AI-facilitated individualized nutritional guidance with ABC-structured prompts improves short-term dietary intake adequacy and patient-reported symptoms after gastrointestinal cancer surgery: a randomized controlled trial

Postoperative nutritional management is critical for gastrointestinal cancer surgery patients, yet discharge advice is often standardized and lacks individualization. Whether an AI-facilitated individualized and quantified strategy improves short-term dietary intake compared with standard generic advice remains unclear; this trial does not isolate the independent effect of AI.

To determine whether AI-facilitated individualized nutritional guidance using structured prompts improves short-term dietary intake adequacy and patient-reported symptoms versus standard discharge advice.

In this single-center, randomized controlled trial, 90 patients undergoing laparoscopic gastric or colorectal cancer surgery were assigned 1:1 to AI-facilitated individualized guidance generated by DeepSeek v3.2 using an ABC-structured prompt plus clinician review or standard discharge dietary advice (standard care group). The intervention combined AI, individualization, quantified targets, written guidance, and clinician review; the trial cannot isolate AI alone. Primary outcome was energy intake adequacy (≥ 90% of target) at 30 days post-discharge. Secondary outcomes included protein intake adequacy, nutritional status, patient-reported outcomes, process measures (expert-rated quality scores, provider time), and 30-day complications. Outcome assessors were blinded to group assignment.