Natalie Ledesma, MS, RDN, CSO, CLT

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Colorectal Cancer Awareness Month

March is colorectal cancer awareness month and rightfully so. Colorectal cancer is the third most commonly diagnosed cancer in men and women combined in the U.S. It is the second leading cause of cancer death in men and women combined in the U.S. Young onset is still on the rise. In the years 2007-2016, while the rates for people aged 55 or over dropped by 3.6% each year, the rates for people under 55 increased 2% each year. It is estimated that 68% percent of colorectal cancer deaths could be prevented with screening. So, if you're over the age of 45 (and younger if you have any family history), it may be wise to discuss your screening options with your healthcare provider.

Good nutrition may reduce the incidence of cancer and possibly prevent or delay cancer recurrence. It is estimated that one third of cancer deaths in the U.S. can be attributed to diet in adulthood, including diet’s effect on obesity. There are many studies underway to help further understand how diet and colorectal cancer are related. A plant-based diet is a modifiable lifestyle factor that is encouraged for prevention of colorectal cancer. Note that a plant-based diet is not a plant-only vegetarian diet, but one that is rich in healthful plant foods - vegetables, fruits, nuts/seeds, beans/legumes, and whole grains.


In a study including over 1000 colon cancer patients with stage III disease who received chemotherapy, eating a “Western-pattern diet” high in red and processed meat, sweets and desserts, dairy products, and potatoes was associated with a 3-fold higher risk of cancer recurrence and death. In the same population, patients who consumed 2 sugar-sweetened beverages (including soda, sports drinks, fruits and vegetable juices with added sugar) daily had a 67% greater risk of disease recurrence or death compared to patients who consumed these beverages less than 2 times per month.

Summary - Healthy Colorectal Cancer Diet 

  • Eat 8 to 10 colorful vegetables and fruit servings daily.

    • One cup or more of vegetables with two or more of your meals

    • Two to three pieces of fruit

    • 8 fl oz vegetable-only juice

    • If possible, opt for organic, however, it is most important to eat a wide variety of fruits and vegetables every day - organic or conventional

  • Consume 30-45 grams of fiber daily.

    • You can meet your fiber goal if you eat 8 to 10 servings of fruits and vegetables plus one serving of chia and/or flax seed (1 Tbsp), one serving of beans/legumes, or at least two servings of whole grains daily

  • Avoid processed and refined grains/flours/sugars. Opt for more healthful starchy vegetables and/or whole grains.

    • Healthful starchy vegetables may include butternut squash, sweet potatoes, acorn squash, kabocha squash, spaghetti squash

    • Whole grain examples may include quinoa, wild rice, teff, amaranth, steel-cut oats, brown rice

    • Keep WHITE off your plate: white bread, pasta, white rice, cream sauces, cakes, and more

  • Eat protein with every meal; lean protein (wild fish, organic poultry, organic eggs, organic yogurt) and/or plant protein (beans/legumes, nuts/seeds, organic soy).

  • Limit or eliminate red meat and avoid processed meats (meats preserved with nitrates/nitrites such as hot dogs, sausages, bologna, and some lunch meats) altogether.

  • Include healthy fats daily, such as cold-water fish (salmon, trout, herring, sardines, black cod), flaxseeds, chia seeds, walnuts, extra-virgin olive oil, avocados, and nuts.

  • If including dairy in the diet, opt for organic, low-fat dairy, preferably fermented.

  • Consume herbs and spices daily.

  • Drink plenty of fluids, water or non-caffeinated beverages throughout the day.

    • Avoid sodas, sugar-containing drinks, fruit juice

    • Limit or avoid alcohol

  • Consume adequate amounts of vitamin D and calcium daily.

    • Maintain serum 25(OH)-vitamin D levels above 40 ng/ml and less than 100 ng/ml

  • Engage in daily physical activity; build up to 150 minutes/week or more of aerobic exercise to achieve and/or maintain a healthy body weight.

  • For stress reduction, consider yoga, meditation, guided imagery, a support group, or other activity.