Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Comment
  • Published:

Food as medicine in gastrointestinal cancer therapy

Diet modulates not only gastrointestinal cancer risk but also survivorship, providing an opportunity to improve cancer-related outcomes and quality of life through suitable dietary and lifestyle interventions in survivors of cancer. This Comment summarizes the evidence and ongoing trials investigating diet in gastrointestinal cancer survival, including potential underlying mechanisms and future research directions.

This is a preview of subscription content, access via your institution

Access options

Buy this article

Prices may be subject to local taxes which are calculated during checkout

Fig. 1: Dietary patterns and components associated with cancer survivorship.

References

  1. Jayakrishnan, T. & Ng, K. Early-onset gastrointestinal cancers: a review. JAMA https://doi.org/10.1001/jama.2025.10218 (2025).

    Article  PubMed  Google Scholar 

  2. Shah, U. A. & Iyengar, N. M. Plant-based and ketogenic diets as diverging paths to address cancer: a review. JAMA Oncol. 8, 1201–1208 (2022).

    Article  PubMed  PubMed Central  Google Scholar 

  3. Bouvard, V. et al. Carcinogenicity of consumption of red and processed meat. Lancet Oncol. 16, 1599–1600 (2015).

    Article  PubMed  Google Scholar 

  4. Chan, D. S. M. et al. Post-diagnosis dietary factors, supplement use and colorectal cancer prognosis: a global cancer update programme (CUP Global) systematic literature review and meta-analysis. Int. J. Cancer 155, 445–470 (2024).

    Article  CAS  PubMed  Google Scholar 

  5. Cheng, E. et al. Plant-based diet and survival among patients with metastatic colorectal cancer. J. Natl Cancer Inst. 117, 169–179 (2025).

    Article  CAS  PubMed  Google Scholar 

  6. Tabung, F. K. et al. Post-diagnosis dietary insulinemic potential and survival outcomes among colorectal cancer patients. BMC Cancer 20, 817 (2020).

    Article  PubMed  PubMed Central  Google Scholar 

  7. Gurjao, C. et al. Discovery and features of an alkylating signature in colorectal cancer. Cancer Discov. 11, 2446–2455 (2021).

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  8. Byrd, D. A. et al. The gut microbiome is associated with disease-free survival in stage I-III colorectal cancer patients. Int. J. Cancer 157, 64–73 (2025).

    Article  PubMed  Google Scholar 

  9. Wang, X. et al. Personalized nutrition intervention improves nutritional status and quality of life of colorectal cancer survivors in the community: a randomized controlled trial. Nutrition 103–104, 111835 (2022).

    Article  PubMed  Google Scholar 

  10. Ravasco, P., Monteiro-Grillo, I. & Camilo, M. Individualized nutrition intervention is of major benefit to colorectal cancer patients: long-term follow-up of a randomized controlled trial of nutritional therapy. Am. J. Clin. Nutr. 96, 1346–1353 (2012).

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgements

F.C.M. and U.A.S. thank the TREC Training Workshop R25CA203650 (principal investigator: M. Irwin) for their support. U.A.S. was supported in part by a National Institutes of Health/National Cancer Institute (NIH/NCI) Cancer Center Support Grant (P30CA008748), an American Society of Hematology Scholar Award, and a Leukemia and Lymphoma Society Academic Clinical Trials Grant during this work. M.M.S. was supported by the NCI of the NIH under award number K12 CA237806 from the Emory K12 Clinical Oncology Training Program. Additional support was provided by the Georgia CTSA ULI Program (grant number UL1 TR002378) and the Society of Gastrointestinal and Endoscopic Surgeons Research Grant Award.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Urvi A. Shah.

Ethics declarations

Competing interests

U.A.S. reports research funding support from Celgene/BMS and Janssen to the institution; research support from Sabinsa Pharmaceuticals and M&M Labs to the institution; and personal fees from Janssen Biotech, Sanofi and i3Health outside the submitted work. M.M.S. is a proctor with Intuitive Surgical, Inc. F.C.M. declares no competing interests.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Malcomson, F.C., Shah, M.M. & Shah, U.A. Food as medicine in gastrointestinal cancer therapy. Nat Rev Gastroenterol Hepatol (2025). https://doi.org/10.1038/s41575-025-01117-0

Download citation

  • Published:

  • DOI: https://doi.org/10.1038/s41575-025-01117-0

Search

Quick links

Nature Briefing: Cancer

Sign up for the Nature Briefing: Cancer newsletter — what matters in cancer research, free to your inbox weekly.

Get what matters in cancer research, free to your inbox weekly. Sign up for Nature Briefing: Cancer