A bilingual dietary intervention early in treatment is feasible and
prevents weight gain in childhood acute lymphoblastic leukemia (ALL)
Abstract
Background: Childhood acute lymphoblastic leukemia (ALL) is the most
common pediatric malignancy. The onset of obesity during childhood ALL
has been well established and is associated with inferior survival rates
and increased treatment-related toxicities. This pilot study sought to
determine if a dietary intervention is feasible and minimizes weight
gain during the initial phases of treatment for ALL. Methods:
Participants were recruited from four institutions, fluent in English or
Spanish, between 5-21 years old, and enrolled within three days of
starting induction therapy. Participants were counseled for six months
to follow a low glycemic diet. Dietary and anthropometric data were
collected at baseline, end of induction, and end of month six
(NCT03157323). Results: Twenty-three of 28 participants (82.1%) were
evaluable and included in the analysis. Dietary intake of several
nutrients targeted by the nutrition intervention declined (sugar, P =
0.003 and glycemic load, P = 0.053). We also observed a persistent
increase in total vegetables across each timepoint (P = 0.015) and by
the end of the intervention (P = 0.033). Importantly, we did not observe
an increase in body mass index z-score during induction or over the
six-month intervention period. Most families found the nutrition
intervention easy to follow (60%) and affordable (95%) despite
simultaneous initiation of treatment for ALL. Conclusions: A six-month
nutrition intervention initiated during the initial phase of treatment
for childhood ALL is feasible and may prevent weight gain. Our
preliminary findings need to be confirmed in a larger clinical trial.