The Nutritional Impact of Childhood Cancer: Insights from a Feasibility Cohort Study

Malnutrition, including undernutrition and overnutrition, affects survival, treatment response, and quality of life in children with cancer. However, its prevalence, trajectory, and clinical impact remain underexplored. This non-randomized pilot feasibility study evaluated the feasibility of comprehensive nutritional data collection and documented nutritional status from diagnosis through treatment in 38 children (<18 years) with pediatric cancer or Langerhans Cell Histiocytosis in New Zealand (June 2022-September 2023). Anthropometric, biochemical, and clinical data were collected at diagnosis and four follow-up points. Micronutrient abnormalities, including excesses and deficiencies, were highly prevalent, peaking at 3 months post-diagnosis (95%) and declining by month 12 (55%). Patients experienced reduced linear growth (p = .013) and increasing BMI over time (p = .03). Micronutrient status was significantly associated with malnutrition risk scores (SCAN and STRONGkids; p < .001), BMI-for-age z-scores, and weight status (BMI-for-age percentiles). Treatment complications were associated with micronutrient status (p < .001), weight status (p = .016), and malnutrition risk scores (p < .001). Nutritional challenges in pediatric cancer extend beyond weight changes to include micronutrient imbalances and clinical consequences. Routine nutritional assessment and targeted interventions, such as dietary optimization, micronutrient supplementation, and physical activity programs, are essential to improving treatment tolerance, recovery, and long-term health outcomes.