Original communication: Basal metabolic rate in children with a solid tumor
Broeder, E. den; Oeseburg, B. ; Lippens, R.J.J. ; Staveren, W.A. van; Sengers, R.C.A. ; Hof, M.A. van 't; Tolboom, J.J.M. - \ 2001
European Journal of Clinical Nutrition 55 (2001). - ISSN 0954-3007 - p. 673 - 681.
Objective: To study the level of and changes in basal metabolic rate (BMR) in children with a solid tumour at diagnosis and during treatment in order to provide a more accurate estimate of energy requirements for nutritional support. Design: An observational study. Setting: Tertiary care at the Centre for Paediatric Oncology, University Hospital Nijmegen. Subjects: Thirteen patients were recruited from a population of patients visiting the University Hospital Nijmegen for treatment. All patients asked to participate took part in and completed the study. Intervention: BMR was measured by indirect calorimetry, under stringent, standardised conditions, for 20 min and on three different occasions in all patients. Continuous breath gas analysis using a mouthpiece was performed. Weight, height and skinfold measurements were performed before each measurement. Main outcome measures: BMR was expressed as percentage of the estimated reference value, according to the Schofield formulas based on age, weight and sex, and in kJ (kcal) per kg of fat-free mass. Results: At diagnosis, the BMR was higher than the estimated reference BMR in all patients and 44␘f the patients were considered hypermetabolic. Mean BMR (as percentage of reference) was significantly increased (11.6øs.d. 6.7› P=0.001), but decreased during treatment in 12 of the 13 patients (mean decrease 12.7øs.d. 3.9› P<0.0001). Furthermore, a significant negative correlation (P=-0.67; P=0.01) was found between the change in BMR and tumour response. Conclusions: These data suggest that the BMR of children with a solid tumour is increased at diagnosis and possibly during the first phase of oncologic treatment. This may be important when determining energy requirements for nutritional support
Nasogastric tube feeding in children with cancer: The effect of two different formulas on weight, body composition, and serum protein concentrations
Broeder, E. den; Lippens, L.J.J. ; Hof, M.A. van 't; Tolboom, J.J.M. ; Sengers, R.C.A. ; Berg, A.M.J. van den; Staveren, W.A. van - \ 2000
Journal of Parenteral and Enteral Nutrition 24 (2000)6. - ISSN 0148-6071 - p. 351 - 360.
Background: Treatment of cancer cachexia partly involves the administration of adequate amounts of energy. The aim of this study was to assess the tolerance and efficacy of two equal volumes of tube feeding, one with a standard (1 kcal/mL) and one with a high energy density (1.5 kcal/mL), during the intensive phase of treatment. Methods: Nutritional status was assessed weekly, in 27 children with a solid tumor, by measuring weight, height, midupper arm circumference, biceps and triceps skinfold, and serum proteins. Tolerance was assessed by recording the occurrence of vomiting and by expressing the administered volume as a percentage of the required volume. Results: Both formulas were equally well tolerated, leading to a significantly higher energy intake in the energy-enriched formula group. In both formula groups, all anthropometric variables increased significantly (range of mean increase, 5.2% to 25.5%; p < .05) during the first 4 weeks of intervention. Between 4 and 10 weeks, variables continued to increase significantly in the energy-enriched group, resulting in adequate repletion, in contrast to the standard formula group. The concentration of serum proteins, low at initiation of tube feeding, returned to the normal range within 2 to 4 weeks with no significant differences between the two groups. Conclusions: The energy-enriched formula was more effective in improving the nutritional status of children with cancer during the intensive phase of treatment than the standard formula. Intensive, protocolized administration of an energy-enriched formula should therefore be initiated as soon as one of the criteria for initiation of tube feeding is met.
Effects of naso-gastric tube feeding on the nutritional status of children with cancer.
Broeder, E. de; Lippens, R.J.J. ; Hof, M.A. van 't; Tolboom, J.M. ; Staveren, W.A. van; Hofman, Z. ; Sengers, R.C.A. - \ 1998
European Journal of Clinical Nutrition 52 (1998). - ISSN 0954-3007 - p. 494 - 500.
|Long term effects of consumption of full-fat or reduced-fat products in healthy non-obese volunteers: assessment of energy expenditure and substrate oxidation.
Verboeket-van de Venne, W.P.H.G. ; Westerterp, K.R. ; Hermans-Lippens, T.J.F.M.B. ; Graaf, C. de; Hof, K.H. van het; Weststrate, J.A. - \ 1996
Metabolism : Clinical and Experimental 45 (1996). - ISSN 0026-0495 - p. 1004 - 1010.
|Retrospective study of the effect of tube feeding on nutritional status of pediatric cancer patients.
Heijnen, A.M.P. ; Schiffelers, S. ; Dusseldorp, M. van; Lippens, R.J.J. - \ 1994
In: Abstract 2nd Int. Congr. Nutrition in pediatrics. Lisboa, Portugal (1994)