Abstract
Patients with pediatric acute lymphoblastic leukemia (ALL) experience rapid weight gain during treatment and increases in weight are maintained throughout treatment and beyond. Without prompt interventions, altered dietary and physical activity behaviors may become difficult to reverse, contributing to obesity risk long-term. Fifteen children, aged 3–9 years, diagnosed with pediatric ALL who were on maintenance therapy or within two years of treatment completion (mean BMI percentile: 70.4th) and one parent from each family, were enrolled into a 12-week lifestyle intervention delivered remotely through web-based sessions and phone calls with a lifestyle coach. Outcomes were assessed at baseline and end of the intervention. Thirteen of the 15 enrolled families (86.7%) completed the intervention. Parents reduced the “pressure to eat” feeding practice (change in mean score: −0.60, 95% CI: −1.12 to −0.07; p-value = 0.03) post intervention. Children increased the consumption of milk (0.54 serving/d, 0.02 to 1.07; p-value = 0.04) and percent of calories from protein (2.54%, 0.22 to 4.87%; p-value = 0.04) and reduced the consumption of potatoes (−0.16 serving/d, -0.30 to −0.03; p-value = 0.02). No significant changes were observed for children’s levels of physical activity, BMI, or waist circumference. Results from this pilot support the feasibility and preliminary efficacy of early lifestyle intervention among pediatric ALL survivors.
Highlights
Acute lymphoblastic leukemia (ALL) is the most common type of cancer diagnosed in children.Pediatric patients with acute lymphoblastic leukemia (ALL) are are at a high risk of obesity [1] and experience unhealthy weight gain early in treatment [2,3,4,5,6]
These findings provide strong support to integrate lifestyle interventions early in cancer care to address the early onset of obesity and cardiovascular disease (CVD) risk factors among pediatric ALL patients
We reported here the feasibility and initial efficacy of an early lifestyle intervention on enhancing parenting style and practices, improving dietary intake and levels of physical activity, and preventing excess weight gain among patients with pediatric ALL who were on treatment or within two years of treatment completion
Summary
Pediatric patients with ALL are are at a high risk of obesity [1] and experience unhealthy weight gain early in treatment [2,3,4,5,6]. Cardiovascular disease (CVD) risk factors such as insulin resistance and hypertension occur early during treatment for pediatric ALL patients [4,7]. When patients become long-term survivors, they develop severe, life threatening, or fatal conditions more frequently and at a much younger age than their siblings [8,9]. It is possible that early onset of obesity and obesity-related morbidities contribute to a high chronic disease burden among long-term survivors of childhood
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