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Childhood leukaemia: a model of pre-obesity

Published online by Cambridge University Press:  28 February 2007

J. C. Ventham  and
J. J. Reilly
J. C. Ventham
Affiliation:
Department of Human Nutrition, University of Glasgow, Yorkhill Hospital, Glasgow G3 8SJ, UK
J. J. Reilly*
Affiliation:
Department of Human Nutrition, University of Glasgow, Yorkhill Hospital, Glasgow G3 8SJ, UK
*
*Corresponding author: Dr John J. Reilly, fax +44 (0)141 201 9275, email jjr2y@clinmed.gla.ac.uk
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Abstract

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The prevalence of obesity in children, as in adults, is increasing dramatically. The extent to which this is due to reduced energy expenditure, increased energy intake, or both, is unclear at present. This in part reflects the limitations of existing models of the pre-obese state. In childhood acute lymphoblastic leukaemia (ALL), patients typically gain weight excessively during and after 2 years of therapy, and are at high risk of becoming obese. Previous studies have failed to identify the cause of obesity in these patients. We have tested the hypothesis that excess weight gain in ALL is due to reduced total energy expenditure (TEE), measured using the doubly-labelled water method, and have identified risk factors for excess weight gain in ALL. Pre-obese children with ALL in the dynamic phase of weight gain are less physically active than their peers, with a reduced TEE of approximately 1.2 (95 % CI 0.2, 2.2) MJ/d. While other factors might contribute to excess weight gain, lifestyle (i.e. reduced habitual physical activity) plays a central role in ALL. Several considerations suggest that ALL might be a useful model of the pre-obese state: lifestyle is critical to development of obesity in ALL; ALL is relatively common; approximately 70 % of patients survive; patients are readily accessible during the 2 years of therapy and beyond.

Keywords

ObesityPhysical activityDoubly-labelled waterEnergy expenditure
Type
Postgraduate Symposium
Information
Proceedings of the Nutrition Society , Volume 58 , Issue 2 , May 1999 , pp. 277 - 281
Copyright
Copyright © The Nutrition Society 1999

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