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Healthy Nutrition Protects Against Infections in Kids with ALL

Healthy Nutrition Protects Against Infections in Kids with ALL
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Published on February 19, 2021

The Importance of Healthy Nutrition for Pediatric ALL Patients 

Many experts recommend a diet that is high in fruits, vegetables, whole grains and lean meats for patients with cancer. This is especially important for growing kids who are facing the side effects of a cancer diagnosis and treatment.

A research team from the Columbia University Irving Medical Center in New York studied the effects of dietary intake of antioxidants on rates of infections, mucositis (painful inflammation in the digestive system), relapse and disease-free survival (DFS) during certain phases of therapy among children and teens with acute lymphoblastic leukemia (ALL).1

The team enrolled 794 children in a clinical trial that took place during their treatment for ALL, the most common type of pediatric cancer, and asked them (or their parents) to fill out a food frequency questionnaire at the time of diagnosis and again at the end of induction. (Induction is often the first phase of chemotherapy treatment for children with ALL. Patients are at high risk of infection and side effects during this period.)2

Of the 513 participants who completed the dietary surveys at both time points, 23% and 16% experienced a bacterial infection and 4% and 10% experienced mucositis during the induction or postinduction phases of treatment, respectively. Researchers found that patients who consumed more beta carotene, carotenoids and vitamin A had a lower risk of infection; patients who consumed higher levels of vitamin A, E, zinc and carotenoids had a lower risk of developing mucositis.

The bottom line: in this study, increased intake of dietary antioxidants was associated with significantly lower rates of infection and mucositis.

Translating the Results at Home

Antioxidants are substances that may protect your cells against free radicals, which play a role in cancer and other diseases. Free radicals are molecules produced when your body breaks down food or when you're exposed to tobacco smoke or radiation. Antioxidants, such as vitamins C and E, may help protect cells from damage caused by free radicals. Plant-based foods are the best sources — there’s no healthier way to get these substances.3

Eat the Rainbow

A simple way to think about how you and your child are eating is to think week to week, not day-to-day. During a given week, did you serve up a colorful variety of fresh fruits and veggies? Sometimes parents (including myself here) become concerned about a day of sub-par eating, but pediatricians encourage folks like us to think about food options and choices over the course of a week. In doing so, you’ll be able to make adjustments to add more colorful foods at snack and meal times. Fruits, vegetables, whole grains, nuts, seeds, herbs and spices, and even cocoa, all contribute to a healthy variety of foods to choose from.

Foods High in Antioxidants

Try adding more of these antioxidant-rich foods into snacks and meals to get the most benefits. This is not an exhaustive list and a board-certified dietitian or nutritionist can help explain in further detail.

  • Beans (black, red, kidney, pinto)
  • Fruits (apples, blackberries, blueberries, cranberries, kiwi, plums, raspberries, strawberries)
  • Nuts (almonds, cashews, pecans)
  • Dark leafy greens (kale, spinach)
  • Veggies (avocado, bell peppers, russet potatoes, tomatoes)
  • Sweets (dark chocolate)
  • Spices and herbs4 (fresh basil, cinnamon, garlic, onions)

If you are not sure where to turn, ask your child’s treatment center if they have a dietitian on staff, says board-certified nutritionist Julie Langford, MPH, RD, CSO, LDN.

“I always recommend that you would go to your treatment center and ask if you have a dietician available to you. What I find is that a lot of people actually have a dietitian available, but it may never have been offered to them. A lot of centers have someone that's dedicated just to the cancer center, or sometimes the hospital dietitians will cover the oncology outpatient or inpatient floors, and so they might be available to you and you just don't know it,” Julie explained.

~Lauren Evoy Davis

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1Ladas EJ, PhD,Blonquist TM, Maneka Puligandla M, et al. Protective Effects of Dietary Intake of Antioxidants and Treatment-Related Toxicity in Childhood Leukemia: A Report From the DALLT Cohort. J Clin Oncol. 2020 38:19, 2151-59.

2Treatment of Children With Acute Lymphocytic Leukemia. American Cancer Society.

3Antioxidants. Mayo Clinic.

4Reilly CT. Top 20 Foods High in Antioxidants. American Dietetic Association.

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