Antioxidant intake in paediatric oncology patients

[摘要] ENGLISH ABSTRACT: Background: The role of antioxidants and adequate nutrition in the prevention and course ofcancer treatment is globally recognised in nullifying the effects of free radicals and increasing thenutritional status of children during treatment.Objective: To investigate whether children with cancer meet their Dietary Reference Values andSafe Intakes for antioxidants, energy and protein.Design: Single centre prospective study.Setting: Children were recruited from the East of England Primary Treatment Centre usingconvenience sampling over 8 months. Forty-two children and adolescents diagnosed with a Solidtumour, 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 werecontacted to complete four non-consecutive days of 24-hr food recalls. Data was categorised intodiet alone, diet + food supplement (FS), tube feeding (tube) or diet + multi-vitamin-mineralsupplementation (VMS). Malnutrition was determined by weight-for-age z-scores. Nutrient intakewas 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) withLymphoma and 43% (n=18) with Solid tumours. Sixty seven percent (n=28) underwentchemotherapy and 33% (n=14) a combination of therapies. Significant correlations were seenbetween 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 ofchildren achieved ≥100% of requirements for diet + VMS (EFR 1; p<0.05; EFR2 p<0.05) than forother 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 monthfor selenium or zinc. Vitamin A (EFR1≤ 100% diet alone p<0.05) and zinc (EFR1≤ 100% diet alonep=0.02) met the least of the LRNI in the 1st month compared to other antioxidants. No statisticalsignificant difference was observed between the number of children attaining their EAR's betweenthe 3 modes of feeding in the 1st month and 3rd month. In the 1st month 27% (n=8) of participantsconsumed 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 1stmonth 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 mineralsupplements mostly achieved their RNI's compared to other feeding modes. Across feeding modessome 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 ofobesity. More research is required to determine the clinical implications of these findings.

[发布机构] Stellenbosch University