By failing to follow a heart-healthy lifestyle, 73% of adult survivors of childhood cancer more than doubled their risk of developing metabolic syndrome and related health problems, according to a new study.

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 triglycerides, and other abnormalities that often occur together. Metabolic syndrome is associated with greater odds of developing heart disease, diabetes, stroke, and other potentially fatal health problems. This prevalence is similar to that among the general population (34%), yet only 22% of the study participants were older than 40 years, while 68% of the general population is older than 40 years.

Researchers reported in Cancer (2014; doi:10.1002/cncr.28670) 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.

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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 in Memphis, Tennessee. “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.”

The United States is home to more than 360,000 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. The participants were enrolled in the St. Jude Lifetime Cohort Study (St. Jude LIFE), which brings childhood cancer survivors treated at St. Jude back to the hospital for several days of health screenings and other tests. Participants are at least 18 years old and 10 years from their diagnosis. Survivors in this study ranged in age from 19 to 60 years old. Half were younger than 33 years.

Only 27% of study participants met at least 4 of 7 requirements for a healthy lifestyle that 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.