Cancer Causes & Control

, Volume 24, Issue 2, pp 313–321 | Cite as

Contribution of diet and physical activity to metabolic parameters among survivors of childhood leukemia

  • Emily S. Tonorezos
  • Kim Robien
  • Debra Eshelman-Kent
  • Chaya S. Moskowitz
  • Timothy S. Church
  • Robert Ross
  • Kevin C. Oeffinger
Original paper

Abstract

Purpose

Determine the relationship between diet and metabolic abnormalities among adult survivors of childhood acute lymphoblastic leukemia (ALL).

Methods

We surveyed 117 adult survivors of childhood ALL using the Harvard Food Frequency Questionnaire. Physical activity energy expenditure (PAEE) was measured with the SenseWear Pro2 Armband. Insulin resistance was estimated using the Homeostasis Model for Insulin Resistance (HOMA-IR). Visceral and subcutaneous adiposity were measured by abdominal CT. Adherence to a Mediterranean diet pattern was calculated using the index developed by Trichopoulou. Subjects were compared using multivariate analysis adjusted for age and gender.

Results

Greater adherence to a Mediterranean diet pattern was associated with lower visceral adiposity (p = 0.07), subcutaneous adiposity (p < 0.001), waist circumference (p = 0.005), and body mass index (p = 0.04). For each point higher on the Mediterranean Diet Score, the odds of having the metabolic syndrome fell by 31 % (OR 0.69; 95 % CI 0.50, 0.94; p = 0.019). Higher dairy intake was associated with higher HOMA-IR (p = 0.014), but other individual components of the Mediterranean diet, such as low intake of meat or high intake of fruits and vegetables, were not significant. PAEE was not independently associated with metabolic outcomes, although higher PAEE was associated with lower body mass index.

Conclusions

Adherence to a Mediterranean diet pattern was associated with better metabolic and anthropometric parameters in this cross-sectional study of ALL survivors.

Keywords

Insulin resistance Leukemia Mediterranean diet Obesity Survivorship 

Abbreviations

ALL

Acute lymphoblastic leukemia

BMI

Body mass index

CRT

Cranial radiotherapy

FFQ

Food frequency questionnaire

HOMA-IR

Homeostasis model for insulin resistance

PAEE

Physical activity energy expenditure

Notes

Acknowledgments

This work was supported by research grants from the National Institutes of Health (R01-CA 100474 and K05-CA165702), the Howard J. and Dorothy Adleta Foundation, and the Donald W. Reynolds Cardiovascular Research Center at Dallas, the General Clinical Research Center (Grant M01-RR-00633 and CTSA UL1-RR-024982), and an American Cancer Society Cancer Control Career Development Award.

Conflict of interest

None of the authors has a possible conflict of interest to declare.

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Copyright information

© Springer Science+Business Media Dordrecht 2012

Authors and Affiliations

  • Emily S. Tonorezos
    • 1
    • 2
  • Kim Robien
    • 3
    • 4
  • Debra Eshelman-Kent
    • 5
  • Chaya S. Moskowitz
    • 6
  • Timothy S. Church
    • 7
  • Robert Ross
    • 8
  • Kevin C. Oeffinger
    • 1
    • 9
  1. 1.Department of MedicineMemorial Sloan-Kettering Cancer CenterNew YorkUSA
  2. 2.Department of MedicineWeill Cornell Medical CollegeNew YorkUSA
  3. 3.Division of Epidemiology and Community Health, School of Public HealthUniversity of MinnesotaMinneapolisUSA
  4. 4.Cancer Detection, Treatment and Survivorship Program, Masonic Cancer CenterUniversity of MinnesotaMinneapolisUSA
  5. 5.Division of Hematology OncologyCincinnati Children’s Hospital Medical CenterCincinnatiUSA
  6. 6.Department of Epidemiology and BiostatisticsMemorial Sloan-Kettering Cancer CenterNew YorkUSA
  7. 7.Pennington Biomedical Research CenterBaton RougeUSA
  8. 8.Queen’s UniversityKingstonCanada
  9. 9.Department of PediatricsMemorial Sloan-Kettering Cancer CenterNew YorkUSA

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