Researchers looked at what cancer survivors eat across the United States and found that most aren’t eating as healthily as they should be. The study examined nearly 1,900 cancer survivors and measured their diet quality using a scoring system. While eating habits were similarly poor across different racial and ethnic groups, the reasons behind these habits differed. The findings suggest that doctors and nutritionists need to create different strategies to help cancer survivors from different backgrounds improve their eating habits and stay healthier after treatment.
The Quick Take
- What they studied: How well cancer survivors are eating and whether eating habits differ based on race and ethnicity
- Who participated: 1,841 cancer survivors age 20 and older from across the United States, representing different racial and ethnic backgrounds including Hispanic/Mexican American, Non-Hispanic White, and Non-Hispanic Black populations
- Key finding: Cancer survivors scored an average of 60.8 out of 100 on a diet quality test, which is considered low. Surprisingly, all racial and ethnic groups had similar poor scores, but different factors influenced their eating choices
- What it means for you: If you’re a cancer survivor, this research suggests you may benefit from working with a nutritionist to improve your diet. The good news is that the problem isn’t unique to any one group, so solutions can be developed for everyone. Talk to your doctor about personalized nutrition guidance based on your background and circumstances.
The Research Details
This was a secondary analysis, meaning researchers used data that had already been collected by the U.S. government’s National Health and Nutrition Examination Survey (NHANES) from 2011 to 2020. They looked at information from cancer survivors in this large national database and analyzed what they reported eating over two separate 24-hour periods. The researchers used a tool called the Healthy Eating Index (HEI)-2020, which scores diets based on how much of different food groups people eat—like vegetables, fruits, whole grains, and how much added sugar and refined grains they consume. A higher score means a healthier diet.
The researchers compared diet quality scores across different racial and ethnic groups and looked at whether factors like age, income, education, weight, physical activity, and alcohol use were connected to diet quality. They used statistical tests designed for large national surveys to make sure their findings were accurate and representative of all cancer survivors in the United States.
This research approach is important because it uses real-world data from a nationally representative sample, meaning the findings likely apply to cancer survivors across the entire country, not just one hospital or clinic. By looking at data that was already collected, researchers could study a large number of people without the cost and time of conducting a brand-new study. Understanding diet quality in cancer survivors is crucial because eating well can help prevent other health problems and improve quality of life after cancer treatment.
This study has several strengths: it includes a large, diverse sample of nearly 1,900 cancer survivors from across the United States, and it uses standardized methods for measuring diet that are used by government health agencies. However, the study is cross-sectional, meaning it captures a snapshot in time rather than following people over years, so we can’t prove that diet quality causes health problems—only that they’re connected. Additionally, the study relies on people remembering what they ate, which can be inaccurate. The findings are published in a peer-reviewed journal, which means other experts reviewed the work before publication.
What the Results Show
The average diet quality score for cancer survivors was 60.8 out of 100, which falls into the ‘poor’ range according to nutrition standards. This means most cancer survivors aren’t eating enough fruits, vegetables, and whole grains, and are eating too much refined grains and added sugar.
When researchers compared scores across racial and ethnic groups, they found no major differences: Hispanic/Mexican American survivors scored 62.1, Non-Hispanic White survivors scored 60.8, and Non-Hispanic Black survivors scored 60.0. This suggests that poor diet quality is a widespread problem affecting cancer survivors regardless of race or ethnicity.
However, the factors connected to poor diet quality were different for each group. For White survivors, age and alcohol use were linked to diet quality. For Black survivors, age, where they were born, and weight were connected to diet quality. For Hispanic/Mexican American survivors, sex, age, education level, income, and physical activity were all linked to diet quality. This means that to help each group eat better, doctors and nutritionists may need to focus on different issues.
When looking at specific food categories, cancer survivors did best with protein foods and vegetables—these had the highest scores. However, they did worst with refined grains (like white bread and processed cereals) and added sugars (like soda and desserts)—these had the lowest scores. This pattern was consistent across all racial and ethnic groups, suggesting that reducing refined grains and added sugars should be a priority for all cancer survivors.
Previous research has shown that cancer survivors often struggle with diet quality and that poor eating habits can increase the risk of other health problems. This study confirms those findings on a national scale and adds important information about how different racial and ethnic groups experience these challenges differently. The finding that all groups have similarly poor diet quality, but for different reasons, suggests that previous one-size-fits-all nutrition advice may not be effective.
This study has several important limitations. First, it’s cross-sectional, meaning it shows a snapshot in time and can’t prove that diet quality causes health problems—only that they’re connected. Second, the study relies on people remembering what they ate over 24-hour periods, which can be inaccurate. Third, the study doesn’t explain why diet quality is poor or what barriers cancer survivors face when trying to eat well. Finally, the study doesn’t include information about cancer type, stage, or time since treatment, which could affect eating habits.
The Bottom Line
Cancer survivors should work with a registered dietitian or nutritionist to improve their diet quality. Focus on eating more vegetables, fruits, and whole grains while reducing refined grains and added sugars. The specific strategies may need to be tailored based on your background, income level, education, and lifestyle. Talk to your oncology team about nutrition support services available to you. (Confidence level: Moderate—this is based on observational data, not controlled experiments.)
This research is most relevant to cancer survivors who want to improve their health after treatment. It’s also important for doctors, nurses, and nutritionists who work with cancer survivors. Healthcare systems and public health agencies should care about these findings because they suggest that current nutrition guidance may not be reaching all cancer survivors equally. If you’re a cancer survivor from any racial or ethnic background, this research applies to you.
Improving diet quality is a gradual process. You may notice increased energy and better digestion within 2-4 weeks of eating better. More significant health benefits, like improved weight management and reduced disease risk, typically take 3-6 months of consistent healthy eating. Long-term benefits accumulate over years.
Want to Apply This Research?
- Track daily servings of vegetables, fruits, whole grains, and added sugar intake. Set a goal to eat at least 2-3 cups of vegetables and 1-2 cups of fruit daily, choose whole grains for at least half your grain intake, and limit added sugars to less than 25-36 grams per day.
- Use the app to log meals and receive real-time feedback on diet quality. Set reminders to eat vegetables at lunch and dinner. Create a shopping list feature that prioritizes whole foods and limits processed items. Connect with a registered dietitian through the app for personalized guidance based on your specific background and circumstances.
- Weekly review of diet quality scores to identify patterns. Monthly check-ins with a healthcare provider or dietitian to adjust goals. Track how you feel—energy levels, digestion, and overall wellness—alongside diet quality scores to see the real-world impact of eating better.
This research describes patterns in diet quality among cancer survivors but does not prove that diet quality causes specific health outcomes. The findings are based on self-reported dietary information, which may not be completely accurate. If you are a cancer survivor, consult with your oncologist and a registered dietitian before making significant dietary changes, especially if you are currently undergoing treatment or taking medications that may interact with certain foods. This information is for educational purposes and should not replace professional medical advice.
This research translation is published by Gram Research, the science division of Gram, an AI-powered nutrition tracking app.