Failure to Adopt a Healthy Lifestyle More Than Doubles Risk of Metabolic Syndrome in Childhood Cancer Survivors


Key Points

  • The prevalence of metabolic syndrome among survivors of childhood cancer was 31.5% (22% aged > 40 years), which is comparable to the rates reported in the general population (68% aged > 40 years).
  • For survivors who did not adopt a lifestyle including regular exercise and a healthy diet, the relative risk of developing a metabolic syndrome was 2.4 in women and 2.2 in men.

A St. Jude Children’s Research Hospital study found that 73% of adult survivors of childhood cancer more than doubled their risk of developing metabolic syndrome and related health problems by failing to follow a heart-healthy lifestyle. The results were published online in the journal Cancer.

Almost 32% of the 1,598 adult survivors of childhood cancer in the study had metabolic syndrome, an umbrella term for health risk factors like high blood pressure, abdominal obesity, elevated triglyceride, and other abnormalities that often occur together. The prevalence was similar to rates reported for much older adults in the general public. Metabolic syndrome is associated with greater odds of developing heart disease, diabetes, stroke, and other potentially fatal health problems.

Researchers reported that adult survivors of childhood cancer who failed to adopt a lifestyle that included regular exercise and a healthy diet were more than twice as likely to develop metabolic syndrome as survivors who did. The risk was 2.4 times higher in women and 2.2 times greater in men.

Study Details

The participants were enrolled in the St. Jude Lifetime Cohort Study and ranged in age from 19 to 60 years old; half were less than 33 years old. Previous studies of metabolic syndrome in pediatric cancer survivors focused primarily on survivors of acute lymphoblastic leukemia (ALL), but this study included survivors of various cancers, including lymphoma, sarcoma, neuroblastoma, brain, and other tumors.

The prevalence of metabolic syndrome among survivors, 22% of whom were older than age 40, was 31.5%. That was greater than rates reported in small studies of young pediatric cancer survivors, but comparable to the 34% reported in the general population, 68% of whom were older than 40.

Health screenings and survivor self-reports found that 27% of study participants met at least four of seven requirements for a healthy lifestyle as defined by the World Cancer Research Fund/American Institute for Cancer Research. The list included maintaining a healthy weight, moderate intake of alcohol and red meat, being physically active, and eating a diet low in sodium and high in complex carbohydrates, fruits and vegetables.

About two-thirds of survivors in this study were overweight or obese, three-quarters reported eating less than five servings of fruits and vegetables daily and more than half reported inadequate exercise or complex carbohydrates. In addition, 90% reported eating too much red meat and nearly 70% too much sodium.

Findings Underscore Importance of Healthy Lifestyle

Lifestyle had a greater impact on the likelihood of developing metabolic syndrome than risk factors associated with childhood cancer treatment, including cranial irradiation.

“This is good news for the nation’s growing population of adult survivors of childhood cancer,” said corresponding author Kirsten Ness, PhD, an associate member of the St. Jude Department of Epidemiology and Cancer Control. “This suggests that if you maintain a healthy lifestyle by staying active and eating a diet that is low in fat, sugar, and salt and rich in fruit and vegetables you should be able to influence whether or not you develop metabolic syndrome.”

Previous research has found that many survivors of childhood cancer face significant challenges, including chronic health problems, and may be at risk for premature aging. Survivors whose cancer treatment included chest and cranial irradiation or chemotherapy with anthracylcine are known to be at an increased risk for cardiomyopathy or metabolic syndrome. A previous St. Jude–led study found that lifestyle and risk factors related to cancer treatment were a particularly toxic mix for aging childhood cancer survivors.

This study was the largest yet to evaluate how lifestyle impacts the risk of metabolic syndrome in a diverse group of pediatric cancer survivors.

Dr. Ness is the corresponding author for the Cancer article.

The study was funded in part by a grant from the National Cancer Institute and ALSAC. The study authors reported no potential conflicts of interest.

The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.