Correlation Between Nutrition Assessment Data and Percent Body Fat via Plethysmography in Pediatric Oncology Patients

Abstract

Background: Routine nutrition assessment is a core part of the nutrition management of the pediatric oncology population. The aims of this study were to build on the findings of a previous study to investigate the relationship between nutrition assessment variables and percent body fat (%BF) and to produce an equation to predict %BF in the pediatric oncology population. Methods: The nutrition status assessment criteria for comparison with %BF measures were adapted with permission from the St Jude Children’s Research Hospital nutrition screening system, Department of Clinical Nutrition. Additional measures not part of the screening system included midarm circumference (MAC); triceps, biceps, suprailiac, and subscapular skinfolds; and arm fat area. %BF was determined via air displacement plethysmography and interpreted via percentiles derived from body fat reference curves for healthy children. Results: Forty-two children, 22 males and 20 females, participated in the study. Correlational analysis revealed significant correlations with %BF and weight and body mass index z scores, percentage of ideal body weight (%IBW), MAC, skinfolds, arm fat area, and the total nutrition screening score. No relationship was found between height z score, percentage of weight loss over the previous 1 month, serum albumin, diagnosis risk, oral intake, and impending therapy or treatment side effects. Regression analysis found %BF = (1.4 × Biceps Skinfolds (mm) + (0.16 × %IBW) − 1 to have the strongest correlation (r² = 0.74). Conclusions: The equation presented here requires validation to estimate %BF in the pediatric oncology population.

Keywords

nutrition assessment percent body fat oncology children

Get full access to this article

View all access options for this article.

References

Ladas

Sacks

Brophy

. Standards of nutritional care in pediatric oncology. Pediatr Blood Cancer. 2006;46:339-344.

Bowman

Williams

Sanders

. Algorithm for nutritional support: experience of the metabolic and infusion support service of St. Jude Children’s Research Hospital. Int J Cancer Suppl. 1998;11:76-80.

McCallum

Polisena

eds. The Clinical Guide to Oncology Nutrition. Chicago, IL: Oncology Nutrition Dietetic Group, American Dietetic Association; 2000.

Smith

Stevens

Booth

. Malnutrition at diagnosis of malignancy in childhood: common but mostly missed. Eur J Pediatr. 1991;150:318-322.

Kumar

Marwaha

Bhalla

Gulati

. Protein energy malnutrition and skeletal muscle wasting in childhood acute lymphoblastic leukaemia. Indian Pediatr. 2000;37:720-726.

Oguz

Karadeniz

Pelit

Hasanoglu

. Arm anthropometry in evaluation of malnutrition in children with cancer. Pediatr Hematol Oncol. 1999;16:35-41.

Murphy

White

Davies

PSW

. The validity of simple nutritional measures in paediatric oncology patients. Br J Nutr. 2009;101:1388-1392.

Halton

Atkinson

Barr

. Growth and body composition in response to chemotherapy in children with acute lymphoblastic leukemia. Int J Cancer Suppl. 1998;11:81-84.

van der Sluis

van den Heuvel-Eibrink

Hahlen

Krenning

de Muinck Keizer-Schrama

. Altered bone mineral density and body composition, and increased fracture risk in childhood acute lymphoblastic leukemia. J Pediatr. 2002;141:204-210.

10.

De Graaf Siebold

Meeuwsen-van der Roest

Schraffordt Koops

Zijlstra

. Dissociation of body weight and lean body mass during cancer chemotherapy. Eur J Cancer Clin Oncol. 1987;23:731-737.

11.

Lange

Gerbing

Feusner

. Mortality in overweight and underweight children with acute myeloid leukemia. JAMA. 2005;293:203-211.

12.

White

Davies

PSW

Murphy

. Validation of percent body fat indicators in pediatric oncology nutrition assessment. J Pediatr Hematol Oncol. 2008;30:124-129.

13.

Pietsch

Ford

. Children with cancer: measurements of nutritional status at diagnosis. Nutr Clin Prac. 2000;15:185-188.

14.

McCarthy

Cole

Fry

Jebb

Prentice

. Body fat reference curves for children. Int J Obes. 2006;30:598-602.

15.

National Center for Health Statistics. 2000 CDC Growth Charts. Selected Percentiles and LMS Parameters. Hyattsville, MD: National Center for Health Statistics; 2004.

16.

Centers for Disease Control and Prevention. Growth charts. Developed by the National Center for Health Statistics in collaboration with the National Center for Chronic Disease Prevention and Health Promotion. 2000. http://www.cdc.gov/growthcharts. Accessed January 2010.

17.

Frisancho

. Triceps Skin fold and upper arm muscle size norms for assessment of nutritional status. Am J Clin Nutr. 1974;27:1052-1058.

18.

Dempster

Aitkens

. A new air displacement method for the determination of human body composition. Med Sci Sports Exerc. 1995;27:1692-1697.

19.

Wells

Fuller

Wright

Fewrell

Cole

. Evaluation of air-displacement plethysmography in children aged 5-7 years using a three-component model of body composition. Br J Nutr. 2003; 90:699-707.

20.

Siri

. Body composition from fluid spaces and density: analysis of methods. In: Brozek

Henschel

eds. Techniques for Measuring Body Composition. Washington, DC: National Academy of Sciences; 1961:223-244.

21.

Elia

. Guidelines for Detection and Management of Malnutri- tion. Maidenhead, UK: Malnutrition Advisory Group, Standing Committee of BAPEN; 2000.

22.

Garofolo

Lopez

Petrilli

. High prevalence of malnutrition among patients with solid non-hematological tumors as found by using skinfold and circumference measurements. Sao Paulo Med J. 2005;123:277-281.

23.

Brennan

Gill

Pennells

Eden

Thomas

Clayton

. Insulin-like growth factor I, IGF binding protein 3, and IGFBP protease activity: relation to anthropometric indices in solid tumours or leukaemia. Arch Dis Child. 1999;80:226-230.

24.

Davies

Didcock

Didi

Ogilvy-Stuart

Wales

Shalet

. Growth, puberty and obesity after treatment for leukaemia. Acta Paediatr Suppl. 1995;411:45-50; discussion 51.

25.

Cancer Therapy Evaluation Program. Common toxicity criteria document for adverse events, version 3.0. DCTD, NCI, NIH, DHHS. http://ctep.cancer.gov. Accessed January 2010.

26.

Donaldson

Wesley

DeWys

. A study of the nutritional status of pediatric cancer patients. Am J Dis Child. 1981;135:1107-1112.

27.

Merrit

Kalsh

Roux

Ashley-Mills

Siegel

. Significance of hypoalbuminemia in pediatric oncology patients: malnutrition and infection JPEN J Parenter Enteral Nutr. 1985; 9:303-306.

28.

Brennan

. Sensitive measures of nutritional status in children with cancer in hospital and in the field. In J Cancer Suppl. 1998;11:10-13.

29.

Ittenbach

Busion

Stallings

. Statistical validation of air-displacement plethysmography for body composition assessment in children. Ann Hum Biol. 2006;33:187-201.

30.

Fields

Goran

. Body composition techniques and the four-compartment model in children. J Appl Physiol. 2000;86:613-620.

31.

Buison

Ittenbach

Stallings

. Methodological agreement between two-compartment body composition methods in children. Am J Hum Biol. 2006;18:470-480.

32.

Murphy

Buntain

Wong

. The use of air displacement plethysmography in children and adolescents with cystic fibrosis. Eur J Clin Nutr. 2004;58:985-989.

33.

Forbes

. Body composition in adolescence. In: Falkner

Tanner

eds. Human Growth 2: Postnatal Growth. London, UK: Bailliere Tindall; 1978:239-272.

34.

Armstrong

Chow

Sklar

. Alterations in pubertal timing following therapy for childhood malignancies. Endocr Dev. 2009; 15:25-39.

35.

Murphy

White

Davies

PSW

. Body composition of children with cancer. Am J Clin Nutr. 2010;92:55-60.

Supplementary Material

Please find the following supplemental material available below.

For Open Access articles published under a Creative Commons License, all supplemental material carries the same license as the article it is associated with.

For non-Open Access articles published, all supplemental material carries a non-exclusive license, and permission requests for re-use of supplemental material or any part of supplemental material shall be sent directly to the copyright owner as specified in the copyright notice associated with the article.

0.00 MB

0.28 MB