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

Understanding the role of adipose tissue distribution and adipokine-related RNA expression in the tumor microenvironment on breast cancer outcomes in a racially and ethnically diverse sample

We will test the central hypothesis that adipose tissue depots (visceral vs. subcutaneous), measured using computed tomography scans, have differing associations with adipokine and adipokine receptor gene expression profiles and related gene signatures in the breast tumor microenvironment, which can be used to develop outcome predictive models. This study will (1) Examine whether adipose tissue distribution impacts cell type-specific RNA expression profiles of leptin, adiponectin, and their receptors in breast tumors and the adjacent breast TME; (2) Define associations of these RNA expression profiles with breast tumor clinicopathology; and (3) Examine whether these RNA expression profiles predict breast cancer recurrence and mortality.
Investigator: Feliciano, Elizabeth
Funder: National Cancer Institute

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. 2020 02 01;6(2):264-270.

Current Position(s):

Section Affiliations:

Primary Research Interests:

Studies

Understanding the role of adipose tissue distribution and adipokine-related RNA expression in the tumor microenvironment on breast cancer outcomes in a racially and ethnically diverse sample

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

Adipose Tissue Distribution and Cardiovascular Disease Risk Among Breast Cancer Survivors

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

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

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

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

Cachexia: A systemic consequence of progressive, unresolved disease

Associations of post-diagnosis lifestyle with prognosis in women with invasive breast cancer

Association of Inflammatory Biomarkers With Survival Among Patients With Stage III Colon Cancer

Long-term Trajectories of Physical Function Decline in Women With and Without Cancer

Sleep duration, plasma metabolites, and obesity and diabetes: A metabolome-wide association study in US women

Metabolic abnormalities and survival among patients with non-metastatic breast cancer

Body composition from single versus multi-slice abdominal computed tomography: Concordance and associations with colorectal cancer survival

Adipose tissue radiodensity and mortality among patients with nonmetastatic breast cancer

Quantifying Frailty Requires a Conceptual Model Before a Statistical Model-Reply

Adherence to the American Cancer Society Guidelines on nutrition and physical activity for cancer prevention and obesity-related cancer risk and mortality in Black and Latina Women's Health Initiative participants

Adiposity and cancer survival: a systematic review and meta-analysis

Association of sleep duration and insomnia with metabolic syndrome and its components in the Women's Health Initiative

The association of abdominal adiposity with premature discontinuation of postoperative chemotherapy in colon cancer

Diabetes Incidence Among Hispanic/Latino Adults in the Hispanic Community Health Study/Study of Latinos (HCHS/SOL)

Trajectories of objectively measured physical function among older breast cancer survivors in comparison with cancer-free controls

Predicting obstructive sleep apnea severity in children referred for polysomnography: use of the Pediatric Sleep Questionnaire and Subscales

Comparison of Electronic Frailty Metrics for Prediction of Adverse Outcomes of Abdominal Surgery

Greater Body Fatness Is Associated With Higher Protein Expression of LEPR in Breast Tumor Tissues: A Cross-Sectional Analysis in the Women's Circle of Health Study

Abdominal adipose tissue radiodensity is associated with survival after colorectal cancer

Neighborhood and Individual Socioeconomic Disadvantage and Survival Among Patients With Nonmetastatic Common Cancers

Plant-Based Dietary Patterns and Breast Cancer Recurrence and Survival in the Pathways Study

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

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

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)

Diet Quality and Breast Cancer Recurrence and Survival: The Pathways 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

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

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

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

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

Identifying metabolomic profiles of inflammatory diets in postmenopausal women

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

Adipose Tissue Distribution and Cardiovascular Disease Risk Among Breast Cancer Survivors

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

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

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

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

Identifying Metabolomic Profiles of Insulinemic Dietary Patterns

Adipose Tissue Distribution and Survival Among Women with Nonmetastatic Breast Cancer

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

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

Non-alcoholic fatty liver disease and colorectal cancer survival

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

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

The Obesity Paradox in Cancer: How Important Is Muscle?

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

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

Muscle radiodensity and mortality in patients with colorectal cancer

Objective Sleep Characteristics and Cardiometabolic Health in Young Adolescents

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

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

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

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