Feasibility and Acceptability Findings of an Energy Balance Data Repository of Children, Adolescents, and Young Adults with Cancer.

Maria C Swartz,Stephanie J Wells,Karen Moody,Alaina K Teague,Laura S Kabiri,Keri Schadler,Joya Chandra,Kris M Mahadeo,Theresa Honey,Min Fu

doi:10.3390/jcm9092879

Abstract

Cancer patients suffer changes in energy balance (EB), the combination of energy intake (nutrition) and energy expenditure (physical activity (PA)), which may influence cancer-related morbidity, mortality, and quality of life. Significant gaps remain in our understanding of the frequency and magnitude of these EB changes. Herein, we report on the feasibility and acceptability of a longitudinal repository of EB outcomes in children, adolescents and young adults (AYA) with cancer along the cancer continuum to fill these gaps. This EB repository includes PA, nutrition, and physical function (PF) parameters. PA data were gathered through activity trackers. Nutritional data were gathered through food diaries and micronutrient labs. PF was assessed with validated objective and patient-reported measures. Feasibility was achieved with >50% enrollment of eligible patients (n = 80, Mage = 18.1 ± 7.5); 26 were children with cancer and 54 were AYAs with cancer. An 88.75% retention rate indicated acceptability. Despite COVID-19 disruptions, >50% of participants provided completed data for PA and micronutrient labs as of April 2020. Food diaries and PF data collection experienced disruptions. Methodological adaptations are in progress to minimize future disruptions. Overall, our findings demonstrate that prospective EB assessments are feasible and acceptable among children and AYAs with cancer.

Highlights

Energy balance (EB), which collectively refers to the combination of energy intake and energy expenditure (physical activity (PA)), is an area of growing interest within the pediatric and adolescent and young adult (AYA) oncology communities [1,2,3]
In children and AYA with cancer, malnutrition—including both over and undernutrition—is a risk factor for inferior cancer-related outcomes [4] and PA is associated with improved quality of life and physical function [5]
Our data suggest that longitudinal EB assessments are feasible and acceptable in young cancer patients and survivors, with the use of wearable activity trackers, 3-day food diaries, laboratory evaluations, and a flexible enrollment strategy

Summary

Introduction

Energy balance (EB), which collectively refers to the combination of energy intake (nutrition) and energy expenditure (physical activity (PA)), is an area of growing interest within the pediatric and adolescent and young adult (AYA) oncology communities [1,2,3] This is largely due to evidence supporting the role of EB in patient outcomes [4]. There are emerging preclinical data that suggest that PA may improve tumor response to treatment [6,7] and that obesity may reduce tumor response to treatment via adipocyte signaling [8] Both the intake and expenditure aspects of the EB equation as they relate to cancer outcomes will be reviewed briefly below. There remains a critical gap in understanding the precise nutritional needs of young cancer patients and survivors [10,16,17,18]

Objectives

Results

Discussion

Conclusion