Nutritional status at diagnosis of cancer in children and adolescents in Guatemala and its relationship to socioeconomic disadvantage: A retrospective cohort study

Abstract

Background At least 80% of children with cancer live in low‐ and middle‐income countries where the prevalence of malnutrition and socioeconomic disadvantage is high. We examined the relationship between nutritional status (NS), assessed by arm anthropometry, and socioeconomic status (SES) in children diagnosed with cancer at Unidad Nacional de Oncologia Pediatrica (UNOP) in Guatemala over a three‐year period. Method Patients aged 0 to 18 years of age diagnosed between January 2015 and December 2017 were included. NS was evaluated by mid‐upper arm circumference, triceps skin fold thickness, and serum albumin level, and subjects were classified as adequately nourished, moderately depleted, and severely depleted nutritionally. SES was measured by a 15‐item instrument developed at UNOP. Results Of 1365 patients diagnosed in the study period, 1060 (78%) fulfilled the eligibility criteria. Only 6% of patients were classified as medium to high, the remainder as medium–low to extremely low SES. Almost 47% were severely depleted at diagnosis, 19% moderately depleted, and 34% adequately nourished. SES was shown to be a determinant of NS; with progressively lower SES, the probability of a decline in NS increased by a factor of 1.04 points (P < 0.0001). Leukemia and lymphoma were also important predictors of nutritional depletion with odds ratios of 6.08 (95% CI, 1.74–28.28; P = 0.008) for leukemias and 4.83 (95% CI, 1.33–23.03; P = 0.03) for lymphomas. Conclusion Both low SES and a diagnosis of leukemia or lymphoma are strong predictors of poor NS at diagnosis in children with cancer in Guatemala.

Assessment of nutritional status in children with cancer: Significance of arm anthropometry and serum visceral proteins

“…The total prevalence of malnutrition in patients younger than 5 years was twice as high as that in older cases, and seven of 10 cases with moderate malnutrition were younger cases. Higher proportion of children with embryonal tumors like neuroblastoma, hepatoblastoma, and Wilms tumor were reported to be severely depleted compared to other solid tumors 27 . Nutritional problems in children with abdominal solid tumors may be associated with the nature of the diseases and therapies as well as delayed presentation with advanced disease.…”

“…Higher proportion of children with embryonal tumors like neuroblastoma, hepatoblastoma, and Wilms tumor were reported to be severely depleted compared to other solid tumors. 27 The cross-sectional AMA and AFA indices were proposed to be better indices than direct arm anthropometry in children. 6 We could not were nutritionally depleted had higher abandonment rates and poorer survival.…”

Maya K’iche’ Food Groups and Implications for Guatemalan Food Guidelines

“…1,2 Noncommunicable diseases are largely a result of inappropriate food consumption, food behaviors, and food availability. 3 -5 Guatemala has experienced issues surrounding food security in the last 40 years, and the Maya population is most vulnerable. 6,7 One of the NCD prevention strategies implemented by the National Ministry of Health are the Guatemalan Food Guidelines (GFG).…”

Estado nutricional e sobrevida global de crianças e adolescentes com câncer acompanhados pelo serviço de nutrição

“…20,[60][61][62][63][64] Entretanto, publicações de outros países em desenvolvimento reportaram prevalências mais altas. 21,29,[65][66][67][68][69]…”

“…Quando agrupados os diagnósticos, pacientes com tumores sólidos apresentaram a maior prevalência de subnutrição, assim como observado por Lemos et al (2014) 13 e em revisão sistemática por Revuelta Iniesta et al (2015)51 . Já Villanueva et al (2019)65 observaram maior prevalência de subnutrição por CB em crianças com linfomas, seguido por pacientes com tumores sólidos Sala et al (2012) 29. encontraram IMC diagnosticou maior porcentagem de subnutrição e de sobrepeso ao diagnóstico do que a CB.…”