title: Nutritional intake of long-term survivors of childhood acute lymphoblastic leukemia: evidence for bone health interventional opportunities.
abstract: BACKGROUND
  Survivors of childhood acute lymphoblastic leukemia (ALL) are vulnerable to exaggeration of the aging process including decreased bone mineral density (BMD). As little is known about their dietary or nutrient intake that may affect their long-term bone health, we examined nutrient intake in long-term survivors of childhood ALL.
  
  
  METHODS
  Survivors (n = 164) of childhood ALL who had completed treatment for at least 5 years and were in continuous remission, completed a 110-item food questionnaire that reflected dietary intake over the previous year. The analyzed cohort comprised 34 females and 38 males younger than 19 years and 45 females and 47 males at least 19 years. Reported nutrient intake and food selection were compared with age-specific Recommended Dietary Allowance and USDA Pyramid Food Guide. Body mass index was compared to the general US population, adjusted for age, gender, Tanner stage and race.
  
  
  RESULTS
  Less than 30% of participants met recommended dietary intakes for vitamin D, calcium, potassium, or magnesium regardless of age. Mean daily caloric intake was 2,204 kcal (51% from carbohydrates) for younger and 2,160 kcal (49% from carbohydrates) for older participants. Energy intake from sweets was 70% higher than recommended. Participants < 19 years were less likely to have a healthy weight (odds ratio 0.48, 95% CI 0.30-0.79); > 19 years more likely to be overweight (odds ratio 1.95, 95% CI 1.11-3.32, P < 0.002).
  
  
  CONCLUSIONS
  Survivors of childhood ALL need careful dietary intervention to optimize long-term health.
authors.affiliation: Department of Preventive Medicine, University of Tennessee, Health Science Center, Memphis, Tennessee, USA.
authors.forename: Frances A
authors.initials: FA
authors.lastname: Tylavsky
authors.forename: Karen
authors.initials: K
authors.lastname: Smith
authors.forename: Harriet
authors.initials: H
authors.lastname: Surprise
authors.forename: Sarah
authors.initials: S
authors.lastname: Garland
authors.forename: Xiaowei
authors.initials: X
authors.lastname: Yan
authors.forename: Elizabeth
authors.initials: E
authors.lastname: McCammon
authors.forename: Melissa M
authors.initials: MM
authors.lastname: Hudson
authors.forename: Ching-Hon
authors.initials: CH
authors.lastname: Pui
authors.forename: Sue C
authors.initials: SC
authors.lastname: Kaste
mesh_terms: D000293:Adolescent; D000328:Adult; D001835:Body Weight; D015519:Bone Density; D002136:Calcium, Dietary / Q000008:administration & dosage; D002648:Child; D004032:Diet; D015930:Diet Records; D002149:Energy Intake; D005260:Female; D006801:Humans; D008297:Male; D018673:Nutrition Policy; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000150:complications*; D017741:Survivors; D014807:Vitamin D / Q000008:administration & dosage; D055815:Young Adult
chemical_list: D002136:Calcium, Dietary; D014807:Vitamin D