Improved nutrition in adolescents and young adults after childhood cancer - INAYA study.
Multimodality treatment improves the chance of survival but increases the risk for long-term side effects in young cancer survivors, so-called" Adolescents and Young Adults"(AYAs). Compared to the general population AYAs have a 5 to 15-fold increased risk of cardiovascular morbidity. Thus, improving modifiable lifestyle risk factors is of particular importance.



The INAYA trial included AYAs between 18 and 39 years receiving an intensified individual nutrition counseling at four time points in a 3-month period based on a 3-day dietary record. At week 0 and 12 AYAs got a face-to-face counseling, at week 2 and 6 by telephone. Primary endpoint was change in nutritional behavior measured by Healthy Eating Index - European Prospective Investigation into Cancer and Nutrition (HEI-EPIC).



Twenty-three AYAs (11 female, 12 male, median age 20 years (range 19-23 years), median BMI: 21.4 kg/m2(range: 19.7-23.9 kg/m2) after completion of cancer treatment for sarcoma (n = 2), carcinoma (n = 2), blastoma (n = 1), hodgkin lymphoma (n = 12), or leukemia (n = 6) were included (median time between diagnosis and study inclusion was 44 month). The primary endpoint was met, with an improvement of 20 points in HEI-EPIC score in 52.2 % (n = 12) of AYAs. At baseline, median HEI-EPIC score was 47.0 points (range from 40.0 to 55.0 points) and a good, moderate and bad nutritional intake was seen in 4.3, 73.9 and 21.7 % of AYAs. At week 12, median HEI-EPIC improved significantly to 65.0 points (range from 55.0 to 76.0 points) (p ≤ 0.001) and a good, moderate and bad nutritional intake was seen in 47.8, 52.2 and 0 % of AYAs. No change was seen in quality of life, waist-hip ratio and blood pressure.



Intensified nutrition counseling is feasible and seem to improve nutritional behavior of AYAs. Further studies will be required to demonstrate long-term sustainability and confirm the results in a randomized design in larger cohorts.



Clinical trial identifier DRKS00009883 on DRKS.
Department of Oncology, Hematology, BMT with Section Pneumology, Hubertus Wald Tumour Center - University Cancer Center Hamburg, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany. j.quidde@uke.de.
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0000-0001-7419-7449
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Quidde
Department of Oncology, Hematology, BMT with Section Pneumology, Hubertus Wald Tumour Center - University Cancer Center Hamburg, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany.
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von Grundherr
Department of Oncology, Hematology, BMT with Section Pneumology, Hubertus Wald Tumour Center - University Cancer Center Hamburg, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany.
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B
Koch
Department of Oncology, Hematology, BMT with Section Pneumology, Hubertus Wald Tumour Center - University Cancer Center Hamburg, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany.
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C
Bokemeyer
Department of Paediatric Hematology and Oncology, University Hospital Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany.
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Escherich
Hochschule Neubrandenburg - University of Applied Sciences, Fachbereich Agrarwirtschaft und Lebensmittelwissenschaften, Brodaer Straße 2, 17033, Neubrandenburg, Germany.
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Valentini
Hochschule Neubrandenburg - University of Applied Sciences, Fachbereich Agrarwirtschaft und Lebensmittelwissenschaften, Brodaer Straße 2, 17033, Neubrandenburg, Germany.
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D
Buchholz
Hamburger Krebsgesellschaft e.V., Butenfeld 18, 22529, Hamburg, Germany.
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Schilling
Department of Oncology, Hematology, BMT with Section Pneumology, Hubertus Wald Tumour Center - University Cancer Center Hamburg, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany.
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Stein
D000293:Adolescent; D000328:Adult; D015415:Biomarkers; D015992:Body Mass Index; D002648:Child; D005247:Feeding Behavior; D005260:Female; D006801:Humans; D008297:Male; D009369:Neoplasms / Q000175:diagnosis / Q000453:epidemiology*; D015596:Nutrition Assessment; D009752:Nutritional Status; D011788:Quality of Life; D017741:Survivors; D049629:Waist-Hip Ratio; D055815:Young Adult
D015415:Biomarkers