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

Abstract

Introduction: The aim of this study was to evaluate the nutritional status of children undergoing cancer treatment and to assess changes in their nutritional status depending on selected clinical, demographic, and social factors.

Material and 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 measurements of weight, body mass index (BMI), height, and arm anthropometry (MUAC, mid-upper arm circumference; TSFT, triceps skinfold thickness, and SCFT, subscapular skinfold thickness). Body composition (UMA, upper arm muscle area), arm fat index (AFI), and the sum of SCFT and TSFT (SFsum) were also assessed. Additionally, the nutritional status of patients at baseline was compared to that of a control group consisting of 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 2.08–17.67]; male 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 or body composition depending on the type of cancer, intensity of treatment, or 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 ages of 18 and 35.

Conclusions: Children with cancer show changes in the nutritional status compared to 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 nutritional status can be determined based on selected clinical, demographic, and social factors.