Whole Grain Intake and Cardiometabolic Conditions among Adult Survivors of Childhood Cancer: A Report from the St. Jude Lifetime Cohort Study

Background: Despite improved survival, childhood cancer survivors experience serious morbidity and elevated mortality due to cardiometabolic conditions in young adulthood. Identifying modifiable nutritional factors are essential for developing targeted interventions to improve survivors’ long-term health.

Methods: In 2,571 young adult survivors of childhood cancer [mean age =32.6 (SD=8.3) years] enrolled in the St. Jude Lifetime Cohort Study, dietary intake was assessed using Block food frequency questionnaire. Systematic medical assessments were conducted to evaluate blood pressure, weight, height, waist circumference, serum fasting lipids, glucose, and insulin. Logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) after adjusting for age, sex, race/ethnicity, family income, total energy intake, physical activity, smoking, alcohol consumption, and dietary patterns. 

Results: The mean daily dietary intake of whole grain was 1.2 ounce equivalents per 2,000 kcal in childhood cancer survivors. Only 3.7 % of the survivors met the recommended intake (≥3 ounce equivalents/2,000 kcal per day). Compared to those who consumed the lowest quartile of whole grain, survivors in the highest quartile had 30-50% lower odds of having dyslipidemia (OR=0.60, 95%CI: 0.47-0.77, P for trend=0.0002), diabetes (OR=0.66, 95%CI: 0.52-0.84, P for trend=0.0007), abdominal obesity (OR=0.66, 95%CI: 0.51-0.87, P for trend=0.03), and metabolic syndrome (OR=0.63, 95%CI: 0.47-0.85, P for trend=0.02). Similar associations were observed in survivor regardless of patient characteristics and treatment exposure.

Conclusions: Low whole grain consumption may serve as an important target for dietary interventions to reduce the elevated cardiometabolic conditions in the growing cohort of childhood cancer survivors.