Understanding the patient and family experience of nutrition and dietetic support during childhood cancer treatment

Clarke, Emma; Pugh, Gemma; Heuvel, Eveline van den; Winstanley, Mark; Wood, Andrew C.; Laughton, Stephen; Lovell, Amy L.

doi:10.1007/s00520-023-07787-3

Cited by 3 publications

(4 citation statements)

References 36 publications

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“…22 Finally, communication approaches that are tailored to childhood cancer survivors and inclusive of their unique needs should be prioritized. 23,24 Although overweight and obesity pose significant challenges for survivors and the overall population, underweight appears to represent an understudied risk.…”

Section: Discussionmentioning

confidence: 99%

Risk of increased mortality in underweight survivors: A brief report from the Childhood Cancer Survivor Study

Tonorezos,

Chou,

Moskowitz

et al. 2024

Pediatric Blood & Cancer

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BackgroundApproximately 1 in 10 adult survivors of childhood cancer is underweight. Although the consequences of being overweight or obese have been well described, outcomes among childhood cancer survivors who are underweight are unknown.ObjectiveTo determine whether underweight status increases the risk of mortality.ProcedureCohort study: Marginal models with generalized estimating equations to evaluate the associations between body mass index (BMI), serious or life‐threatening chronic conditions, and death in the setting of long‐term follow‐up questionnaires and National Death Index search. Participants: C. Exposure: Underweight status, defined as body mass index (BMI) < 18.5 kg/m2 compared with ideal body weight. Based on available literature on body weight and mortality from the general population, ideal body weight was defined as BMI 22.0‐24.9 kg/m2. Main outcomes: Overall mortality and cancer‐specific mortality.ResultsOf 9454 survivors (median age 35 years old (range, 17‐58), an average of 17.5 years from diagnosis), 627 (6.6%) participants were underweight at baseline or follow‐up questionnaire. Of 184 deaths, 29 were among underweight survivors. Underweight status was more common among females (9.1% vs. 4.5%, p < .01) and participants with younger age at diagnosis (8.2% for < 5 years vs. 6.1% for ≥5 years, p < .01), lower household income (8.9% for < $20,000 vs. 6.0% for ≥ $20,000, p < .01), or a history of serious chronic condition (p = .05). After adjustment for these factors, in addition to prior smoking and a history of radiation therapy, the risk of all‐cause mortality within two years of BMI report was increased (OR 2.85; 95% CI: 1.63‐4.97; p < .01) for underweight survivors, compared with ideal‐weight survivors.ConclusionsChildhood cancer survivors who are underweight are at increased risk for late mortality that appears unrelated to smoking status, recognized chronic disease, or subsequent malignancy. Whether targeted nutritional interventions would ameliorate this risk is unknown.

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Section: Discussionmentioning

confidence: 99%

Risk of increased mortality in underweight survivors: A brief report from the Childhood Cancer Survivor Study

Tonorezos,

Chou,

Moskowitz

et al. 2024

Pediatric Blood & Cancer

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“…During cancer treatment, due to side effects such as vomiting, nausea, diarrhea, changes in the sense of taste and smell, as well as due to stress, the intake of macro-and microelements in recommended amounts is difficult. In the study conducted by Clark E. et al it has been shown that 86% parents of cancer children had concerns about nutrition during treatment such as vomiting, anorexia and weight loss (9). In addition, it is a common practice among parents to increase the calorie content of diet by giving their child unhealthy snacks with low nutritional value (104).…”

Section: Diet Quality In Children With Cancermentioning

confidence: 99%

“…Assessment of diet quality should also be part of the nutritional status control (1). Research shows that parents and caregivers of children with cancer have difficulties in composing a diet in accordance with the standards (9,10). Children are more likely to eat high-carbohydrate (11), salty snacks and strong-flavor products (10), but they limit the consumption of vegetables and fruits (11).…”

Section: Introductionmentioning

confidence: 99%

Nutritional status, body composition and diet quality in children with cancer

Schab,

Skoczen

2024

Front. Oncol.

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During cancer treatment, nutritional status disorders such as malnutrition or obesity affect the tolerance of cancer treatment, quality of life, but also the pharmacokinetics of drugs. It is hypothesized that changes in fat and lean body mass can modify chemotherapy volume distribution, metabolism and clearance. In children with cancer, lean body mass decreases or remains low during treatment and fat mass increases. Body composition is influenced by the cancer itself, aggressive multimodal-therapies, changes in metabolism, unbalanced diet and reduced physical activity. Due to the side effects of treatment, including changes in the sense of taste and smell, nausea, vomiting, diarrhea, and stress, eating according to recommendation for macronutrients and micronutrients is difficult. Research indicates that throughout cancer treatment, the consumption of fruits, vegetables, and dairy products tends to be insufficient, whereas there is an elevated intake of sugar and unhealthy snacks. Children exhibit a preference for high-carbohydrate, salty, and strongly flavored products. This review revealed the importance of body composition and its changes during cancer treatment in children, as well as eating habits and diet quality.

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“…CAYAs cancer survivors and their families experienced significant and distressing nutrition challenges and perceived as reassuring the chance to receive a nutritional support (22). However, only one study has proven the efficacy of a one-year nutritional intervention program in improving diet quality of children diagnosed with cancer (23).…”

Section: Open Access Edited Bymentioning

confidence: 99%

Innovative strategies to predict and prevent the risk for malnutrition in child, adolescent, and young adult cancer survivors

Guida,

Andreozzi,

Zama

et al. 2023

Front. Nutr.

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Children, adolescents, and young adult cancer survivors (CAYAs) constitute a growing population requiring a customized approach to mitigate the incidence of severe complications throughout their lifetimes. During cancer treatment, CAYAs cancer survivors undergo significant disruptions in their nutritional status, elevating the risks of mortality, morbidity, and cardiovascular events. The assessment of nutritional status during cancer treatment involves anthropometric and dietary evaluations, emphasizing the necessity for regular assessments and the timely identification of risk factors. Proactive nutritional interventions, addressing both undernutrition and overnutrition, should be tailored to specific age groups and incorporate a family-centered approach. Despite encouraging interventions, a notable evidence gap persists. The goal of this review is to comprehensively examine the existing evidence on potential nutritional interventions for CAYAs cancer survivors. We explore the evidence so far collected on the nutritional intervention strategies elaborated for CAYAs cancer survivors that should target both undernutrition and overnutrition, being age-specific and involving a family-based approach. Furthermore, we suggest harnessing artificial intelligence (AI) to anticipate and prevent malnutrition in CAYAs cancer survivors, contributing to the identification of novel risk factors and promoting proactive, personalized healthcare.

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Understanding the patient and family experience of nutrition and dietetic support during childhood cancer treatment

Cited by 3 publications

References 36 publications

Risk of increased mortality in underweight survivors: A brief report from the Childhood Cancer Survivor Study

Risk of increased mortality in underweight survivors: A brief report from the Childhood Cancer Survivor Study

Nutritional status, body composition and diet quality in children with cancer

Innovative strategies to predict and prevent the risk for malnutrition in child, adolescent, and young adult cancer survivors

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