Physical Activity and Nutrition to Halt Elevated Risk in the Pancreas Interception Center

Inclusion Criteria: * Age 18 years or older * Endoscopically, radiologically, or biopsy-proven pancreatic intraductal papillary mucinous neoplasm (IPMN) over 15 mm in size * Eastern Cooperative Oncology Group (ECOG) performance status 0-2 * Ability to sign informed consent * Ability to read and speak English or Spanish * Body Mass Index (BMI) greater than or equal to 25 kg/m2 * Visceral obesity based on MRI quantification of visceral and subcutaneous fat; ratio of visceral to subcutaneous fat area greater than 0.4 and/or elevated cytokine, incretin or adipokine biomarkers Exclusion Criteria: * No diagnosis of an IPMN * IPMN with high grade dysplasia, cancer or other high-risk features * Screen failure for exercise safety * Underlying unstable cardiac or pulmonary disease or symptomatic cardiac disease * Recent fracture or acute musculoskeletal injury * Numeric pain rating scale of 7 or more out of 10 * Myopathic or rheumatologic disease that impacts physical function