Nutritional Status and Body Composition at Diagnosis, of South Indian Children with Acute Lymphoblastic Leukaemia (ALL)

Document Type : Research Articles

Authors

1 Division of Nutrition, St. John’s Research Institute St. John’s National Academy of Health Sciences, Bengaluru, Karnataka, India.

2 Research Scholar, Manipal Academy of Higher Education (MAHE), Manipal.

3 Division of Medical Informatics, St. John’s Research Institute, St. John’s National Academy of Health Sciences, Bengaluru, Karnataka, India.

4 Department of Physiology, St. John’s Medical College, St. John’s National Academy of Health Sciences, Bengaluru, Karnataka, India.

5 Division of, Epidemiology, Biostatistics and Population Health, St. John’s Research Institute, St. John’s National Academy of Health Sciences, Bengaluru, Karnataka, India.

6 Department of Pediatric Oncology, St. John’s Medical College Hospital, St. John’s National Academy of Health Sciences, Bengaluru, Karnataka, India.

7 Department of Nuclear Sciences and Applications, International Atomic Energy Agency (IAEA), Vienna, Austria.

Abstract

Background: Accurate estimation of body composition, particularly, Body Cell Mass (BCM), which is independent of hydration status is important in children with cancer. This study aimed to accurately measure the anthropometry and body composition of children with Acute Lymphoblastic Leukaemia (ALL) at diagnosis and compare them with healthy children from South India. Methods: This was a cross-sectional study in children aged 2 to 8 y with ALL from St. John’s Medical College Hospital, Bengaluru, and age and sex-matched, normal-weight children recruited as controls from communities. Anthropometry (weight, height, circumferences), skinfolds and body composition measurements using a whole-body potassium counter were performed. Body mass index-for-age, weight and height for age z-scores were calculated using WHO child growth standards. Biochemical markers, dietary intake and physical activity details were recorded. Categorical and continuous variables were analyzed by chi-square and independent t-tests respectively.     Results: The mean age of the children with ALL (n = 39) was 4.6±1.9 y and control group (n=39) was 4.7±1.9 y; 61.5% were boys. The prevalence of underweight, overweight/obesity and stunting were 17.9%, 7.7%, and 10.3% respectively. The mean weight and height, of children with ALL and children in the control group were 16.8±6.2 kg and 16.4±4.1 kg, 104.3±14.9 cm and 105.1±12.2 cm, respectively with no statistical difference. Children with ALL showed lower body cell mass index kg/m2 (4.6± 0.8), compared to children in the control group (4.7±0.9) p=0.527, but higher fat mass index kg/m2 (3.6±1.1 vs. 3.4±0.8) p=0.276. Conclusion: At diagnosis, anthropometric and body composition measurements were similar between children with ALL and children in the control group. The BCM showed a non-significant trend of being lower in children with ALL, which requires close monitoring during treatment. Evaluating early-stage nutritional status and body composition can help in planning appropriate interventions during treatment to prevent long term non-communicable diseases.

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