Abstract
Cancer-related fatigue (CRF) is a debilitating adverse effect among children with cancer and a significant barrier to physical activity (PA) participation. PA interventions are effective at reducing fatigue and improving both quality of life (QOL) and functional outcomes in children with cancer. However, 50–70% of children with cancer do not meet PA guidelines. Thus, adjuvant methods are needed to increase PA participation. Given the growing interest in the use of beetroot juice to reduce exercise-induced fatigue, our narrative review evaluated the potential use of beetroot to improve PA participation to counter CRF and improve QOL. Our review of 249 articles showed a lack of published clinical trials of beetroot in children and adults with cancer. Trials of beetroot use had been conducted in a noncancer population (n = 198), and anticancer studies were primarily in the preclinical phase (n = 40). Although results are promising, with beetroot juice shown to counter exercise-induced fatigue in a variety of athletic and patient populations, its use to counter CRF in children with cancer is inconclusive. Pilot and feasibility studies are needed to examine the potential benefits of beetroot to counter CRF, increase PA participation, and improve QOL in children with cancer.
Highlights
They found that nitrate supplementation decreased the mitochondrial protein content of two transporter proteins involved in adenosine triphosphate (ATP)/adenosine diphosphate (ADP) proton uncoupling during hydrolysis: adenine nucleotide translocase (ANT) and mitochondrial uncoupling protein 3 (UCP-3)
Despite apparent widespread use among patients as complementary medicine, beetroot juice has not been widely studied in this context
Trials registered in ClinicalTrials.gov showed that researchers are beginning to evaluate the potential use of dietary beetroot juice in adult cancer patients to improve aerobic performance, cardiovascular function, muscle strength, body composition, and/or decrease treatment-related symptoms, but this research has not yet been published to our knowledge
Summary
Childhood cancer is the second leading cause of death among children aged 1 to 14 years in the United States [1]. Children describe CRF in terms of physical sensations such as tiredness, sleepiness, lack of energy, and lack of desire to interact and participate in daily activities [5]. An increase in fatigue has been associated with poor sleep quality [8], a decrease in sleep duration [9,10], sleep disturbances [11], and decreased physical performance [12]. CRF has been associated with depression [5,13] and poor neurocognitive outcomes represented by poorer performance in task efficiency and memory tests [14]. CRF affects the quality of life (QOL) of children with cancer by impeding patients’ ability to engage in daily activities [15]. There is a growing interest in developing non-pharmacological interventions to minimize fatigue and its negative impact on pediatric cancer patients [16,17]
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