A randomized nutrition counseling intervention in pediatric leukemia patients receiving steroids results in reduced caloric intake

Li, Rhea; Donnella, Hayley; Knouse, Phillip; Raber, Margaret; Crawford, Karla; Swartz, Maria C.; Wu, Jimin; Liu, Diane; Chandra, Joya

doi:10.1002/pbc.26231

Cited by 23 publications

(53 citation statements)

References 24 publications

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“…Dietary and exercise‐based interventions are being developed for children with cancer with greater frequency. For example, recent randomized controlled trials have demonstrated the effectiveness of dietary and physical activity interventions in reducing caloric intake in patients with acute lymphoblastic leukemia receiving steroids or increasing physical activity and weight loss in survivors . Integrating interventions within the transtheoretical model may heighten the chance of success of these interventions and allows for a theoretical framework with which to guide investigation.…”

Section: Discussionmentioning

confidence: 99%

Psychosocial determinants of physical activity and dietary behaviors in adolescents and young adults with cancer and survivors

Diorio

Lin

Ginn

et al. 2018

Pediatric Blood & Cancer

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Section: Discussionmentioning

confidence: 99%

Psychosocial determinants of physical activity and dietary behaviors in adolescents and young adults with cancer and survivors

Diorio

Lin

Ginn

et al. 2018

Pediatric Blood & Cancer

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“…One full‐text was excluded as the study participants with chronic conditions were not using corticosteroids, leaving three included studies that were published between 2009 and 2017. These mainly reported on work undertaken in Anglo‐American contexts (the United Kingdom and United States).…”

Section: Resultsmentioning

confidence: 99%

“…All included studies used experimental designs (Table ). Each study had a small sample size, ranging from 13 patients to 23 patients . The studies differed in terms of length of observation and population included.…”

Section: Resultsmentioning

confidence: 99%

“…There was a lack of clarity on the definition of corticosteroid treatment being used in the populations that were included in the RCTs. The study by Li et al was the most ambiguous as the study did not explicitly state the type (prednisone/dexamethasone), dose or duration of the corticosteroids used . It is assumed that patients included in this study were on chronic corticosteroids as stated by the authors.…”

Section: Resultsmentioning

confidence: 99%

“…Two studies examined dietary interventions while one study assessed a combined exercise and dietary intervention (Table ). Li et al examined patient‐tailored nutritional counselling as a complex intervention based on American Academy of Paediatrics that comprised nutrition education and diet plans, goal‐setting, meal‐planning, recipe modification and side effect management . Patients received the combined intervention on a monthly basis for a total of 12 months, and the control group only received nutritional counselling on an as‐needed basis .…”

Section: Resultsmentioning

confidence: 99%

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Obesity prevention in corticosteroid‐treated patients: Use and effectiveness of strategies for weight management

Conklin

Hong

2019

Clinical Obesity

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Summary We conducted a systematic review to identify the use and effectiveness of clinical interventions to prevent or mitigate weight gain in patients using systemic corticosteroids. We independently searched nine bibliometric databases for reviews and longitudinal studies published up to 26 October 2018, and assessed the quality of studies meeting inclusion criteria. We identified 3893 records and screened 3037 eligible studies, read four full‐texts and extracted data from three randomized control trials. Two studies examined a diet‐only intervention for weight management, while one study examined a mixed intervention for diet and exercise. Overall, existing evidence is of poor quality and based on small feasibility studies of either paediatric leukaemia or female lupus patients, which suggested divergent effects of lifestyle interventions on weight, body mass index or waist circumference. Current evidence suggests a state of clinical equipoise that deserves greater research attention given the prevalent use of corticosteroids for treating a variety of chronic conditions. Robust high‐quality longitudinal studies to decipher preventive strategies of steroid‐induced weight gain must be prioritized in research and policy to improve patient care and prevent further obesity‐related disease burden.

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A bilingual dietary intervention early in treatment is feasible and prevents weight gain in childhood acute lymphoblastic leukemia

Walters

Mowbray

Jubelirer

et al. 2021

Pediatric Blood & Cancer

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Background Childhood acute lymphoblastic leukemia (ALL) is the most common pediatric malignancy. The onset of obesity during childhood ALL has been well established and is associated with inferior survival rates and increased treatment‐related toxicities. This pilot study sought to determine if a dietary intervention is feasible and minimizes weight gain during the initial phases of treatment for ALL. Methods Participants were recruited from four institutions, fluent in English or Spanish, between 5 and 21 years old, and enrolled within 3 days of starting induction therapy. Participants were counseled for 6 months to follow a low glycemic diet. Dietary and anthropometric data were collected at diagnosis, end of induction, and end of month 6 (NCT03157323). Results Twenty‐three of 28 participants (82.1%) were evaluable and included in the analysis. Dietary changes targeted by the nutrition intervention were successful; sugar intake declined (P = .003), whereas vegetable intake increased (P = .033). The majority of participants were able to adhere to the dietary principles prescribed: ≥70.0% reduced glycemic load and ≥60.0% increased fiber intake and decreased sugar intake. Importantly, we did not observe an increase in body mass index z‐score during induction or over the 6‐month intervention period. Most families found the nutrition intervention easy to follow (60%) and affordable (95%) despite simultaneous initiation of treatment for ALL. Conclusions A 6‐month nutrition intervention initiated during the initial phase of treatment for childhood ALL is feasible and may prevent weight gain. Our preliminary findings need to be confirmed in a larger clinical trial.

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A randomized nutrition counseling intervention in pediatric leukemia patients receiving steroids results in reduced caloric intake

Abstract: A year-long dietary intervention was effective at reducing caloric intake in pediatric ALL patients receiving steroid-based chemotherapy, indicating that this is a modality that can be built upon for obesity prevention and management.

Cited by 23 publications

References 24 publications

Psychosocial determinants of physical activity and dietary behaviors in adolescents and young adults with cancer and survivors

Psychosocial determinants of physical activity and dietary behaviors in adolescents and young adults with cancer and survivors

Obesity prevention in corticosteroid‐treated patients: Use and effectiveness of strategies for weight management

A bilingual dietary intervention early in treatment is feasible and prevents weight gain in childhood acute lymphoblastic leukemia

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