Changes in the nutritional status of children with cancer depending on clinical, demographic and social factors

Abstract

Purpose The aim of the study was to evaluate the nutritional status of children undergoing cancer treatment and to assess changes in the nutritional status depending on selected clinical, demographic, and social factors. Methods This was a single-center prospective cohort study of children aged 2 to 18 years, who were diagnosed with cancer and received treatment between October 2019 and January 2022. The nutritional status of patients was evaluated before and after cancer treatment based on the measurements of weight, body mass index (BMI), height, and arm anthropometry (mid-upper arm circumference [MUAC], triceps skinfold thickness [TSFT], and subscapular skinfold thickness [SCFT]). Body composition (upper arm muscle area [UMA], arm fat index [AFI], and the sum of SCFT and TSFT [SFsum]) was also assessed. Additionally, the nutritional status of patients at baseline was compared with that of the control group including 30 healthy children. The obtained results were analyzed depending on selected demographic, clinical, and social factors. Results The study included 40 patients (median age, 11.29 years [range, 5.25-13.27 years]; men, 67.5%). At baseline, malnutrition was reported in 5% and 7.5% of children based on weight and BMI, respectively, and in 7.5% of patients based on MUAC. At follow-up, malnutrition increased by 17.5% based on body weight and BMI and by 2.5% based on MUAC. UMA allowed the diagnosis of protein-energy malnutrition in 27.5% of patients. Moreover, low UMA was significantly more common in children with cancer than in controls. Overnutrition at follow-up was identified in a higher percentage of patients based on AFI and SFsum measurements than based on BMI (27.5%, 35%, and 10%, respectively). There were no differences in anthropometric measurements and body composition depending on the type of cancer, intensity of treatment, and place of residence. However, weight, BMI, MUAC, UMA, and SFsum were higher in males, suggesting the possible effect of sex. A higher prevalence of underweight determined by BMI was noted in patients whose parents had university education or were between the age of 18 to 35 years. Conclusions Children with cancer show changes in the nutritional status compared with healthy children. Body composition can be used to identify these changes with greater accuracy than anthropometric measurements such as weight, height, BMI, and arm anthropometry. The risk of changes in the nutritional status can be determined based on selected clinical, demographic, and social factors.