"People with stage III colon cancer who regularly eat nuts are at significantly lower risk of cancer recurrence and mortality than those who dont according to a new large study led by researchers at Yale Cancer Center. The findings were published today in the Journal of Clinical Oncology. The study followed  participants in a clinical trial for a median of . years after they were treated with surgery and chemotherapy. Those who regularly consumed at least two oneounce servings of nuts each week demonstrated a  improvement in diseasefree survival and a  improvement in overall survival. Further analysis of this cohort revealed that diseasefree survival increased by  among the subgroup of nut consumers who ate tree nuts rather than peanuts said Charles S. Fuchs M.D. director of Yale Cancer Center and senior author of the study. Tree nuts include almonds walnuts hazelnuts cashews and pecans among others. In contrast peanuts are actually in the legume family of foods. These findings are in keeping with several other observational studies that indicate that a slew of healthy behaviors  including increased physical activity keeping a healthy weight and lower intake of sugar and sweetened beverages  improve colon cancer outcomes said Temidayo Fadelu M.D. a postdoctoral fellow at DanaFarber Cancer Institute and lead author of the paper. The results highlight the importance of emphasizing dietary and lifestyle factors in colon cancer survivorship. Additionally the researchers emphasized the study highlighted connections between biological mechanisms that worsen disease not just in colon cancer but in certain chronic illnesses such as type  diabetes. Many previous studies have reported that nuts among other health benefits may help to reduce insulin resistance a condition in which the body has difficulty processing the insulin hormone. Insulin resistance leads to unhealthy levels of sugar in the blood and is often a predecessor to type  diabetes and related illnesses. Earlier research among patients with colon cancer has revealed worse outcomes among those with lifestyle factors  such as obesity lack of exercise and a diet with high levels of carbohydrates  that heighten insulin resistance and quickly raise levels of blood sugar. These studies support the hypothesis that behaviors that make you less insulinresistant including eating nuts seem to improve outcomes in colon cancer Fuchs said. However we dont know yet what exactly about nuts is beneficial. Nuts also might play a positive role by satisfying hunger with less intake of carbohydrates or other foods associated with poor outcomes Fuchs noted. Patients may not be eating nuts due to concerns about the high fat content said Fuchs. For example a oneounce serving of about  almonds holds about  calories including  grams of fat. People ask me if increasing nut consumption will lead to obesity which leads to worse outcomes he said. But whats really interesting is that in our studies and across the scientific literature in general regular consumers of nuts tend to be leaner. Dietary changes can make a difference. An earlier analysis of diets in the same patient cohort by Fuchs and his colleagues found a significant link between coffee consumption and reduced recurrence and mortality in colon cancer. When Fuchs advises his patients about lifestyle choices first and foremost I talk about avoiding obesity exercising regularly and staying away from a highcarbohydrate diet he said. Then we talk about things like coffee and nuts. If you like coffee or nuts enjoy them and if you dont there are many other helpful steps you can take. Overall we are working to apply the same rigorous science to the understanding of diet and lifestyles in the colon cancer patient population that we apply to defining new drugs Fuchs said. Cocorresponding authors on the paper are Jeffrey Meyerhardt M.D. of DanaFarber and Ying Bao M.D. of Brigham and Womens Hospital. Lead funding for the research was provided by the National Cancer Institute. Support also came from private sponsors including Pfizer Oncology and the International Tree Nut Council Nutrition Research  Education Foundation. The private sponsors did not participate in the design conduct or analysis of the study or in review or approval of the paper."