Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.
Department of Clinical and Health Psychology, University of Florida, Gainesville, Florida.
Pediatr Blood Cancer. 2021 Apr;68(4):e28811. doi: 10.1002/pbc.28811. Epub 2020 Dec 31.
Childhood acute lymphoblastic leukemia (ALL) survivors' increased risk for adverse health outcomes could be mitigated through consuming a balanced diet. Nonetheless, >70% of adult survivors do not meet survivorship dietary recommendations. ALL treatment may amplify risk for restricted dietary preferences (picky eating) and poor self-regulation of food intake that could contribute to suboptimal diets in survivorship. This study aims to: (a) characterize differences in picky eating and self-regulation of food intake between survivors and peer controls; and (b) examine the associations between these eating behaviors and dietary quality in ALL survivors relative to peer controls.
Participants were children (5-13 years) with (n = 32) and without (n = 32) a history of ALL and their caregivers. Children's dietary quality (Healthy Eating Index-2015) was calculated from 24-h dietary recalls. Caregivers completed the Child Eating Behavior Questionnaire-Food Fussiness subscale and the Child Self-Regulation in Eating Questionnaire.
Independent samples t-tests revealed survivors exhibited greater picky eating than peer controls but comparable self-regulation of food intake. Bootstrapped grouped multivariate regression results showed that for ALL survivors, greater picky eating was associated with worse dietary quality (controlling for age and self-regulation of food intake). For peer controls, worse self-regulation of food intake was associated with poorer dietary quality (controlling for picky eating and age).
Results provide preliminary support that different eating behaviors contribute to poor dietary quality in children with and without an ALL history. These findings suggest that interventions to improve ALL survivors' dietary quality may benefit targeting picky eating.
儿童急性淋巴细胞白血病 (ALL) 幸存者健康状况不良的风险增加，可以通过均衡饮食来降低。然而，超过 70%的成年幸存者不符合生存饮食建议。ALL 治疗可能会放大对限制饮食偏好（挑食）和食物摄入自我调节能力差的风险，这可能导致生存期间的饮食不佳。本研究旨在：(a) 描述幸存者和同龄对照组之间挑食和食物摄入自我调节的差异；(b) 相对于同龄对照组，检查这些饮食行为与 ALL 幸存者饮食质量之间的关联。
参与者为患有（n=32）和未患有（n=32）ALL 的儿童（5-13 岁）及其照顾者。通过 24 小时膳食回忆计算儿童的饮食质量（健康饮食指数-2015）。照顾者完成儿童饮食行为问卷-食物挑剔分量表和儿童饮食自我调节问卷。
独立样本 t 检验显示，幸存者的挑食行为比同龄对照组更严重，但食物摄入自我调节能力相当。有放回的分组多元回归结果表明，对于 ALL 幸存者，挑食程度越严重，饮食质量越差（控制年龄和食物摄入自我调节）。对于同龄对照组，食物摄入自我调节能力越差，饮食质量越差（控制挑食和年龄）。
结果初步支持不同的饮食行为会导致有和没有 ALL 病史的儿童饮食质量差。这些发现表明，改善 ALL 幸存者饮食质量的干预措施可能受益于针对挑食的干预。
