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Year : 2015  |  Volume : 52  |  Issue : 2  |  Page : 225-228

The development, testing, and preliminary feasibility of an adaptable pediatric oncology nutrition algorithm for low-middle income countries

1 School of Medical Science, UNSW Medicine, University of NSW, Australia, Australia
2 Instituto de Tratamento do Câncer Infantil, Instituto da Criança do Hospital das Clínicas, Faculty of Medicine, University of Sao Paulo, Sao Paulo, Brazil
3 Children's Nutrition Research Centre, Queensland Children's Medical Research Institute, The University of Queensland, Brisbane, Australia
4 Clinical Nutrition Services, St Jude Children's Research Hospital, Memphis, Tennessee, USA
5 Division of Pediatric Oncology, Tata Memorial Hospital, Mumbai, Maharashtra, India
6 Steve Biko Academic Hospital and University of Pretoria Oncology Complex, Pretoria, South Africa
7 Division of Pediatric Hematology/Oncology/Stem Cell Transplant, Columbia University, New York, United States

Correspondence Address:
CAK Fleming
School of Medical Science, UNSW Medicine, University of NSW, Australia
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/0019-509X.175834

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Background: Survivors of childhood cancer are at increased risk for several cardiometabolic complications. Obesity/overweight and metabolic syndrome have been widely reported in Western literature, but data from India are lacking. Aims: To perform an objective assessment of nutritional status in a cohort of childhood cancer survivors (CCSs) and to find risk factors for extremes in nutritional status. Settings And Design: The study was a retrospective chart review of CCSs who attended the late effects clinic of a referral pediatric oncology center over the period of 1 year. Materials And Methods: An objective assessment of nutritional status was done, and results were analyzed in two groups: Adult survivors (present age <18 years) and child and adolescent survivors (CASs) (<18 years). The data were then analyzed for possible risk factors. Results: Six hundred and forty-eight survivors were included in the study; of these, 471 were <18 years at follow-up, and 177 were 18 years or older. The prevalence of obesity, overweight, normal, and undernutrition was 2.6%, 10.8%, 62.7%, and 28.8% (CASs) and 0%, 8.5%, 62.7%, and 28.8% (adult survivors), respectively. Factors predictive of overweight/obesity were an initial diagnosis of acute lymphoblastic leukemia, or brain tumor and follow-up duration of >20 years or current age >30 years in adult survivors. Conclusions: The prevalence of obesity/overweight is lower in our cohort when compared to Western literature. It remains to be clarified whether this reflects the underlying undernutrition in our country, or whether our cohort of survivors is indeed distinct from their Western counterparts. Comparison with age/sex-matched normal controls and baseline parameters would yield more meaningful results.


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