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PURPOSE: Diseases associated with prior treatment, such as obesity, have been described in cancer survivors. Recent studies have shown that current estimates of overweight do not differ from that in the general population, suggesting the influence of environmental factors, such as dietary intake. In this context, there is increasing interest in the examination of health behaviors that may modify and reduce the risk of overweight and obesity. This study aimed to evaluate the characteristics of dietary intake among child cancer survivors living in a developing country. METHODS: This retrospective cross-sectional study included children and adolescents up to 18 years of age. Dietary intake of the patients was assessed using 24-hour dietary recall. RESULTS: All age groups showed sufficient carbohydrate and protein consumption levels. The mean percentages of carbohydrate and protein consumption were 54% and 20.8%, respectively. Regarding lipid quality, survivors showed low consumption levels of polyunsaturated and monounsaturated fats. The consumption level of saturated fats was close to the upper limit. Fiber intake was below the recommended level in all patient categories, and its mean was 11.5 g/day. The average daily intake of some vitamins and minerals was below the recommended intake levels for all sexes and age groups, with values below 50% of suitability. CONCLUSION: The imbalance of lipids quality and low consumption of micronutrients demonstrated that the diet quality is poor in child cancer survivors. This favors the development of not only obesity but also other chronic diseases, and potentially predisposes such patients to secondary cancers. IMPLICATIONS FOR CANCER SURVIVORS: this is a relevant issue due to the increased number of childhood cancer survivors who develop obesity and chronic and metabolic complications due to inadequate food consumption. Our study may help understand, prevent, or minimize public health problems.

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Abstract Purpose: Obesity is a late effect in survivors of childhood cancer and correlates with chronic complications. Survivors of leukemia, brain tumors, and hematopoietic stem cell transplantation are more likely to develop obesity resulting from treatment modalities such as radiotherapy and glucocorticoids. This paper analyzes and integrates the current data available to health professionals in order to clarify strategies that can be used to treat and prevent obesity in childhood cancer survivors. Sources: This is a literature review from on scientifically reliable electronic databases. We selected articles published in the last five years and earlier articles of great scientific importance. Data synthesis: The mechanisms involved in the pathophysiology of obesity in cancer survivors are not completely understood, but it is believed that damage to the hypothalamus and endocrine disorders such as insulin resistance, leptin resistance, and hormone deficiency may be involved. The body composition of this group includes a predominance of adipose tissue, especially in those undergoing hematopoietic stem cell transplant and total body irradiation. The use of body mass index in these patients may lead to an underestimation of individuals' risk for metabolic complications. Conclusion: Early identification of groups using accurate anthropometric assessments, interventional treatment, and/or preventative measures and counseling is essential to minimize the adverse effects of treatment. Physical activity and healthy eating to promote adequacy of weight in the whole population should be encouraged.

Resumo Objetivo: A obesidade é um efeito tardio em sobreviventes do câncer na infância e está correlacionada com complicações crônicas. Os sobreviventes da leucemia, tumores cerebrais e transplante de células-tronco hematopoiéticas têm maior probabilidade de desenvolver obesidade como resultado das modalidades de tratamento, como radioterapia e glicocorticoides. Este artigo analisa e integra os dados atuais disponíveis a profissionais da saúde para esclarecer as estratégias que podem ser usadas para tratar e prevenir a obesidade em sobreviventes do câncer na infância. Fontes: Esta é uma análise da literatura de bases de dados eletrônicas cientificamente confiáveis. Selecionamos artigos publicados nos últimos cinco anos e artigos mais antigos de grande importância científica. Resumo dos dados: Os mecanismos envolvidos na fisiopatologia da obesidade em sobreviventes do câncer não são completamente entendidos, porém acredita-se que o dano no hipotálamo e disfunções endócrinas, como resistência à insulina, resistência à leptina e deficiência hormonal, possam estar envolvidos. A composição corporal desse grupo inclui uma predominância de tecido adiposo, principalmente em pacientes submetidos a transplante de células-tronco hematopoiéticas e irradiação de todo o corpo. O uso do índice de massa corporal nesses pacientes poderá levar a uma subestimação do risco de complicações metabólicas nessas pessoas. Conclusão: A identificação precoce de grupos por meio de avaliações antropométricas precisas, o tratamento intervencional e/ou medidas preventivas e aconselhamento são fundamentais para minimizar os efeitos colaterais do tratamento. A atividade física e alimentação saudável devem ser incentivadas para promover a perda de peso na população em geral.

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RESUMEN

PURPOSE: Obesity is a late effect in survivors of childhood cancer and correlates with chronic complications. Survivors of leukemia, brain tumors, and hematopoietic stem cell transplantation are more likely to develop obesity resulting from treatment modalities such as radiotherapy and glucocorticoids. This paper analyzes and integrates the current data available to health professionals in order to clarify strategies that can be used to treat and prevent obesity in childhood cancer survivors. SOURCES: This is a literature review from on scientifically reliable electronic databases. We selected articles published in the last five years and earlier articles of great scientific importance. DATA SYNTHESIS: The mechanisms involved in the pathophysiology of obesity in cancer survivors are not completely understood, but it is believed that damage to the hypothalamus and endocrine disorders such as insulin resistance, leptin resistance, and hormone deficiency may be involved. The body composition of this group includes a predominance of adipose tissue, especially in those undergoing hematopoietic stem cell transplant and total body irradiation. The use of body mass index in these patients may lead to an underestimation of individuals' risk for metabolic complications. CONCLUSION: Early identification of groups using accurate anthropometric assessments, interventional treatment, and/or preventative measures and counseling is essential to minimize the adverse effects of treatment. Physical activity and healthy eating to promote adequacy of weight in the whole population should be encouraged.

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