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With the rapid development of cardio-oncology, the cardiovascular toxicity risks faced by CRC patients during radiotherapy, chemotherapy, targeted therapy, and immunotherapy have become increasingly prominent, emerging as a key factor affecting long-term patient outcomes. However, there was currently a lack of systematic integration regarding the mechanisms underlying the interplay between the gut microbiota, nutritional interventions, and cardio-oncology in the management of CRC. This article aims to review the mechanisms underlying the interaction between CRC and the gut microbiota, the effects of nutritional interventions on the gut microbiota and tumor progression, and the important role of cardio-oncology in the treatment of CRC. This review examines the emerging evidence on how gut microbiota and nutrition interact to influence CRC development, progression, and therapeutic response, and proposes a theoretical basis for integrating these insights into multidisciplinary comprehensive treatment strategies.<\/jats:p>","DOI":"10.3389\/fimmu.2026.1908629","type":"journal-article","created":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T11:19:21Z","timestamp":1789730361000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Progress on the regulation of colorectal cancer and cardio-oncology by the gut microbiota and nutrients"],"prefix":"10.3389","volume":"17","author":[{"given":"Aibo","family":"Liu","sequence":"first","affiliation":[{"name":"Department of Laboratory Medicine, Sichuan Academy of Medical Sciences and Sichuan Provincial People\u2019s Hospital","place":["Chengdu, China"]},{"name":"Genetic diseases Key Laboratory of Sichuan 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