Nutr Res Pract.  2019 Jun;13(3):214-221. 10.4162/nrp.2019.13.3.214.

A prospective study on changes in body composition and fat percentage during the first year of cancer treatment in children

  • 1Department of Pediatrics, Seoul National University Bundang Hospital, Seoul National University College of Medicine, 82 Gumi-ro 173 Beon-gil, Bundang-gu, Seongnam, Gyeonggi 13620, Korea.


S/OBJECTIVES: Cancer treatment may lead to significant body composition changes and affect growth and disease outcomes in pediatric cancer patients. This prospective study aimed to evaluate short- and long-term body compositions changes focused on body fat during the first year of cancer treatment in children.
A prospective study was conducted in 30 pediatric cancer patients (19 hematologic malignancies and 11 solid tumors) and 30 age- and sex-matched healthy controls. Anthropometric measurements and body composition analysis using whole body dual energy X-ray absorptiometry were performed at baseline and 1, 6, and 12 month(s) of cancer treatment. Kruskal-Wallis tests, Wilcoxon paired t tests, and generalized estimation equation (GEE) were applied for statistical analysis.
At baseline, no differences in weight, height, body mass index, abdominal circumferences, body fat, and fat-free mass were observed between 30 controls and 30 pediatric cancer patients. Total fat mass (P < 0.001) and body fat percentage (P = 0.002) increased significantly during the first month, but no changes were observed from 1 to 12 months; however, no changes in the total mass were observed during the first year of cancer treatment. Meanwhile, the total fat-free mass decreased during the first month (P = 0.008) and recovered between 6 and 12 months of follow-up (P < 0.001). According to GEE analysis, there was a significant upward trend in body fat percentage during the first year, especially the first month, of cancer treatment in children with hematologic malignancies, but not in those with solid tumors.
Our results indicate that cancer treatment is related to significant body composition changes and rapid body fat gain, particularly during the first month after initiating cancer treatment, in children with hematologic malignancies. Therefore, individualized dietary strategies to prevent excessive fat gain are needed in pediatric cancer patients for better outcomes.


Body composition; body fat distribution; neoplasms; child; absorptiometry

MeSH Terms

Absorptiometry, Photon
Adipose Tissue
Body Composition*
Body Fat Distribution
Body Height
Follow-Up Studies
Hematologic Neoplasms
Prospective Studies*


  • Fig. 1 Study participant flowchart

  • Fig. 2 Changes in the median total fat-free mass in pediatric cancer patients. A significant decrease during the first month of cancer treatment followed by an increase between 6 and 12 months is shown. No significant changes were observed between 1 month and 6 months.

  • Fig. 3 Changes in the median total fat mass (A) and body fat percentage (B) in pediatric cancer patients. A significant increase during the first month of cancer treatment followed by no changes up to 12 months is shown.

  • Fig. 4 Generalized estimation equation analysis of trends for changes in body fat percentage in each pediatric cancer group. A significant upward trend for changes in body fat percentage during the first year, especially the first month of cancer treatment in children with hematologic malignancies, but not in those with solid tumors, is shown.


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