Pao-Hwa Lin

Overview:


My research interest lies generally in the area of dietary patterns and chronic diseases including hypertension using controlled feeding study and lifestyle intervention designs.

Two major controlled feeding clinical trials that I was involved in include the Dietary Approaches to Stop Hypertension (DASH) Study and the Dietary Approaches to Stop Hypertension-Sodium (DASH-Sodium) Study. In addition to being an active member for the diet committee for DASH, I also function as the chair of the diet committee for the DASH-Sodium study.  I am familiar with the development and operation of a controlled feeding study, which means the process of study design, development of questionnaire/forms for data collection/monitoring, development of quality assurance procedure, and data analysis.

I've also helped with the design and implementation of the lifestyle behavioral intervention program for the Hypertension Improvement Project (HIP), PREMIER clinical trial, Weight Loss Maintenance trial (WLM), ENCORE study, and the Cell Phone Intervention for You (CITY) trial.

Key words: Diet, controlled feeding study, mineral, blood pressure, nutrition.

Positions:

Associate Professor in Medicine

Medicine, Nephrology
School of Medicine

Member of Duke Molecular Physiology Institute

Duke Molecular Physiology Institute
School of Medicine

Member of the Duke Cancer Institute

Duke Cancer Institute
School of Medicine

Education:

Ph.D. 1990

University of Texas, Austin

Grants:

Cellphone Intervention Trial for Young Adults (CITY)

Administered By
Medicine, Nephrology
Awarded By
National Institutes of Health
Role
Co Investigator
Start Date
End Date

Facility and Web-based Approaches to Lifestyle Change in Resistant Hypertension

Administered By
Psychiatry & Behavioral Sciences, Behavioral Medicine
Awarded By
National Institutes of Health
Role
Co Investigator
Start Date
End Date

Lifestyle, CVD Risk and Cognitive Impairment

Administered By
Psychiatry & Behavioral Sciences, Behavioral Medicine
Awarded By
National Institutes of Health
Role
Co Investigator
Start Date
End Date

Identifying Strategies for Effective Weight Management in Diverse Interventions

Administered By
Medicine, Nephrology
Awarded By
University of Pittsburgh
Role
Principal Investigator
Start Date
End Date

CAPS1 and CAPS2 clinical trial

Administered By
Medicine, Nephrology
Awarded By
Institute for Medical Research, Inc.
Role
Principal Investigator
Start Date
End Date

Publications:

Vegetable Consumption and Progression of Prostate Cancer.

Authors
Csizmadi, I; Lin, P-H; Freedland, SJ
MLA Citation
Csizmadi, Ilona, et al. “Vegetable Consumption and Progression of Prostate Cancer.Jama, vol. 323, no. 24, June 2020, pp. 2529–30. Pubmed, doi:10.1001/jama.2020.6729.
URI
https://scholars.duke.edu/individual/pub1451406
PMID
32573662
Source
pubmed
Published In
Jama
Volume
323
Published Date
Start Page
2529
End Page
2530
DOI
10.1001/jama.2020.6729

Preliminary evidence of effects of potassium chloride on a metabolomic path to diabetes and cardiovascular disease.

INTRODUCTION: Low potassium intake can affect cardiovascular disease (CVD) risk and cardiometabolic risk factors. OBJECTIVE: We hypothesize that potassium chloride (KCl) supplementation can improve cardiovascular risk metabolomic profile. METHODS: In this secondary analysis of a pilot randomized clinical trial (RCT) of 26 participants with prediabetes randomized to KCl or placebo, we performed targeted mass-spectrometry-based metabolomic profiling on baseline and 12-week (end-of-study) plasma samples. Principal component analysis (PCA) was used to reduce the many correlated metabolites into fewer, independent factors that retain most of the information in the original data. RESULTS: Those taking KCl had significant reductions (corresponding to lower cardiovascular risk) in the branched-chain amino acids (BCAA) factor (P = 0.004) and in valine levels (P = 0.02); and non-significant reductions in short-chain acylcarnitines (SCA) factor (P = 0.11). CONCLUSIONS: KCl supplementation may improve circulating BCAA levels, which may reflect improvements in overall cardiometabolic risk profile. CLINICAL TRIALS REGISTRY: Clinicaltrials.gov identifier: NCT02236598; https://clinicaltrials.gov/ct2/show/NCT02236598.
Authors
Chatterjee, R; Davenport, CA; Kwee, L; D'Alessio, D; Svetkey, LP; Lin, P-H; Slentz, CA; Ilkayeva, O; Johnson, J; Edelman, D; Shah, SH
MLA Citation
Chatterjee, Ranee, et al. “Preliminary evidence of effects of potassium chloride on a metabolomic path to diabetes and cardiovascular disease.Metabolomics, vol. 16, no. 7, June 2020, p. 75. Pubmed, doi:10.1007/s11306-020-01696-w.
URI
https://scholars.duke.edu/individual/pub1448208
PMID
32556595
Source
pubmed
Published In
Metabolomics
Volume
16
Published Date
Start Page
75
DOI
10.1007/s11306-020-01696-w

Public interest in dietary supplements for prostate cancer prevention

Authors
Patel, DN; Kuhlmann, P; Lin, PH; Freeland, SJ
MLA Citation
Patel, D. N., et al. “Public interest in dietary supplements for prostate cancer prevention.” Prostate Cancer and Prostatic Diseases, Jan. 2020. Scopus, doi:10.1038/s41391-020-0257-8.
URI
https://scholars.duke.edu/individual/pub1452891
Source
scopus
Published In
Prostate Cancer and Prostatic Diseases
Published Date
DOI
10.1038/s41391-020-0257-8

A Randomized Controlled Trial of a 6-Month Low-Carbohydrate Intervention on Disease Progression in Men with Recurrent Prostate Cancer: Carbohydrate and Prostate Study 2 (CAPS2).

PURPOSE: Both weight loss and low-carbohydrate diets (LCD) without weight loss prolong survival in prostate cancer models. Few human trials have tested weight loss or LCD on prostate cancer. EXPERIMENTAL DESIGN: We conducted a multi-site randomized 6-month trial of LCD versus control on PSA doubling time (PSADT) in patients with prostate cancer with biochemical recurrence (BCR) after local treatment. Eligibility included body mass index (BMI) ≥ 24 kg/m2 and PSADT 3 to 36 months. The LCD arm was instructed to eat [Formula: see text]20 g/carbs/day; the control arm instructed to avoid dietary changes. Primary outcome was PSADT. Secondary outcomes included weight, lipids, glucose metabolism, and diet. RESULTS: Of 60 planned patients, the study stopped early after an interim analysis showed futility. Twenty-seven LCD and 18 control patients completed the study. At 6 months, although both arms consumed similar protein and fats, the LCD arm reduced carbohydrates intake (-117 vs. 8 g, P < 0.001) and lost weight (-12.1 vs. -0.50 kg, P < 0.001). The LCD arm reduced HDL, triglycerides, and HbA1c with no difference in total cholesterol or glucose. Mean PSADT was similar between LCD (21 months) and control (15 months, P = 0.316) arms. In a post hoc exploratory analysis accounting for prestudy PSADT, baseline PSA, primary treatment, and hemoconcentration, PSADT was significantly longer in LCD versus control (28 vs. 13 months, P = 0.021) arms. Adverse events were few, usually mild, and returned to baseline by 6 months. CONCLUSIONS: Among BCR patients, LCD induced weight loss and metabolic benefits with acceptable safety without affecting PSADT, suggesting LCD does not adversely affect prostate cancer growth and is safe. Given exploratory findings of longer PSADT, larger studies testing LCD on disease progression are warranted.
Authors
Freedland, SJ; Allen, J; Jarman, A; Oyekunle, T; Armstrong, AJ; Moul, JW; Sandler, HM; Posadas, E; Levin, D; Wiggins, E; Howard, LE; Wu, Y; Lin, P-H
MLA Citation
Freedland, Stephen J., et al. “A Randomized Controlled Trial of a 6-Month Low-Carbohydrate Intervention on Disease Progression in Men with Recurrent Prostate Cancer: Carbohydrate and Prostate Study 2 (CAPS2).Clin Cancer Res, vol. 26, no. 12, June 2020, pp. 3035–43. Pubmed, doi:10.1158/1078-0432.CCR-19-3873.
URI
https://scholars.duke.edu/individual/pub1433501
PMID
32108029
Source
pubmed
Published In
Clinical Cancer Research : an Official Journal of the American Association for Cancer Research
Volume
26
Published Date
Start Page
3035
End Page
3043
DOI
10.1158/1078-0432.CCR-19-3873

Metabolomic effects of androgen deprivation therapy treatment for prostate cancer.

Androgen deprivation therapy (ADT) is the main treatment strategy for men with metastatic prostate cancer (PC). However, ADT is associated with various metabolic disturbances, including impaired glucose tolerance, insulin resistance and weight gain, increasing risk of diabetes and cardiovascular death. Much remains unknown about the metabolic pathways and disturbances altered by ADT and the mechanisms. We assessed the metabolomic effects of ADT in the serum of 20 men receiving ADT. Sera collected before (baseline), 3 and 6 months after initiation of ADT was used for the metabolomics and lipidomics analyses. The ADT-associated metabolic changes were identified by univariable and multivariable statistical analysis, ANOVA, and Pearson correlation. We found multiple key changes. First, ADT treatments reduced the steroid synthesis as reflected by the lower androgen sulfate and other steroid hormones. Greater androgen reduction was correlated with higher serum glucose levels, supporting the diabetogenic role of ADT. Second, ADT consistently decreased the 3-hydroxybutyric acid and ketogenesis. Third, many acyl-carnitines were reduced, indicating the effects on the fatty acid metabolism. Fourth, ADT was associated with a corresponding reduction in 3-formyl indole (a.k.a. indole-3-carboxaldehyde), a microbiota-derived metabolite from the dietary tryptophan. Indole-3-carboxaldehyde is an agonist for the aryl hydrocarbon receptor and regulates the mucosal reactivity and inflammation. Together, these ADT-associated metabolomic analyses identified reduction in steroid synthesis and ketogenesis as prominent features, suggesting therapeutic potential of restricted ketogenic diets, though this requires formal testing. ADT may also impact the microbial production of indoles related to the immune pathways. Future research is needed to determine the functional impact and underlying mechanisms to prevent ADT-linked comorbidities and diabetes risk.
Authors
Chi, J-T; Lin, P-H; Tolstikov, V; Oyekunle, T; Chen, EY; Bussberg, V; Greenwood, B; Sarangarajan, R; Narain, NR; Kiebish, MA; Freedland, SJ
MLA Citation
Chi, Jen-Tsan, et al. “Metabolomic effects of androgen deprivation therapy treatment for prostate cancer.Cancer Med, vol. 9, no. 11, June 2020, pp. 3691–702. Pubmed, doi:10.1002/cam4.3016.
URI
https://scholars.duke.edu/individual/pub1436182
PMID
32232974
Source
pubmed
Published In
Cancer Medicine
Volume
9
Published Date
Start Page
3691
End Page
3702
DOI
10.1002/cam4.3016