Nutrition and physical activity interventions delivered to children and young people during cancer treatment: a systematic literature review.
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PURPOSE: Evaluate the evidence for nutrition and/or physical activity interventions delivered during cancer treatment and determine their efficacy. METHODS: The protocol was registered on PROSPERO (reference CRD42024513364) and completed according to the PRISMA guidelines. A comprehensive search of MEDLINE, Embase, SCOPUS, and ProQuest Health & Medical Sciences databases was conducted from inception to March 22, 2024. Risk of bias was assessed using ROB1 for randomised controlled trials, the Newcastle-Ottawa Scale for non-randomised studies, and the NIH tool for uncontrolled studies. RESULTS: Of the 8349 articles identified, 77 were eligible for inclusion and data extraction. These included 4 nutrition-only, 68 physical activity-only, and 4 combined nutrition and physical activity interventions. Due to significant heterogeneity in study design, variables, and outcomes, a meta-analysis was not performed. There was consistent evidence that physical activity interventions can improve exercise capacity and strength in the paediatric cancer population while benefits to physical function are inconsistent. Effective interventions utilised supervised physical activity of moderate intensity. Emerging evidence suggests that nutrition interventions can improve diet quality. CONCLUSION: Future prospective intervention studies should consider both nutrition and physical activity and incorporate standardised outcome measures to maximise advancements in this field.