Cancer survivors face unique health challenges beyond the disease itself. Many enter survivorship with elevated cardiometabolic risk, including weight gain, loss of muscle mass, insulin resistance, and other metabolic changes that can persist long after treatment and increase long-term risk for cardiovascular disease. Addressing these challenges requires a comprehensive approach that combines nutrition, exercise, and behavioral support.
Emily B. Hill, PhD, RDN, studies the intersection of cancer survivorship and cardiometabolic health, exploring how lifestyle behaviors can improve long-term outcomes after a cancer diagnosis. “I study the impact of lifestyle behaviors on health and how we can design interventions to improve nutrition, physical activity, sleep quality, and stress management among those living with and beyond cancer,” Dr. Hill explains. Her work also evaluates clinical indicators such as body composition, insulin resistance, lipid profiles, blood pressure, and markers of inflammation to understand how multiple health behavior change interventions affect the trajectory of survivorship.
A central focus of her research is BfedBwell, a tailored nutrition program designed to complement BfitBwell, a structured exercise program for cancer survivors offered in the CU Anschutz Health and Wellness Center and supported by the University of Colorado Cancer Center. “While BfitBwell has been incredibly successful in improving physical function, fatigue, and quality of life, we consistently saw a gap in the nutrition and behavioral support available during the same period of recovery, particularly for those struggling with overweight or obesity,” Dr. Hill says. Many survivors enter exercise programs with goals related to nutrition, weight management, or improving cardiometabolic health, but exercise alone cannot fully address the metabolic changes that occur during and after treatment. BfedBwell provides dietitian-led education, individualized support, and hands-on behavioral skill development to help survivors learn about evidence-based lifestyle recommendations and navigate common nutrition challenges around meal planning, emotional eating, and rebuilding healthy routines.
Dr. Hill emphasizes that survivorship nutrition is about adopting an overall healthy dietary pattern, not focusing on individual foods. “Overall eating patterns, rather than single ‘superfoods’ or individual nutrients, show the most promise for supporting long-term health after cancer treatment,” she explains. The BfedBwell program emphasizes a predominantly plant-based, whole-food dietary pattern that is both flexible and sustainable over time. Meals follow evidence-based guidelines from the World Cancer Research Fund, the American Institute for Cancer Research, and the American Cancer Society, focusing on vegetables, fruits, whole grains, beans, nuts, and seeds, while including smaller portions of animal-based foods and limiting processed meats, sugary drinks, and highly processed snacks. This approach supports healthier body weight, better glucose and cholesterol control, and reduced inflammation—benefits that are especially important for people who have had cancer.
Measuring the impact of lifestyle interventions like BfitBwell and BfedBwell goes beyond weight or BMI. “Weight alone doesn’t tell the full story, especially for survivors who may have lost muscle, gained fat, or experienced changes in metabolism during treatment,” she explains. To capture the real effects of these interventions, she examines multiple dimensions of health, from body composition and metabolic biomarkers to functional ability, dietary habits, and behavioral patterns.
Her team uses DXA scans to track changes in lean and fat mass, providing insights that the scale can’t show. They also monitor key indicators of metabolic health—such as glucose, insulin, cholesterol, and markers of inflammation—while measuring functional outcomes like strength, endurance, fatigue, and the ability to perform daily activities. Dr. Hill also incorporates nutrition biomarkers and multi-omic methods, which together increase the rigor of dietary assessment and may help to identify personalized responses to changes in lifestyle behaviors. On the behavioral side, she evaluates adherence to lifestyle recommendations, health beliefs, self-confidence in food choices, and emotional or stress-related eating. As Dr. Hill explains, "This multimodal assessment strategy allows us to capture the full impact of our lifestyle interventions on metabolism, functional outcomes, dietary intake, factors influencing behavior change, and overall survivorship trajectories far beyond what weight alone can convey."
As she develops and optimizes the BfedBwell program, Dr. Hill is exploring some of the biggest unanswered questions in oncology nutrition in order to more precisely capture the complexity of diet and exercise behaviors and their biological consequences in a way that meaningfully informs intervention design. “We still don’t fully understand how specific dietary patterns interact with the microbiome, metabolome, and inflammatory pathways during survivorship,” she explains. Her research aims to link lifestyle behaviors with these biological indicators to identify more objective markers of dietary intake, responsiveness to intervention, and health improvement—insights that could allow programs to be tailored to each survivor’s unique biology. She’s also investigating how interconnected behaviors like sleep and stress influence immune function and modify responses to nutrition and exercise programs. "These questions represent the next frontier in oncology nutrition," Dr. Hill states, "and they offer a pathway to developing truly effective programs that support survivors in improving their long-term health."
Ultimately, BfedBwell represents a comprehensive approach to survivorship care, addressing both sides of the energy balance equation and supporting survivors in building sustainable, evidence-based habits that improve long-term cardiometabolic health. As Emily puts it, “Integrating nutrition with exercise allows us to meet survivors’ needs more holistically—supporting strength and functional recovery while helping individuals make sustainable dietary changes that improve weight management and long-term cardiometabolic health.”
Emily Hill’s work has earned recognition through highly competitive national and international awards, including a National Cancer Institute K99/R00 career development grant to develop and test BfedBwell, and a WCRF INSPIRE Research Challenge early career grant to study the combined impact of BfedBwell and BfitBwell on diet, exercise, sleep quality, stress, and immune function. Funding for the INSPIRE Research Challenge was obtained from the American Institute for Cancer Research (AICR), as part of the World Cancer Research Fund International grant program. These prestigious grants not only validate the significance of her research but also position her at the forefront of shaping the future of survivorship care—helping individuals thrive long after treatment ends.