Dietary Intake and Diet Quality of Adult Survivors of Childhood Cancer and the General Population: Results from the SCCSS-Nutrition Study

Fabiën N Belle, Angeline Chatelan, Rahel Kasteler, Luzius Mader, Idris Guessous, Maja Beck-Popovic, Marc Ansari, Claudia E Kuehni, Murielle Bochud, Fabiën N Belle, Angeline Chatelan, Rahel Kasteler, Luzius Mader, Idris Guessous, Maja Beck-Popovic, Marc Ansari, Claudia E Kuehni, Murielle Bochud

Abstract

Childhood cancer survivors (CCSs) are at increased risk of developing chronic health conditions. This may potentially be reduced by a balanced diet. We aimed to compare dietary intake and diet quality using the Alternative Healthy Eating Index (AHEI) of adult CCSs and the general Swiss population. A food frequency questionnaire (FFQ) was completed by CCSs with a median age of 34 (IQR: 29-40) years. We compared dietary intake of 775 CCSs to two population-based cohorts who completed the same FFQ: 1276 CoLaus and 2529 Bus Santé study participants. CCSs consumed particular inadequate amounts of fiber and excessive amounts of sodium and saturated fat. Dietary intake was similar in CCSs and the general population. The mean AHEI was low with 49.8 in CCSs (men: 47.7, women: 51.9), 52.3 in CoLaus (men: 50.2, women: 54.0), and 53.7 in Bus Santé (men: 51.8, women: 54.4) out of a maximum score of 110. The AHEI scores for fish, fruit, vegetables, and alcohol were worse in CCSs than in the general population, whereas the score for sugar-sweetened beverages was better (all p < 0.001). Diet quality at follow-up did not differ between clinical characteristics of CCSs. Long-term CCSs and the general population have poor dietary intake and quality in Switzerland, which suggests similar population-based interventions for everyone.

Keywords: AHEI; Europe; Swiss Childhood Cancer Registry; childhood cancer survivors; dietary intake; food frequency questionnaire.

Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Nutrient intake compared with DACH recommended intake or limit in childhood cancer survivors (SCCSS-Nutrition) and the general population in Switzerland (Bus Santé and CoLaus) a. The length of the bar per nutrient corresponds to the percentage of mean intake (95% CIs) compared to the recommended intake level * 100. Recommended intake is estimated on the basis of age and sex according to dietary recommendations for Germany (D), Austria (A) and Switzerland (CH) (DACH) 2015, weighted by the age and sex distribution per study population. For alcohol intake the maximum tolerated dosage was taken. Nutritional goals were set at 100 when the mean intake met the recommended intake or the maximum tolerated dosage. a Standardized on sex and age at survey according to CCSs. * p < 0.05 compared to CCSs. ** p < 0.001 compared to CCSs.
Figure 2
Figure 2
Percentages of Alternate Healthy Eating Index a,b of maximum score with 95% CIs in childhood cancer survivors (SCCSS-Nutrition) and the general population in Switzerland (Bus Santé and CoLaus) c a Adapted from Chiuve et al. [40] b Intermediate food intake was scored proportionately between the minimum score zero and the maximum score ten. The maximal total AHEI score was 110. c Adjusted for sex, age at survey, and if applicable ICCC-3 diagnosis, general population is additionally standardized on sex and age at survey according to CCSs. * p < 0.05 compared to CCSs. ** p < 0.001 compared to CCSs.

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