The treatment of cancer has consequences for the nutritional status of a child. Some children lose a lot of weight during treatment and are at risk of malnutrition, while others gain a lot of weight.
But how do the children fare after the treatment?
Does their nutritional status recover or are the changes that occur during treatment, such as being overweight, permanent?
These questions were the focus of a recently published study.
Nursing researchers Aeltsje Brinksma and Wim Tissing, a pediatric oncologist and head of supportive care, conducted their research on children who were originally treated at UMCG. This was a group of children aged 0 to 18 years with a haematological condition, a brain tumour or a solid tumor.
Aeltsje Brinksma explains: “We collected data on the nutritional status at diagnosis and one year and seven years after diagnosis. The children were measured at these times, they filled out questionnaires themselves or together with their parents and kept a food diary. Other data were collected from the medical records. This way we obtained accurate data on weight, height, BMI, fat and fat-free mass, and factors such as age, gender, type of cancer, nutritional intake and physical activity.”
Extra weight and fat mass
The data were analyzed and the researchers observed significant differences. In children with haematological cancer and brain tumour, the BMI continued to rise after the end of treatment. This quadrupled the percentage of survivors overweight seven years after diagnosis.
Aeltsje comments: “We calculated that 27.3% of the children had overweight after the end of treatment. That is higher than 15.5% and 18.6% in children and adolescents in the Netherlands respectively. The acquired extra weight and fat mass disappeared during treatment, but not after the end of treatment.”
Risk of under- and overweight
An important conclusion from this study is that children who become heavier and develop extra fat mass during treatment do not lose this after treatment. Factors that influence weight gain or fat mass are the type of cancer (haematological and brain tumour), lower BMI at diagnosis and higher BMI of the mother.
Aeltsje Brinksma emphasizes: “It is important that during treatment attention is not only given to the risk of malnutrition but also to the risk of developing overweight. Although in the study we did not find a direct correlation between nutrition intake (eating a lot or unhealthily) and weight gain, attention to a healthy diet and sufficient exercise during treatment is important.
For children and parents, this is a difficult message. Particularly because children sometimes have periods of no appetite and eat little, they are allowed to eat more ‘unhealthy’ things, which is very logical. It is really a challenge to continue eating ‘healthy’ when food tastes different or to continue exercising and playing sports when you feel tired and miserable.”
Currently, follow-up research is being conducted at the Princess Máxima Center in which the metabolism of children is mapped in addition to their nutritional intake and physical activity. This study may provide even better insight into how overweight develops and how it can be prevented.