Research

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11 pages, 845 KiB

Open AccessArticle

Cellular Oxidative Stress in Pediatric Leukemia and Lymphoma Patients Undergoing Treatment Is Associated with Protein Consumption

by Margaret Raber, Jimin Wu, Hayley Donnella, Phillip Knouse, Mayurika Pise, Mark Munsell, Diane Liu and Joya Chandra

Nutrients 2020, 12(1), 75; https://doi.org/10.3390/nu12010075 - 27 Dec 2019

Cited by 7 | Viewed by 3187

Abstract

Over and under nutrition are associated with worse outcomes for children with leukemia and lymphoma; however, the molecular basis for this clinical observation is not well understood. Many chemotherapeutics used for leukemia treatment are known to generate oxidative stress in vitro; therefore, we [...] Read more.

Over and under nutrition are associated with worse outcomes for children with leukemia and lymphoma; however, the molecular basis for this clinical observation is not well understood. Many chemotherapeutics used for leukemia treatment are known to generate oxidative stress in vitro; therefore, we evaluated redox status and diet in pediatric leukemia patients during therapy in order to ascertain relationships between nutrition and oxidative stress. Dietary intake and redox measures in peripheral blood mononuclear cells from 32 pediatric leukemia and lymphoma patients were collected over six months during treatment. Baseline measures when patients were off chemotherapy and subsequent assessments were collected after one, two and six months. Oxidative stress increased over time in all patients, consistent with chemotherapy-induced redox effects. Older and younger children showed significantly different baseline levels of reactive oxygen species, which increased over time in all age ranges. Diet was assessed at points proximal to oxidative stress measurements and revealed a novel association with consumption of animal protein, vegetable protein, and total protein intake. Our findings demonstrate that chemotherapy increases oxidative stress in pediatric leukemia patients, and raises the possibility that dietary protein or altered protein metabolism could contribute to clinical outcomes. Full article

(This article belongs to the Special Issue Important Aspects of Nutrition in Children with Cancer)

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18 pages, 1652 KiB

Open AccessArticle

Sodium and Potassium Intakes and Cardiovascular Risk Profiles in Childhood Cancer Survivors: The SCCSS-Nutrition Study

by Fabiën N. Belle, Christina Schindera, Idris Guessous, Maja Beck Popovic, Marc Ansari, Claudia E. Kuehni and Murielle Bochud

Nutrients 2020, 12(1), 57; https://doi.org/10.3390/nu12010057 - 24 Dec 2019

Cited by 8 | Viewed by 3294

Abstract

Risk of cardiovascular disease (CVD), common in childhood cancer survivors (CCSs), may be affected by diet. We assessed sodium (Na) and potassium (K) intake, estimated from food frequency questionnaires (FFQs) and morning urine spots, and its associations with cardiovascular risk in CCSs. We [...] Read more.

Risk of cardiovascular disease (CVD), common in childhood cancer survivors (CCSs), may be affected by diet. We assessed sodium (Na) and potassium (K) intake, estimated from food frequency questionnaires (FFQs) and morning urine spots, and its associations with cardiovascular risk in CCSs. We stratified CCSs into three risk profiles based on (A) personal history (CVD, CVD risk factors, or CVD risk-free), (B) body mass index (obese, overweight, or normal/underweight), and (C) cardiotoxic treatment (anthracyclines and/or chest irradiation, or neither). We obtained an FFQ from 802 and sent a spot urine sample collection kit to 212, of which 111 (52%) returned. We estimated Na intake 2.9 g/day based on spot urine and 2.8 g/day based on FFQ; the estimated K intake was 1.6 g/day (spot urine) and 2.7 g/day (FFQ). CCSs with CVD risk factors had a slightly higher Na intake (3.3 g/day), than CCSs risk free (2.9 g/day) or with CVD (2.7 g/day, p = 0.017), and obese participants had higher Na intake (4.2 g/day) than normal/underweight CCSs (2.7 g/day, p < 0.001). Daily Na intake was above, and daily K intake below, the national recommended levels. Adult survivors of childhood cancer need dietary assistance to reduce Na and increase K intake. Full article

(This article belongs to the Special Issue Important Aspects of Nutrition in Children with Cancer)

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11 pages, 312 KiB

Open AccessArticle

Metabolic Disturbances in Children Treated for Solid Tumors

by Ewa Barg, Joanna Połubok, Marta Hetman, Aleksandra Gonera, Olimpia Jasielska, Dorota Sęga-Pondel, Karolina Galant and Bernarda Kazanowska

Nutrients 2019, 11(12), 3062; https://doi.org/10.3390/nu11123062 - 15 Dec 2019

Cited by 2 | Viewed by 3283

Abstract

Metabolic disturbances are among the most common disorders diagnosed in pediatric patients after anti-cancer therapy (ACT). The aim of our study was to evaluate the prevalence of metabolic disturbances among patients after ACT. The study group comprised 44 patients (31 boys) treated for [...] Read more.

Metabolic disturbances are among the most common disorders diagnosed in pediatric patients after anti-cancer therapy (ACT). The aim of our study was to evaluate the prevalence of metabolic disturbances among patients after ACT. The study group comprised 44 patients (31 boys) treated for solid tumors and 31 patients in the control group. Body weight, height, body mass index (BMI) values, lipid parameters are expressed in Standard Deviation Score (SDS), based on centile charts. Indicators of risk to atherosclerosis were calculated. Obesity/overweight was observed in one third of the patients. Hypercholesterolemia occurred in half of them, elevated tryglicerides (TG) SDS in 11, and elevated low-density lipoprotein cholesterol (LDL-C) SDS in nine of the patients. Increased levels of both cholesterol SDS and LDL SDS were found in nine patients and four of them also showed elevated levels of TG SDS. There were significant differences in lipid parameters between the sexes. Risk indicators of lipid disorders defined by statistical distances (τ) were determined for the study group and the control group. The sum of the risk ratios of lipid disorders in the study group was 150 times higher than in the control group. Patients after ACT require special monitoring of lipids profiles and thyroid function as they are at higher risk for dyslipidemia and atherosclerosis than healthy people. Full article

(This article belongs to the Special Issue Important Aspects of Nutrition in Children with Cancer)

18 pages, 2532 KiB

Open AccessArticle

Increased Adiposity Enhances the Accumulation of MDSCs in the Tumor Microenvironment and Adipose Tissue of Pancreatic Tumor-Bearing Mice and in Immune Organs of Tumor-Free Hosts

by William J. Turbitt, Shawntawnee D. Collins, Huicui Meng and Connie J. Rogers

Nutrients 2019, 11(12), 3012; https://doi.org/10.3390/nu11123012 - 10 Dec 2019

Cited by 22 | Viewed by 3810

Abstract

Obesity is associated with increased risk and reduced survival for many types of cancer. Increasing adiposity may affect the balance between immunosuppressive and antitumor mechanisms critical for dictating cancer progression or remission. The goal of the current study was to determine if increased [...] Read more.

Obesity is associated with increased risk and reduced survival for many types of cancer. Increasing adiposity may affect the balance between immunosuppressive and antitumor mechanisms critical for dictating cancer progression or remission. The goal of the current study was to determine if increased adiposity altered tumor growth, survival, and myeloid-derived suppressor cell (MDSC) accumulation in a subcutaneous murine model of pancreatic cancer. C57BL/6 mice were placed on a 30% kcal calorie-restricted diet, 10% kcal from fat diet fed ad libitum, or 60% kcal from fat diet fed ad libitum for 16 weeks to generate lean, overweight, and obese mice, respectively; followed by subcutaneous injection with 1 × 10⁶ Panc.02 cells. We observed a significant linear relationship between increased adiposity and increased tumor growth and mortality; increased accumulation of Gr-1⁺CD11b⁺ MDSCs; and reduced CD8 T cell:MDSC ratio in multiple tissues, including tumor. Increased adiposity also increased the accumulation of MDSCs in the spleen and lymph node of tumor-free mice. These data suggest adiposity induces MDSC accumulation, which may contribute to an immunosuppressive environment promoting tumor growth. Overall, our findings provide a rationale to prevent or reverse increased body weight as a strategy to reduce the accumulation of immunosuppressive cell types. Full article

(This article belongs to the Special Issue Important Aspects of Nutrition in Children with Cancer)

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22 pages, 1022 KiB

Open AccessArticle

Dietary Intakes Are Associated with HDL-Cholesterol in Survivors of Childhood Acute Lymphoblastic Leukaemia

by Sophia Morel, Devendra Amre, Emma Teasdale, Maxime Caru, Caroline Laverdière, Maja Krajinovic, Daniel Sinnett, Daniel Curnier, Emile Levy and Valérie Marcil

Nutrients 2019, 11(12), 2977; https://doi.org/10.3390/nu11122977 - 05 Dec 2019

Cited by 9 | Viewed by 3518

Abstract

Survivors of childhood acute lymphoblastic leukemia (cALL) are at high risk of developing dyslipidemia, including low HDL-cholesterol (HDL-C). This study aimed to examine the associations between food/nutrient intake and the levels of HDL-C in a cohort of children and young adult survivors of [...] Read more.

Survivors of childhood acute lymphoblastic leukemia (cALL) are at high risk of developing dyslipidemia, including low HDL-cholesterol (HDL-C). This study aimed to examine the associations between food/nutrient intake and the levels of HDL-C in a cohort of children and young adult survivors of cALL. Eligible participants (n = 241) were survivors of cALL (49.4% boys; median age: 21.7 years old) recruited as part of the PETALE study. Nutritional data were collected using a validated food frequency questionnaire. Fasting blood was used to determine participants’ lipid profile. Multivariable logistic regression models were fitted to evaluate the associations between intakes of macro- and micronutrients and food groups and plasma lipids. We found that 41.3% of cALL survivors had at least one abnormal lipid value. Specifically, 12.2% had high triglycerides, 17.4% high LDL-cholesterol, and 23.1% low HDL-C. Low HDL-C was inversely associated with high intake (third vs. first tertile) of several nutrients: proteins (OR: 0.27, 95% CI: 0.08–0.92), zinc (OR: 0.26, 95% CI: 0.08–0.84), copper (OR: 0.34, 95% CI: 0.12–0.99), selenium (OR: 0.17, 95% CI: 0.05–0.59), niacin (OR: 0.25, 95% CI: 0.08–0.84), riboflavin (OR: 0.31, 95% CI: 0.12–0.76) and vitamin B12 (OR: 0.35, 95% CI: 0.13–0.90). High meat consumption was also inversely associated (OR: 0.28, 95% CI: 0.09–0.83) with low HDL-C while fast food was positively associated (OR: 2.41, 95% CI: 1.03–5.63) with low HDL-C. The role of nutrition in the development of dyslipidemia after cancer treatment needs further investigation. Full article

(This article belongs to the Special Issue Important Aspects of Nutrition in Children with Cancer)

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13 pages, 833 KiB

Open AccessArticle

Poor Dietary Polyphenol Intake in Childhood Cancer Patients

by Ashly Liu, Jennifer Cohen and Orazio Vittorio

Nutrients 2019, 11(11), 2835; https://doi.org/10.3390/nu11112835 - 19 Nov 2019

Cited by 2 | Viewed by 4473

Abstract

Emerging research demonstrates polyphenol-rich diets like the Mediterranean diet may play a role in improving the outcomes of adult cancer therapy. To date, there are no trials assessing the intake or efficacy of polyphenol-rich diets in childhood cancer patients. In this study we [...] Read more.

Emerging research demonstrates polyphenol-rich diets like the Mediterranean diet may play a role in improving the outcomes of adult cancer therapy. To date, there are no trials assessing the intake or efficacy of polyphenol-rich diets in childhood cancer patients. In this study we collected dietary data on 59 childhood cancer patients on treatment using a three-pass 24-h dietary recall (24-HDR), which is based on a validated and structured three-part methodology. Polyphenol consumption was calculated by matching the food consumption data with polyphenol content extracted from the most updated Phenol-Explorer database. The mean total polyphenol intake was 173.31 ± 141.02 mg/day. The major food sources of polyphenols were fruits, beverages, and cereals. There were no significant associations with time since diagnosis, body mass index (BMI) z-score, types of cancer, treatment intensity, food-related symptoms, relapse, and total daily polyphenol intake. Further investigation with larger studies will facilitate the steps in assessing the value of polyphenol-rich dietary patterns in future nutritional interventions for childhood cancer patients. Full article

(This article belongs to the Special Issue Important Aspects of Nutrition in Children with Cancer)

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13 pages, 263 KiB

Open AccessArticle

Early Lifestyle Intervention for Obesity Prevention in Pediatric Survivors of Acute Lymphoblastic Leukemia

by Fang Fang Zhang, Michael Kelly, Mengxi Du, Jennifer J. G. Welch, Nadine Santacruz, Jacqueline Rhoades, Christina Luongo Kamins, ZoAnn Dreyer and Michael E. Scheurer

Nutrients 2019, 11(11), 2631; https://doi.org/10.3390/nu11112631 - 02 Nov 2019

Cited by 13 | Viewed by 3309

Abstract

Patients with pediatric acute lymphoblastic leukemia (ALL) experience rapid weight gain during treatment and increases in weight are maintained throughout treatment and beyond. Without prompt interventions, altered dietary and physical activity behaviors may become difficult to reverse, contributing to obesity risk long-term. Fifteen [...] Read more.

Patients with pediatric acute lymphoblastic leukemia (ALL) experience rapid weight gain during treatment and increases in weight are maintained throughout treatment and beyond. Without prompt interventions, altered dietary and physical activity behaviors may become difficult to reverse, contributing to obesity risk long-term. Fifteen children, aged 3–9 years, diagnosed with pediatric ALL who were on maintenance therapy or within two years of treatment completion (mean BMI percentile: 70.4^th) and one parent from each family, were enrolled into a 12-week lifestyle intervention delivered remotely through web-based sessions and phone calls with a lifestyle coach. Outcomes were assessed at baseline and end of the intervention. Thirteen of the 15 enrolled families (86.7%) completed the intervention. Parents reduced the “pressure to eat” feeding practice (change in mean score: −0.60, 95% CI: −1.12 to −0.07; p-value = 0.03) post intervention. Children increased the consumption of milk (0.54 serving/d, 0.02 to 1.07; p-value = 0.04) and percent of calories from protein (2.54%, 0.22 to 4.87%; p-value = 0.04) and reduced the consumption of potatoes (−0.16 serving/d, -0.30 to −0.03; p-value = 0.02). No significant changes were observed for children’s levels of physical activity, BMI, or waist circumference. Results from this pilot support the feasibility and preliminary efficacy of early lifestyle intervention among pediatric ALL survivors. Full article

(This article belongs to the Special Issue Important Aspects of Nutrition in Children with Cancer)

Review

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13 pages, 259 KiB

Open AccessReview

A Narrative Review on the Potential of Red Beetroot as an Adjuvant Strategy to Counter Fatigue in Children with Cancer

by Maria C. Swartz, Kaitlyn Allen, Rachel R. Deer, Elizabeth J. Lyons, Michael D. Swartz and Tom Clifford

Nutrients 2019, 11(12), 3003; https://doi.org/10.3390/nu11123003 - 07 Dec 2019

Cited by 9 | Viewed by 3793

Abstract

Cancer-related fatigue (CRF) is a debilitating adverse effect among children with cancer and a significant barrier to physical activity (PA) participation. PA interventions are effective at reducing fatigue and improving both quality of life (QOL) and functional outcomes in children with cancer. However, [...] Read more.

Cancer-related fatigue (CRF) is a debilitating adverse effect among children with cancer and a significant barrier to physical activity (PA) participation. PA interventions are effective at reducing fatigue and improving both quality of life (QOL) and functional outcomes in children with cancer. However, 50–70% of children with cancer do not meet PA guidelines. Thus, adjuvant methods are needed to increase PA participation. Given the growing interest in the use of beetroot juice to reduce exercise-induced fatigue, our narrative review evaluated the potential use of beetroot to improve PA participation to counter CRF and improve QOL. Our review of 249 articles showed a lack of published clinical trials of beetroot in children and adults with cancer. Trials of beetroot use had been conducted in a noncancer population (n = 198), and anticancer studies were primarily in the preclinical phase (n = 40). Although results are promising, with beetroot juice shown to counter exercise-induced fatigue in a variety of athletic and patient populations, its use to counter CRF in children with cancer is inconclusive. Pilot and feasibility studies are needed to examine the potential benefits of beetroot to counter CRF, increase PA participation, and improve QOL in children with cancer. Full article

(This article belongs to the Special Issue Important Aspects of Nutrition in Children with Cancer)

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