Photo by Alex Green

March marks National Nutrition Month: The Academy of Nutrition and Dietetics sponsors National Nutrition Month, a time to focus on making informed food choices and developing healthy eating and physical activity habits. If you are a parent or caregiver of a child with cancer, you already know that the type of food going into a cancer-filled body is extremely important and can make a significant impact on life outcomes. Over the last few decades, numerous studies have examined the relationship between nutrition and childhood cancer and the importance of providing adequate nutritional support to pediatric cancer patients. These studies have covered a wide range of topics, including the effects of nutrition on treatment outcomes, the dietary needs of pediatric cancer patients, and the impact of cancer and its treatments on nutritional status and food intake. One of the most significant studies by The Children’s Oncology Group (COG) has been cited and followed by several clinicians and research groups, and we’ll review its findings here.

The COG was established in 1991 to improve the treatment and outcomes of children and adolescents with cancer. The COG is a national organization that brings together leading pediatric cancer specialists across the United States and Canada to collaborate on research and treatment initiatives. Before the establishment of the COG, pediatric cancer care was often fragmented and inconsistent, with limited access to cutting-edge treatments and limited opportunities for collaboration among pediatric cancer specialists. The COG was established to address these challenges and improve the treatment and outcomes of children and adolescents with cancer.

Photo by Pavel Danilyuk

Today, the COG is one of the world’s largest and most influential pediatric cancer research organizations, conducting groundbreaking research and clinical trials that have helped improve the treatment and outcomes of pediatric cancer patients. One of the most extensive studies is the COG’s Nutrition Assessment and Support Study (NASS), a multi-center prospective study aimed at improving the nutritional status of children with cancer. NASS was started in 2008 and conducted over several years, with data collection at multiple centers across the United States. The study enrolled over 2,000 children with cancer and assessed their nutritional status at diagnosis and throughout treatment. Though the study is older, it is still highly referenced by current studies being conducted today.

The key findings and recommendations of the NASS study and several other smaller studies that used NASS as a reference point are as follows:

• Frequent Nutrition Assessment: Malnutrition is a common problem in pediatric cancer patients, and it can negatively affect their growth, body composition, and physical functioning. Early and frequent nutrition assessments and individualized nutrition interventions can improve outcomes for pediatric cancer patients. Several risk factors for malnutrition include a low pre-diagnosis body mass index (BMI), chemotherapy-induced nausea and vomiting, and prolonged hospitalization.
• Maintaining weight and strength: Cancer treatments, such as chemotherapy and radiation, can cause side effects such as nausea, vomiting, and decreased appetite, leading to weight loss and reduced muscle mass. Good nutrition can help children maintain their weight and build strength to endure treatments and recover more quickly.
• Supporting the immune system: A balanced diet rich in vitamins and minerals can help support the immune system, which is crucial for fighting infections, healing, and reducing the risk of cancer recurrence.
• Reduced treatment side effects: Good nutrition can help reduce the severity of treatment side effects, such as nausea, vomiting, and mouth sores. For example, some studies have shown that omega-3 fatty acids and certain antioxidants can help reduce inflammation and oxidative stress caused by chemotherapy and radiation.
• Improving overall health and well-being: Good nutrition can improve children’s overall health and well-being, helping them feel better physically and emotionally and cope with the stress of cancer treatment.
• Improved treatment outcomes: Children with cancer who receive adequate nutritional support during treatment consistently show improved treatment outcomes, including higher rates of survival and reduced risk of recurrence.
• Reduced hospital stays: Adequate nutritional support has been linked to shorter hospital stays, reducing the risk of exposure to infections and other health risks associated with hospitalization.
• Fuel for cancer cell growth: Cancer cells need a constant supply of energy and nutrients to grow and divide. A diet high in sugar and fat can provide cancer cells with the energy they need to grow, while a balanced and nutritious diet can help slow their growth.
• Inflammation: Inflammation can promote the growth and progression of cancer cells. A diet high in processed foods, sugar, and unhealthy fats can increase inflammation in the body, while a diet rich in fruits, vegetables, and healthy fats can help reduce inflammation.
• Antioxidant protection: Antioxidants can help protect against oxidative stress, which can damage cells and increase the risk of cancer. A diet rich in antioxidants, such as vitamin C and E, beta-carotene, and selenium, can help protect against oxidative stress and reduce cancer risk.
• Hormone regulation: Certain nutrients, such as soy and phytoestrogens, can help regulate hormones and reduce the risk of hormone-sensitive cancers, such as breast and prostate cancer.
• Immune system support: A balanced and nutritious diet can support the immune system, which is crucial for fighting cancer and preventing recurrence.

Cancer biology and nutrition are closely interconnected, as the nutrients in the food we eat can significantly impact the growth and progression of cancer cells. While the NASS study was large and well-designed, more research is needed to fully understand the relationship between nutrition and childhood cancer.

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Nevertheless, these findings highlight the importance of providing pediatric cancer patients with adequate nutritional support to improve treatment outcomes and quality of life. Individual nutritional needs can vary greatly depending on factors such as the type of cancer, stage of the disease, and treatment plan. Please speak with a registered dietitian or a nutritionist that will help you with your child’s specific nutritional needs and develop a customized meal plan.

Here to Serve can help you find healthy sources to keep your child’s diet in check and follow a cancer-friendly nutrition plan! We can assist with home meal coordination and provide recipe suggestions in conjunction with recommendations from your doctor and dietitian/nutritionist! If you or someone you know could benefit from our services, please get help here.

By Sameera Rangwala

All information on this blog is for informational and educational purposes only. Always consult a medical provider in your particular area of need before making significant changes in your medical decisions or lifestyle.

References:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6679209/
https://onlinelibrary.wiley.com/doi/10.1002/pbc.28213
https://pubmed.ncbi.nlm.nih.gov/18064639/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6679209/
https://www.sciencedirect.com/topics/medicine-and-dentistry/nutritional-assessment