# Beneficial effects of a high-anthocyanin diet versus a Westernized diet on colorectal cancer risk: a systematic review

**Authors:** Alberto Vásquez, Paula Zúñiga, Keila Torres, Andrew F. G. Quest, Layla Simón

PMC · DOI: 10.3389/fimmu.2026.1736018 · Frontiers in Immunology · 2026-02-12

## TL;DR

This paper reviews how diets rich in anthocyanins may help prevent colorectal cancer, compared to Western diets that increase cancer risk.

## Contribution

The study systematically compares the preventive effects of anthocyanin-rich diets versus Western diets on colorectal cancer risk.

## Key findings

- Anthocyanin-rich diets reduce CRC risk by modulating oxidative stress and inflammation.
- Western diets are linked to increased gut inflammation and tumor burden.
- Anthocyanins improve gut microbial diversity and restore gut barrier integrity.

## Abstract

Colorectal cancer (CRC) is one of the leading causes of morbidity and mortality worldwide. Its incidence has been strongly associated with dietary patterns of the Western diet (WD), which are characterized by high intakes of saturated fats, ultra-processed foods, red and processed meats, refined grains, and added sugars. In contrast, numerous studies have highlighted the potential health benefits of anthocyanins—bioactive compounds with anti-inflammatory, antioxidant, and antitumoral properties. This systematic review aimed to evaluate the effects of anthocyanin-rich diets on CRC prevention and compare them with the effects of WD.

A systematic search was conducted in PubMed, Scopus, and SciELO databases following PRISMA 2020 guidelines. Search terms included: “anthocyanin” OR “anthocyanins” AND “prevention” AND “colorectal cancer” AND “Western diet” AND “effect.”

Sixteen studies met the inclusion criteria. Anthocyanin-rich interventions demonstrated consistent preventive effects, including the modulation of oxidative stress, suppression of oncogenic signaling pathways, induction of apoptosis in CRC cells, and restoration of gut barrier integrity and microbial diversity. Notably, these interventions exerted significant anti-inflammatory effects by downregulating pro-inflammatory cytokines, inhibiting NF-κB, and attenuating colitis-associated tumorigenesis. In contrast, Western dietary patterns were consistently associated with enhanced colonic inflammation, alterations in gut microbial composition, impairment of mucosal immune regulation, and increased colorectal tumor burden.

This systematic review provides evidence supporting the protective role of anthocyanin-rich diets in CRC prevention. However, further research is needed to examine drug-nutrient interactions in the context of comorbidities, evaluate various sources of anthocyanins, and better understand the factors influencing their bioavailability and absorption.

https://osf.io/b56yz/overview, identifier osf-registrations-b56yz-v.

## Linked entities

- **Chemicals:** anthocyanin (PubChem CID 145858), anthocyanins (PubChem CID 145858)
- **Diseases:** colorectal cancer (MONDO:0005575)

## Full-text entities

- **Genes:** Muc2 (mucin 2) [NCBI Gene 17831] {aka 2010015E03Rik, MCM, wnn}, Kras (Kras proto-oncogene, GTPase) [NCBI Gene 16653] {aka K-Ras, K-Ras 2, K-ras, Ki-ras, Kras-2, Kras2}, Mapk1 (mitogen-activated protein kinase 1) [NCBI Gene 26413] {aka 9030612K14Rik, ERK, Erk2, MAPK2, PRKM2, Prkm1}, Il6st (interleukin 6 signal transducer) [NCBI Gene 16195] {aka 5133400A03Rik, CD130, D13Ertd699e, gp130}, FAS (Fas cell surface death receptor) [NCBI Gene 355] {aka ALPS1A, APO-1, APT1, CD95, FAS1, FASTM}, RPS6KB1 (ribosomal protein S6 kinase B1) [NCBI Gene 6198] {aka PS6K, S6K, S6K-beta-1, S6K1, STK14A, p70 S6KA}, Lpcat1 (lysophosphatidylcholine acyltransferase 1) [NCBI Gene 210992] {aka 2900035H07Rik, Aytl2, LPCAT, LPCAT-1, lysoPAFAT, mLPCAT1}, KAT8 (lysine acetyltransferase 8) [NCBI Gene 84148] {aka LIGOWS, MOF, MYST1, ZC2HC8, hMOF}, SOD1 (superoxide dismutase 1) [NCBI Gene 6647] {aka ALS, ALS1, HEL-S-44, IPOA, SOD, STAHP}, Slc25a20 (solute carrier family 25 (mitochondrial carnitine/acylcarnitine translocase), member 20) [NCBI Gene 57279] {aka 1110007P09Rik, CAC, Cact, mCAC}, Nlrp3 (NLR family, pyrin domain containing 3) [NCBI Gene 216799] {aka AGTAVPRL, AII/AVP, Cias1, FCAS, FCU, MWS}, Trp53 (transformation related protein 53) [NCBI Gene 22059] {aka Tp53, bbl, bfy, bhy, p44, p53}, CTNNB1 (catenin beta 1) [NCBI Gene 1499] {aka CTNNB, EVR7, MRD19, NEDSDV, armadillo}, Tnf (tumor necrosis factor) [NCBI Gene 21926] {aka DIF, TNF-a, TNF-alpha, TNFSF2, TNFalpha, Tnfa}, Mpo (myeloperoxidase) [NCBI Gene 17523] {aka mKIAA4033}, H4C6 (H4 clustered histone 6) [NCBI Gene 8361] {aka H4, H4/c, H4FC, HIST1H4F}, Cd274 (CD274 antigen) [NCBI Gene 60533] {aka A530045L16Rik, B7h1, Pdcd1l1, Pdcd1lg1, Pdl1}, BCL2L1 (BCL2 like 1) [NCBI Gene 598] {aka BCL-XL/S, BCL2L, BCLX, Bcl-X, PPP1R52}, BCL2 (BCL2 apoptosis regulator) [NCBI Gene 596] {aka Bcl-2, PPP1R50}, MTOR (mechanistic target of rapamycin kinase) [NCBI Gene 2475] {aka FRAP, FRAP1, FRAP2, RAFT1, RAPT1, SKS}, AIFM1 (apoptosis inducing factor mitochondria associated 1) [NCBI Gene 9131] {aka AIF, AUNX1, CMT2D, CMTX4, COWCK, COXPD6}, CCND1 (cyclin D1) [NCBI Gene 595] {aka BCL1, D11S287E, PRAD1, U21B31}, GLS (glutaminase) [NCBI Gene 2744] {aka AAD20, CASGID, DEE71, EIEE71, GAC, GAM}, Rela (Rela proto-oncogene, NFKB subunit) [NCBI Gene 19697] {aka p65, p65 NF-kappa B, p65 NFkB}, SLC1A5 (solute carrier family 1 member 5) [NCBI Gene 6510] {aka AAAT, ASCT2, ATBO, M7V1, M7VS1, R16}, GSK3B (glycogen synthase kinase 3 beta) [NCBI Gene 2932], EGFR (epidermal growth factor receptor) [NCBI Gene 1956] {aka ERBB, ERBB1, ERRP, HER1, NISBD2, NNCIS}, Stat3 (signal transducer and activator of transcription 3) [NCBI Gene 20848] {aka 1110034C02Rik, Aprf}, Akt1 (Akt serine/threonine kinase 1) [NCBI Gene 11651] {aka Akt, LTR-akt, PKB, PKB/Akt, PKBalpha, Rac}, Klf4 (Kruppel-like transcription factor 4 (gut)) [NCBI Gene 16600] {aka EZF, Gklf, Zie}, APC (APC regulator of Wnt signaling pathway) [NCBI Gene 324] {aka BTPS2, DESMD, DP2, DP2.5, DP3, GS}, Apc (APC, WNT signaling pathway regulator) [NCBI Gene 11789] {aka CC1, Min, mAPC}, ULK1 (unc-51 like autophagy activating kinase 1) [NCBI Gene 8408] {aka ATG1, ATG1A, UNC51, Unc51.1, hATG1}, EP300 (EP300 lysine acetyltransferase) [NCBI Gene 2033] {aka KAT3B, MKHK2, RSTS2, p300}, Tlr4 (toll-like receptor 4) [NCBI Gene 21898] {aka Lps, Ly87, Ran/M1, Rasl2-8}, STAT5A (signal transducer and activator of transcription 5A) [NCBI Gene 6776] {aka MGF, STAT5}, Mapk14 (mitogen-activated protein kinase 14) [NCBI Gene 26416] {aka CSBP2, Crk1, Csbp1, Mxi2, PRKM14, PRKM15}, BAX (BCL2 associated X, apoptosis regulator) [NCBI Gene 581] {aka BCL2L4}, FASLG (Fas ligand) [NCBI Gene 356] {aka ALPS1B, APT1LG1, APTL, CD178, CD95-L, CD95L}, AKT1 (AKT serine/threonine kinase 1) [NCBI Gene 207] {aka AKT, PKB, PKB-ALPHA, PRKBA, RAC, RAC-ALPHA}, STAT3 (signal transducer and activator of transcription 3) [NCBI Gene 6774] {aka ADMIO, ADMIO1, APRF, HIES}, SRC (SRC proto-oncogene, non-receptor tyrosine kinase) [NCBI Gene 6714] {aka ASV, SRC1, THC6, c-SRC, p60-Src}, MYC (MYC proto-oncogene, bHLH transcription factor) [NCBI Gene 4609] {aka MRTL, MYCC, bHLHe39, c-Myc}, Cybb (cytochrome b-245, beta polypeptide) [NCBI Gene 13058] {aka CGD91-phox, Cgd, Cyd, Nox2, gp91-1, gp91phox}, Casp3 (caspase 3) [NCBI Gene 12367] {aka A830040C14Rik, AC-3, CASP-3, CC3, CPP-32, CPP32}, Il17a (interleukin 17A) [NCBI Gene 16171] {aka Ctla-8, Ctla8, IL-17, IL-17A, Il17}, Pdcd1 (programmed cell death 1) [NCBI Gene 18566] {aka Ly101, PD-1, Pdc1}, Il6 (interleukin 6) [NCBI Gene 16193] {aka Il-6}, EIF4EBP1 (eukaryotic translation initiation factor 4E binding protein 1) [NCBI Gene 1978] {aka 4E-BP1, 4EBP1, BP-1, PHAS-I}, SIRT1 (sirtuin 1) [NCBI Gene 23411] {aka SIR2, SIR2L1, SIR2alpha}, CASP3 (caspase 3) [NCBI Gene 836] {aka CPP32, CPP32B, SCA-1}, NFKB1 (nuclear factor kappa B subunit 1) [NCBI Gene 4790] {aka CVID12, EBP-1, KBF1, NF-kB, NF-kB1, NF-kappa-B1}, COL11A2 (collagen type XI alpha 2 chain) [NCBI Gene 1302] {aka DFNA13, DFNB53, FBCG2, HKE5, OSMEDA, OSMEDB}, CYCS (cytochrome c, somatic) [NCBI Gene 54205] {aka CYC, HCS, THC4}, COX2 (cytochrome c oxidase subunit II) [NCBI Gene 17709], Ifng (interferon gamma) [NCBI Gene 15978] {aka IFN-g, If2f, Ifg}
- **Diseases:** colitis (MESH:D003092), cardiovascular disease (MESH:D002318), digestive disease (MESH:D004066), metastasis (MESH:D009362), adenomatous polyps (MESH:D018256), CRC (MESH:D015179), tumorigenic (MESH:D002471), carcinogenic (MESH:D011230), micronutrient deficiencies (MESH:D007153), nutritional deficiencies (MESH:D044342), deaths (MESH:D003643), WD (MESH:D020241), intestinal injury (MESH:D007410), colonic dysplasia (MESH:D003108), inflammatory bowel disease (MESH:D015212), mucosal (MESH:D052016), type 2 diabetes (MESH:D003924), dysbiosis (MESH:D064806), Cancer (MESH:D009369), intestinal polyps and tumors (MESH:D007417), rectal cancer (MESH:D012004), Inflammatory (MESH:D007249), hereditary cancer syndromes (MESH:D009386), dyslipidemia (MESH:D050171), metabolic (MESH:D008659), colon tumor (MESH:D003110), obesity (MESH:D009765), weight gain (MESH:D015430), colorectal carcinogenesis (MESH:D063646), adenoma (MESH:D000236)
- **Chemicals:** butyrate (MESH:D002087), fatty acid (MESH:D005227), malonic dialdehyde (MESH:D008315), carbohydrates (MESH:D002241), H2S (MESH:D006862), Anthos (-), sodium (MESH:D012964), alpha-ketoglutarate (MESH:D007656), alcohol (MESH:D000438), sulfite (MESH:D013447), Anthocyanin (MESH:D000872), ROS (MESH:D017382), calcium (MESH:D002118), Cy3g (MESH:C462279), flavonoid (MESH:D005419), glutamine (MESH:D005973), polyphenol (MESH:D059808), lipid (MESH:D008055), vitamin D. (MESH:D014807), glucosides (MESH:D005960), oxygen (MESH:D010100), AOM (MESH:D001397), N-glycolylneuraminic acid (MESH:C032592), sugars (MESH:D000073893), fiber (MESH:D004043), vinegar (MESH:D019342), free radicals (MESH:D005609)
- **Species:** Rattus norvegicus (brown rat, species) [taxon 10116], Bacteroides fragilis (species) [taxon 817], Homo sapiens (human, species) [taxon 9606], Vaccinium meridionale (species) [taxon 57538], Aronia melanocarpa (black chokeberry, species) [taxon 661339], Bilophila wadsworthia (species) [taxon 35833], gut metagenome (species) [taxon 749906], Brassica oleracea var. botrytis (cauliflower, varietas) [taxon 3715], Bifidobacterium pseudolongum (species) [taxon 1694], Oryza sativa (Asian cultivated rice, species) [taxon 4530], Fusobacterium nucleatum (species) [taxon 851], Mus musculus (house mouse, species) [taxon 10090], Flavobacterium (genus) [taxon 237], Hibiscus sabdariffa (red-sorrel, species) [taxon 183260], Escherichia coli (E. coli, species) [taxon 562], Malus domestica (apple, species) [taxon 3750], Legionella (genus) [taxon 445]
- **Mutations:** rs6983267, rs1042522, rs7623023, rs7737692
- **Cell lines:** SW480 — Homo sapiens (Human), Colon adenocarcinoma, Cancer cell line (CVCL_0546), Caco-2 — Homo sapiens (Human), Colon adenocarcinoma, Cancer cell line (CVCL_0025), HT-29 — Homo sapiens (Human), Colon adenocarcinoma, Cancer cell line (CVCL_0320), ISO48 — Homo sapiens (Human), Induced pluripotent stem cell (CVCL_A8PP), LoVo — Homo sapiens (Human), Colon adenocarcinoma, Cancer cell line (CVCL_0399), HCT 116 — Homo sapiens (Human), Colon carcinoma, Cancer cell line (CVCL_0291)

## Full text

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## Figures

3 figures with captions in the complete paper: https://tomesphere.com/paper/PMC12935606/full.md

## References

54 references — full list in the complete paper: https://tomesphere.com/paper/PMC12935606/full.md

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Source: https://tomesphere.com/paper/PMC12935606