Zhang Fang Fang, Ojha Rohit P, Krull Kevin R, Gibson Todd M, Lu Lu, Lanctot Jennifer, Chemaitilly Wassim, Robison Leslie L, Hudson Melissa M
Friedman School of Nutrition Science and Policy and
Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA; and.
J Nutr. 2016 Dec;146(12):2497-2505. doi: 10.3945/jn.116.238261. Epub 2016 Oct 19.
Poor nutritional intake can exacerbate the chronic disease burden in childhood cancer survivors, whereas a healthful diet serves a protective function. Few studies have provided detailed evaluations of the diet of childhood cancer survivors.
This study aimed to evaluate diet quality and dietary intakes of key food groups and nutrients in a large cohort of childhood cancer survivors and whether cancer and treatment characteristics have an impact on survivors' long-term intake.
Diet was assessed in 2570 adult survivors of childhood cancer enrolled in the St. Jude Lifetime cohort (mean age = 32.3 y) by using the Block food-frequency questionnaire. The Healthy Eating Index-2010 (HEI-2010) was calculated to quantify diet quality. Cancer diagnosis and treatment exposure were abstracted from medical records. Differences in HEI-2010 by patient characteristics and treatment exposure were examined by using ANCOVA.
The mean ± SD HEI-2010 in childhood cancer survivors was 57.9 ± 12.4 of a maximum score of 100. Referenced to Dietary Reference Intakes, survivors consumed inadequate amounts of vitamin D, vitamin E, potassium, fiber, magnesium, and calcium (27%, 54%, 58%, 59%, 84%, and 90% of the recommended intakes) but excessive amounts of sodium and saturated fat (155% and 115% of the recommended intakes) from foods. Survivors diagnosed when <5 y of age had a lower diet quality than did those diagnosed when ≥5 y of age (mean HEI-2010 score: 56.9 compared with 58.2; P = 0.046). Survivors who received higher radiation doses to the abdomen had a lower diet quality than those who received lower doses (mean HEI-2010 scores = 58.9, 57.2, 56.7, and 56.1 for doses of 0, 1-19.9, 20-29.9, and ≥30 Gy, respectively; P = 0.02).
Long-term childhood cancer survivors have poor adherence to the 2010 Dietary Guidelines for Americans. Findings reinforce the need to incorporate nutrition into cancer care to improve diet quality and to reduce morbidities.
营养摄入不足会加重儿童癌症幸存者的慢性病负担，而健康饮食则具有保护作用。很少有研究对儿童癌症幸存者的饮食进行详细评估。
本研究旨在评估一大群儿童癌症幸存者的饮食质量、关键食物组和营养素的膳食摄入量，以及癌症和治疗特征是否对幸存者的长期摄入量有影响。
通过使用Block食物频率问卷，对参加圣裘德终身队列研究（平均年龄 = 32.3岁）的2570名儿童癌症成年幸存者的饮食进行评估。计算2010年健康饮食指数（HEI-2010）以量化饮食质量。从医疗记录中提取癌症诊断和治疗暴露情况。使用协方差分析检查患者特征和治疗暴露导致的HEI-2010差异。
儿童癌症幸存者的平均±标准差HEI-2010为57.9±12.4（满分100分）。参照膳食参考摄入量，幸存者摄入的维生素D、维生素E、钾、纤维、镁和钙不足（分别为推荐摄入量的27%、54%、58%、59%、84%和90%），但从食物中摄入的钠和饱和脂肪过量（分别为推荐摄入量的155%和115%）。5岁前确诊的幸存者饮食质量低于5岁及以上确诊的幸存者（平均HEI-2010得分：56.9对比58.2；P = 0.046）。腹部接受较高辐射剂量的幸存者饮食质量低于接受较低剂量的幸存者（0、1 - 19.9、20 - 29.9和≥30 Gy剂量组的平均HEI-2010得分分别为58.9、57.2、56.7和56.1；P = 0.02）。
长期的儿童癌症幸存者对2010年美国膳食指南的依从性较差。研究结果强化了将营养纳入癌症护理以改善饮食质量和降低发病率的必要性。
