Nutritional Assessment of Children With Cancer

Abstract

Regardless of which parts of the world they live in, most children will develop and grow at a similar rate if proper nutrition is ensured. Children from developing countries are at risk for primary malnutrition. Children undergoing anticancer therapy are at higher risk for secondary malnutrition, including obesity and growth retardation. Periodic nutritional assessments are important for planning effective dietary interventions for such children. In this review, we describe malnutrition as it occurs in children with cancer and various ways of assessing the nutritional status of these children, depending on the availability of resources in their local hospitals. Objective and subjective data should be used to complete the nutritional assessment. We discuss screening methods, including the use of subjective global assessment. Different parts of nutritional assessment include medical history; physical examination; biochemical and hematological data, such as visceral proteins, blood glucose levels, and lipid profiles, hemoglobin and hematocrit, and the lymphocyte count; anthropometric measurements; and food and nutrition history. We review medical tests and procedures to determine nutritional status, including nitrogen balance, delayed cutaneous hypersensitivity, prognostic nutritional index, creatinine height index, maldigestion and malabsorption tests, indirect calorimetry, and dual energy X ray absorptiometry (DXA scan). Evaluation and interpretation of data and estimation of nutritional risk are discussed, including proper techniques and use of anthropometric measures, selection and use of growth charts, calculation of caloric and protein needs, and the percentage of calories ingested. These methods will enable local health care providers to accurately assess the nutritional status of children with cancer, identify children at risk, and plan adequate nutritional interventions.

Nutritional Assessment of Children with Acute Lymphoblastic Leukemia

“…Table 1 reveals A total of 30 children with newly diagnosed ALL were included in this study, their age range from (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14) years, mean age (5.4 ± 3.4SD). Sixteen were males and fourteen were females, reveals that 16 (53.3%) of patients included in this study were males and 14 (46.6%) were females.…”

“…Malnutrition can lead to a decreased immune function, in already immune compromised patients; delay wound healing and reduce drug metabolism. Also, as mentioned earlier it can be a contributing factor to death and poor prognosis [1,8,9].…”

“…Plant based diets high in fiber and unsaturated fatty acids can lower total cholesterol. Hemoglobin/Hematocrit in state of malnutrition, hemoglobin and hematocrit tend to decrease because of inadequate amount of protein consumption and possibly iron deficiency [9].…”

Clinical implications of malnutrition in children with cancer

“…This omission, of which the Dutch authors are aware (their reference 21), is compounded by a mis-representation of the data; the authors of the Central American study did not "promote the use of BMI as an indicator of nutritional status" in children with cancer, preferring arm anthropometry for reasons articulated previously [3]. Loeffen and colleagues may also take note of a study conducted subsequently in Guatemala that reported on the restoration of good survival prospects for children with acute lymphoblastic leukemia who were malnourished at diagnosis but normalized their nutritional status during therapy [4].…”

The Effectiveness of Enteral Nutrition Support in the Growth of Children Patients with Cancer

“…This assessment includes medical history, physical examination, biochemical and hematological data, such as visceral proteins, blood glucose levels, and lipid profiles, hemoglobin, hematocrit and lymphocyte counts, anthropometric measurements, and food and nutrition history. Visceral proteins such as prealbumin, transferrin and retinol-binding protein have emerged as indicators of nutritional status [4,5]. Anthropometric measurements are a primary component of the nutrition assessment process in pediatric oncology patients.…”