The opportunities and challenges for nutritional intervention in childhood cancers

Abstract

Diet dictates nutrient availability in the tumor microenvironment, thus affecting tumor metabolic activity and growth. Intrinsically, tumors develop unique metabolic features and are sensitive to environmental nutrient concentrations. Tumor-driven nutrient dependencies provide opportunities to control tumor growth by nutritional restriction or supplementation. This review summarized the existing data on nutrition and pediatric cancers after systematically searching articles up to 2023 from four databases (PubMed, Web of Science, Scopus, and Ovid MEDLINE). Epidemiological studies linked malnutrition with advanced disease stages and poor clinical outcomes in pediatric cancer patients. Experimental studies identified several nutrient dependencies (i.e., amino acids, lipids, vitamins, etc.) in major pediatric cancer types. Dietary modifications such as calorie restriction, ketogenic diet, and nutrient restriction/supplementation supported pediatric cancer treatment, but studies remain limited. Future research should expand epidemiological studies through data sharing and multi-institutional collaborations and continue to discover critical and novel nutrient dependencies to find optimal nutritional approaches for pediatric cancer patients.

Feasibility study of micronutrient status and body mass index of newly diagnosed pediatric oncology patients: Research commentary

“…The role of micronutrient supplementation to assess benefit or harm is required. The role of micronutrients from a cancer control perspective requires further basic and clinical research 2,28 …”

“…The role of micronutrients from a cancer control perspective requires further basic and clinical research. 2,28…”

“…Micronutrient research should be embedded in large phase III co‐operative group studies. There is an urgent need to understand the relevance of micronutrients in the biology of pediatric cancer and the treatment thereof 28,29 …”

Recommendations for Nutritional Supplementation in Pediatric Oncology: A Compilation of the Facts

“…Children with cancer are regularly faced with nutritional challenges; it is estimated that up to 70% of pediatric patients with malignancies experience malnutrition [ 1 , 2 , 3 , 4 ]. The pathogenesis of malnutrition, which is defined as an imbalance in nutrient requirements and intake that causes adverse effects on growth, neurocognitive function, and body function, is complex.…”

“…It is common for parents of critically ill children to worry about their eating habits and resort to additional supplements in order to meet their child’s nutritional needs. Although the human body has efficient homeostatic mechanisms that regulate the absorption and retention of many nutrients, which decreases the likelihood of toxicities, the safety of long-term use of these supplements must not be overlooked [ 4 , 27 , 55 ].…”