Improved nutrition in adolescents and young adults after childhood cancer- INAYA study

Abstract

Background: 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. Methods: 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). Results: Twenty-three AYAs (11 female, 12 male, median age 20years (range 19-23years), median BMI: 21.4kg/m2 (range: 19.7-23.9kg/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 44month). 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. Conclusion: 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. Trial registration: Clinical trial identifier DRKS00009883on DRKS.