The Role of Nutrition in Primary and Secondary Prevention of Cardiovascular Damage in Childhood Cancer Survivors

Abstract

Innovative therapeutic strategies in childhood cancer led to a significant reduction in cancer-related mortality. Cancer survivors are a growing fragile population, at risk of long-term side effects of cancer treatments, thus requiring customized clinical attention. Antineoplastic drugs have a wide toxicity profile that can limit their clinical usage and spoil patients’ life, even years after the end of treatment. The cardiovascular system is a well-known target of antineoplastic treatments, including anthracyclines, chest radiotherapy and new molecules, such as tyrosine kinase inhibitors. We investigated nutritional changes in children with cancer from the diagnosis to the end of treatment and dietary habits in cancer survivors. At diagnosis, children with cancer may present variable degrees of malnutrition, potentially affecting drug tolerability and prognosis. During cancer treatment, the usage of corticosteroids can lead to rapid weight gain, exposing children to overweight and obesity. Moreover, dietary habits and lifestyle often dramatically change in cancer survivors, who acquire sedentary behavior and weak adherence to dietary guidelines. Furthermore, we speculated on the role of nutrition in the primary prevention of cardiac damage, investigating the potential cardioprotective role of diet-derived compounds with antioxidative properties. Finally, we summarized practical advice to improve the dietary habits of cancer survivors and their families.

Irradiation-Induced Dysbiosis: The Compounding Effect of High-Fat Diet on Metabolic and Immune Functions in Mice

“…Children diagnosed with cancer experience dramatic changes in their dietary habits during cancer treatment and well into survivorship [ 21 , 22 , 23 ]. Such dramatic changes independently or in combination with cancer treatment exert a major impact on the increased cardio-metabolic complications risk reported in childhood cancer survivors [ 5 , 24 ].…”

Innovative strategies to predict and prevent the risk for malnutrition in child, adolescent, and young adult cancer survivors

“…After completing cancer treatment, CAYAs cancer survivors can be more exposed to overnutrition, due to a combination of poor dietary habits and a sedentary lifestyle with profound metabolic alteration secondary to the cancer treatment itself (5,6). Overweight and obesity increases cardiovascular risk and mortality and are related to greater fatigue, reduced physical activity and depression, deeply affecting the quality of life (7,8).…”

A Multimodal Lifestyle Psychosocial Survivorship Program in Young Cancer Survivors

“…Although a healthy lifestyle can reduce the risk for cardiovascular events 17 , 18 and has a positive impact on health-related QOL, 19 , 20 surveys of cancer survivors’ health behaviors show that a considerable proportion do not engage in sufficient physical activity 21 , 22 , 23 and adhere to a balanced diet. 24 , 25 Personalized physical activity or nutritional counseling, as well as age-appropriate interventions, are described to improve health behavior, QOL, and the psychosocial situation of CAYAs, 24 , 26 , 27 , 28 , 29 but evidence is still sparse.…”