The crypt is the fundamental unit of epithelial proliferation in the intestinal mucosa. The progeny of the pluripotent stem cells located near the base of the crypt migrate towards the crypt orifice, divide once or twice more, and then undergo differentiation, senescence and exfoliation. Programmed cell death (apoptosis) also occurs deep in the proliferative zone. Various lines of evidence suggest that apoptosis provides a protective mechanism against neoplasia by removing genetically damaged stem cells from the epithelium before they can undergo clonal expansion. Several different classes of food constituents, including certain polyunsaturated fatty acids, the short-chain fatty acid butyrate, and some phytochemicals including flavonoids and glucosinolates breakdown products, can modulate both cellular proliferation and programmed death. Each of these food components has also been shown to suppress the emergence of aberrant crypt foci in animal models of carcinogenesis. Further mechanistic and clinical studies are required to establish whether such dietary effects can be exploited to achieve preventive or therapeutic effects in humans.