Endocrine Abstracts

JOINT2729

Background: Childhood cancer survivors (CCS) are at an increased risk of obesity, though underlying mechanisms remain unclear.

Aim: To characterize nutritional habits of CCS, compare them to the general pediatric population, and identify differences between normal-weight and overweight/obese CCS.

Methods: A cross-sectional study comprising 118 CCS (aged 14.8±3.8 years, females=54%), at least one-year post-treatment (average 7.3±4.1 years). Nutritional habits were assessed using a validated questionnaire including an FFQ component. Results were compared to data from a representative sample of healthy children and adolescents (MABAT survey).

Results: At recruitment, 3.4% of participants were underweight, 60.1% had a normal weight, 27.2% were overweight, and 9.3% were classified as obese, not significantly different compared to the general pediatric population in Israel. Still, compared to MABAT participants, male patients were twice as likely to consider themselves “too fat" (24.5% vs. 11.7%, P = 0.017). While total caloric intake was similar, diet composition differed significantly. Protein and fat percentage of energy intake in CCS were significantly (<0.001) higher compared to data from the general population, while carbohydrate percentage of energy was lower in CCS (P < 0.001). Fiber intake was lower in male CCS compared to the general population (P = 0.003), but not in female CCS. Within the study group, dietary composition was a significant predictor of weight gain over a one-year period from baseline with a higher carbohydrate percentage positively correlated with BMI increase (r = 0.294, P = 0.020). Eating habits, such as family meals, screen time during meals, and take-out food consumption, did not differ significantly between CCS and MABAT participants. However, within the study cohort overweight/obese CCS were more likely to have a cafeteria/kiosk at school (65.1% vs. 40%, P = 0.013) and purchase sweetened beverages during school hours (80% vs. 54.2%, P = 0.046). Frequent fast-food consumption (3-4 times per week) was significantly associated with overweight status (66.7% vs. 33.3%, P = 0.015), as was meal location, with overweight CCS more likely to eat at friends’ homes, restaurants, or alone (P = 0.015). Overweight/obese CCS were more likely to feel "too fat" (45% vs. 5.7%, P < 0.001), be unhappy with their weight (59.6% vs. 24.3%, P = 0.003), and experience food-related distress, yet only 14% sought guidance from a dietitian.

Conclusion: CCS exhibited distinct dietary patterns, with higher protein and fat intake but lower carbohydrate and fiber intake than the general population. Overweight/obese survivors reported greater body image concerns, weight dissatisfaction, and food-related distress, highlighting the need for targeted nutritional and psychological support.