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Stress, Immunity, and Diet: A New Perspective on Colorectal Cancer Risk and Progression.

Chronic stress and poor diet weaken gut immunity, increasing colorectal cancer risk
Chronic stress and poor diet weaken gut immunity, increasing colorectal cancer risk

Colorectal cancer (CRC) is a leading cause of cancer-related deaths globally. While genetic predisposition contributes to CRC risk, emerging research underscores the significant impact of modifiable lifestyle factors—particularly chronic stress and diet—on the immune environment of the gut and CRC progression.()


The intestinal mucosal immune system serves as the gut’s primary defense mechanism. Chronic stress and poor diet can impair this system, weakening the intestinal barrier, disrupting immune regulation, and increasing the likelihood of inflammation-driven tumor development.()


The Biological Impact of Chronic Stress on the Gut


Chronic psychological stress activates the hypothalamic-pituitary-adrenal (HPA) axis, leading to sustained cortisol release, which suppresses key immune functions. Yang et al. (2024) demonstrated that persistent stress alters the composition and function of mucosal immune cells, including macrophages and dendritic cells, critical for identifying and eliminating abnormal cells in the gut .()


This immune suppression compromises the epithelial barrier, allowing microbial components like lipopolysaccharides to enter the bloodstream, triggering systemic inflammation that fosters a tumor-promoting environment . Stress also disrupts the gut microbiota balance, reducing beneficial bacterial species and promoting pathogenic bacteria—a phenomenon known as dysbiosis . 


Further research indicates that chronic stress diminishes populations of beneficial bacteria such as Lactobacillus johnsonii, which are instrumental in maintaining gut health and preventing tumor progression . 


Diet and Lifestyle in CRC Prevention and Survival


Dietary choices significantly influence the gut immune environment. Vallis and Wang (2022) reported that diets rich in fiber, plant-based foods, and whole grains are protective against CRC, whereas diets high in processed meats, red meat, saturated fats, and sugars are linked to increased CRC risk and poorer survival outcomes . 


Fiber-rich diets promote the production of short-chain fatty acids (SCFAs) like butyrate, which support mucosal integrity and exhibit anti-inflammatory and anti-proliferative effects on colonic cells . Conversely, Western-style diets impair the gut microbiota and elevate pro-inflammatory metabolites, compromising mucosal immunity .()


Additional lifestyle factors such as physical activity, weight management, and moderate alcohol consumption are associated with reduced CRC incidence and improved outcomes, partly through modulation of inflammation and immune regulation .()


Stress and Diet: A Dangerous Synergy


Chronic stress and poor diet often coexist and reinforce each other. Stress-induced emotional eating typically involves high-fat, high-sugar comfort foods, exacerbating gut inflammation. This combination accelerates mucosal damage, increases inflammatory markers, and disrupts microbial balance, contributing to CRC development and progression .()


Addressing these interconnected risks necessitates an integrated approach combining psychological support—such as cognitive behavioral therapy and stress management techniques—with targeted nutrition interventions that promote gut health and immune resilience .()


CRC progression is closely linked to the integrity of the gut’s mucosal immune system. Chronic stress impairs immune regulation, weakens the gut barrier, and alters the microbiome, promoting tumor growth. However, protective diets and healthy lifestyles can mitigate these effects. Public health strategies and clinical care should integrate psychological stress management and nutrition to prevent and manage colorectal cancer effectively.()


References

1. Yang S, Li Y, Zhang Y, Wang Y. Impact of chronic stress on intestinal mucosal immunity in colorectal cancer progression. Cytokine Growth Factor Rev. 2024;76:1–10.

2. Vallis J, Wang PP. The role of diet and lifestyle in colorectal cancer incidence and survival. In: Morgado-Diaz JA, editor. Gastrointestinal Cancers [Internet]. Brisbane (AU): Exon Publications; 2022 Sep 30. Chapter 2.

3. McCollum SE, Shah YM. Stressing out cancer: chronic stress induces dysbiosis and enhances colon cancer growth. Cancer Res. 2024 Mar 4;84(5):645–647. doi: 10.1158/0008-5472.CAN-23-3871. PMID: 38437637; PMCID: PMC12176054.

4. Chronic stress accelerates colorectal cancer progression by disrupting the balance of gut microbiota, new study shows. ecancer. 2024 Oct 14.

5. World Cancer Research Fund/American Institute for Cancer Research. Diet, nutrition, physical activity and colorectal cancer. 2017.

6. News-Medical.net. Chronic stress disrupts gut microbiota, promoting colorectal cancer growth [Internet]. 2024 Oct 13 [cited 2025 Jul 3]. Available from: https://www.news-medical.net/news/20241013/Chronic-stress-disrupts-gut-microbiota-promoting-colorectal-cancer-growth.aspx

7. Drug Target Review. How chronic stress hastens the progression of colorectal cancer [Internet]. 2024 Oct 13 [cited 2025 Jul 3]. Available from: https://www.drugtargetreview.com/news/153691/how-chronic-stress-hastens-the-progression-of-colorectal-cancer


 
 
 
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