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Higher physical activity levels and less sedentary time are associated with more robust diurnal cortisol rhythms in colorectal cancer survivors up to 12 months post-treatment.

In 74 colorectal cancer survivors, more total sedentary time (per 2 hours/day) was associated with a flatter cortisol slope (β=0.19; 95%CI=0.06,0.33) and higher cortisol awakening response (β=0.14; 95%CI=0.01,0.27). More total physical activity (per 1 hour/day) was associated with higher relative amplitude of cortisol (β=0.23; 95%CI=0.03,0.43), indicating more robust diurnal rhythms.

Last updated: Aug 1, 2026•0 RCTs•📖 Read as article →

Evidence Score

Evidence Score34/100
Human RCT☆☆☆☆☆
Meta-analysis☆☆☆☆☆
Mechanism★★★★★
Safety★★★★☆
Confidencelow

Study Evidence

Study 1. Sedentary behavior and physical activity are longitudinally associated with diurnal cortisol rhythms in individuals up to 1 year after colorectal cancer treatment: A prospective cohort study.

observational

Frenken KG, Scheer FAJL, Qian J, Bours MJL, Breukink SO, Janssen-Heijnen MLG, Konsten J, Keulen ETP, Bons JAP, Meijer K, Steindorf K, de Vos-Geelen J, Weijenberg MP, Buffart LM, van Roekel EH · Research square (2026)

Participants: N/A
Duration: 12 months
Intervention: Accelerometer-assessed sedentary behavior and physical activity (measured at 6 weeks, 6 months, and 12 months post-treatment)
Outcome: Diurnal cortisol rhythms: relative amplitude of cortisol (RA_cort), diurnal slope, area under the curve (AUC), cortisol awakening response (CAR)
Effect Size: β=0.19 for flatter slope per 2 hours/day more sedentary time; β=0.23 for higher RA_cort per 1 hour/day more physical activity
Population: 74 colorectal cancer survivors up to 12 months after cancer treatment

Result:

PubMed: 42523521DOI: 10.21203/rs.3.rs-10268142/v1

Mechanism Graph

Sedentary behavior increases sedentary time
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Sedentary time is associated with flatter cortisol slope and lower cortisol amplitude
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Physical activity increases day-night contrast in activity
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Higher physical activity and less sedentary time are associated with more robust diurnal cortisol rhythms

Limitations

  • ⚠Small sample size (n=74) limits generalizability
  • ⚠Observational design cannot establish causality
  • ⚠Potential residual confounding despite adjustment

Frequently Asked Questions

What is the main finding of this study?▼

More sedentary time is linked to flatter cortisol slopes and higher cortisol awakening response, while more physical activity is linked to more robust diurnal cortisol rhythms in colorectal cancer survivors.

How was sedentary behavior measured?▼

Sedentary time was measured using thigh-worn accelerometers over 7 days at three timepoints: 6 weeks, 6 months, and 12 months after cancer treatment.

What does a flatter cortisol slope indicate?▼

A flatter cortisol slope indicates a less robust diurnal rhythm, which is associated with fatigue, depressive symptoms, and poorer quality of life.

Can these results be used to design interventions?▼

Yes, the authors suggest that reducing sedentary time and increasing physical activity may be targets for interventions aimed at improving cortisol rhythmicity after colorectal cancer treatment.

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References

  1. 1.Frenken KG, Scheer FAJL, Qian J, Bours MJL, Breukink SO, Janssen-Heijnen MLG, Konsten J, Keulen ETP, Bons JAP, Meijer K, Steindorf K, de Vos-Geelen J, Weijenberg MP, Buffart LM, van Roekel EH. "Sedentary behavior and physical activity are longitudinally associated with diurnal cortisol rhythms in individuals up to 1 year after colorectal cancer treatment: A prospective cohort study.." Research square, 2026. PMID: 42523521 DOI: 10.21203/rs.3.rs-10268142/v1
Disclaimer: This content is for educational purposes only and is not medical advice. Evidence scores reflect the quality and quantity of available research, not clinical recommendations. Always consult a healthcare professional before starting any supplement or intervention.