Associations between diet and chronic disease burden in adult survivors of childhood cancer in the St. Jude Lifetime Cohort (SJLIFE) study.

Abstract

e22017 Background: Nutritional intake can impact health. Data describing associations between diet or specific dietary components and chronic health conditions in long-term survivors of childhood cancer are limited. This study evaluated the associations between specific components of diet and chronic disease burden in childhood cancer survivors. Methods: Adult survivors (≥5 years) of childhood cancer participating in SJLIFE (n = 2822), who completed a clinical evaluation and the Block Food Frequency Questionnaire were included. 168 chronic conditions were graded using a modified Common Terminology for Adverse Events. Conditions were summed within grade category, multiplied by weights (1, 2, 3, and 8 for grades 1-4, respectively) and standardized (z-scores) with higher scores indicating more disease burden. Adherence to the 2015 Dietary Guidelines for Americans was scored with the Healthy Eating Index-15 (HEI). Intake of key food groups and nutrients was estimated and divided into quartiles for analysis. Multivariable logistic regression, adjusted for sex, age, and race was used to compare dietary intake and higher disease burden (defined as a z-score > 0). Results: Survivors (median [range] survival time 23 [10-49] years, diagnosis age 7 [0-24] years, 47.6% female, 16.9% non-white, 38.0% leukemia, 19.5% lymphoma, 10.3% CNS tumor, 32.2% other solid tumor) had an average of 10.0 (95% CI 9.7-10.3) conditions by 30 years of age and had a mean score on the HEI of 57.9±12.2 (out of 100 where the population average is 59). Scores on the HEI were not associated with disease burden z-score. Compared to those in the lowest quartile, survivors who consumed in the highest quartile of dark green vegetables (OR 0.77, 95% CI 0.61-0.97), legumes (OR 0.74, 95% CI 0.59-0.92), and whole grains (OR 0.75, 95% CI 0.60-0.95) were less likely to have a disease burden z-score > 0, whereas those who consumed in the highest quartile of white potatoes (OR 1.31, 95% CI 1.05-1.64), refined grains (OR 1.26, 95% CI 1.01-1.58), and added sugars (OR: 1.27, 95% CI 1.01-1.56) were more likely to have a disease burden z-score > 0. Conclusions: Specific components of diet are associated with chronic disease burden in long term survivors of cancer. Dietary interventions may have potential to decrease chronic disease burden in this population.