There is little information about how diet influences the health of childhood acute lymphoblastic leukemia (cALL) survivors. This study explores the associations between diet quality indices, cardiometabolic health indicators and inflammatory biomarkers among cALL survivors. Participants were part of the PETALE study (n = 241, median age: 21.7 years). Adherence to 6 dietary scores and caloric intake from ultra-processed foods were calculated. Multivariate logistirac regressions, Student t-tests and Mann-Whitney tests were performed. We found that 88% of adults and 46% of children adhered poorly to the Mediterranean diet, 36.9% had poor adherence to the World Health Organisation (WHO) recommendations and 76.3% had a diet to be improved according to the HEI-2015 score. On average, ultra-processed foods accounted for 51% of total energy intake. Low HDL-C was associated with a more inflammatory diet (E-DIITM score) and higher intake of ultra-processed foods. A greater E-DII score was associated with elevated insulin resistance (HOMA-IR), and consumption of ultra-processed foods was correlated with high triglycerides. Circulating levels of TNF-α, adiponectin and IL-6 were influenced by diet quality indices, while CRP and leptin were not. In conclusion, survivors of cALL have poor adherence to dietary recommendations, adversely affecting their cardiometabolic health.

Survivors of childhood acute lymphoblastic leukemia (cALL) are at high risk of developing dyslipidemia, including low HDL-cholesterol (HDL-C). This study aimed to examine the associations between food/nutrient intake and the levels of HDL-C in a cohort of children and young adult survivors of cALL. Eligible participants (n = 241) were survivors of cALL (49.4% boys; median age: 21.7 years old) recruited as part of the PETALE study. Nutritional data were collected using a validated food frequency questionnaire. Fasting blood was used to determine participants’ lipid profile. Multivariable logistic regression models were fitted to evaluate the associations between intakes of macro- and micronutrients and food groups and plasma lipids. We found that 41.3% of cALL survivors had at least one abnormal lipid value. Specifically, 12.2% had high triglycerides, 17.4% high LDL-cholesterol, and 23.1% low HDL-C. Low HDL-C was inversely associated with high intake (third vs. first tertile) of several nutrients: proteins (OR: 0.27, 95% CI: 0.08–0.92), zinc (OR: 0.26, 95% CI: 0.08–0.84), copper (OR: 0.34, 95% CI: 0.12–0.99), selenium (OR: 0.17, 95% CI: 0.05–0.59), niacin (OR: 0.25, 95% CI: 0.08–0.84), riboflavin (OR: 0.31, 95% CI: 0.12–0.76) and vitamin B12 (OR: 0.35, 95% CI: 0.13–0.90). High meat consumption was also inversely associated (OR: 0.28, 95% CI: 0.09–0.83) with low HDL-C while fast food was positively associated (OR: 2.41, 95% CI: 1.03–5.63) with low HDL-C. The role of nutrition in the development of dyslipidemia after cancer treatment needs further investigation.

Background: Survivors of childhood acute lymphoblastic leukemia (cALL) are at high risk of developing dyslipidemia (high LDL-cholesterol, high triglycerides, or low HDL-cholesterol). Studies showed that, similarly to the general population, cALL survivors do not respect dietary guidelines. However, whether nutritional intakes affect the lipid profile of this high-risk population remains unknown. This study aims to examine the associations between macro- and micronutrients and the presence of dyslipidemia in children and young adult survivors of cALL. Methods: Participants (n=247) survivors of cALL were recruited as part of the PETALE study at Sainte-Justine University Health Center (49.4% boys; median age: 21.7 yrs, range: 8.5-41.0 yrs; median time since diagnosis: 15.2 yrs, range: 5.4-28.2 yrs). Nutritional data were collected using a validated food frequency questionnaire (FFQ) comprising 190 items. Fasting blood was used to determine participants’ lipid profile by enzymatic reactions. Multivariable logistic regression models were fitted to evaluate the associations between intakes of macro- and micronutrients and dyslipidemia. The model included the following covariables: body mass index, age at diagnosis, age at diagnosis2, sex, and total energy intake. Results: Despite their young age, 41.3% of cALL survivors had dyslipidemia defined by having at least one abnormal lipid value. Specifically, 12.2% had high triglycerides and 17.4% high LDL-cholesterol and 23.1% low HDL-cholesterol. Our analysis revealed that having low HDL-cholesterol was associated with higher intakes in several nutrients (3rd vs. 1st tertile). They were proteins [odd ratio (OR): 0.27, 95%CI: 0.08-0.92, P<0.05], zinc (OR: 0.26, 95%CI: 0.08-0.84, P<0.05), copper (OR: 0.34, 95%CI: 0.12-0.99, P<0.05), selenium (OR: 0.17, 95%CI: 0.05-0.59, P<0.01), niacin (OR: 0.25, 95%CI: 0.08-0.84, P<0.05), riboflavin (OR: 0.24, 95%CI: 0.07-0.84, P<0.05), and vitamin B12 (OR: 0.35, 95%CI: 0.13-0.90, P<0.05). Conclusion: Our study shows the potential protective role of specific macro- and micronutrients on HDL-cholesterol levels in cALL survivors. These results stress the importance of deepening our understanding of the impact of nutrition in the development of dyslipidemia after cancer treatment. Nutritional strategies could be a valuable approach to prevent long-term cardiometabolic complications in cALL survivors. Citation Format: Sophia Morel, Devendra Amre, Emma Teasdale, Caroline Laverdière, Daniel Sinnett, Emile Levy, Valérie Marcil. Nutritional intakes are associated with HDL-cholesterol levels in survivors of childhood acute lymphoblastic leukemia [abstract]. In: Proceedings of the AACR Special Conference on the Advances in Pediatric Cancer Research; 2019 Sep 17-20; Montreal, QC, Canada. Philadelphia (PA): AACR; Cancer Res 2020;80(14 Suppl):Abstract nr B66.