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Title: Low levels of energy expenditure in childhood cancer survivors: Implications for obesity prevention

item ZHANG, FANG - Tufts University
item ROBERTS, SUSAN - Tufts University
item PARSONS, SUSAN - Tufts - New England Medical Center
item MUST, AVIVA - Tufts - New England Medical Center
item KELLY, MICHAEL - Tufts - New England Medical Center
item WONG, WILLIAM - Children'S Nutrition Research Center (CNRC)
item SALTZMAN, EDWARD - Tufts University

Submitted to: Journal of Pediatric Hematology/Oncology
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 11/26/2014
Publication Date: 11/6/2014
Citation: Zhang, F.F., Roberts, S.B., Parsons, S.K., Must, A., Kelly, M.J., Wong, W.W., Saltzman, E. 2014. Low levels of energy expenditure in childhood cancer survivors: Implications for obesity prevention. Journal of Pediatric Hematology/Oncology. 37(3):232-236.

Interpretive Summary: Obesity is common among children following cancer treatment. Obesity increases their risk of other chronic diseases and shortens their life expectancy. The cause of obesity following cancer treatment is not known. One possible cause could be a decrease in their calorie usage following cancer treatment. We measured the daily calorie usage on 17 children following cancer treatment with a stable isotope method, the doubly labeled water method. The method is considered the reference method for measuring calorie usage under free-living conditions. The results showed that following cancer treatment, these children spent about 500 calories a day less than expected thus leading to excessive weight gain. Future studies are needed to find out whether these children ate more and/or becoming less physically active following cancer treatment so that necessary guidelines can be developed to reduce their risk of obesity and the potential complications.

Technical Abstract: Childhood cancer survivors are at an increased risk of obesity but causes for this elevated risk are uncertain. We evaluated total energy expenditure in childhood cancer survivors using the doubly labeled water method in a cross-sectional study of 17 survivors of pediatric leukemia or lymphoma (median age, 11.5 y). Mean total energy expenditure was 2073 kcal/d, which was nearly 500 kcal/d lower than estimated energy requirements with recommended levels of physical activity. This energy gap is likely to contribute to the risk of obesity in this population and future trials are needed to assess implications and potential treatment strategies.