Diet and Obesity in Children with Acute Lymphoblastic Leukemia
Health Hacks The dangers of childhood obesity range from cardiovascular disease to prediabetes and bone and joint problems.
These effects are even more threatening for kids who are already sick with a disease like cancer. But what are the effects of childhood obesity on children and adolescents who are already sick with a disease like cancer?
Elena J. Ladas, Ph.D., RD, an assistant professor of nutrition in pediatrics in the Institute of Human Nutrition at Columbia University Medical Center, has set out to answer this question, specifically for children and adolescents with acute lymphoblastic leukemia, otherwise referred to as ALL. In the first study of its kind, Dr. Ladas will research how best to curb childhood obesity during ALL treatment and examine the effects of childhood obesity on both prognosis and recurrence. The study began in January of this year and will continue through December 2019.
The role of prevention
"ALL is the most common childhood cancer," Dr. Ladas explains. "In fact, a quarter of all pediatric cancers are leukemia. Yet there have been few nutrition studies related to this disease—or in the area of pediatric oncology in general. Even more concerning is the association of obesity and survival of ALL. Children who are obese throughout therapy have twice the risk of reduced survival. Therapeutic interventions that prevent the development of obesity may have a real impact on improving survival in children with ALL.
"Survival rates for childhood acute lymphoblastic leukemia have increased from below 10 percent to about 90 percent, with two to three year treatment plans."
Survival rates for childhood ALL have increased from below 10 percent to about 90 percent, with two to three year treatment plans. However, treatment comes with side effects, many of which are nutrition related. Approximately 50 percent of children become obese by the end of treatment, and the obesity often persists long after treatment ends.
As part of her research, Dr. Ladas will examine the diets of nearly 800 children and adolescents undergoing treatment for ALL. She will start by looking at the amount of sugar in their diets, measured by the glycemic index and glycemic load of the foods that they eat during treatment. Then she will compare the prognosis and reoccurrence rates with different diets.
Cancer care revisited
"Thanks to a grant from the American Cancer Society, we may finally get a clear understanding of why so many pediatric ALL survivors become obese and how that ultimately impacts their health," says Dr. Ladas. "We’ll be asking questions like: How does diet change during treatment? Is it a nutrient we should be worried about? Calcium and vitamin D? Patterns of dietary intake?"
Until now, modifying the diet and exercise habits of pediatric cancer patients has not been part of the standard of care. Dr. Ladas hopes that this research will begin to change that.
"We want to empower both patients and parents," she says. “We want them to know with confidence that the foods they eat may be just as important as the medicines they take."