The Impact of Oral Nutritional Supplementation on Body Mass Index in Children Treated for Cancer

Objectives and the Study: This was a retrospective single center study where records from malnourished pediatric cancer patients were collected and analyzed from Kocaeli University Hospital, Pediatric Oncology, Turkey. The aim was to assess the impact of oral nutritional supplementation on body mass index (BMI) in malnourished children treated for cancer.

Methods: Inclusion criteria included a diagnosis of cancer and all standard treatments completed in the department according to the standard protocol regimens for the specific indications. Patients were considered malnourished if weight for height was below -2 SD as determined from gender specific WHO growth charts. The cohorts included patients treated during 2010-2016 time period. Patients who received oral nutritional supplementation (ONS) in addition to their specific anti-cancer regimen were recorded for their nutritional status based on weight, height and BMI during their follow up visits. Records were obtained for a period of 8 months from the start of the treatment.

Results: A total of 60 pediatric cancer patients with malnutrition (%64,6 male, %35,4 female) were included in the study. Data were analyzed either for all patients (total) or after clustering in to following tumor groups; CNS tumors 13.3 % (8 patients), lymphoma 18.3% (11 patients), other tumors 68.3% (41 patients). Comparison of pre-ONS and post-ONS anthropometric data has shown an increase in bodymass index (BMI) for the total patients group data with an increase in BMI for 36 patients (60%) versus decrease in BMI in 24 patients (40%) (p< 0.05) (Figure 1). Statistically significant increase was also observed for other tumors group (24 patients versus 17 patients) (p< 0.001) and for lymphoma group (8 patients versus 3 patients) (p=0.012). Although not statistically significant, there was an increase in BMI for CNS tumors group as well (4 patients versus 4 patients (p=0.068).

Conclusions: ONS is an important intervention in pediatric cancer patients that increases BMI and improves the nutritional status. The extent of improvement is possibly related to the disease type and location