Elizabeth M. Cespedes Feliciano, ScD, SM

People

Kaiser Permanente Division of Research
2000 Broadway
Oakland, CA 94612

510-891-5988 (phone)
elizabeth.m.cespedes@kp.org

Elizabeth M. Cespedes Feliciano, ScD, SM, is a Research Scientist II at the Kaiser Permanente Northern California Division of Research. Her research focuses on identifying, understanding, and intervening on modifiable risk factors for obesity and cancer-related metabolic diseases. She holds a Bachelor of Arts from Brown University, a Masters in Social and Behavioral Sciences from the Harvard T.H. Chan School of Public Health, and a doctorate in Epidemiology and Nutrition, also from Harvard University. Dr. Cespedes Feliciano’s research focuses on two main content areas: (1) cancer survivorship, specifically assessing body composition and cancer outcomes including treatment-related toxicity, surgical complications, recurrence, and survival, and (2) cardiometabolic health, specifically assessing the role of sleep and diet.

Current Position(s):

Research Scientist II, Division of Research, Kaiser Permanente Northern California

Section Affiliations:

Cancer

Primary Research Interests:

Obesity
Cancer
Sleep
Dietary patterns
Ethnic minority health and health disparities
Diabetes
Behavior change
Chronic disease prevention

Studies

Informatics approaches to assessing patient frailty in surgical care

Patient frailty increases the risk for surgical complications, which are common, costly, and deadly, especially for older Americans. To improve surgical care for older adults, we will investigate whether electronic measures of frailty can help reduce complications by identifying which patients are likely to be readmitted to the hospital or die soon after surgery.
Investigator: Feliciano, Elizabeth
Funder: National Institute on Aging

Body Composition and Breast Cancer Survival: Immune and Metabolic Biomarkers in Breast Tumors

We previously found that one third of nonmetastatic breast cancer patients had sarcopenia (age-related loss of muscle tissue) at the time of their diagnosis and that having sarcopenia and obesity was associated with an 89% increased risk of death. This study will use 1,400 archived clinical tumor tissues from stage II-III breast cancer patients for whom we have data on body composition, metabolic syndrome, weight history, cancer therapy, and long-term follow-up for breast cancer outcomes. We will classify breast cancer molecular subtypes, measure gene expression levels in immune and metabolic pathways potentially influenced by body composition and the metabolic syndrome, and examine whether alterations in the breast cancer tumor microenvironment mediate the association of body composition and breast cancer survival.
Investigator: Feliciano, Elizabeth
Funder: National Cancer Institute

D3-creatine dilution to assess skeletal muscle mass in colon cancer patients

Among colon cancer patients participating in a resistance training intervention during chemotherapy, this study will examine whether a new method to evaluate skeletal muscle mass (d3-creatine dilution) is associated with the key cancer outcomes of strength and physical function, chemotherapy toxicity, inflammation, cardiometabolic risk factors and markers of tumor recurrence.
Investigator: Feliciano, Elizabeth
Funder: National Cancer Institute

Pediatric obstructive sleep apnea: predictive modeling to streamline care

To prioritize pediatric attended polysomnography and treatment for children most in need while reducing the unnecessary use of overnight sleep studies, we propose to build and rigorously evaluate a clinical risk prediction model. We will combine data from pediatric sleep questionnaires with other risk factors derived from the electronic medical record to predict obstructive sleep apnea severity among pediatric sleep patients and evaluate our model's performance in an independent sample.
Investigator: Feliciano, Elizabeth
Funder: The Permanente Medical Group

Healthful dietary patterns, intermediate biomarkers and long-term breast cancer prognosis

To strengthen the dietary guidelines for breast cancer survivors, we examine whether at-diagnosis concordance with healthful dietary patterns is associated with recurrence or breast cancer death, or with prognostic biomarkers (i.e., body composition, inflammation or metabolic syndrome). Secondarily, we will examine whether improving diet quality (or maintaining high diet quality) after diagnosis reduces risk of recurrence or breast cancer death.
Investigator: Feliciano, Elizabeth
Funder: American Institute for Cancer Research

Beyond Body Mass Index: Bringing Body Composition into Oncology Practice

This project consists of development of electronic tools to rapidly assess body composition in colorectal cancer and breast cancer patients and present this information to clinicians. It leverages Kaiser Permanente Northern California’s electronic medical records and repository of CT images, including 6,000 images from colorectal cancer and breast cancer patients that were previously manually analyzed for body composition. This project has three major aims: validate software to automatically assess body composition from clinically-acquired imaging (Aim 1); improve the predictive performance of established colorectal cancer risk prediction models through the addition of body composition variables (Aim 2); and develop a prototype of an electronic decision support tool that presents personalized patient risk information to clinicians in an understandable and actionable format (Aim 3).
Investigator: Feliciano, Elizabeth
Funder: National Cancer Institute

Highlighted Publications

Body Composition, Adherence to Anthracycline and Taxane-Based Chemotherapy, and Survival After Nonmetastatic Breast Cancer

Author(s): Cespedes Feliciano EM; Chen WY; Lee V; Albers KB; Prado CM; Alexeeff S; Xiao J; Shachar SS; Caan BJ

JAMA Oncol. 2019 Dec 05.

Current Position(s):

Section Affiliations:

Primary Research Interests:

Studies

Informatics approaches to assessing patient frailty in surgical care

Body Composition and Breast Cancer Survival: Immune and Metabolic Biomarkers in Breast Tumors

D3-creatine dilution to assess skeletal muscle mass in colon cancer patients

Pediatric obstructive sleep apnea: predictive modeling to streamline care

Healthful dietary patterns, intermediate biomarkers and long-term breast cancer prognosis

Beyond Body Mass Index: Bringing Body Composition into Oncology Practice

Highlighted Publications

Body Composition, Adherence to Anthracycline and Taxane-Based Chemotherapy, and Survival After Nonmetastatic Breast Cancer

Chronotype, Social Jet Lag, and Cardiometabolic Risk Factors in Early Adolescence

Adipose Tissue Distribution and Cardiovascular Disease Risk Among Breast Cancer Survivors

Actigraphy-Derived Daily Rest-Activity Patterns and Body Mass Index in Community-Dwelling Adults

Association of Systemic Inflammation and Sarcopenia With Survival in Nonmetastatic Colorectal Cancer: Results From the C SCANS Study

Metabolic Dysfunction, Obesity, and Survival Among Patients With Early-Stage Colorectal Cancer

Multiple Healthful Dietary Patterns and Type 2 Diabetes in the Women's Health Initiative.

Comparison of Self-Reported Sleep Duration With Actigraphy: Results From the Hispanic Community Health Study/Study of Latinos Sueño Ancillary Study.

Long-term changes in sleep duration, energy balance and risk of type 2 diabetes

Television viewing, bedroom television, and sleep duration from infancy to mid-childhood.

Publications

Weight stability masks changes in body composition in colorectal cancer: a retrospective cohort study

Predictive Value of DXA Appendicular Lean Mass for Incident Fractures, Falls, and Mortality, Independent of Prior Falls, FRAX, and BMD: Findings from the Women's Health Initiative (WHI)

Alignment of dietary patterns with the Dietary Guidelines for Americans 2015-2020 and risk of all-cause and cause-specific mortality in the Women's Health Initiative Observational Study

Recruitment strategies and design considerations in a trial of resistance training to prevent dose-limiting toxicities in colon cancer patients undergoing chemotherapy

Sleep characteristics and risk of ovarian cancer among postmenopausal women

Association of Prediagnostic Frailty, Change in Frailty Status, and Mortality After Cancer Diagnosis in the Women's Health Initiative

Deep learning method for localization and segmentation of abdominal CT

Association of Low Muscle Mass and Low Muscle Radiodensity With Morbidity and Mortality for Colon Cancer Surgery

Postdiagnosis Physical Activity: Association With Long-Term Fatigue and Sleep Disturbance in Older Adult Breast Cancer Survivors

Evaluation of automated computed tomography segmentation to assess body composition and mortality associations in cancer patients

Body Composition, Adherence to Anthracycline and Taxane-Based Chemotherapy, and Survival After Nonmetastatic Breast Cancer

Chronotype, Social Jet Lag, and Cardiometabolic Risk Factors in Early Adolescence

Adipose Tissue Distribution and Cardiovascular Disease Risk Among Breast Cancer Survivors

Identifying Metabolomic Profiles of Insulinemic Dietary Patterns

Identifying metabolomic profiles of inflammatory diets in postmenopausal women

Body Composition and Cardiovascular Events in Patients With Colorectal Cancer: A Population-Based Retrospective Cohort Study

Muscle segmentation in axial computed tomography (CT) images at the lumbar (L3) and thoracic (T4) levels for body composition analysis

Association of Daily Rest-Activity Patterns With Adiposity and Cardiometabolic Risk Measures in Teens

Adipose Tissue Distribution and Survival Among Women with Nonmetastatic Breast Cancer

The association of medical and demographic characteristics with sarcopenia and low muscle radiodensity in patients with nonmetastatic colorectal cancer

Associations Between Timing of Meals, Physical Activity, Light Exposure, and Sleep With Body Mass Index in Free-Living Adults

The evolution of body composition in oncology-epidemiology, clinical trials, and the future of patient care: facts and numbers

Non-alcoholic fatty liver disease and colorectal cancer survival

Screening for low muscularity in colorectal cancer patients: a valid, clinic-friendly approach that predicts mortality

Change in longitudinal trends in sleep quality and duration following breast cancer diagnosis: results from the Women's Health Initiative

Objective Sleep Characteristics and Cardiometabolic Health in Young Adolescents

Clinical implications of low skeletal muscle mass in early-stage breast and colorectal cancer

Muscle radiodensity and mortality in patients with colorectal cancer

The deterioration of muscle mass and radiodensity is prognostic of poor survival in stage I-III colorectal cancer: a population-based cohort study (C-SCANS)

The Obesity Paradox in Cancer: How Important Is Muscle?

An Empirical Dietary Inflammatory Pattern Score Is Associated with Circulating Inflammatory Biomarkers in a Multi-Ethnic Population of Postmenopausal Women in the United States

Associations of pre-existing co-morbidities with skeletal muscle mass and radiodensity in patients with non-metastatic colorectal cancer

The Importance of Body Composition in Explaining the Overweight Paradox in Cancer-Counterpoint

The Plausibility of the Obesity Paradox in Cancer-Response-Reply to Point

Association of Muscle and Adiposity Measured by Computed Tomography With Survival in Patients With Nonmetastatic Breast Cancer

Cardiometabolic risk factors and survival after breast cancer in the Women's Health Initiative

Actigraphy-Derived Daily Rest-Activity Patterns and Body Mass Index in Community-Dwelling Adults

Muscle mass at the time of diagnosis of nonmetastatic colon cancer and early discontinuation of chemotherapy, delays, and dose reductions on adjuvant FOLFOX: The C-SCANS study

Methodological considerations for disentangling a risk factor's influence on disease incidence versus postdiagnosis survival: The example of obesity and breast and colorectal cancer mortality in the Women's Health Initiative

Association of Systemic Inflammation and Sarcopenia With Survival in Nonmetastatic Colorectal Cancer: Results From the C SCANS Study

Explaining the Obesity Paradox: The Association between Body Composition and Colorectal Cancer Survival (C-SCANS Study)

Body mass index, PAM50 subtype, recurrence and survival among patients with nonmetastatic breast cancer

Adiposity, post-diagnosis weight change, and risk of cardiovascular events among early-stage breast cancer survivors

Actigraphic Sleep Patterns of U.S. Hispanics: The Hispanic Community Health Study/Study of Latinos

Association of Weight Change after Colorectal Cancer Diagnosis and Outcomes in the Kaiser Permanente Northern California Population

Physical activity induced protection against breast cancer risk associated with delayed parity

Physical activity from menarche to first pregnancy and risk of breast cancer

Metabolic Dysfunction, Obesity, and Survival Among Patients With Early-Stage Colorectal Cancer

Post-diagnosis Weight Change and Survival Following a Diagnosis of Early Stage Breast Cancer

What Should Cardiologists Tell Their Patients About a Healthy Dietary Pattern?

Change in Dietary Patterns and Change in Waist Circumference and DXA Trunk Fat Among Postmenopausal Women

Multiple Healthful Dietary Patterns and Type 2 Diabetes in the Women's Health Initiative.

Comparison of Self-Reported Sleep Duration With Actigraphy: Results From the Hispanic Community Health Study/Study of Latinos Sueño Ancillary Study.

Association between sleeping difficulty and type 2 diabetes in women

Long-term changes in sleep duration, energy balance and risk of type 2 diabetes

Television viewing, bedroom television, and sleep duration from infancy to mid-childhood.