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Childhood cancer survivors lowered metabolic syndrome risk through lifestyle choices
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Heart-healthy lifestyle choices were associated with a lower risk for metabolic syndrome among childhood cancer survivors, according to recent findings.
“One of the most significant findings among adult [childhood cancer survivors] is an increased risk of developing cardiovascular disease, including coronary artery disease,” researcher Kirsten Ness, PhD, of St. Jude Children’s Research Hospital in Memphis, Tenn., and colleagues wrote. “Anthracycline chemotherapy and chest radiation are known risk factors for cardiomyopathy, likely worsened by modifiable risk factors including obesity, dyslipidemia, and insulin resistance, which are common in this population.”
Kirsten Ness
Ness and colleagues evaluated 1,598 patients enrolled in the St. Jude Lifetime Cohort Study, which followed adult childhood cancer survivors who were treated at St. Jude Children’s Research Hospital between October 2007 and October 2012.
All study participants were aged at least 18 years (49.2% male, with a median age of 32.7 years) and were 10 years from their cancer diagnosis.
The definition of metabolic syndrome was based on the Third Report of the National Cholesterol Education Program Adult Treatment Panel. Study participants were defined as having metabolic syndrome if they were treated for at least three of the following:
- Abdominal obesity (waist circumference >102 cm in men and >88 cm in women);
- Triglycerides ≥150 g/dL;
- HDL cholesterol <40 mg/dL in males and <50 mg/dL in females;
- Hypertension (systolic blood pressure ≥130 mm Hg or diastolic BP ≥85 mm Hg);
- Fasting plasma glucose ≥100 mg/dL.
Scores based on the World Cancer Research Fund/American Institute for Cancer Research (WCRF/AICR) guidelines were calculated for each patient using anthropometric measurements, data on dietary consumption and self-reported physical activity data as determined through the National Health and Nutrition Examination Survey physical activity questionnaire.
Study participants who met at least four of the WCRF/AICR recommendations were judged to be in compliance with the guidelines. Researchers used gender-stratified, log-binomial regression models to analyze the correlations between dietary/lifestyle status and metabolic syndrome. This analysis was adjusted for current age, age at cancer diagnosis, cranial radiotherapy status, education and household income.
The researchers found that 31.8% of the participants were within the parameters of a metabolic syndrome diagnosis and 27% were compliant with WCRF/AICR guidelines. Among women, those who did not adhere to the WCRF/AICR guidelines were 2.4 times (95% CI, 1.7-3.3) more likely to have metabolic syndrome than those who were compliant with the guidelines. Men who failed to follow the guidelines were 2.2 times (95% CI, 1.6-3) more likely to develop metabolic syndrome than those who followed the guidelines.
“These findings are important because they indicate that adults who were treated for cancer as children have the opportunity to influence their own health outcomes,” Ness said in a press release. “Cancer survivors should not smoke. In addition, adopting a lifestyle that includes maintaining a healthy body weight, regular physical activity, and a diet that includes fruits and vegetables and that limits refined sugars, excessive alcohol, red meat, and salt has potential to prevent development of the metabolic syndrome.”
Disclosure: One of the study researchers received personal fees for acting as a scientific adviser to Novo Nordisk.
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