Study Finds Plant-Rich Foods, Nuts/Seeds May Benefit Childhood Cancer Survivors

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A recent study, published by Wang et al in the Journal of Clinical Oncology, conducted as part of the St. Jude Lifetime Cohort (SJLIFE), may provide new insights into how diet may affect aging in adult survivors of childhood cancer. This study, involving 3,322 participants aged 18 to 65, found that a higher consumption of dark green vegetables and nuts/seeds may be associated with a lower risk of premature aging, whereas an increased intake of refined grains may be linked to a higher risk.

These findings may contribute to the growing understanding of the impact of specific dietary choices on the long-term health of childhood cancer survivors. This study may be pivotal in understanding the importance of specific plant-based dietary choices in managing long-term health outcomes and enhancing the quality of life for childhood cancer survivors. 

About the Study 

“Due to advancements in treatments, childhood cancer patients are experiencing longer life spans. Our research is dedicated to addressing the delayed consequences of these treatments, especially early-onset aging. We are exploring how diet influences the aging process, aiming to develop new methods to alleviate these effects. This research could benefit not only childhood cancer survivors but also other populations susceptible to premature aging,” highlighted lead study author Mei Wang, MS, of the Washington University School of Medicine in St. Louis.  

The study examined the dietary habits of childhood cancer survivors of various types. The participants’ diets over the past year were meticulously assessed using a food frequency questionnaire. It covered their intake of total fruits, vegetables (and their subgroups), whole grains, refined grains, nuts/seeds, and other nutrients. 

Among the participants, 54% were male, and 85% were non-Hispanic White. Further, 59% were diagnosed with cancer before age 10, 24% were diagnosed between the ages of 10 and 14, and 17% were diagnosed at or older than age 15. The investigators noted that 36% were leukemia survivors, 19% were lymphoma survivors, 13% were survivors of central nervous system tumors, and 6% were survivors of Wilms tumors.

The assessment of premature aging was conducted at the study’s outset using the Deficit Accumulation Index—which categorized participants into low-, medium-, and high-risk groups. Of note, 20% of the participants were classified as at medium risk and 8% at high risk of premature aging.  

Premature aging, particularly observed in childhood cancer survivors, refers to the early onset of aging-related health issues. These survivors, despite improved cancer survival rates, often develop chronic conditions, cognitive impairments, and frailty at a younger age than their peers without a history of cancer. This accelerated aging may be partly attributed to the long-term effects of cancer treatments on the body’s biological aging processes. Lifestyle factors, including diet and physical activity, may also be influential. This study was focused on understanding how diet, especially plant-based diets, can mitigate premature aging in this group, aiming to develop specific dietary guidelines for childhood cancer survivors.

Key Findings 

Each increase of 0.5 cups/1,000 kcal in dark green vegetable intake nearly halved the odds of being in the high-risk category for premature aging. For every 1 oz/1,000 kcal increase in nut/seed consumption, there was a notable decrease in the premature aging risk. Additionally, a higher consumption of refined grains correlated with an increased risk of premature aging. There was no direct relationship between the intake of fruits and whole grains and the risk of premature aging. Certain nutrients found in plant-rich foods—such as dietary folate, beta-carotene, lutein/zeaxanthin, and vitamin E—were associated with a lower risk of premature aging. 

Next Steps 

The study’s researchers plan to delve into the overall dietary patterns of adult survivors of childhood cancer, moving beyond examining individual food groups. This approach will seek to acknowledge the complexity of diets, which involves various food combinations consumed daily. The researchers aim to understand how these patterns correlate with premature aging risk. Additionally, they plan to translate this knowledge into actionable strategies to improve the diets of childhood cancer survivors. 

ASCO Expert Perspective  

“This study reveals a compelling link between a diet rich in dark green vegetables and nuts/seeds and reduced signs of premature aging in adults who were treated for cancer in childhood. This demonstrates the essential role of modifiable lifestyle factors, like diet, in enhancing quality of life for childhood cancer survivors, long after their treatment has ended. The goal is to shift the focus from merely surviving to thriving post-cancer treatment, marking a new era in survivorship research,” concluded Fumiko Chino, MD, an ASCO expert.

Disclosure: This study was supported in part by the National Institutes of Health, the St. Jude Children’s Research Hospital–Washington University St. Louis Implementation Sciences Collaborative, and the American Lebanese-Syrian Associated Charities. For full disclosures of the study authors, visit

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®.