The role of nutrition in children with cancer

Abstract

In recent years, the influence of nutrition on the health and growth of children has become increasingly important. The relevance of nutrition is even greater for children who are facing cancer. Malnutrition, within the context of undernutrition and overnutrition, may impact not only the effectiveness of treatments and outcomes, but also the quality of life for patients and their families. In this article, we review nutritional assessment methods for children with cancer, focusing on the specific characteristics of this population and analyze the efficacy of nutritional interventions, which include enteral, parenteral, and nutritional education. From our analysis, two important conclusions emerged: i) there is a need to focus our attention on the nutritional status and the body composition of oncologic children, since these factors have a relevant impact on clinical outcomes during treatment as well as after their conclusion; ii) the support of skilled clinical nutrition personnel would be extremely helpful for the global management of these patients.

Role of Nutrition in Pediatric Patients with Cancer

“…In pediatric cancer patients, there are additional energy requirements compared to adults, as children are in a phase of growth and development [ 15 ]. If these requirements are not met, the linear growth pattern may be compromised.…”

“…Additionally, undernutrition can make patients more susceptible to infections and alter drug metabolism, leading to increased toxicity. These factors can lead to delays in treatment, poorer overall survival and event-free survival, and an increased risk of relapses [ 7 , 15 , 16 ].…”

“…Reduced weight and changes in body composition can have pharmacokinetic implications by affecting CHT volume of distribution, absorption, metabolism, and clearance from blood, resulting in reduced tolerance to treatment. Protein-caloric undernutrition can also alter the renal and hepatic metabolism of certain chemotherapeutic agents, leading to an increase in adverse effects, such as profound myelosuppression and febrile neutropenia (FN) [ 7 , 15 ]. In obese patients, changes in body composition and organ function may be associated with altered serum protein binding, metabolism, and clearance of chemotherapeutic drugs.…”

“…In addition, hyperglycemia, a complication of the therapies used in the treatment of pediatric cancer patients, has been associated with an increased risk of infections and reduced survival in pediatric cancer patients [ 12 , 13 , 14 ]. Long-term health outcomes are influenced by late-treatment-related effects, such as endocrinopathies, reduced bone mass, metabolic syndrome, cardiovascular disease, obesity, and hypertension [ 15 ]. Indeed, children are at a growth and development stage and require additional energy.…”

C -Reactive Protein, Leukocyte Count and Neutrophils: A Diagnostic Aid in Acute Appendicitis

“…Nutrition is an essential factor in pediatric oncology that affects the development of the disease, symptoms, response to chemotherapy, cancer recovery and survival. 14,15,16 Therefore, it has a strong impact on the quality of life and prognosis of the disease. Poor nutritional status leads to wasting J Islamabad Med Dental Coll 2022 of muscle mass, decreased functional capacity, higher incidence of infections, drug toxicity and increased hospitalization, as well as higher mortality.…”