Changes in dietary habits following a colon cancer diagnosis: insights from the prospective ECHO (Eating habits CHanges in Oncologic patients) STUDY 2.0.

Introduction: Colorectal cancer (CRC) is the third most common cancer worldwide and the second leading cause of cancer-related deaths. Nevertheless, it is estimated that more than 5.7 million people globally are currently living with it. CRC development is influenced by various environmental factors, and the benefits of a healthy lifestyle, particularly dietary changes, are receiving growing attention. While the mechanisms linking specific nutrients to CRC carcinogenesis are still under investigation, evidence suggests that prognosis and long-term outcomes may be influenced by post-diagnosis dietary habits. Methods: Here we report data from the ECHO 2.0 study (Eating habits CHanges in Oncologic patients), an observational investigation focused on post-diagnosis dietary changes, among Italian CRC patients. Data were collected from 98 subjects through a questionnaire designed to investigate changes in their food consumption, supplement use, and adoption of specific diets following surgery. Ninety-eight patients (45 females and 53 males) completed the survey, with most aged 65 years or older. Results: We observed that some patients reported positive dietary changes, including an increase in the consumption of vegetables, fresh fruit, and fish and shellfish, as well as a decrease in the intake of processed meat, desserts, red meat, animal fats, alcoholic beverages, refined bread and pasta, soft drinks, and baked goods. Despite CRC survivors made some positive changes to their nutritional habits, those modifications were mostly followed by a few of them, while over half of patients consumed nutritional supplements after diagnosis. Moreover, changes in nutritional habits were mainly adopted without consulting or informing the oncologist, and even if nearly half of patients believed that a moderate or strong link existed between cancer and nutrition, only one-third of them sought dietary information after being diagnosed. Discussion: Our findings suggest that, after diagnosis, CRC patients have made modest dietary changes, with only a few increasing their consumption of healthy foods. Furthermore, a significant proportion of survivors did not seek dietary information after their diagnosis, highlighting a gap in patient empowerment. These results emphasize the important role of healthcare providers, particularly oncologists, in identifying diet as a potential risk factor and directing patients toward appropriate nutritional support.