This discovery propels the need for more work to determine how energy balance – a combination of diet and exercise – can be implemented effectively during treatment to manage or treat obesity.
“The purpose of the review was to delineate between obesity reduction as a goal for energy balance interventions versus simply changing diet or adding exercise,” says Joya Chandra, Ph.D., associate professor of Pediatric Research and the study’s lead author. “For example, our review confirmed modifying diet or adding moderate exercise can improve chemotherapy efficacy independent of weight loss.”
The researchers reviewed 67 studies including 32 novel clinical trials in pediatric patients, and data from a variety of cohorts with pediatric patients diagnosed with different cancers, including patients with acute lymphoblastic leukemia (ALL), rhabdomyosarcoma and brain tumors. The cellular mechanisms by which energy balance impacts tumor growth also were highlighted.
“What’s exciting about this study is that it lays the groundwork for additional studies in a pediatric clinical setting that involves specific diet and exercise interventions,” says Keri Schadler, Ph.D., assistant professor of Pediatric Research, and co-author of the study.
The relationship between diet and exercise and its positive effects on treatment outcomes in obese cancer patients has sparked interest for quite some time, but for pediatric patients, the research has been limited.
While healthy eating is encouraged during and after treatment, special diet interventions as part of treatment for pediatric patients are uncommon. Additionally, when it comes to physical activity, clinicians are cautious about administering an exercise regimen in a cancer care setting.
Chandra, who is co-director of MD Anderson’s Center for Energy Balance in Cancer Prevention and Survivorship, is helping her Pediatric Research team and colleagues throughout the institution understand the connection between nutrition, physical activity, obesity and cancer.
“The results from our study gives credibility to the need for energy balance interventions in clinical settings to improve treatment outcomes for pediatric patients,” says Eugenie Kleinerman, M.D., professor of Pediatrics, and a co-author of the study.