The Association Between Diet Quality Scores with Inflammation and Treatment Outcomes in Children with Acute Lymphoblastic Leukemia; A Cross-Sectional Study

Abstract

Background Acute Lymphoblastic Leukemia is the most common childhood cancer. Considering the importance of diet in the treatment process of cancer patients, the purpose of this study was to investigate the relationship between diet quality and inflammatory/therapeutic outcomes. Methods In this cross-sectional study, 147-item Food Frequency Questionnaire was used to collect dietary data from patients. Diet quality was evaluated by the Healthy Eating Index 2015 (HEI-2015), Dietary Diversity Score (DDS), Dietary Acid Load (DAL), and Planet Base Diet Index (PDI). Linear regression analysis was then employed to explore potential associations between dietary scores and the C-reactive protein (CRP), Neutrophil-to-Lymphocyte Ratio (NLR), Monocyte-to-Lymphocyte Ratio (MLR), Platelet-to-Lymphocyte Ratio (PLR), Prognostic Nutrition Index (PNI), Prognostic Index (PI), Glasgow prognostic score (GPS), Febrile neutropenia (FN), and Hospitalization duration outcomes. Result In this study with 54 patients, we found that a higher DDS score is linked to a reduction in NLR (ß: -0.30, P-value: 0.057) and an increase in PNI among women (ß: 3.90, P-value: 0.01). Furthermore, an inverse relationship was observed between the PDI score and both CRP (ß: -0.63, P-value: 0.02) and GPS (ß: -0.02, P-value: 0.052) in men. However, the length of hospital stay was seen to rise with an increase in PDI, both in crude models (ß: 0.36, P-value: 0.03) and when adjusted for other factors (ß: 0.40, P-value: 0.02). No additional significant links were discovered between food scores and the outcomes studied. Conclusion In conclusion, a diet that is both higher in quality and more varied leads to a reduction in inflammation-related outcomes. Furthermore, closely following PDI guidelines is linked to longer hospital stays. To achieve more dependable findings, further research in this area is necessary.