A DIET HIGH IN FRUITS and vegetables has been linked to longer survival and better health after a cancer diagnosis, but people who have a history of cancer often fall short on meeting healthy diet recommendations.
In a study published June 3, 2025, in Public Health Nutrition, researchers used responses to the Health Information National Trends Survey to assess the eating habits and knowledge about dietary risk factors of cancer survivors and people with no cancer history. They found that 82% of cancer survivors did not meet the American Cancer Society (ACS) dietary recommendations to eat about 2 cups of fruit a day. Additionally, 75% of people didn’t get the recommended 2 to 3 cups of vegetables each day. These were the same proportions seen among people with no history of cancer.
“This is a big issue, that we do have a high percent of people—not only cancer survivors, but all other people—who cannot meet the dietary guideline,” says study author Yunxia Lu, an epidemiologist focused on cancer prevention at the University of California, Irvine. Lu notes that other studies support these findings.
These findings highlight a greater need for diet education, especially for cancer survivors, says Beth Beckett, an oncology dietitian at Nassif Community Cancer Center in Cedar Rapids, Iowa, who was not involved in the study.
“People know that fruits and vegetables are really healthy and important for their health, but the practicality of it, the follow-through, is lacking,” Beckett says.
Awareness of Dietary Effects on Recurrence Risk
Both cancer survivors and people with no cancer history were equally aware that a healthy diet can decrease cancer recurrence, and researchers found the groups did not significantly differ in awareness of how fruit and vegetables, fiber, sugar-sweetened beverages and alcohol intake can impact that risk.
Although Beckett was hoping to see cancer survivors had better dietary patterns, she wasn’t shocked by the findings. “I’m surprised when I meet with people one-on-one, some of them really don’t understand the association between diet and cancer recurrence.”
Understanding why some foods are more beneficial to health can help cancer survivors make changes that lower their risk for recurrence.
A diet rich with fruits and vegetables can support a healthy gut and microbiome, which is the collection of viruses and microorganisms in the body that may affect a person’s health.
People who understand the reasons behind suggested changes to their eating habits may be more likely to embrace them, says Beth Beckett, oncology dietitian at Nassif Community Cancer Center in Cedar Rapids, Iowa.
“They need to know why the fruits and vegetables are helping them,” Beckett says. “And I tell them it’s because they’re offering so much more than just that one nutrient that you might associate with that food. They’re filling you up with fewer calories. They’re replacing foods that you’re eating that are less healthy. And they’re fueling the good bacteria in your gut that we’re seeing more and more is tied to disease prevention.”
Beckett shares the following dietary changes cancer survivors can make to lower their recurrence risk:
- Choose fish, poultry and nonanimal sources of protein over red meat. Additionally, limit your intake of processed meat such as bacon, hot dogs and ham, which are high in preservatives and sodium.
- Avoid trend diets or supplements and focus on getting those benefits from fruits and vegetables.
- Keep fruit on hand for breakfast. Add berries to yogurt or oatmeal, or a banana with peanut butter on it. Fruit can also be good replacements for snacks.
- Serve vegetables (raw or cooked) with your lunch and dinner.
- Add beans, which are high in antioxidants. When using canned beans, you can rinse them off if you are concerned about sodium.
- Cook with olive oil or avocado oil, as they are low in saturated fat and are minimally processed.
A growing body of research shows diet correlates with other benefits for people with various types of cancer.
“There are quite a few studies that show that when people don’t follow the dietary guidelines, they have an increased risk of mortality, especially in colorectal cancer, and there’s some evidence for breast cancer,” Lu says. Also, studies show that people with cancer who follow dietary recommendations are less likely to have a recurrence, she says.
Getting Support for Lifestyle Changes
The current time-strapped environment in oncology offices may leave little opportunity for nutritional counseling.
“When the patient sees the doctor, most of the clinicians are talking more about the measurement of a cancer-related symptom or treatment, but they may deliver very limited guidance on dietary information,” Lu says. “One reason is that those health care providers may not feel prepared or they have limited training in nutrition.”
Cancer survivors may want to make some changes, but they don’t know where to start.
“People know that a healthy diet is related with cancer prevention, but [health care providers] don’t emphasize much about the long-term outcomes in cancer survivors,” Lu says.
Available Resources for Cancer Survivors
Oncology dietitians and nutritionists often help patients who are being treated for cancer with specific symptoms, such as nausea and vomiting, appetite loss and weight loss, and taste or smell changes. But patients may need to ask for this kind of support once they have finished treatment.
“A lot of our job is focused on malnutrition,” Beckett says. “We’re seeing head and neck cancer patients with feeding tubes, and we’re seeing people that are losing large amounts of weight during treatment. While most cancer centers have at least one dietitian, a lot of times, there aren’t enough to do more survivorship education.”
Cancer survivors who don’t receive a referral after treatment can seek out the help of dietitians. “We’re the ones who would be able to take the time and have the training to be able to do that counseling.”
In addition, some cancer centers include survivorship programs that provide training in dietary behaviors, cooking classes and other learning opportunities. Online, the ACS and the American Institute for Cancer Research have resources that focus on diet, exercise and weight management. Beckett says she also directs survivors to other recipe sites that may not be cancer specific but provide easy instructions for nutritious meals. “The key is to make it easy for people, and not to be too complicated,” she says
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