Changes in nutritional status in childhood cancer patients: A prospective cohort study

Aeltsje Brinksma*, Petrie F. Roodbol, Esther Sulkers, Willem A. Kamps, Eveline S. J. M. de Bont, Annemieke M. Boot, Johannes G. M. Burgerhof, Rienk Y. J. Tamminga, Wim J. E. Tissing

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

69 Citations (Scopus)


BACKGROUND & AIMS: Under- and overnutrition are linked to adverse outcomes during and after childhood cancer treatment. Therefore, understanding the timing of weight loss and weight gain and their contributory factors is essential for improving outcomes. We aimed to determine in which period of treatment changes in nutritional status occurred and which factors contributed to these changes.

METHODS: A prospective cohort study of 133 newly diagnosed cancer patients with hematological, solid, and brain malignancies was performed. Anthropometric data and related factors were assessed at 0, 3, 6 and 12 months after diagnosis.

RESULTS: Despite initial weight loss at the beginning of treatment in patients with hematological and solid malignancies, body mass index (BMI) and fat mass (FM) increased within 3 months with 0.13 SDS (P < 0.001) and 0.05 SDS (P = 0.021) respectively. Increase continued during the following months and resulted in a doubling of the number of overnourished patients. Fat free mass (FFM), which was already low at diagnosis, remained low. During the entire study period about 17% of the patients were undernourished on the basis of low FFM. Tube feeding and diminished activity level were related to increases in BMI and %FM respectively. No relationship was found between energy intake or corticosteroids and increase in BMI or %FM.

CONCLUSIONS: BMI and FM increased during and after the period of intensive treatment, while FFM remained low. Improvement of nutritional status might be accomplished by increasing physical activity from the early phase of treatment.

Original languageEnglish
Pages (from-to)66-73
Number of pages8
JournalClinical Nutrition
Issue number1
Publication statusPublished - Feb-2015
Event45th Congress of the International-Society-of-Paediatric-Oncology (SIOP) - Hong Kong, United Kingdom
Duration: 25-Sept-201329-Sept-2013


  • Body composition
  • Childhood cancer
  • Malnutrition
  • Nutritional status
  • Obesity

Cite this