Do Childhood Cancer Survivors Meet the Diet and Physical Activity Guidelines? A Review of Guidelines and Literature.

Zhang Zhang

doi:10.6000/1929-4247.2012.01.01.06

Abstract

Despite advances in cancer treatment, childhood cancer survivors are at higher risk of developing chronic health conditions than peers who have not had cancer. Being overweight or obese adds to the already elevated risk of cardiovascular diseases and metabolic abnormalities. Diet and physical activity are modifiable behaviors that reduce obesity risk and have been shown to improve cancer survival in adult cancer survivors. Specific guidelines have been developed for cancer survivors that provide advice on nutrition, physical activity and weight management following cancer diagnosis and treatment. In this review, we report on existing nutrition and physical activity guidelines for cancer survivors, supplemented by available literature on diet and physical activity status of childhood cancer survivors and their associations with health-related outcomes. The 2012 American Cancer Society (ACS) and the 2008 Children’s Oncology Group (COG) guidelines provide similar advice on diet but the ACS guidelines also offer specific advice on physical activity and weight management. Thirty-one observational studies and 18 intervention trials published prior to June 2012 that met the inclusion criteria were reviewed. Results suggest that a high proportion of childhood cancer survivors had poor adherence to dietary and physical activity guidelines. Although findings from existing intervention trials are preliminary due to small sample size, available evidence suggests that exercise intervention is safe and feasible for patients and survivors of childhood cancer. Childhood cancer survivors should be encouraged to engage in physical activity, adopt a healthy diet, and maintain a healthy weight throughout cancer survivorship.

Highlights

Advances in cancer treatment have result in increased numbers of long-term survivors of childhood cancer
Specific guidelines on nutrition and physical activity have been developed for cancer survivors, including those developed by the American Cancer Society (ACS) [4,5,6], the World Cancer Research Fund/the
Studies were included in this review if they met the following criteria: (1) were research articles published in peer-reviewed journals; (2) included patients diagnosed with cancer prior to age 21 years; (3) addressed diet and/or physical activity or their associations with health-related outcomes; and (4) English language abstract available

Summary

INTRODUCTION

Advances in cancer treatment have result in increased numbers of long-term survivors of childhood cancer (i.e. cancer diagnosed before age 21 years). American Institute for Cancer Research (WCFR/AICR) [7], and the American College of Sports Medicine (ACSM) [8] All of these guidelines focus primarily on survivors of adult cancers but contain little information for survivors of childhood, adolescent and young adult cancers. The only available guidelines for childhood cancer survivors are the Long-Term Followup Guidelines for Survivors of Childhood, Adolescent, and Young Adult Cancers, published in 2008 by the Children’s Oncology Group (COG) [9] These guidelines do not focus on nutrition and physical activity, but do include a section on “the Healthy Living after Treatment for Childhood Cancer” that provides advice on nutrition and physical activity [9]. Do Childhood Cancer Survivors Meet the Diet we performed a literature review to assess knowledge about diet and physical activity practices and associated health outcomes in childhood cancer survivors

COMPARISON OF 2012 ACS GUIDELINES AND 2008 COG GUIDELINES

Summary of Current Guidelines

RESULTS

Summary of Observational Studies

Summary of Intervention Trials

CONCLUSION