Division of Public Health Sciences, Department of Surgery, and the Alvin J. Siteman Cancer Center, Washington University School of Medicine, St Louis, MO.
Department of Surgery, Division of Supportive Care in Cancer, University of Rochester Medical Center, James P. Wilmot Cancer Institute, Rochester, NY.
J Clin Oncol. 2024 May 1;42(13):1553-1562. doi: 10.1200/JCO.23.01260. Epub 2024 Jan 23.
To identify dietary factors that are related to premature aging in adult survivors of childhood cancer, we examined the associations between plant food intakes and age-related deficit accumulation.
A total of 3,322 childhood cancer survivors (age 18-65 years, mean = 31, standard deviation = 8.4) in the St Jude Lifetime Cohort had total fruit, total vegetables and subgroups, whole grains, refined grains, nuts/seeds, and nutrients intake assessed using a food frequency questionnaire. Premature aging at baseline was assessed by the deficit accumulation index (DAI) and categorized as low, medium, and high risk. Multinomial logistic regressions (reference: low risk) adjusting for confounders estimated odds ratios (ORs) and 95% CIs. Multivariable linear regression of a continuous intake against a continuous DAI was also performed.
Dark green vegetable (OR = 0.47 [95% CI, 0.28 to 0.78] per 1/2 cup/1,000 kcal increment) and nuts/seeds intakes (OR = 0.71 [95% CI, 0.47 to 1.08] per 1 oz/1,000 kcal increment; coefficient = -0.0115, = .02) were associated with a lower risk of premature aging. Conversely, refined grain intake was related to an increased risk of premature aging (OR = 1.33 [95% CI, 0.99 to 1.78], per 1 oz/1,000 kcal increment; coefficient = 0.0093, = .005). Fruit and whole grain intakes were not associated with premature aging risk. Among nutrients abundant in plant foods, dietary folate intake was associated with a lower risk of premature aging (OR = 0.89 [95% CI, 0.80 to 0.99] per 50 mcg/1,000 kcal increase). Beta-carotene, lutein/zeaxanthin, and vitamin E intakes from foods were also related to a modestly lower, but not statistically significant, risk of premature aging.
Specific plant foods are associated with lower risk of premature aging, providing targets for the interventions to promote healthy aging in childhood cancer survivors.
为了确定与儿童癌症成年幸存者过早衰老相关的饮食因素,我们研究了植物性食物摄入与与年龄相关的缺陷积累之间的关联。
圣裘德终身队列中共有 3322 名年龄在 18-65 岁之间(平均=31,标准差=8.4)的儿童癌症幸存者,使用食物频率问卷评估了总水果、总蔬菜和亚组、全谷物、精制谷物、坚果/种子以及营养素的摄入量。采用缺陷积累指数(DAI)评估基线时的过早衰老,并分为低、中、高风险。在调整混杂因素后,使用多项逻辑回归(参考:低风险)估计比值比(OR)和 95%置信区间(CI)。还对连续摄入与连续 DAI 进行了多变量线性回归。
深色绿叶蔬菜(OR=0.47 [95% CI,0.28 至 0.78],每增加 1/2 杯/1000 千卡)和坚果/种子摄入量(OR=0.71 [95% CI,0.47 至 1.08],每增加 1 盎司/1000 千卡;系数=-0.0115, =.02)与较低的过早衰老风险相关。相反,精制谷物的摄入与过早衰老的风险增加有关(OR=1.33 [95% CI,0.99 至 1.78],每增加 1 盎司/1000 千卡;系数=0.0093, =.005)。水果和全谷物的摄入量与过早衰老的风险无关。在富含植物性食物的营养素中,膳食叶酸的摄入与较低的过早衰老风险相关(OR=0.89 [95% CI,0.80 至 0.99],每增加 50 mcg/1000 千卡)。来自食物的β-胡萝卜素、叶黄素/玉米黄质和维生素 E 的摄入量也与适度降低但无统计学意义的过早衰老风险相关。
特定的植物性食物与较低的过早衰老风险相关,为促进儿童癌症幸存者健康衰老的干预措施提供了目标。