Acute lymphoblastic leukemia and obesity: increased energy intake or decreased physical activity?

Background Obesity is a well-known problem in children with acute lymphoblastic leukemia ( ALL), and it might be the result of an excess in energy intake, reduced energy expenditure, or both. The aim of this study is to describe energy intake and physical activity during treatment for ALL with intermittent dexamethasone ( DEXA). Methods Body mass index (BMI), energy intake, and physical activity were measured in 16 ALL patients on maintenance treatment and in 17 healthy controls. ALL patients were measured during ("on DEXA") and in between ("off DEXA") DEXA treatments. Results In patients, the mean increase in BMI z-score was 1.4 +/- 1.1. Energy intake on DEXA was higher (2,125.9 +/- 476.0 vs 1,775.1 +/- 426.1 kcal/24 h, p<0.05) and energy intake off DEXA was lower (1,305.0 +/- 249.4 vs 1,775.1 +/- 426.1 kcal/24 h, p<0.05), compared to healthy controls. Physical activity on DEXA was lower compared to healthy controls (30.0 +/- 3.9 vs 40.0 +/- 6.0 kcal kg(-1) 24 h(-1), p<0.001 and 7,303.1 +/- 4,622.9 vs 13,927.2 +/- 3,822.7 steps, p<0.05). Physical activity off DEXA was not different compared to healthy controls. Conclusion Weight gain in patients on ALL treatment might be owing to increased energy intake and decreased physical activity during treatment with DEXA.