1
|
Tolín Hernani MDM, Miranda Cid MDC, Guerrero Cuevas M, Álvarez Calatayud G, Sánchez C. Perception of Paediatricians and Families about Nutritional Supplements: Acceptance, Tolerability and Satisfaction in Malnourished Children (PerceptiONS Jr Study). Nutrients 2024; 16:2475. [PMID: 39125355 PMCID: PMC11313921 DOI: 10.3390/nu16152475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2024] [Revised: 07/22/2024] [Accepted: 07/26/2024] [Indexed: 08/12/2024] Open
Abstract
BACKGROUND Malnutrition is a common situation in the Spanish paediatric population. Malnourished children may benefit from different strategies, including dietary modifications or nutritional supplements (NS). It is important to know the different factors that can influence treatment tolerance and adherence, and their impact on nutrition monitoring. OBJECTIVES To explore the perception of doctors who prescribe nutritional supplements (NS) in children and to investigate different factors involved in tolerance and adherence. MATERIAL AND METHODS A cross-sectional, descriptive observational study based on an ad hoc electronic survey designed to study doctors' perceptions of at least five of their children with NS and their families, subjected to outpatient follow up. Variables included were the socio-demographic variables of the doctors and children, nutritional status of the patients, amount and characteristics of NS (hyper-caloric oral with fibre (HOFF), oral peptide (OPF) and hyper-caloric infant (HIF)), route of administration, perceived benefits, satisfaction, palatability, adherence, and acceptance. RESULTS 815 patients aged 0-16 years (mean 10.6 years; SD 7.8) were included. A proportion of 64% received HOFF, 16% FOP, and 20% HIF. A proportion of 84% received exclusive oral NS. Total daily calorie intake prescribed with NS ranged from 30-75% in 48.2% of cases, though it was significantly higher in children under 6 months of age. Improvement in overall condition, nutritional status and quality of life was observed in 82%, 79.5%, and 80% of subjects. Improvement in tolerance and digestive symptoms was reported in 83.5% and 72% of subjects. The degree of satisfaction and acceptance of NS was very good in 80% of cases, with taste being the most influential factor (82.3%). Adherence was adequate in more than 60%, and smell was the most significant feature in lack of adherence (55%). The flavour of the best-accepted supplement was chocolate (44%). A total of 97% of prescribing doctors would recommend the same formula again. CONCLUSIONS In our study, prescribing doctors and families perceived an excellent benefit from the use of the prescribed formulas, improved quality of life, high satisfaction, acceptance, and adherence. The positive factors for adequate adherence were sufficient information about the formulations and their benefits, and continuity of care during follow-up. Prescribing doctors would recommend supplement use again given the perceived benefits and satisfaction.
Collapse
Affiliation(s)
- María del Mar Tolín Hernani
- Digestive, Hepatology and Paediatric Nutrition Unit, Infant Maternal Hospital, Hospital General Universitario Gregorio Marañón, 28007 Madrid, Spain; (M.d.M.T.H.); (M.d.C.M.C.); (G.Á.C.)
| | - María del Carmen Miranda Cid
- Digestive, Hepatology and Paediatric Nutrition Unit, Infant Maternal Hospital, Hospital General Universitario Gregorio Marañón, 28007 Madrid, Spain; (M.d.M.T.H.); (M.d.C.M.C.); (G.Á.C.)
| | | | - Guillermo Álvarez Calatayud
- Digestive, Hepatology and Paediatric Nutrition Unit, Infant Maternal Hospital, Hospital General Universitario Gregorio Marañón, 28007 Madrid, Spain; (M.d.M.T.H.); (M.d.C.M.C.); (G.Á.C.)
| | | | - César Sánchez
- Digestive, Hepatology and Paediatric Nutrition Unit, Infant Maternal Hospital, Hospital General Universitario Gregorio Marañón, 28007 Madrid, Spain; (M.d.M.T.H.); (M.d.C.M.C.); (G.Á.C.)
| |
Collapse
|
2
|
Reel SM, Siegel RM, Pillay Smiley N. Pediatric Oncology and Obesity: An Introduction for General Pediatricians. Clin Pediatr (Phila) 2024; 63:589-593. [PMID: 37542412 DOI: 10.1177/00099228231191957] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/07/2023]
Abstract
For pediatric patients with cancer, a healthy lifestyle is important for treatment outcomes and beyond. General pediatricians play a major role in the care of these patients, particularly given the improved rates of survival. Pediatric obesity has many negative consequences, but it is an area where primary care providers can make an impact and provide support to childhood cancer survivors. To provide the best quality of care for this population, there must be collaboration between primary care and oncology providers. Additionally, general practioners should feel empowered to offer standard nutrition and physical activity recommendations to all childhood cancer survivors. For pediatric patients who carry a cancer diagnosis, cure is no longer the only goal. Pediatric providers across specialties need to work as a team to improve long-term quality of life for these patients, starting with modifiable healthy habits.
Collapse
Affiliation(s)
| | - Robert M Siegel
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
- Center for Better Health and Nutrition, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Natasha Pillay Smiley
- Cancer and Blood Diseases Institute, The Cure Starts Now Foundation Brain Tumor Center, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
- University of Cincinnati College of Medicine, Cincinnati, OH, USA
| |
Collapse
|
3
|
Lovell AL, Gardiner B, Henry L, Bate JM, Brougham MFH, Iniesta RR. The evolution of nutritional care in children and young people with acute lymphoblastic leukaemia: a narrative review. J Hum Nutr Diet 2024. [PMID: 38185902 DOI: 10.1111/jhn.13273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2023] [Accepted: 12/08/2023] [Indexed: 01/09/2024]
Abstract
BACKGROUND Acute lymphoblastic leukaemia (ALL) is the most common paediatric malignancy in the world. Advances in treatment protocols have resulted in survival rates of >80% in most high-income countries (HIC); however, children and young people (CYP) with ALL continue to face significant nutrition-related challenges during treatment. METHODS This narrative review outlines the changing landscape of treatment and survivorship for CYP with ALL and the advances in nutrition knowledge that call for changes to clinical nutrition practice. RESULTS The incidence of ALL has remained stable in HIC; however, there have been significant advances in survival over the past 30 years. Overweight and obesity are increasingly prevalent in CYP with ALL at diagnosis, during treatment and in survivorship. Coupled with poor diet quality, high-energy and saturated fat intakes, altered eating behaviours and inactivity, this necessitates the need for a shift in nutrition intervention. Undernutrition remains a concern for CYP with high-risk treatment protocols where oral or enteral nutrition support remains a cornerstone of maintaining nutrition status. CONCLUSIONS With improved treatment protocols and high survival rates, a shift to focusing on diet quality, prevention of excessive weight gain and obesity during treatment and survivorship is necessary.
Collapse
Affiliation(s)
- Amy L Lovell
- Department of Nutrition and Dietetics, The University of Auckland, Faculty of Medical and Health Sciences, Auckland, New Zealand
- Starship Blood and Cancer Centre, Starship Child Health, Auckland, New Zealand
| | - Breeana Gardiner
- Department of Nutrition and Dietetics, Great Ormond Street Hospital NHS Foundation Trust, London, UK
| | - Louise Henry
- Department of Nutrition and Dietetics, Royal Marsden NHS Foundation Trust, Surrey, UK
| | - Jessica M Bate
- Department of Paediatric Oncology, Southampton Children's Hospital, Southampton, UK
| | - Mark F H Brougham
- Department of Haematology and Oncology, Royal Hospital for Sick Children, Edinburgh, UK
| | - Raquel Revuelta Iniesta
- Children's Health and Exercise Research Centre (CHERC), Faculty of Health and Life Sciences, Public Health and Sport Sciences, Medical School, St Luke's Campus, University of Exeter, Exeter, UK
- Child Life and Health, University of Edinburgh, Edinburgh, UK
| |
Collapse
|
4
|
Clarke E, Pugh G, van den Heuvel E, Kavanagh E, Cheung P, Wood A, Winstanley M, Braakhuis A, Lovell AL. Navigating nutrition as a childhood cancer survivor: Understanding patient and family needs for nutrition interventions or education. Nutr Diet 2023; 80:494-510. [PMID: 36916152 DOI: 10.1111/1747-0080.12803] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Revised: 01/23/2023] [Accepted: 01/29/2023] [Indexed: 03/16/2023]
Abstract
AIM Nutrition challenges are common during childhood cancer treatment and can persist into survivorship, increasing the risk of non-communicable diseases. Evidence-based practice and implementation of nutrition interventions/education for childhood cancer survivors has been poorly investigated and may influence their future health. This study aimed to explore the nutrition interventions/education needs of childhood cancer survivors and the barriers and facilitators to delivering follow-up services in New Zealand. METHODS Semi structured interviews were conducted with childhood cancer survivors and/or their families (n=22) and health professionals (n=9) from a specialist paediatric oncology centre in New Zealand. Interviews were audio-recorded and transcribed verbatim. Transcripts were analysed inductively using thematic analysis. A multi-level consensus coding methodology was used where each theme and associated subthemes were discussed with the study team for confirmation to ensure accurate coding and analysis. RESULTS Three themes emerged from the analysis: (1) the current survivorship care pathway does not provide adequate interventions/education, (2) weight and dietary changes are common challenges and (3) requirements for interventions/education in survivorship are varied. Common nutrition-related concerns included fussy eating/limited dietary intake, poor diet quality, difficulties with tube weaning, and challenges with weight gain. Participants expressed a desire for education on healthy eating alongside information about cancer-related nutrition issues, such as learned food aversions. A preference for clear referral pathways and multifaceted interventions tailored to individual patient needs was identified. CONCLUSION The trifecta of treatment side effects, negative feeding practices and poor messaging from health professionals creates a challenging environment to optimise nutrition. A stepped care model matching the intervention intensity with the childhood cancer survivors is required. Education for healthcare professionals will improve the delivery of timely interventions/education and monitoring practices.
Collapse
Affiliation(s)
- Emma Clarke
- Department of Nutrition and Dietetics, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
| | - Gemma Pugh
- National Child Cancer Network, Te Aho o Te Kahu Cancer Control Agency, Wellington, New Zealand
| | - Eveline van den Heuvel
- Starship Blood and Cancer Centre, Starship Child Health, Te Whatu Ora, Health, Auckland, New Zealand
| | - Erin Kavanagh
- LEAP Long Term Assessment Programme, Starship Blood and Cancer Centre, Starship Child Health, Te Whatu Ora, Health, Auckland, New Zealand
| | - Pamela Cheung
- LEAP Long Term Assessment Programme, Starship Blood and Cancer Centre, Starship Child Health, Te Whatu Ora, Health, Auckland, New Zealand
| | - Andrew Wood
- Starship Blood and Cancer Centre, Starship Child Health, Te Whatu Ora, Health, Auckland, New Zealand
| | - Mark Winstanley
- Starship Blood and Cancer Centre, Starship Child Health, Te Whatu Ora, Health, Auckland, New Zealand
| | - Andrea Braakhuis
- Department of Nutrition and Dietetics, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
| | - Amy L Lovell
- Department of Nutrition and Dietetics, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
- Starship Blood and Cancer Centre, Starship Child Health, Te Whatu Ora, Health, Auckland, New Zealand
| |
Collapse
|
5
|
Sehgal M, Jain V, Agarwala S, Dhua A, Goel P, Yadav DK, Bakhshi S, Kalaivani M. Anthropometric Outcomes in Survivors of Pediatric Solid Tumors. Nutr Cancer 2023; 75:1795-1802. [PMID: 37545131 DOI: 10.1080/01635581.2023.2242104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Revised: 07/18/2023] [Accepted: 07/21/2023] [Indexed: 08/08/2023]
Abstract
Nutritional status is an important aspect of childhood cancer, with a bearing on the disease and subsequent survivorship. We sought to evaluate the long-term anthropometric outcomes in a cohort of pediatric solid tumor survivors treated between 1994 and 2016. Anthropometry was noted at the time of presentation, after completion of therapy, and at the last follow-up. The z-scores for weight-for-age, height-for-age, and BMI-for-age were calculated using WHO growth charts for ages <5 years and the Indian Academy of Pediatrics growth charts for age >/= 5 years. BMI was calculated for adult survivors. We included 317 survivors, comprising 48, 81, and 188 survivors of Hepatoblastoma (HB), Malignant Germ cell Tumor (MGCT), and Wilms Tumor (WT) respectively. The median age at diagnosis was 24.5 (IQR 59-13.2) months, with a follow-up ranging from 5 to 19.54 years. The z-scores of the collective cohort and individual cohorts of HB, MGCT, and WT showed an improving trend from diagnosis to the last follow-up. The difference in the prevalence of malnutrition was found to be statistically significant when any two-time points were compared. Of the 28 adult survivors, 43% were noted to be underweight. Thus, anthropometric measures improve during follow-up, however, up to 15% of children persist in being malnourished.
Collapse
Affiliation(s)
- Mehak Sehgal
- Department of Pediatric Surgery, All India Institute of Medical Sciences, New Delhi, India
| | - Vishesh Jain
- Department of Pediatric Surgery, All India Institute of Medical Sciences, New Delhi, India
| | - Sandeep Agarwala
- Department of Pediatric Surgery, All India Institute of Medical Sciences, New Delhi, India
| | - Anjan Dhua
- Department of Pediatric Surgery, All India Institute of Medical Sciences, New Delhi, India
| | - Prabudh Goel
- Department of Pediatric Surgery, All India Institute of Medical Sciences, New Delhi, India
| | - Devendra Kumar Yadav
- Department of Pediatric Surgery, All India Institute of Medical Sciences, New Delhi, India
| | - Sameer Bakhshi
- Department of Medical Oncology, All India Institute of Medical Sciences, New Delhi, India
| | - Mani Kalaivani
- Department of Biostatistics, All India Institute of Medical Sciences, New Delhi, India
| |
Collapse
|
6
|
Wilson RL, Soja J, Yunker AG, Uno H, Gordon E, Cooney T, Dieli-Conwright CM. Obesity Risk of Pediatric Central Nervous System Tumor Survivors: A Cross-Sectional Study. Nutrients 2023; 15:nu15102269. [PMID: 37242152 DOI: 10.3390/nu15102269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 04/29/2023] [Accepted: 05/09/2023] [Indexed: 05/28/2023] Open
Abstract
Adult survivors of pediatric central nervous system (CNS) tumors are at the highest risk for morbidity and late mortality among all childhood cancers due to a high burden of chronic conditions, and environmental and lifestyle factors. This study aims to epidemiologically characterize young adult survivors of pediatric CNS tumors using body mass index (BMI) to assess risk factors for obesity. Using a cross-sectional design, young adults (18-39 years) previously treated for pediatric CNS tumors and followed in a survivorship clinic during 2016-2021 were examined. Demographic, BMI, and diagnosis information were extracted from medical records of the most recent clinic visit. Data were assessed using a two-sample t-test, Fisher's exact test, and multivariable logistical regression. 198 survivors (53% female, 84.3% White) with a BMI status of underweight (4.0%), healthy weight (40.9%), overweight (26.8%), obesity (20.2%), and severe obesity (8.1%) were examined. Male sex (OR, 2.414; 95% CI, 1.321 to 4.414), older age at follow-up (OR, 1.103; 95% CI, 1.037 to 1.173), and craniopharyngioma diagnosis (OR, 5.764; 95% CI, 1.197 to 27.751) were identified as significant (p < 0.05) obesity-related (≥25.0 kg/m2) risk factors. The majority of patients were overweight or obese. As such, universal screening efforts with more precise determinants of body composition than BMI, risk stratification, and targeted lifestyle interventions are warranted during survivorship care.
Collapse
Affiliation(s)
- Rebekah L Wilson
- Division of Population Sciences, Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA 02215, USA
- Department of Medicine, Harvard Medical School, Boston, MA 02215, USA
| | - Jacqueline Soja
- Boston Children's Cancer and Blood Disorders Center, Boston, MA 02215, USA
| | - Alexandra G Yunker
- Division of Population Sciences, Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA 02215, USA
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA 02215, USA
| | - Hajime Uno
- Division of Population Sciences, Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA 02215, USA
- Department of Medicine, Harvard Medical School, Boston, MA 02215, USA
| | - Erin Gordon
- Boston Children's Hospital, Boston, MA 02215, USA
| | - Tabitha Cooney
- Division of Population Sciences, Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA 02215, USA
- Department of Medicine, Harvard Medical School, Boston, MA 02215, USA
- Boston Children's Cancer and Blood Disorders Center, Boston, MA 02215, USA
| | - Christina M Dieli-Conwright
- Division of Population Sciences, Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA 02215, USA
- Department of Medicine, Harvard Medical School, Boston, MA 02215, USA
| |
Collapse
|
7
|
Tripodi SI, Bergami E, Panigari A, Caissutti V, Brovia C, De Cicco M, Cereda E, Caccialanza R, Zecca M. The role of nutrition in children with cancer. TUMORI JOURNAL 2023; 109:19-27. [PMID: 35722985 PMCID: PMC9896537 DOI: 10.1177/03008916221084740] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
In recent years, the influence of nutrition on the health and growth of children has become increasingly important. The relevance of nutrition is even greater for children who are facing cancer. Malnutrition, within the context of undernutrition and overnutrition, may impact not only the effectiveness of treatments and outcomes, but also the quality of life for patients and their families. In this article, we review nutritional assessment methods for children with cancer, focusing on the specific characteristics of this population and analyze the efficacy of nutritional interventions, which include enteral, parenteral, and nutritional education. From our analysis, two important conclusions emerged: i) there is a need to focus our attention on the nutritional status and the body composition of oncologic children, since these factors have a relevant impact on clinical outcomes during treatment as well as after their conclusion; ii) the support of skilled clinical nutrition personnel would be extremely helpful for the global management of these patients.
Collapse
Affiliation(s)
- Serena Ilaria Tripodi
- Paediatric Haematology and Oncology,
Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
- Serena Ilaria Tripodi, Paediatric
Haematology and Oncology, Fondazione IRCCS Policlinico San Matteo, Viale Golgi
19, Pavia, 27100, Italy.
| | - Elena Bergami
- Paediatric Haematology and Oncology,
Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Arianna Panigari
- Paediatric Haematology and Oncology,
Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Valentina Caissutti
- Clinical Nutrition and Dietetics Unit,
Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Carlotta Brovia
- Clinical Nutrition and Dietetics Unit,
Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Marica De Cicco
- Paediatric Haematology and Oncology,
Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
- Cell Factory, Fondazione IRCCS
Policlinico San Matteo, Pavia, Italy
| | - Emanuele Cereda
- Clinical Nutrition and Dietetics Unit,
Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Riccardo Caccialanza
- Clinical Nutrition and Dietetics Unit,
Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Marco Zecca
- Paediatric Haematology and Oncology,
Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| |
Collapse
|
8
|
Prasad M, Moulik NR, Jatia S, Dhamne C, Parambil BC, Chichra A, Narula G, Banavali SD, Chinnaswamy G. Impact of a pediatric oncology nutrition program: Lessons learnt over a decade. Pediatr Blood Cancer 2022; 69:e29728. [PMID: 35441780 DOI: 10.1002/pbc.29728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Revised: 03/17/2022] [Accepted: 03/29/2022] [Indexed: 11/09/2022]
Abstract
BACKGROUND The management of malnutrition in children with cancer remains a challenge in low-middle-income countries (LMICs). We describe our pediatric oncology nutrition program and its impact over the past decade. METHODS We evaluated the impact of our nutrition program in accordance with the International Society of Paediatric Oncology-Paediatric Oncology in Developing Countries (SIOP PODC) Nutritional Program Evaluation in the areas of service delivery (number served, increments in delivery, number of trained care providers), patients at-risk (proportion identified with malnutrition at diagnosis/follow-up), and efficiency of nutritional interventions (proportion assessed, proportion achieved healthy weight, clinicians trained). We analyzed available data for trends between 2009 and 2020, and comparisons were made using the Fisher t test. This study was approved by our institutional ethics committee. RESULTS From 2010 to 2020, 17 749 children treated at our center were beneficiaries of the nutritional program, including assessment and intervention. During this period, trained pediatric nutritionists increased from 2 to 8; SIOP PODC level from 2 to 3-4, and nutrition budget increased 15-fold. At diagnosis (n = 5618) and six-month follow-up (n = 2674), 59.6% and 51.2% children were undernourished, 34.8% and 43% well nourished, and 4.7% and 5.7% overnourished. From 2016 onward, fewer children were undernourished at follow-up-69.5% (2016), 60% (2018), 54% (2019), and 55% (2020, P < 0.001). The program helped train over 500 clinicians in nutrition. CONCLUSIONS Improved financial support and capacity building have helped build and sustain an effective nutrition program. Priority areas include implementation of best practices, early nutritional intervention, continued education, and locally relevant research.
Collapse
Affiliation(s)
- Maya Prasad
- Division of Paediatric Oncology, Tata Memorial Centre, Mumbai, Maharashtra, India.,Homi Bhabha National Institute (HBNI), Mumbai, Maharashtra, India
| | - Nirmalya Roy Moulik
- Division of Paediatric Oncology, Tata Memorial Centre, Mumbai, Maharashtra, India.,Homi Bhabha National Institute (HBNI), Mumbai, Maharashtra, India
| | - Shalini Jatia
- Division of Paediatric Oncology, Tata Memorial Centre, Mumbai, Maharashtra, India
| | - Chetan Dhamne
- Division of Paediatric Oncology, Tata Memorial Centre, Mumbai, Maharashtra, India.,Homi Bhabha National Institute (HBNI), Mumbai, Maharashtra, India
| | - Badira Cheriyalinkal Parambil
- Division of Paediatric Oncology, Tata Memorial Centre, Mumbai, Maharashtra, India.,Homi Bhabha National Institute (HBNI), Mumbai, Maharashtra, India
| | - Akanksha Chichra
- Division of Paediatric Oncology, Tata Memorial Centre, Mumbai, Maharashtra, India.,Homi Bhabha National Institute (HBNI), Mumbai, Maharashtra, India
| | - Gaurav Narula
- Division of Paediatric Oncology, Tata Memorial Centre, Mumbai, Maharashtra, India.,Homi Bhabha National Institute (HBNI), Mumbai, Maharashtra, India
| | - Shripad D Banavali
- Division of Paediatric Oncology, Tata Memorial Centre, Mumbai, Maharashtra, India.,Homi Bhabha National Institute (HBNI), Mumbai, Maharashtra, India
| | - Girish Chinnaswamy
- Division of Paediatric Oncology, Tata Memorial Centre, Mumbai, Maharashtra, India.,Homi Bhabha National Institute (HBNI), Mumbai, Maharashtra, India
| |
Collapse
|
9
|
Poirée M, Duplan M, Letort-Bertrand M, Thouvenin S, Deparis M, Galland F, Aladenise C, Lervat C. Soins de support en oncologie pédiatrique ou le respect des besoins fondamentaux des enfants et adolescents. Bull Cancer 2022; 109:557-567. [DOI: 10.1016/j.bulcan.2021.10.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Revised: 10/11/2021] [Accepted: 10/24/2021] [Indexed: 11/29/2022]
|
10
|
Cohen J, Goddard E, Brierley ME, Bramley L, Beck E. Poor Diet Quality in Children with Cancer During Treatment. J Pediatr Oncol Nurs 2021; 38:313-321. [PMID: 33960867 DOI: 10.1177/10434542211011050] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background: With improved long-term health outcomes and survivorship, the long-term nutritional management of childhood cancer survivors, from diagnosis to long-term follow-up, has become a priority. The aim of this study was to examine the diet quality of children receiving treatment for cancer. Methods: Participants were parents of children with cancer who were receiving active treatment and not receiving supplementary nutrition. A 24-h dietary recall assessed food and nutrient intake. Serves of food group intakes and classification of core and discretionary items were made according to the Australian Dietary Guidelines and compared with age and sex recommendations. Results: Sixty-four parents participated (75% female). Most children were not consuming adequate intake of vegetables (94% of patients), fruit (77%), and milk/alternatives (75%). Of the vegetables that were consumed, half were classified as discretionary foods (e.g., chips/fries). Nearly half (49%) of children exceeded recommendations for total sugar intake and 65% of patients had an excessive sodium intake. Discussion: Children receiving cancer treatment are consuming diets of reasonable quantity, but poor quality. Information provided during treatment should focus on educating parents on a healthy diet for their child, the importance of establishing healthy eating habits for life, and strategies to overcome barriers to intake during treatment.
Collapse
Affiliation(s)
- Jennifer Cohen
- School of Women's and Children's Health, 7800UNSW Sydney, Sydney, NSW, Australia.,Kids Cancer Centre, 63623Sydney Children's Hospital, Sydney, Australia
| | - Emma Goddard
- School of Medicine, 8691University of Wollongong & Illawarra Health and Medical Research Institute, Wollongong, NSW, Australia
| | - Mary-Ellen Brierley
- School of Women's and Children's Health, 7800UNSW Sydney, Sydney, NSW, Australia
| | - Lynsey Bramley
- Kids Cancer Centre, 63623Sydney Children's Hospital, Sydney, Australia
| | - Eleanor Beck
- School of Medicine, 8691University of Wollongong & Illawarra Health and Medical Research Institute, Wollongong, NSW, Australia
| |
Collapse
|
11
|
Kunin-Batson AS, Klosky JL, Carlson-Green B, Brinkman TM. Health Behaviors and Neurocognitive Function in Survivors of Childhood Cancer. J Clin Oncol 2021; 39:1786-1794. [PMID: 33886366 DOI: 10.1200/jco.20.02512] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
| | - James L Klosky
- Department of Pediatrics, Emory University School of Medicine & Aflac Cancer and Blood Disorders Center, Children's Healthcare of Atlanta, Atlanta, GA
| | | | - Tara M Brinkman
- Departments of Epidemiology & Cancer Control and Psychology, St. Jude Children's Research Hospital
| |
Collapse
|
12
|
Chardon ML, Pinto S, Slayton WB, Fisher RS, Janicke DM. Eating behaviors and dietary quality in childhood acute lymphoblastic leukemia survivors. Pediatr Blood Cancer 2021; 68:e28811. [PMID: 33381920 DOI: 10.1002/pbc.28811] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Revised: 10/29/2020] [Accepted: 10/30/2020] [Indexed: 11/06/2022]
Abstract
BACKGROUND Childhood acute lymphoblastic leukemia (ALL) survivors' increased risk for adverse health outcomes could be mitigated through consuming a balanced diet. Nonetheless, >70% of adult survivors do not meet survivorship dietary recommendations. ALL treatment may amplify risk for restricted dietary preferences (picky eating) and poor self-regulation of food intake that could contribute to suboptimal diets in survivorship. This study aims to: (a) characterize differences in picky eating and self-regulation of food intake between survivors and peer controls; and (b) examine the associations between these eating behaviors and dietary quality in ALL survivors relative to peer controls. METHODS Participants were children (5-13 years) with (n = 32) and without (n = 32) a history of ALL and their caregivers. Children's dietary quality (Healthy Eating Index-2015) was calculated from 24-h dietary recalls. Caregivers completed the Child Eating Behavior Questionnaire-Food Fussiness subscale and the Child Self-Regulation in Eating Questionnaire. RESULTS Independent samples t-tests revealed survivors exhibited greater picky eating than peer controls but comparable self-regulation of food intake. Bootstrapped grouped multivariate regression results showed that for ALL survivors, greater picky eating was associated with worse dietary quality (controlling for age and self-regulation of food intake). For peer controls, worse self-regulation of food intake was associated with poorer dietary quality (controlling for picky eating and age). CONCLUSIONS Results provide preliminary support that different eating behaviors contribute to poor dietary quality in children with and without an ALL history. These findings suggest that interventions to improve ALL survivors' dietary quality may benefit targeting picky eating.
Collapse
Affiliation(s)
- Marie L Chardon
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Stefania Pinto
- Department of Clinical and Health Psychology, University of Florida, Gainesville, Florida
| | - William B Slayton
- Department of Pediatrics, University of Florida, Gainesville, Florida
| | - Rachel S Fisher
- Department of Psychology, Oklahoma State University, Stillwater, Oklahoma
| | - David M Janicke
- Department of Clinical and Health Psychology, University of Florida, Gainesville, Florida
| |
Collapse
|
13
|
Prasad M, Sawant S, Dhir AA. Comment on: Nutritional concerns of survivors of childhood cancer: A "First World" perspective; perspective from a low/middle-income country. Pediatr Blood Cancer 2020; 67:e28362. [PMID: 32386098 DOI: 10.1002/pbc.28362] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Accepted: 04/06/2020] [Indexed: 12/15/2022]
Affiliation(s)
- Maya Prasad
- Division of Pediatric Oncology, Tata Memorial Centre, Mumbai, India.,Homi Bhabha National Institute, Mumbai, India
| | - Sheela Sawant
- Department of General Medicine, Tata Memorial Centre, Mumbai, India.,Homi Bhabha National Institute, Mumbai, India
| | - Aruna Alahari Dhir
- Department of General Medicine, Tata Memorial Centre, Mumbai, India.,Homi Bhabha National Institute, Mumbai, India
| |
Collapse
|
14
|
Rogers PC, Barr RD. The relevance of nutrition to pediatric oncology: A cancer control perspective. Pediatr Blood Cancer 2020; 67 Suppl 3:e28213. [PMID: 32096351 DOI: 10.1002/pbc.28213] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2019] [Revised: 01/22/2020] [Accepted: 01/23/2020] [Indexed: 02/06/2023]
Abstract
It is indisputable that adequate and appropriate nutrition is fundamental to the health, growth, and development of infants, children, and adolescents, including those with cancer. Nutrition has a role in most of the accepted components of the cancer control spectrum, from prevention through to palliation. The science of nutrigenomics, nutrigenetics, and bioactive foods (phytochemicals), and how nutrition affects cancer biology and cancer treatment, is growing. Nutritional epigenetics is giving us an understanding that there are possible primary prevention strategies for pediatric cancers, especially during conception and pregnancy, which need to be studied. Primary prevention of cancer in adults, such as colorectal cancer, should commence early in childhood, given the long gestation of nutritionally related cancers. Obesity avoidance is definitely a target for both pediatric and adult cancer prevention, commencing in childhood. There is now compelling evidence that the nutritional status of children with cancer, both overweight and underweight, does affect cancer outcomes. This is a potentially modifiable prognostic factor. Consistent longitudinal nutritional assessment of patients from diagnosis through treatment and long-term follow-up is required so that interventions can be implemented and evaluated. While improving, there remains a dearth of basic and clinical nutritional research in pediatric oncology. The perspective of evaluating nutrition as a cancer control factor is discussed in this article.
Collapse
Affiliation(s)
- Paul C Rogers
- British Columbia Children's Hospital and University of British Columbia, Vancouver, Canada
| | - Ronald D Barr
- Department of Pediatrics, McMaster University, Hamilton, Canada
| |
Collapse
|