title: Nutritional status and weakness following pediatric hematopoietic cell transplantation.
abstract: Survivorship after pediatric HCT has increased over the past decade. Focus on long-term care and well-being remains critical due to risk of poor dietary habits and exaggerated sedentary behavior, which can lead to muscle weakness, increased risk for obesity, and cardiometabolic disorders. Nutrition and physical activity are key factors in survivorship; however, data are limited. Comprehensive nutritional assessments, including nutrition-focused physical examination, grip strength, and food/activity surveys, were completed in 36 pediatric HCT survivors (aged 2-25 years). Patients were divided into undernutrition, normal-nutrition, and overnutrition categories. Fifty percent of participants were classified as normal nutrition, 22% undernutrition, and 28% overnutrition. Few patients met the U.S. Dietary Guidelines recommended intake for vegetables, fiber, saturated fat, and So FAS. Patients in the undernutrition group demonstrated significantly lower grip strength than those in the normal- and overnutrition groups. When grip strength was normalized to body mass, patients in the overnutrition group had the highest prevalence of weakness. Using NHANES reference data, maximum grip strength and NGS cutoffs were identified that could significantly distinguish the nutrition groups. Comprehensive nutritional assessments and grip strength measurements are feasible, non-invasive, easy to perform, and inform both under- and overnutrition in pediatric HCT survivors.
authors: Department of Pediatrics, Blood and Marrow Transplantation Program, University of Michigan, Ann Arbor, MI, USA.
authors: Sandra
authors: S
authors: Bouma
authors: Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, MI, USA.
authors: Mark
authors: M
authors: Peterson
authors: Department of Pediatrics, Blood and Marrow Transplantation Program, University of Michigan, Ann Arbor, MI, USA.
authors: Erin
authors: E
authors: Gatza
authors: Department of Pediatrics, Blood and Marrow Transplantation Program, University of Michigan, Ann Arbor, MI, USA.
authors: Sung Won
authors: SW
authors: Choi
mesh_terms: D000293:Adolescent; D015992:Body Mass Index; D001835:Body Weight; D002648:Child; D002675:Child, Preschool; D005247:Feeding Behavior; D005260:Female; D018737:Hand Strength; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D008297:Male; D044342:Malnutrition; D018908:Muscle Weakness / Q000503:physiopathology*; D015596:Nutrition Assessment; D009749:Nutrition Surveys; D009752:Nutritional Status; D009765:Obesity / Q000150:complications; D044343:Overnutrition; D015995:Prevalence; D055815:Young Adult
keywords: child malnutrition; hematopoietic stem cell transplantation; nutrition assessment; pediatrics