Nutritional status at presentation, comparison of assessment tools, and importance of arm anthropometry in children with cancer in India.
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Date
2015-04
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Abstract
BACKGROUND: In India, approximately 40,000 new cases of cancer in children are diagnosed each year. However, there are no good studies
analyzing their nutritional status. Also, since accurate and sensitive nutritional assessment is critical for optimal clinical outcomes through
timely remediation of malnutrition, it is important to assess the relative sensitivity and feasibility of commonly used nutritional screening tools.
METHODS: This observational study analyzed height/length (cm), weight (kg), mid-upper arm circumference (MUAC), triceps skinfold thickness
(TSFT) as well as their Z-scores or percentiles, albumin levels and history of weight loss at diagnosis in children aged 2–15 years being treated for
cancer between November 2008 to December 2013. Body mass index (BMI) and arm muscle circumference (AMC) were calculated respectively
from height and weight, and MUAC and TSFT. RESULTS: A total of 1693 new patients were enrolled; 1187 had all anthropometric measurements
performed. The prevalence of malnutrition was 38%, 57%, 76%, 69% and 81% on the basis of BMI, TSFT, MUAC, AMC, and arm TSFT + MUAC
respectively with the highest prevalence in solid abdominal tumours. Addition of BMI and serum albumin to arm anthropometry increased the
proportion classified as severely nutritionally depleted by a mere 2% & 1.5% respectively. Positive history of significant weight loss additionally
identified 16.5% at nutritional risk over arm anthropometry. CONCLUSIONS: The prevalence of malnutrition in Indian children with cancer at
presentation is very high ranging from 40% and 80% depending on the method used for assessment, being higher with MUAC and lowest with
BMI. Either MUAC alone or TSFT + MUAC (wherever feasible) should be used for screening for malnutrition in children with cancer at diagnosis
to plan timely nutritional interventions, reduce the treatment-related morbidity and optimise their chance of long-term cure.
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Keywords
Arm anthropometry, children with cancer, India, nutrition assessment tools, nutritional status
Citation
Shah P, Jhaveri U, Idhate T B, Dhingra S, Arolkar P, Arora B. Nutritional status at presentation, comparison of assessment tools, and importance of arm anthropometry in children with cancer in India. Indian Journal of Cancer. 2015 Apr-June; 52(2): 210-215.