ABSTRACT
Introduction
This study investigated the prevalence of malnutrition at childhood cancer diagnosis in South Africa and the association with 1-year post-diagnosis overall survival (OS).
Method
Nutritional status was prospectively assessed for newly diagnosed children with cancer. Chronic undernutrition was defined as two standard deviations (SDs) or more below zero for height/length-for-age (HAZ), and acute as underweight (weight-for-age [WAZ], and wasted as body mass index for age [BAZ] and mid-upper arm circumference for age [MUAC/A]). The association between the nutritional status at diagnosis and age, sex, disease group and 1-year post-diagnosis OS was analysed with Cox regression and hazard ratios (HRs).
Results
Less than 15% were chronically malnourished (stunted: 14.3%) and up to 24.3% acutely undernourished (wasted: 24.3% MUAC-Z and BAZ 8.1%), 11.6% underweight, of 320 patients at cancer diagnosis). More females than males were underweight (12.2% vs. 4.5%; p = 0.027). Children of 5 years of age and older had a higher prevalence of wasting (18.7%) than children under 5 years of age (3.9%) (p < 0.001) at diagnosis, with significant improvement 6 months after diagnosis. Stunting was significantly associated with poorer OS at 3 years after a cancer diagnosis (HR 1.8; 95% CI 1.1, 2.8; p = 0.011).
Conclusion
MUAC/A identified more children with undernutrition than other nutritional parameters. Stunting was significantly associated with poorer OS 3 years and EFS 2 years after a cancer diagnosis. Optimal nutritional support should be provided for South African children, especially those with acute and chronic malnutrition, to improve OS.
Journal of Human Nutrition and Dietetics, Volume 38, Issue 4, August 2025. Read More