Body composition of children with cancer during treatment and in survivorship

Alexia J Murphy; Melinda White; Sarah A Elliott; Liane Lockwood; Andrew Hallahan; Peter Sw Davies

doi:10.3945/ajcn.114.099697

Body composition of children with cancer during treatment and in survivorship

Am J Clin Nutr. 2015 Oct;102(4):891-6. doi: 10.3945/ajcn.114.099697. Epub 2015 Aug 12.

Authors

Alexia J Murphy¹, Melinda White², Sarah A Elliott³, Liane Lockwood⁴, Andrew Hallahan⁵, Peter Sw Davies³

Affiliations

¹ Children's Nutrition Research Centre, Child Health Research Centre, School of Medicine, and alexia.murphy@uq.edu.au.
² Department of Dietetics and Food Service, Lady Cilento Children's Hospital, Brisbane, Australia; and.
³ Children's Nutrition Research Centre, Child Health Research Centre, School of Medicine, and.
⁴ Oncology Service, Children's Health Queensland, Brisbane, Australia.
⁵ Queensland Children's Medical Research Institute, The University of Queensland, Brisbane, Australia; Oncology Service, Children's Health Queensland, Brisbane, Australia.

PMID: 26269368
DOI: 10.3945/ajcn.114.099697

Abstract

Background: Malnutrition as assessed with the use of body-composition measurements is a poorly understood short- and long-term complication of childhood cancer.

Objectives: We aimed to evaluate the body composition of 2 childhood cancer cohorts as follows: 1) children currently undergoing cancer treatment and 2) childhood cancer survivors. We also aimed to compare the prevalence of obesity and undernutrition between the cancer groups and investigate the impact of cancer type on body composition.

Design: Eighty-two children during the treatment of cancer and 53 childhood cancer survivors were involved in the study. Height, weight, body cell mass, percentage of fat, fat mass index, and fat-free mass index were assessed. Subjects were compared with age- and sex-matched healthy controls.

Results: The on-treatment group had a higher percentage of fat (P = 0.0001) and fat mass index (P = 0.0001) and a significantly lower body cell mass index (P = 0.0001) and fat-free mass index (P = 0.003) than did matched controls. The survivor group had a significantly higher percentage of fat (P = 0.03) and fat mass index (P = 0.04) and significantly lower body cell mass index (P = 0.0001) than did matched controls. The prevalence of undernutrition was high in both groups with 48% (95% CI: 36%, 60%) of the on-treatment group and 53% (95% CI: 40%, 66%) of the survivors considered undernourished. According to the percentage of fat cutoffs, significantly more on-treatment patients were obese (55%; 95% CI: 40%, 60%) than were survivors (26%; 95% CI: 14%, 38%) (P = 0.005). There were no statistically significant differences in body composition between cancer types in either the on-treatment or the survivor group.

Conclusions: Overnutrition and undernutrition are major concerns in the short and long term for children with cancer. Children treated for cancer have increased fat mass and decreased body cell mass, which are evident during treatment and in survivorship. This trial was registered at http://www.ANZCTR.org.au as ACTRN12614001279617 and ACTRN12614001269628.

Keywords: body composition; cancer; childhood cancer survivor; children; malnutrition.

Publication types

Observational Study
Research Support, Non-U.S. Gov't

MeSH terms

Adolescent
Adult
Body Composition*
Body Mass Index
Body Weight
Case-Control Studies
Child
Child, Preschool
Cross-Sectional Studies
Energy Intake
Energy Metabolism
Female
Humans
Male
Malnutrition / complications*
Neoplasms / complications*
Neoplasms / therapy
Obesity / complications*
Prevalence
Prospective Studies
Survival Rate
Survivors
Young Adult

Associated data

ANZCTR/ACTRN12614001269628
ANZCTR/ACTRN12614001279617