Dietary Intake among Children with Acute Lymphoblastic Leukemia (ALL)

Children with acute lymphoblastic leukemia (ALL) are at elevated risk for nutrition-related morbidities both during and after therapy. The degree to which dietary intake fluctuates during cancer therapy and possibly contributes to the development of nutrition-related morbidities is unknown. This study presents the results of the first prospective study describing changes in dietary intake in 667 children undergoing treatment for ALL. Dietary intake was evaluated with a food frequency questionnaire at three timepoints reflecting different intensities of cancer therapy: diagnosis (Time 1-no therapy), induction (Time 2- high-dose therapy), and continuation (Time 3- low-dose therapy). Dietary intake was compared to the Dietary Reference Intakes (DRIs) and normative data. Contrary to expectations, total caloric intake in the majority of patients exceeded the DRIs with a smaller percentage of patients below the DRI for calories. The majority of patients were within the DRI for all other macronutrients with an increase in intake of fat at Time 2. Despite adequate caloric intake, the majority of patients had low dietary intakes of calcium, vitamin D, and vitamin E while excess dietary intakes were observed for zinc and niacin. For folate, most patients were either below or above the DRI. In general, dietary intakes were reflective of normative data suggesting intakes are not significantly altered during treatment for ALL. This study was successful in identifying priority nutrients for dietary intervention and scientific inquiry. The effect of these strategies on the development of nutrition-related morbidities in children with ALL may be considered for future research initiatives