The goal of this clinical trial is to quantify the effects of aerobic exercise training compared to attention control on intermuscular adipose tissue in colorectal cancer survivors.

Inclusion Criteria:

• Age ≥18 years
• Histologically confirmed stage I, II, or III colon or rectal cancer
• Completed surgical resection with curative intent
• Completed other cancer-directed treatments
• Engage in <150 minutes per week of moderate- to vigorous-intensity structured endurance exercise
• No planned major surgery during the study period
• Readiness to exercise, as determined by a modified version of the Physical Activity Readiness Questionnaire
• Ability to provide written informed consent
• Provide written approval by a qualified healthcare professional
• Willing to be randomized

Exclusion Criteria:

• Evidence of metastatic or recurrent colorectal cancer
• Concurrently actively treated other (non-colorectal) cancer
• Scheduled to receive other postoperative cancer-directed treatment(s)
• Currently pregnant, breastfeeding, or planning to become pregnant within the next 24 weeks
• Currently participating in another study with competing outcomes
• Contraindications to magnetic resonance imaging
• Any dietary condition or restriction that would limit tolerance of a mixed meal challenge
• Any other cardiovascular, pulmonary, orthopedic, neurologic, psychiatric, or other condition that, in the investigator's opinion, would preclude participation or successful compliance with the protocol
• Any other situation that, in the opinion of the investigator, would negatively impact subject safety or successful compliance with the protocol