Obesity in Childhood Cancer Survivors: Call for Early Weight Management

Abstract

A high prevalence of obesity and cardiometabolic conditions has been increasingly recognized in childhood cancer survivors. In particular, survivors of pediatric acute lymphoblastic leukemia have been found to be at risk of becoming overweight or obese early in treatment, with increases in weight maintained throughout treatment and beyond. Nutrition plays an important role in the etiology of obesity and cardiometabolic conditions and is among the few modifiable factors that can prevent or delay the early onset of these chronic conditions. However, nutritional intake in childhood cancer survivors has not been adequately examined and the evidence is built on data from small cohorts of survivors. In addition, the long-term impact of cancer diagnosis and treatment on survivors' nutritional intake as well as how survivors' nutritional intake is associated with chronic health conditions have not been well quantified in large-scale studies. Promoting family-based healthy lifestyles, preferably at a sensitive window of unhealthy weight gain, is a priority for preventing the early onset of obesity and cardiometabolic conditions in childhood cancer survivors.

Keywords: childhood cancer; intervention; lifestyle; nutrition; obesity; survivors.

Conflict of interest statement

Author disclosures: FF Zhang and SK Parsons, no conflicts of interests. The funding sources had no role in the design, conduct, or analysis of this study or in the decision to submit the manuscript for publication.

© 2015 American Society for Nutrition.

Figures

FIGURE 1

Changes in prevalence of overweight and obesity during and after treatment in childhood ALL survivors. Values are prevalences (%), n = 83. Reproduced from reference 20 with permission. © 2014 Wiley Periodicals, Inc. ALL, acute lymphoblastic leukemia; Consol, consolidation; Induct, induction.

FIGURE 2

Changes in BMI z score from diagnosis in childhood ALL survivors: a meta-analysis. Values are means (95% CIs), n = 1514. Reproduced from reference 26 with permission. ALL, acute lymphoblastic leukemia; tx, treatment. © 2015 Wiley Periodicals, Inc.

FIGURE 3

A conceptual model of obesity and CVD risk in childhood cancer survivors. CVD, cardiovascular disease.