Slegtenhorst, Sonja (2011-12)
nutritional status of children during treatment.
Objective: To investigate whether children with cancer meet their Dietary Reference Values and
Safe Intakes for antioxidants, energy and protein.
Setting: Children were recruited from the East of England Primary Treatment Centre using
convenience sampling over 8 months. Forty-two children and adolescents diagnosed with a Solid
tumour, Lymphoma or Leukaemia were eligible for data analysis (n=20 male; n=22 female).
Method: Data was collected with an Estimated Food Record (EFR) in the 1st (EFR1) and 3rd month
(EFR2) post-diagnosis. In the week following EFR completion, parents and/or children were
contacted to complete four non-consecutive days of 24-hr food recalls. Data was categorised into
diet alone, diet + food supplement (FS), tube feeding (tube) or diet + multi-vitamin-mineral
supplementation (VMS). Malnutrition was determined by weight-for-age z-scores. Nutrient intake
was compared to the Recommended Nutrient Intake (RNI), the Estimated Average Requirements
(EAR) and the Lower Recommended Nutrient Intake (LRNI).
Result: The sample consisted of 33% (n=14) diagnosed with Leukaemia, 24% (n=10) with
Lymphoma and 43% (n=18) with Solid tumours. Sixty seven percent (n=28) underwent
chemotherapy and 33% (n=14) a combination of therapies. Significant correlations were seen
between the assessment tools in the diet alone category for both months for; vitamins A, C, E,
selenium and protein and for EFR1 for zinc and energy. In both months greater numbers of
children achieved ≥100% of requirements for diet + VMS (EFR 1; p<0.05; EFR2 p<0.05) than for
other feeding modes. Vitamin C achieved the highest intakes compared to the RNI at 773%
(EFR1) and 829% (EFR2). Intakes above 200% of the RNI were seen for vitamins A, C, E,
selenium and zinc. No significant differences were seen between modes of feeding in either month
for selenium or zinc. Vitamin A (EFR1≤ 100% diet alone p<0.05) and zinc (EFR1≤ 100% diet alone
p=0.02) met the least of the LRNI in the 1st month compared to other antioxidants. No statistical
significant difference was observed between the number of children attaining their EAR’s between
the 3 modes of feeding in the 1st month and 3rd month. In the 1st month 27% (n=8) of participants
consumed vitamin and/or mineral supplements, 18% in the 3rd month (n=4). In the 1st month 5%
(n=2) of children were moderately malnourished and 10% (n=4) in 3rd month. Conversely in the 1st
month 3% (n=1) were overweight and 3% (n=1) obese; the leukaemia group predominant.
Conclusion: The research tools showed good correlation. Children using vitamin and/or mineral
supplements mostly achieved their RNI’s compared to other feeding modes. Across feeding modes
some children achieved antioxidant intakes above 200% RNI. LRNI’s on diet alone were not achieved for vitamin A and zinc. The study showed Leukaemics as having a higher prevalence of
obesity. More research is required to determine the clinical implications of these findings.
AFRIKAANSE OPSOMMING: Agtergrond: Die rol van anti-oksidante en voldoende voeding in die voorkoming en verloop van
kanker behandeling word wêreldwyd erken vir vernietiging van die effek van vry radikale en die
verbetering van voedingstatus van kinders tydens behandeling.
Doelwit: Om ondersoek in te stel of kinders met kanker hul Dieet Verwysingswaardes en Veilige
Innames vir anti-oksidante, energie en proteïen bereik.
Ontwerp: Enkel sentrum prospektiewe studie.
Omgewing: Kinders was gewerf deur middel van gerieflikheidsteekproefneming oor 8 maande
vanaf die “East of England Primary Treatment Centre”. Twee-en-veertig kinders en adolessente
gediagnoseer met 'n Soliede tumor, Limfoom of Leukemie het in aanmerking gekom vir dataanalise
(n=20 manlik, n=22 vroulik).
Metode: Data was ingesamel met ‘n Geskatte Voedsel Rekord (GVR) in die eerste (GVR1) en
derde maand (GVR2) na diagnose. In die week na voltooiing van die GVR is ouers en/of kinders
gekontak om vier onopeenvolgende dae van 24-uur herroepe te voltooi. Data was verdeel in dieet
alleen, dieet + voedsel supplement (VS), buisvoeding (buis) of dieet + multi-vitamien-mineraal
supplementasie (VMS). Wanvoeding was bepaal deur middel van gewig-vir-ouderdom z-tellings.
Nutriënt inname was vergelyk met die Aanbevole Nutriënt Inname (ANI), die Geskatte Gemiddelde
Behoeftes (GGB) en die Laer Aanbevole Nutriënt Inname (LANI).
Resultate: Die steekproef het bestaan uit 33% (n=14) gediagnoseer met Leukemie, 24% (n=10)
Limfoom en 43% (n=18) Soliede tumore. Sewe-en-sestig persent (n=28) het chemoterapie ontvang
en 33% (n=14) ‘n kombinasie van terapieë. Betekenisvolle korrelasies was waargeneem tussen
die assesseringsinstrumente in die dieet alleen kategorie vir beide maande vir vitamiene A, C, E,
selenium en proteïen en vir GVR1 ook vir sink en energie. In beide maande het ‘n groter aantal
kinders ≥100% van hul behoeftes bereik vr dieet+VMS (GVR1; p<0.05; GVR2 p<0.05) as vir ander
modi van voeding. Vitamien C het die hoogste innames bereik vergeleke met die ANI teen 773%
(GVR1) en 829% (GVR2). Innames bo 200% van die ANI was waargeneem vir vitamiene A, C, E,
selenium en sink. Geen betekenisvolle verskille was waargeneem tussen modi van voeding in
enige maand vir selenium en sink nie. Vitamien A (GVR1≤100% dieet alleen p<0.05) en sink
(GVR1≤100% dieet alleen p=0.02) het die minste van die LANI bereik in die eerste maand
vergeleke met ander anti-oksidante. Geen statisties beduidende verskil was waargeneem tussen
die aantal kinders wat hul GGB’s bereik het tussen die 3 voedingswyses in die eerste en derde
maande nie. In die eerste maand het 27% (n=8) van deelnemers vitamien en/of mineraal
supplemente ingeneem, en 18% (n=4) in die derde maand. In die eerste maand was 5% (n=2) van
kinders matig wangevoed en 10% (n=4) in die derde maand. In die eerste maand was 3% (n=1)
van kinders oorgewig en 3% (n=1) vetsugtig, die leukemie groep spesifiek.
Gevolgtrekking: Die navorsingsinstrumente het goeie korrelasie getoon. Kinders wat vitamien
en/of mineraal supplemente gebruik het het meestal hul ANI’s bereik vergeleke met ander modi van voeding. Oor voeding modi het sommige kinders anti-oksidant innames bo 200% ANI bereik.
LANI’s op dieet alleen was nie bereik vir Vitamien A en sink nie. Hierdie studie het aangetoon dat
dié met Leukemia ‘n hoër prevalensie van oorgewig/vetsug getoon het. Meer navorsing is nodig
om die kliniese implikasies van die bevindinge te bepaal.
Please refer to this item in SUNScholar by using the following persistent URL: http://hdl.handle.net/10019.1/18050
Nutritional supplementation in Africa--how important is vitamin A?
﻿ Labadarios D. (1994)