Patients with stage III colon cancer who have a high tree nut intake have an improved rate of disease-free and overall survival (DFS and OS, respectively), according to research published in the Journal of Clinical Oncology.1

Research suggests that diet may affect the likelihood of disease recurrence or death among patients with colon cancer. Type 2 diabetes, sedentary lifestyle, Western-pattern diet, and high intake of sugary drinks and food are each associated with recurrence and death in this patient-group. Nut intake, however, is associated with a reduced risk of type 2 diabetes and insulin resistance.

For this prospective study (CALGB 89803; Identifier: NCT00003835), researchers enrolled 1264 patients with stage III colon cancer to determine whether particular dietary patterns affect the risk of disease recurrence or mortality. Patients reported their dietary intake via food frequency questionnaires.

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After exclusions, the final data analysis included 826 patients. Patients with a higher nut intake were more likely to be men, had a higher alcohol intake, and were less likely to have a high glycemic load diet. While patients with a high nut intake tended to consume more calories, they did not have a higher body mass index (BMI) than others.

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The median follow-up was 6.5 years. Patients who consumed at least 2 servings of nuts per week had an improved DFS over non-consumers (adjusted hazard ratio [aHR], 0.58; Ptrend = .03), as well as an improved OS (aHR, 0.43; Ptrend = .01).

This benefit did not, however, appear to apply to peanuts: a subgroup analysis showed that the DFS and OS improvements were confined to high tree nut intake only (HR for DFS, 0.54; Ptrend = .04; HR for OS, 0.47; Ptrend = .04).

The authors concluded that while “the findings of our observational study do not establish causality, the results offer further support of the role of diet and lifestyle as modifiable risk factors of outcomes in patients with colon cancer.”


  1. Fadelu T, Zhang S, Niedzwiecki D, et al. Nut consumption and survival in patients with stage III colon cancer: results from CALGB 89803 (Alliance). J Clin Oncol. 2018 Feb 28. doi: 10.1200/JCO.2017.75.5413 [Epub ahead of print]