Early Nutrition and Physical Activity Interventions in Childhood Cancer Survivors

Abstract

Purpose of review Childhood cancer survivors experience excessive weight gain early in treatment. Lifestyle interventions need to be initiated early in cancer care to prevent the early onset of obesity and cardiovascular disease (CVD). We reviewed the existing literature on early lifestyle interventions in childhood cancer survivors and consider implications for clinical care. Recent findings Few lifestyle interventions focus on improving nutrition in childhood cancer survivors. A consistent effect on reducing obesity and CVD risk factors is not evident from the limited number of studies with heterogeneous intervention characteristics, although interventions with a longer duration and follow-up show more promising trends. Summary Future lifestyle interventions should be of a longer duration and include a nutrition component. Interventions with a longer duration and follow-up are needed to assess the timing and sustainability of the intervention effect. Lifestyle interventions introduced early in cancer care are both safe and feasible.

Acceptability and feasibility of a parent‐targeted dietary intervention in young survivors of childhood cancer: “Reboot”

“…Poor long‐term dietary habits may reflect the continuation of maladaptive parent feeding behaviors such as increased permissiveness of children's intake of “junk foods” rather than vegetables and fruits established during cancer treatment, 10‐12 which influence children's food choices. While these changes reflect an adaptive response to treatment‐related side effects such as nausea and vomiting, 13 evidence of poor dietary intake beyond treatment completion indicates that children's maladaptive eating behaviors are difficult to reverse and likely to persist into adulthood 14,15 . Thus, evidence‐based dietary interventions delivered early in the lifecycle 16 and survivorship trajectory 14 are a clear priority for promoting healthy eating behaviors in this at‐risk population 17 …”

“…While these changes reflect an adaptive response to treatment‐related side effects such as nausea and vomiting, 13 evidence of poor dietary intake beyond treatment completion indicates that children's maladaptive eating behaviors are difficult to reverse and likely to persist into adulthood 14,15 . Thus, evidence‐based dietary interventions delivered early in the lifecycle 16 and survivorship trajectory 14 are a clear priority for promoting healthy eating behaviors in this at‐risk population 17 …”

“…Telephone‐based dietary support may represent an acceptable strategy for promoting healthy eating habits in pediatric cancer survivors who are often geographically dispersed 19 . Earlier studies have targeted or involved parents to reduce caloric intake 20,21 and increase calcium intake 22 in pediatric cancer survivors, but are yet to investigate the acceptability and feasibility of parent‐targeted dietary interventions aimed at promoting vegetables and fruits in this population 14 . To address this gap, we aimed to pilot Reboot, a parent vegetable and fruit intervention in families of young survivors of childhood cancer early off treatment.…”

Sodium and Potassium Intakes and Cardiovascular Risk Profiles in Childhood Cancer Survivors: The SCCSS-Nutrition Study

“…In the general population, hypertension, obesity, diabetes mellitus, smoking, and dyslipidemia are primary contributors to CVD [9][10][11]. These risk factors are also relevant for CCSs, and represent important modifiable factors in the development and severity of CVD [12][13][14]. Efforts to reduce the obesity epidemic are an important pillar of cardiovascular prevention in the general population [9].…”

The Role of Exercise in Pediatric and Adolescent Cancers: A Review of Assessments and Suggestions for Clinical Implementation

“…As a result of the numerous LAE related to pediatric cancer treatment, an interest in using exercise as a therapeutic measure to attenuate or reverse many cancer-related LAE in the pediatric population has surfaced. While comparatively less studied, the research suggests that there is a positive effect of physical activity on organ system function, fatigue, and physical well-being in children during and after cancer treatment [39][40][41][42][43][44][45][46][47][48][49]. It is clear that children who exercise can increase aerobic fitness and strength, with the latter a result of neuromuscular adaptations rather than skeletal muscle hypertrophy.…”