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. Procedure 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 2204 Kcal (51% from carbohydrates) for younger and 2160 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.

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