title: Daily energy expenditure and physical activity in survivors of childhood malignancy.
abstract: Changes in body composition, in particular the onset of obesity, may result from reductions in total daily energy expenditure (TDEE) as a consequence of relative physical inactivity. Children previously treated for acute lymphoblastic leukemia (ALL) become obese, yet the mechanism remains undefined. TDEE and physical activity levels [PAL = TDEE/basal metabolic rate (BMR)] were measured in 34 long-term survivors of ALL and compared with results from 21 survivors of other malignancies and 32 healthy sibling control subjects using the flex-heart rate technique. Body composition was measured by dual energy x-ray absorptiometry. The median TDEE was reduced in the ALL group (150 kJ x kg d(-1)) compared with other malignancies and controls (207 and 185 kJ x kg d(-1), respectively, p < 0.01). This reduction was accounted for mainly by a relative decrease in the PAL of the ALL group (1.24) compared with both other malignancies and controls (1.58 and 1.47, respectively, p < 0.01). TDEE and PAL were correlated with percentage body fat (r = -0.39, p < 0.001 and r = -0.24, p < 0.05, respectively). Obesity in survivors of ALL may, in part, be explained by a reduction in TDEE as a consequence of reduced PAL. The cause of such reduction is uncertain.
authors.affiliation: Department of Child Health, University of Wales College of Medicine, Heath Park, Cardiff, UK.
authors.forename: J T
authors.initials: JT
authors.lastname: Warner
authors.forename: W
authors.initials: W
authors.lastname: Bell
authors.forename: D K
authors.initials: DK
authors.lastname: Webb
authors.forename: J W
authors.initials: JW
authors.lastname: Gregory
mesh_terms: D000293:Adolescent; D000704:Analysis of Variance; D001481:Basal Metabolism; D002648:Child; D002149:Energy Intake; D004734:Energy Metabolism; D005260:Female; D006339:Heart Rate; D006801:Humans; D008297:Male; D009369:Neoplasms; D009765:Obesity / Q000453:epidemiology / Q000209:etiology; D005082:Physical Exertion; D011187:Posture; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000188:drug therapy / Q000532:radiotherapy; D012016:Reference Values; D012044:Regression Analysis; D017741:Survivors