Childhood cancer survivors and adherence to the American Cancer Society Guidelines on Nutrition and Physical Activity
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The objective of this study was to assess adherence of childhood cancer survivors in comparison to cancer-free adults of comparable age and sex (or “controls”) to the 2012 American Cancer Society (ACS) Guidelines on Nutrition and Physical Activity.
As part of the Chicago Healthy Living Study, 431 childhood cancer survivors (18.5 ± 8.1 years from diagnosis) and 361 controls completed a structured, health-focused interview including the Block Brief Food Frequency Questionnaire and Modifiable Activity Questionnaire. From these data, modified adherence scores were computed based on ACS guidelines (maximum score of 8 reflecting complete adherence). Comparisons were made between survivors and controls and among racial-ethnic groups of survivors and controls.
There was no difference in overall ACS adherence scores between survivors and controls (4.3 ± 1.5 vs. 4.2 ± 1.5, p = 0.54). As compared to controls, survivors, on average, had a lower body mass index or BMI (27.9 ± 7.0 vs. 29.3 ± 7.8 kg/m2, p = 0.01) and consumed less fiber (9.2 ± 3.5 vs. 9.7 ± 3.8 g/1,000 kcal, p = 0.05). Within the survivor group, ACS adherence scores did not differ across racial-ethnic groups, but differences were observed with respect to component behaviors. Hispanic survivors had a higher BMI when compared to those of whites (29.2 ± 7.4 vs. 26.2 ± 5.3 kg/m2, p = 0.001). Daily alcohol consumption was greater for whites among both survivors and controls as compared to other racial-ethnic groups (p < 0.017 for all comparisons).
Compared to controls, survivors were not practicing healthier behaviors. Among minority survivors, excess body weight, particularly among Hispanics, is a major concern. Assessment of these behaviors should be incorporated into survivor follow-up care.
Implications for Cancer Survivors
There is much room for improvement in educating and encouraging survivors to follow healthier diet and lifestyle routines to prevent obesity and further morbidity.
KeywordsChildhood cancer survivors Adherence to cancer prevention guidelines Diet Physical activity American Cancer Society
- 1.American Cancer Society. Cancer facts & figures 2012. Atlanta: American Cancer Society; 2012.Google Scholar
- 8.Castellino S, Casillas J, Hudson M, Mertens A, Whitton J, Brooks S, et al. Minority adult survivors of childhood cancer: a comparison of long-term outcomes, health care utilization, and health-related behaviors from the childhood cancer survivor study. J Clin Oncol. 2005;23:6499–507.CrossRefPubMedGoogle Scholar
- 10.Rock C, Doyle C, Demark Wahnefried W, Meyerhardt J, Courneya K, Schwartz A, et al. Nutrition and physical activity guidelines for cancer survivors. Cancer. 2012;62:243–74.Google Scholar
- 11.Kushi L, Doyle C, McCullough M, Rock C, Demark Wahnefried W, Bandera E, et al. American Cancer Society guidelines on nutrition and physical activity for cancer prevention: reducing the risk of cancer with healthy food choices and physical activity. Cancer. 2012;62:30–67.Google Scholar
- 18.U.S. Department of Agriculture and U.S. Department of Health and Human Services. Dietary guidelines for Americans. 7th ed. Washington, DC: U.S. Government Printing Office; 2010. December 2010.Google Scholar
- 19.Kushi LH, Byers T, Doyle C, Bandera EV, McCullough M, Gansler T, et al. American Cancer Society guidelines on nutrition and physical activity for cancer prevention: reducing the risk of cancer with healthy food choices and physical activity. CA- Cancer J Clin. 2006;56:254–81.CrossRefPubMedGoogle Scholar