Department of Medicine, Division of Hematology and Oncology, University of Florida, Gainesville, Florida.
College of Nursing, University of Florida, Gainesville, Florida.
Biol Blood Marrow Transplant. 2020 Jun;26(6):1154-1159. doi: 10.1016/j.bbmt.2020.02.017. Epub 2020 Feb 24.
Hematopoietic stem cell transplantation (HCT) survivors are burdened by a high prevalence and early onset of chronic diseases. Healthy dietary patterns have been associated with lower risks of chronic health conditions in the general population. HCT survivors are susceptible to multiple complications that may result in chronic illness. Unfortunately, no study to date has comprehensively documented the adherence of HCT survivors to the Dietary Guidelines for Americans (DGA), which are designed specifically to provide guidance for making healthy food choices. The primary aim of this study was to evaluate diet quality and nutrient intake adequacy of HCT survivors. A secondary aim was to assess these survivors' willingness to take part in a future dietary intervention. The dietary intake of adults who had undergone autologous or allogeneic HCT for a hematologic disease and were at least 1 year post-transplantation was assessed using the Block 2014 food frequency questionnaire, and diet quality was estimated using the Healthy Eating Index 2015. Nutrient intake adequacies of the group were estimated by the estimated average requirement cutpoint method. Survivors' (n = 90) HEI-2015 scores averaged 61.6 ± 1.1. Adherence to a good-quality diet was reported by only 10% of survivors. Intakes of vitamins A, C, and D, as well as magnesium and calcium, suggested inadequacy. Fiber intake at 8.9 g per 1000 kcal/day fell below the recommended adequate intake. "Change in taste" was associated with lower quality of diet (P = .02). HCT survivors within 2 years post-transplantation were more receptive than survivors beyond 2 years to participating in a dietary intervention (95% versus 65%; P = .0013). Adult HCT survivors reported less-than-optimal adherence to the 2015-2020 DGA and had numerous shortfall nutrient intakes; however, their willingness to participate in a dietary intervention was relatively high. These findings reinforce the need to incorporate nutrition into HCT survivor care.
造血干细胞移植(HCT)幸存者患有多种慢性疾病,且发病率高、发病早。健康的饮食模式与普通人群中较低的慢性健康状况风险相关。HCT 幸存者易患多种并发症,这些并发症可能导致慢性疾病。不幸的是,迄今为止,尚无研究全面记录 HCT 幸存者对《美国人饮食指南》(DGA)的依从性,该指南专门用于指导健康食物选择。本研究的主要目的是评估 HCT 幸存者的饮食质量和营养素摄入充足性。次要目的是评估这些幸存者参与未来饮食干预的意愿。使用 Block 2014 食物频率问卷评估接受过血液系统疾病自体或同种异体 HCT 且移植后至少 1 年的成年人的饮食摄入,并使用 2015 年健康饮食指数(HEI-2015)估计饮食质量。通过估计平均需要量切点法估计组的营养素摄入充足性。幸存者(n=90)的 HEI-2015 评分平均为 61.6±1.1。只有 10%的幸存者报告坚持良好的饮食质量。维生素 A、C 和 D 以及镁和钙的摄入量表明不足。每 1000 千卡 8.9 克的纤维摄入量低于推荐的充足摄入量。“口味变化”与较差的饮食质量相关(P=0.02)。移植后 2 年内的 HCT 幸存者比移植后 2 年以上的幸存者更愿意参与饮食干预(95%比 65%;P=0.0013)。成年 HCT 幸存者对 2015-2020 年 DGA 的依从性较差,且多种营养素摄入不足;然而,他们参与饮食干预的意愿相对较高。这些发现强调了将营养纳入 HCT 幸存者护理的必要性。