Diet—microbiome interaction in colorectal cancer: a potentially discriminatory role for Fusobacterium nucleatum

Abstract Intestinal homeostasis depends on the dynamic interplay among the host, its gut microbiome, and diet. Cohort studies and intervention trials emphasize plant-based diets for chronic disease prevention. Fermentable fiber in these diets is a preferred metabolic fuel for the gut microbiome; prudent diets, encompassing a higher intake of fruits, vegetables, legumes, and rich in fiber, rather than a Western diet, are associated with reduced risk for colorectal cancer (CRC). CRC is characterized by a typical gut microbiome signature, with Fusobacterium nucleatum being an emerging critical species. Remarkably, an inverse association between prudent diets and F. nucleatum–positive CRC risk has been demonstrated, while inflammatory and Western dietary patterns are associated with an increased risk of F. nucleatum–positive CRC tumor subtype. This relationship does not apply to F. nucleatum–negative tumors. The intersection between diet, microbiota composition, and CRC warrants the application of nutritional strategies to prevent the development of CRC.