Healthful Diet Urged for Kids Undergoing Chemo

Treatment lowers antioxidant, nutrient levels

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HealthDay Reporter

MONDAY, Dec. 27, 2004 (HealthDayNews) -- Kids undergoing chemotherapy for the most common form of childhood leukemia have significant reductions in their antioxidant and micronutrient levels, which could lead to bad side effects from the treatment.

If these children would eat more fruits and vegetables, they could improve these levels of antioxidants and micronutrients and prevent some of the negative side effects of chemotherapy, a new study suggests.

"We got interested in looking at this because many parents had approached us about the safety and effectiveness of using antioxidant supplements during chemotherapy for treating leukemia," said lead researcher Dr. Kara M. Kelly, an associate professor of pediatric oncology at Columbia University.

To find out, Kelly and her colleagues first had to understand what happened to levels of vitamins A, E and C during chemotherapy. They studied 103 children who had just been diagnosed with acute lymphoblastic leukemia (ALL).

Kelly and her colleagues took blood samples at diagnosis, after initial treatment, and again after treatment had been intensified, according to their report in the Dec. 27 online edition of Pediatric Blood and Cancer.

The researchers found that, during therapy, oxidative stress increased and antioxidant levels decreased. They also found that antioxidant levels were linked to the side effects of treatment.

"Many children were deficient in antioxidants," Kelly said. "In some incidents, children who were deficient in antioxidants had more side effects from chemotherapy."

Kelly's group noted that children with higher concentrations of vitamins A, E and total carotenoids, had fewer poor outcomes, such as infections and toxicity. However, higher levels of vitamin E oxidative damage were linked with an increased risk of negative side effects.

"There is still a lot more we have to understand about it," Kelly said. "It's not like we can say, 'Take a supplement and it will take care of these side effects.'"

Kelly doesn't think that taking a vitamin supplement will confer any benefit. "We really need to focus on improving the children's diet," she said.

"We would like to develop an intervention that is going to get them to eat more fruits and vegetables. That way you are going to get a more balanced mix of antioxidants, which may help to minimize some of the side effects of therapy."

Kelly advises that parents work with a nutritionist and the child's doctor to improve his or her diet. "In cancer treatment, a diet with more fruits and vegetables is going to have a lot more protective benefits and help the child to tolerate the chemotherapy better," she said.

"It is not clear if this is something about the children, or if the levels of these substances make a difference," said Dr. Herman Kattlove, a medical oncologist and spokesman for the American Cancer Society.

Kattlove is concerned that increasing the levels of antioxidants with supplements might affect the high cure rate experienced with leukemia. "We're doing so well, you don't want to fiddle with things unless you know what you're doing. Before anyone gives these children vitamins, one needs to do some prospective studies," he said.

Kattlove agrees that it's a given that children should eat a healthful diet. However, he notes the patients undergoing chemotherapy often find it hard to eat. "If antioxidants really make a difference, then you may need to go to supplements," he said. "I can't imagine kids on chemotherapy eating salads."

More information

The National Cancer Institute can tell you more about ALL.

SOURCES: Kara M. Kelly, M.D., associate professor, pediatric oncology, Columbia University, New York City; Herman Kattlove, M.D., M.P.H., medical oncologist and spokesman, American Cancer Society, Atlanta; Dec. 27, 2004, Pediatric Blood and Cancer online

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