When we think about people living with chronic disease, diabetes and heart disease come to mind, but cancer survivors are one of the largest groups of people living with chronic disease. The American Cancer Society estimates that there are more than 10 million of us in the United States.

There are few studies on preventing cancer recurrence, yet people who have had cancer are very motivated to change their lifestyles to prevent cancer from returning. There was some good news for survivors of colon cancer in a recent research paper published in the Journal of the American Medical Association. Colon cancer is the third most common cancer in the United States, and researchers were interested in studying dietary patterns in patients with advanced colon cancer. More than 1,000 patients who were at Stage 3 (cancer in the colon that has spread to the lymph nodes but not to other parts of the body) were treated with surgery and chemotherapy and asked to report their dietary intakes during treatment and six months after treatment. A questionnaire called a food frequency survey was used to collect dietary information. This type of survey asks about 130 items — the types of food eaten, the amounts of food, the frequency of eating the food and the preparation. Researchers analyzed the questionnaires and described two eating patterns.

CHRIS ROSENBLOOM FIT TO EAT Have a question of general interest? E-mail Rosenbloom Related: • More on food and drink • Restaurant reviews and search More Rosenbloom [an error occurred while processing this directive] • Chris Rosenbloom, Ph.D., R.D., is a member of the nutrition faculty in the College of Health and Human Sciences at Georgia State University.

One pattern was called the "Western diet," which contained higher intakes of red meat (beef, pork and lamb), processed meat (sausage, luncheon meats and hot dogs), sweets and high-sugar desserts, french fries and refined grains. The other dietary pattern was labeled the "prudent diet," with higher intakes of fruits, vegetables, beans (like black and kidney beans), fish, poultry and whole-grain breads and cereals.

After about five years of follow-up, the results showed that the Western diet was associated with a worse outcome; that is, those eaters had more recurrence of colon cancer than those who ate a "prudent diet." This result held true even when the researchers controlled for other factors that could affect the outcome, such as body weight, age and physical activity.

Researchers cannot say exactly what dietary component of the Western diet had the most influence on the outcome (was it the fat, fiber, vitamins, sugar, minerals?), but perhaps future studies can answer that question. For now, this study gives more strength to the advice to eat a diet high in fruits, vegetables and whole grains and low in fat, sugar and red and processed meats.

The word prudent means "wise or judicious or exercising good judgment," so it would be prudent for cancer survivors to tweak their diets and eat more of the healthy stuff.

DIET MAKEOVER
Here's a one-day makeover to change your diet from a "Western" pattern to a "prudent" diet.

Breakfast
Before: Starbuck's Grande Mocha Frappuccino and cranberry-orange muffin
After: Starbuck's Grande Cafe Americano and blueberry bagel

Lunch
Before: Fast food fried fish sandwich with cheese, tartar sauce, french fries and soft drink
After: Brown-bag tuna salad sandwich made with light mayonnaise, diced celery, green pepper and onion on whole-wheat bread with red leaf lettuce and sliced tomatoes, small bag of pretzel chips and unsweetened iced tea with lemon

Afternoon snack
Before: Vending machine candy bar and energy drink
After: Walk around the office and up a few flights of stairs and ask yourself if you are really hungry. If the answer is yes, reach for a fresh peach or pear and a bottle of calorie-free sparkling water or a chug of low-fat milk.

Dinner
Before: 8-ounce ground chuck beef burger on white bun, ear of corn with butter, potato chips, soft drink
After: 4-ounce ground turkey breast burger, topped with reduced-fat cheese, lettuce, tomato and onion slices, 1 cup of vegetarian baked beans, pre-washed bag of mixed vegetables (broccoli, carrots, cauliflower, snow peas) wrapped in foil, drizzled with olive oil and placed on upper rack of grill while turkey burger cooks, sugar-free beverage or water.