TABLE 4.
Diet quality in adult survivors of childhood cancer by patient characteristics and treatment exposure: the SJLIFE cohort1
| HEI-2010 score | P | |
| Patient characteristics | ||
| Age at study, y | <0.0001 | |
| 18–29 | 55.1 (54.0, 56.2) | |
| 30–39 | 56.3 (55.2, 57.4) | |
| 40–64 | 58.0 (56.7, 59.3) | |
| Sex | <0.0001 | |
| Male | 53.6 (52.6, 54.7) | |
| Female | 59.3 (58.3, 60.4) | |
| Race/ethnicity | 0.06 | |
| Non-Hispanic white | 57.1 (56.2, 57.9) | |
| Other | 55.9 (54.5, 57.2) | |
| Education | <0.0001 | |
| Grades 0–12 | 53.2 (52.0, 54.4) | |
| Some post–high school | 55.7 (54.6, 56.8) | |
| College graduate | 60.1 (59.4, 61.7) | |
| Smoking status | <0.0001 | |
| Nonsmoker | 57.9 (57.0, 58.9) | |
| Former smoker | 57.7 (56.1, 59.2) | |
| Current smoker | 53.9 (52.7, 55.1) | |
| Alcohol consumption | 0.07 | |
| Nondrinker | 56.0 (54.9, 57.1) | |
| <14 g ethanol/d | 57.1 (56.1, 58.2) | |
| ≥14 g ethanol/d | 56.3 (55.9, 57.7) | |
| Physical activity2 | <0.0001 | |
| Active | 58.5 (57.5, 59.6) | |
| Inactive | 54.5 (53.4, 55.5) | |
| Weight status3 | 0.006 | |
| Underweight | 54.1 (51.6, 56.7) | |
| Normal weight | 57.3 (56.3, 58.3) | |
| Overweight | 58.0 (57.0, 59.0) | |
| Obese | 56.5 (55.5, 57.5) | |
| Height,4 SDS | 0.38 | |
| <2 | 57.1 (55.4, 58.8) | |
| ≥2 | 57.9 (57.4, 58.4) | |
| Primary diagnosis | 0.01 | |
| Leukemia | 58.7 (57.9, 59.5) | |
| Lymphoma | 59.4 (58.3, 60.4) | |
| Embryonal tumor | 56.9 (55.5, 58.2) | |
| Sarcoma | 57.3 (56.0, 58.6) | |
| Central nervous system tumor | 57.7 (56.1, 59.3) | |
| Other | 57.0 (55.2, 58.8) | |
| Age at diagnosis, y | 0.045 | |
| <5 | 56.9 (56.0, 57.8) | |
| 5–9 | 58.2 (57.1, 59.2) | |
| 10–14 | 58.5 (57.4, 59.5) | |
| ≥15 | 58.2 (56.9, 59.5) | |
| Treatment exposures | ||
| Any radiation | 0.83 | |
| No | 57.7 (56.9, 58.6) | |
| Yes | 57.8 (57.2, 58.5) | |
| Brain radiation dose,5 Gy | 0.95 | |
| 0 | 58.2 (57.1, 59.3) | |
| 1–19.9 | 57.6 (55.5, 59.7) | |
| 20–29.9 | 57.7 (55.9, 59.6) | |
| ≥30 | 58.1 (55.9, 60.5) | |
| Abdomen radiation dose, Gy | ||
| 0 | 58.9 (58.0, 59.7) | 0.02 |
| 1–19.9 | 57.2 (55.0, 59.4) | |
| 20–29.9 | 56.7 (54.8, 58.5) | |
| ≥30 | 56.1 (54.2, 58.0) | |
| Cumulative alkylating agent dose,6 mg/m2 | 0.85 | |
| 0 | 58.0 (57.2, 58.9) | |
| 1–7999 | 57.6 (56.5, 58.6) | |
| 8000–11,999 | 57.5 (56.2, 58.8) | |
| ≥12,000 | 57.7 (56.5, 58.9) | |
| Cumulative anthracycline dose, mg/m2 | 0.43 | |
| 0 | 58.1 (57.4, 58.9) | |
| 1–99 | 57.0 (55.5, 58.5) | |
| 100–299 | 57.6 (56.5, 58.7) | |
| ≥300 | 57.0 (55.5, 58.5) | |
| Cumulative glucocorticoid dose,7 mg/m2 | 0.03 | |
| 0 | 57.7 (56.9, 58.4) | |
| 1–1499 | 57.1 (55.4, 58.7) | |
| 1500–8999 | 59.7 (57.9, 61.5) | |
| ≥9000 | 56.9 (55.0, 58.5) |
Values are means (95% CIs). For patient characteristics, means, SEs, and P values were adjusted for age at study, sex, race/ethnicity, education, smoking status, alcohol consumption, physical activity, and weight status by using ANCOVA; for cancer and treatment characteristics, means, SEs, and P values were adjusted for age at study, sex, and cancer diagnosis by using ANCOVA. SDS, SD score; SJLIFE, St. Jude Lifetime.
Physical activity was defined as active if engaging in moderate-to-vigorous physical activity ≥150 min/wk and inactive otherwise.
Weight status was defined as underweight if BMI (kg/m2) <18.5, normal weight if BMI = 18.5–24.9, overweight if BMI = 25–29.9, and obese if BMI ≥30.
Height was assessed by SDS. Raw height was converted to SDS by comparing the height of the survivors with the mean height of a reference population (i.e., the 2000 CDC growth chart).
Brain radiation dose was based on the maximum brain segment dose.
Cumulative dose of alkylating agents was calculated as the cyclophosphamide equivalent dose by using the following equation: cyclophosphamide equivalent dose (mg/m2) = 1.0 [cumulative cyclophosphamide dose (mg/m2)] + 0.244 [cumulative ifosfamide dose (mg/m2)] + 0.857 [cumulative procarbazine dose (mg/m2)] + 14.286 [cumulative chlorambucil dose (mg/m2)] + 15.0 [cumulative carmustine (BCNU) dose (mg/m2)] +16.0 [cumulative Lomustine (CCNU) dose (mg/m2)] + 40 [cumulative melphalan dose (mg/m2)] +50 [cumulative Thio-TEPA dose (mg/m2)] + 100 [cumulative nitrogen mustard dose (mg/m2)] + 8.823 [cumulative busulfan dose (mg/m2)].
Cumulative dose of glucocorticoids was calculated by converting the dexamethasone dose to a prednisone equivalent dose (1 mg dexamethasone = 6.67 mg prednisone) and summing across the 2 medications.