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Napartuk M, Bélanger V, Bouchard I, Meloche C, Curnier D, Sultan S, Laverdière C, Sinnett D, Marcil V. Improvement of Diet after an Early Nutritional Intervention in Pediatric Oncology. CHILDREN 2023; 10:children10040667. [PMID: 37189915 DOI: 10.3390/children10040667] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 03/22/2023] [Accepted: 03/30/2023] [Indexed: 04/03/2023]
Abstract
Pediatric cancer survivors may experience cardiometabolic sequelae over the course of their lives as a result of the treatments they have received. While nutrition consists of an actionable target for cardiometabolic health, few nutritional interventions have been documented in this population. This study assessed the changes in diet during a one-year nutritional intervention for children and adolescents undergoing cancer treatments and the participants’ anthropometric and cardiometabolic profiles. A total of 36 children and adolescents (mean age: 7.9 years, 52.8% male) newly diagnosed with cancer (50% leukemia) and their parents underwent a one-year individualized nutrition intervention. The mean number of follow-up visits with the dietitian during the intervention was 4.72 ± 1.06. Between the initial and one-year assessments, there was an improvement in diet quality reflected by the Diet Quality Index (5.22 ± 9.95, p = 0.003). Similarly, the proportion of participants with moderate and good adherence (vs. low adherence) to the Healthy Diet Index score almost tripled after one year of intervention (14% vs. 39%, p = 0.012). In parallel, there was an increase in the mean z-scores for weight (0.29 ± 0.70, p = 0.019) and BMI (0.50 ± 0.88, p = 0.002), and in the mean levels of HDL-C (0.27 ± 0.37 mmol/L, p = 0.002) and 25-hydroxy vitamin D (14.5 ± 28.1 mmol/L, p = 0.03). Overall, this study supports that a one-year nutritional intervention deployed early after a pediatric cancer diagnosis is associated with an improvement in the diets of children and adolescents.
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Affiliation(s)
- Mélanie Napartuk
- Research Center of the CHU Sainte-Justine, Montreal, QC H3T 1C5, Canada
- Department of Nutrition, Faculty of Medicine, Université de Montréal, Montreal, QC H3T 1A8, Canada
| | - Véronique Bélanger
- Research Center of the CHU Sainte-Justine, Montreal, QC H3T 1C5, Canada
- Department of Nutrition, Faculty of Medicine, Université de Montréal, Montreal, QC H3T 1A8, Canada
| | - Isabelle Bouchard
- Research Center of the CHU Sainte-Justine, Montreal, QC H3T 1C5, Canada
| | - Caroline Meloche
- Research Center of the CHU Sainte-Justine, Montreal, QC H3T 1C5, Canada
| | - Daniel Curnier
- Research Center of the CHU Sainte-Justine, Montreal, QC H3T 1C5, Canada
- School of Kinesiology and Physical Activity Sciences, Université de Montréal, Montreal, QC H3G 1Y5, Canada
| | - Serge Sultan
- Research Center of the CHU Sainte-Justine, Montreal, QC H3T 1C5, Canada
- Department of Psychology, Université de Montréal, Montreal, QC H3C 3J7, Canada
| | - Caroline Laverdière
- Research Center of the CHU Sainte-Justine, Montreal, QC H3T 1C5, Canada
- Department of Pediatrics, Faculty of Medicine, Université de Montréal, Montreal, QC H3T 1C5, Canada
| | - Daniel Sinnett
- Research Center of the CHU Sainte-Justine, Montreal, QC H3T 1C5, Canada
- Department of Pediatrics, Faculty of Medicine, Université de Montréal, Montreal, QC H3T 1C5, Canada
| | - Valérie Marcil
- Research Center of the CHU Sainte-Justine, Montreal, QC H3T 1C5, Canada
- Department of Nutrition, Faculty of Medicine, Université de Montréal, Montreal, QC H3T 1A8, Canada
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Egnell C, Närhinen H, Merker A, Jonsson ÓG, Lepik K, Niinimäki R, Schmiegelow K, Stabell N, Klug Albertsen B, Vaitkeviciene G, Ranta S, Harila‐Saari A. Changes in body mass index during treatment of childhood acute lymphoblastic leukemia with the Nordic ALL2008 protocol. Eur J Haematol 2022; 109:656-663. [PMID: 36006839 PMCID: PMC9825898 DOI: 10.1111/ejh.13848] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Revised: 08/11/2022] [Accepted: 08/19/2022] [Indexed: 01/11/2023]
Abstract
OBJECTIVES Children with acute lymphoblastic leukemia (ALL) have a tendency to gain weight during treatment. As overweight and obesity associate with health problems, prophylactic interventions are warranted. Therefore, it is important to identify the children most prone to gain weight. METHODS Patients aged 2.0-17.9 years at ALL diagnosis were identified from the NOPHO ALL2008 registry. Registry data was complemented with height and weight at the end of therapy from questionnaires. Body mass index (BMI) was classified according to international age- and sex-adjusted International Obesity Task Force BMI cut-offs. BMI values were transformed into standard deviation scores (SDS) to calculate the difference in BMISDS during treatment. RESULTS Data on BMI change were available for 765 children. Overweight and obesity doubled during treatment: 9.7% were overweight and 2.1% obese at diagnosis and 21.8% and 5.4% at the end of therapy, respectively. The mean BMISDS change was +0.64. Younger (2.0-5.9 years) and healthy weight children were most prone to become overweight (mean change in BMI SDS +0.85 and + 0.65, respectively). CONCLUSIONS Younger children (2.0-5.9 years) with healthy weight at diagnosis were most prone to becoming overweight and therefore are an important group to target while considering interventions.
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Affiliation(s)
- Christina Egnell
- Astrid Lindgren Children's Hospital, Karolinska University Hospital, and the Department of Women's and Children's HealthKarolinska InstitutetStockholmSweden
| | - Hanna Närhinen
- Department of Women's and Children's HealthUppsala UniversityUppsalaSweden
| | - Andrea Merker
- Astrid Lindgren Children's Hospital, Karolinska University Hospital, and the Department of Women's and Children's HealthKarolinska InstitutetStockholmSweden
| | | | - Kristi Lepik
- Department of Haematology and OncologyTallinn Children's hospitalTallinnEstonia
| | - Riitta Niinimäki
- PEDEGO Research Unit, Medical Research Center Oulu and Department of Children and AdolescentsOulu University Hospital and University of OuluOuluFinland
| | - Kjeld Schmiegelow
- Department of Pediatrics and Adolescent Medicine, University Hospital Rigshospitalet, Copenhagen, Denmark; and Institute of Clinical Medicine, Faculty of MedicineUniversity of CopenhagenCopenhagenDenmark
| | - Niklas Stabell
- Department of PaediatricsUniversity Hospital of North NorwayTromsøNorway
| | - Birgitte Klug Albertsen
- Department of Paediatrics and Adolescent Medicine, Aarhus University Hospital, and Department of Clinical MedicineAarhus UniversityAarhusDenmark
| | - Goda Vaitkeviciene
- Children's HospitalAffiliate of Vilnius University Hospital Santaros Klinikos and Vilnius UniversityVilniusLithuania
| | - Susanna Ranta
- Astrid Lindgren Children's Hospital, Karolinska University Hospital, and the Department of Women's and Children's HealthKarolinska InstitutetStockholmSweden
| | - Arja Harila‐Saari
- Department of Women's and Children's HealthUppsala UniversityUppsalaSweden,Department of Pediatric OncologyUppsala University HospitalUppsalaSweden
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Alves DS, Assunção DT, Silva NCD, Oliveira CM, Amaral ABCN, Rinaldi AEM, Pena GDG. Nutritional Status and Growth Deficit in Children and Adolescents with Cancer at Different Moments of Treatment. Nutr Cancer 2020; 73:1668-1675. [PMID: 32838574 DOI: 10.1080/01635581.2020.1810714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
BACKGROUND Nutrition deficits are common in children and adolescents undergoing cancer treatment and can contribute to a worse prognosis. There are scarce studies regarding this context considering different moments of treatment. The aim of this study was to evaluate the association between moment of treatment and nutritional status in children and adolescents with cancer. METHODS A retrospective study was performed from January 2013 to December 2015, including data from all clinical records of patients under 18 years old with cancer. Clinical, nutritional support and anthropometric data were collected at four moments of treatment from cancer diagnosis: diagnosis (t0), 3 mo, (t1), 6 mo, (t2) and 1 year (t3). In addition, nutritional indicators were evaluated. Generalized Estimating Equation models were performed to analyze changes on anthropometric indices throughout four moments of treatment. RESULTS The sample comprised 73 patients and frequency of nutritional deficits ranged from 13.0% to 18.6%. All nutritional indicators decreased at t1, showed a modest recovery at t2 and a stronger recovery at t3 (p < 0.001). Growth was also impacted during treatment, mainly on patients under 2 years in the first three months of treatment. CONCLUSIONS Moment of treatment was associated with growth deficit and decreased percentiles in development indicators.
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Affiliation(s)
- Débora Santana Alves
- Graduate Program in Health Sciences, Federal University of Uberlandia, Uberlandia, Brazil
| | - Dayane Tonaco Assunção
- School of Medicine, Nutrition Course, Federal University of Uberlandia, Uberlandia, Brazil
| | | | - Cássia Maria Oliveira
- Food and Nutrition Service of Clinical Hospital, Federal University of Uberlandia, Uberlandia, Brazil
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BELIN CHS, BUENO MDC, CRUZ LBDA, SELISTRE SGDA, BEHLING EB. Changes in nutritional status in adolescents surviving leukemia and lymphoma. REV NUTR 2020. [DOI: 10.1590/1678-9865202033e190194] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
ABSTRACT Objective To examine the changes in the nutritional status of adolescents aged 10-19 years after a minimum 12 months interval following oncological treatment for leukemias and lymphomas. Methods Longitudinal design quantitative study conducted at Hospital de Clínicas, Porto Alegre. Adolescents aged 10-19 years after a minimum 12 months interval following oncological treatment for leukemias and lymphomas were included. The measures of weight, height, brachial circumference, triceps skinfold thickness, arm muscle circumference and abdominal circumference were collected. Results The sample comprised 50 adolescents who had survived leukemias and lymphomas. In the follow up 38% of the patients were classified as overweight according to the body mass index for their age. There was a significant increase in body mass index for age between the beginning and the end of treatment and follow up (p=0.013) in female individuals, compared to males. The results indicate a reduction in the Z-score means of height for age, with significant differences between the beginning of treatment and follow up (p=0.016); and end of treatment and follow up (p=0.006) in patients of both genders Conclusion The anthropometric indicators show an important frequency of excess weight and increased tricipital skinfold, as well as a significant increase of the body mass index for age and also a growth deficit among the survivors.
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Núñez-Enríquez JC, Gil-Hernández AE, Jiménez-Hernández E, Fajardo-Gutiérrez A, Medina-Sansón A, Flores-Lujano J, Espinoza-Hernández LE, Duarte-Rodríguez DA, Amador-Sánchez R, Peñaloza-González JG, Torres-Nava JR, Espinosa-Elizondo RM, Flores-Villegas LV, Merino-Pasaye LE, Pérez-Saldivar ML, Dorantes-Acosta EM, Cortés-Herrera B, Solis-Labastida KA, Núñez-Villegas NN, Velázquez-Aviña MM, Rangel-López A, González-Ávila AI, Santillán-Juárez JD, García-Velázquez AJ, Jiménez-Morales S, Bekker-Méndez VC, Rosas-Vargas H, Mata-Rocha M, Sepúlveda-Robles OA, Martín-Trejo JA, Mejía-Aranguré JM. Overweight and obesity as predictors of early mortality in Mexican children with acute lymphoblastic leukemia: a multicenter cohort study. BMC Cancer 2019; 19:708. [PMID: 31319816 PMCID: PMC6639907 DOI: 10.1186/s12885-019-5878-8] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2018] [Accepted: 06/24/2019] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Mexico City has one of the highest incidences and mortality rates of acute lymphoblastic leukemia (ALL) in the world and a high frequency of early relapses (17%) and early mortality (15%). Otherwise, childhood overweight and obesity are reaching epidemic proportions. They have been associated with poor outcomes in children with ALL. The aim of present study was to identify if overweight and obesity are predictors of early mortality and relapse in Mexican children with ALL. METHODS A multicenter cohort study was conducted. ALL children younger than 15 years old were included and followed-up during the first 24 months after diagnosis. Overweight and obesity were classified according World Health Organization (WHO) and Centers for Disease Control and Prevention (CDC) criteria. Early mortality and early relapses were the main outcomes. RESULTS A total of 1070 children were analyzed. Overweight/obesity at diagnosis were predictors of early mortality (WHO: HR = 1.4, 95%CI:1.0-2.0; CDC: HR = 1.6, 95%CI:1.1-2.3). However, no associations between overweight (WHO: HR = 1.5, 95%CI:0.9-2.5; CDC: HR = 1.0; 95% CI:0.6-1.6) and obesity (WHO: HR = 1.5, 95%CI:0.7-3.2; CDC: HR = 1.4; 95%CI:0.9-2.3) with early relapse were observed. CONCLUSIONS Overweight and obese patients embody a subgroup with high risk of dying during leukemia treatment.
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Affiliation(s)
- Juan Carlos Núñez-Enríquez
- Unidad de Investigación Médica en Epidemiologia Clínica, UMAE Hospital de Pediatría "Dr. Silvestre Frenk Freund", Centro Médico Nacional "Siglo XXI", Instituto Mexicano del Seguro Social (IMSS), Mexico City, Mexico
| | - Ana Elena Gil-Hernández
- Unidad de Investigación Médica en Epidemiologia Clínica, UMAE Hospital de Pediatría "Dr. Silvestre Frenk Freund", Centro Médico Nacional "Siglo XXI", Instituto Mexicano del Seguro Social (IMSS), Mexico City, Mexico
| | - Elva Jiménez-Hernández
- Servicio de Hematología Pediátrica, Hospital General "Gaudencio González Garza", Centro Médico Nacional "La Raza", IMSS, Mexico City, Mexico
| | - Arturo Fajardo-Gutiérrez
- Unidad de Investigación Médica en Epidemiologia Clínica, UMAE Hospital de Pediatría "Dr. Silvestre Frenk Freund", Centro Médico Nacional "Siglo XXI", Instituto Mexicano del Seguro Social (IMSS), Mexico City, Mexico
| | - Aurora Medina-Sansón
- Servicio de Hemato-Oncologia, Hospital Infantil de México Federico Gómez, Secretaria de Salud (SS), Mexico City, Mexico
| | - Janet Flores-Lujano
- Unidad de Investigación Médica en Epidemiologia Clínica, UMAE Hospital de Pediatría "Dr. Silvestre Frenk Freund", Centro Médico Nacional "Siglo XXI", Instituto Mexicano del Seguro Social (IMSS), Mexico City, Mexico
| | - Laura Eugenia Espinoza-Hernández
- Servicio de Hematología Pediátrica, Hospital General "Gaudencio González Garza", Centro Médico Nacional "La Raza", IMSS, Mexico City, Mexico
| | - David Aldebarán Duarte-Rodríguez
- Unidad de Investigación Médica en Epidemiologia Clínica, UMAE Hospital de Pediatría "Dr. Silvestre Frenk Freund", Centro Médico Nacional "Siglo XXI", Instituto Mexicano del Seguro Social (IMSS), Mexico City, Mexico
| | - Raquel Amador-Sánchez
- Servicio de Hematología Pediátrica, Hospital General Regional "Carlos McGregor Sánchez Navarro", IMSS, Mexico City, Mexico
| | | | - José Refugio Torres-Nava
- Servicio de Oncología, Hospital Pediátrico de Moctezuma, Secretaria de Salud de la Ciudad de México (SSCDMX), Mexico City, Mexico
| | | | - Luz Victoria Flores-Villegas
- Servicio de Hematología Pediátrica, Centro Médico Nacional "20 de Noviembre", Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado (ISSSTE), Mexico City, Mexico
| | - Laura Elizabeth Merino-Pasaye
- Servicio de Hematología Pediátrica, Centro Médico Nacional "20 de Noviembre", Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado (ISSSTE), Mexico City, Mexico
| | - María Luisa Pérez-Saldivar
- Unidad de Investigación Médica en Epidemiologia Clínica, UMAE Hospital de Pediatría "Dr. Silvestre Frenk Freund", Centro Médico Nacional "Siglo XXI", Instituto Mexicano del Seguro Social (IMSS), Mexico City, Mexico
| | - Elisa María Dorantes-Acosta
- Servicio de Hemato-Oncologia, Hospital Infantil de México Federico Gómez, Secretaria de Salud (SS), Mexico City, Mexico
| | | | - Karina Anastacia Solis-Labastida
- Servicio de Hematología Pediátrica UMAE Hospital de Pediatría "Dr. Silvestre Frenk Freund", Centro Médico Nacional "Siglo XXI", IMSS, Mexico City, Mexico
| | - Nora Nancy Núñez-Villegas
- Servicio de Hematología Pediátrica, Hospital General "Gaudencio González Garza", Centro Médico Nacional "La Raza", IMSS, Mexico City, Mexico
| | | | | | - Ana Itamar González-Ávila
- Servicio de Hematología Pediátrica, Hospital General Regional "Carlos McGregor Sánchez Navarro", IMSS, Mexico City, Mexico
| | | | | | - Silvia Jiménez-Morales
- Laboratorio de Genómica del Cáncer, Instituto Nacional de Medicina Genómica (INMEGEN), Mexico City, Mexico
| | - Vilma Carolina Bekker-Méndez
- Unidad de Investigación Médica en Inmunología e Infectología, Hospital de Infectología "Dr. Daniel Méndez Hernández", "La Raza", IMSS, Mexico City, Mexico
| | - Haydee Rosas-Vargas
- Unidad de Investigación en Genética Humana, UMAE Hospital de Pediatría "Dr. Silvestre Frenk Freund", Centro Médico Nacional "Siglo XXI", IMSS, Mexico City, Mexico
| | - Minerva Mata-Rocha
- Unidad de Investigación en Genética Humana, UMAE Hospital de Pediatría "Dr. Silvestre Frenk Freund", Centro Médico Nacional "Siglo XXI", IMSS, Mexico City, Mexico
| | - Omar Alejandro Sepúlveda-Robles
- Unidad de Investigación en Genética Humana, UMAE Hospital de Pediatría "Dr. Silvestre Frenk Freund", Centro Médico Nacional "Siglo XXI", IMSS, Mexico City, Mexico
| | - Jorge Alfonso Martín-Trejo
- Servicio de Hematología Pediátrica UMAE Hospital de Pediatría "Dr. Silvestre Frenk Freund", Centro Médico Nacional "Siglo XXI", IMSS, Mexico City, Mexico.
| | - Juan Manuel Mejía-Aranguré
- Unidad de Investigación Médica en Epidemiologia Clínica, UMAE Hospital de Pediatría "Dr. Silvestre Frenk Freund", Centro Médico Nacional "Siglo XXI", Instituto Mexicano del Seguro Social (IMSS), Mexico City, Mexico. .,Coordinación de Investigación en Salud, IMSS, Mexico City, Mexico.
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