Cancer prevention community mourns epidemiologist Dr. Alan Kristal

Pioneering researcher studied how diet can lower cancer risk
Photo of Dr. Alan Kristal in his office
Dr. Alan Kristal, for 29 years an epidemiologist working on cancer prevention studies at Fred Hutch, passed away March 22. He is remembered as a passionate scientist and a dear friend. Fred Hutch file photo

Dr. Alan Kristal, a Fred Hutchinson Cancer Research Center epidemiologist and a trained chef whose zest for life was matched by his zeal to discover ways to reduce the risk of cancer, died Friday in Seattle. He was 66.

The cause was pancreatic cancer. He was diagnosed in late August, nearly two years into his retirement from Fred Hutch and the University of Washington.

For more than 29 years, Kristal was a key epidemiologist in the Hutch’s Cancer Prevention Program. There, he built a distinguished career pursuing the link between obesity and cancer and evaluating how dietary and other lifestyle changes might reduce a person’s odds of developing the disease.

“Alan was one of those larger-than-life personalities,” said Dr. Garnet Anderson, senior vice president at Fred Hutch and director of the Public Health Sciences Division, where Kristal carried out his studies. “He was highly opinionated, whip-smart and energetic ­— a forward motion kind of person.”

photo of Dr. Garnet Anderson
Dr. Garnet Anderson, Fred Hutch senior vice president and director of the Public Health Sciences Division Photo by Robert Hood / Fred Hutch

Anderson, who holds the Fred Hutch 40th Anniversary Endowed Chair, worked with him from the early days of the Women’s Health Initiative, the vast research program examining cardiovascular disease, cancer and osteoporosis risk in postmenopausal women.

As principal investigator of the WHI Clinical Coordinating Center, she credits Kristal with building the foundation for that study’s large and complex dietary assessment plans, which are yielding data that researchers are still analyzing today, 25 years after the first women were enrolled.

Kristal brought an intensity to everything he did, whether researching prostate cancer prevention, teaching students how to write grant applications, playing classical piano, kayaking in the Philippines or cooking a 10-course meal for his friends.

His dinners were legendary, said his husband, Jason Lamb, who works for the Bill & Melinda Gates Foundation on financial services projects in Africa and Asia.

“It was a coveted invitation for my colleagues in the Gates Foundation. If they got an invitation to our house for Alan’s cooking, they are literally still talking about it,” he said.

Together for 16 years, Lamb and Kristal traveled the world, hiked and camped, climbed mountains and savored the opera. “When he said, ‘Let’s go for a walk,’ it meant a 10-mile hike. We might climb 3,000 feet. He really liked the solitude of nature,” Lamb said.

And when Kristal became ill, he often preferred to walk miles to the hospital and back. Just weeks away from his death, he went snowshoeing in the Cascades.

“Alan was demanding,” Lamb said. “But he was really soft at the core. If you were afraid of the demanding, you might never meet the core.”

A career in public health begins with the AIDS epidemic

As a young man living in New York in the 1970s, Kristal decided he wanted to be a chef and trained at the famed Culinary Institute of America. Although he never lost his love of cuisine, his professional interest took him toward the science of nutrition and public health. In 1983, as the AIDS epidemic was exploding in New York, he earned a doctorate in public health in epidemiology at Columbia University and was hired by the New York City Department of Public Health. Three years later, he began his decades-long career at Fred Hutch, drawn to Seattle in part by his passion for the outdoors.

“He led a very self-determined life,” said his former colleague, epidemiologist Dr. Emily White, who also retired from the Hutch’s Cancer Prevention Program and is a professor emeritus at UW. “He will be especially remembered for being an iconoclast, for having a wicked sense of humor and for his authenticity.”

White called Kristal a valued collaborator. He published more than 200 papers and led trials on nutritional, behavioral and biological risk factors for various cancers. His studies showed that being overweight increases your risk of prostate cancer, with the risk being even greater for African American men.

Kristal was a leader in  clinical trials of dietary supplements, including a major study funded by the National Cancer Institute involving high doses of vitamin E and selenium, which were expected to lower prostate cancer risk. The surprise findings showed that the combo did not work, and that in some cases vitamin E or selenium supplements alone can increase prostate cancer risk. The study authors recommended that men not take these high-dose supplements.

Kristen Woodward, an editor and former media relations manager at Fred Hutch who worked with Kristal to publicize many of his research findings, said his studies struck a chord because they offered people insight into specific things they could do to reduce cancer risk.

She also loved his sense of humor.

“He had a banner stretched across a wall of his office with “GAY EPIDEMIOLOGIST” stenciled in red. That cracked me up,” Woodward said. “He also kept a pair of Groucho glasses on hand to defuse any situation he deemed too serious. They came in handy now and then.”

photo of Dr. Riki Peters
Dr. Riki Peters, associate director, Public Health Sciences Division Photo by Robert Hood / Fred Hutch

An exacting scientist, a generous mentor and friend

“He is a very special person,” said Dr. Riki Peters, associate director of Public Health Sciences, who also holds a Fred Hutch 40th Anniversary Endowed Chair. “Alan was brave and outspoken, talented and smart, outgoing and funny. He looked out for his junior colleagues. He generously provided his time, support and access.”

Like Kristal, Dr. Marian Neuhouser, head of the Hutch’s Cancer Prevention Program, began her academic career as a nutrition scientist, and like many of her colleagues, is now grieving the loss of a mentor.

“He was tough and exacting,” she said. “Exactly the kind of mentor that helped so many become successful scientists.”

Among the last to visit with Kristal was retired cancer epidemiologist Dr. John Potter, former director of the Public Health Sciences Division.

“We had planned a dinner, but, although Alan was less than happy about being in a hospital bed, it was good to talk with him and say goodbye,” he said. “He was still his feisty self, wryly humorous, still able to laugh at himself and the weirdness of the world that he is now gone from. I hold these memories close.”

It may not be surprising to those who knew Kristal that he kept on working through his retirement, and just a week before he died he worked on the final pages of a manuscript with Fred Hutch Senior Staff Scientist Dr. Jeannette Schenk. The two had been collaborating on a new smartphone app that can assess how much a person has eaten by taking and analyzing 3D images of their food.

Photo of Alan Kristal with fruits and vegetables
Dr. Alan Kristal conducted many studies exploring the value of vegetables in reducing cancer risk. Fred Hutch file photo

“He was very much engaged,” Schenk said. “It was a pet project of ours. He definitely wanted to see it through.”

Among the last to say goodbye to Kristal was former Fred Hutch epidemiologist Dr. Ruth Patterson.

“From the first to the last day of my friendship with this remarkable man, he never ceased to fill me with laughter and astonishment,” she said.

She said that Kristal’s most important scientific lesson to her was to hold oneself to the highest standards. She lauded his passion for rigorous thinking, excellence in writing and scrupulously honest analytic techniques.

“The excellence of Alan Kristal’s science is no accident,” Patterson said. “It is the result of high intention, sincere effort and intelligent execution. What a beautiful legacy.”

Kristal is survived by his husband, Jason Lamb, of Seattle; his mother, Barbara Kristal, of Naples, Florida; and his sister, Ann, of Jacksonville, Florida. A private celebration of his life is pending. In lieu of flowers, Kristal had asked that donations be made to the Seattle Parks Foundation for The AMP: AIDS Memorial Pathway.

Sabin Russell is a former staff writer at Fred Hutchinson Cancer Center. For two decades he covered medical science, global health and health care economics for the San Francisco Chronicle, and he wrote extensively about infectious diseases, including HIV/AIDS. He was a Knight Science Journalism Fellow at MIT and a freelance writer for the New York Times and Health Affairs. 

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