive procedures such as banding, arepermitted)