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Paeds Cancer – Improvement in body composition and BMI

Evidence Summary
The evidence for improvement in body mass composition is inconclusive. Although some studies have shown evidence of improved body composition in groups who have received physio intervention (1,2) others have not demonstrated any positive affect in intervention vs no intervention (3). The sample sizes in all studies have been small. Slater et al have shown an improvement in body composition in children who reported increased physical activity levels 5 years after treatment compared to those who were less active (4).

There is currently no evidence to suggest a positive effect on body mass index due to increased physical activity in childhood cancer patients and survivors.
Quality of Evidence
Low Quality
Strength of Recommendation
Studies looking at exercise interventions on body mass index and body composition in childhood cancer patients and survivors involve small numbers and are of low quality. Definitive conclusions about the effect of exercise in this specific population cannot be drawn but there is a suggestion that activity can lead to a reduction in body fat. Research in to the effect of increased physical activity in wider childhood populations suggests that physical activity has an important role to play in the management of obesity alongside other interventions. Current evidence suggests that physical activity reduces body fat mass and percentage body fat with the effect on body mass index being less clear.


  1. Hartman A, te Winkel ML, van Beek RD, de Muinck Keizer-Schrama SM, Kemper HC, Hop WC, van den Heuvel-Eibrink MM, Pieters R. 2009. A randomized trial investigating an exercise program to prevent reduction of bone mineral density and impairment of motor performance during treatment for childhood acute lymphoblastic leukemia. Pediatr Blood Cancer. 53(1):64-71.
  2. Järvelä LS, Kemppainen J, Niinikoski H, Hannukainen JC, Lähteenmäki PM, Kapanen J, Arola M, Heinonen OJ. 2012. Effects of a home-based exercise program on metabolic risk factors and fitness in long-term survivors of childhood acute lymphoblastic leukemia. Pediatr Blood Cancer. Jul 15;59(1):155-60.
  3. Dubnov-Raz G, Azar M, Reuveny R, Katz U, Weintraub M, Constantini NW. 2015. Changes in fitness are associated with changes in body composition and bone health in children after cancer. Acta Paediatr. Oct;104(10):1055-61.
  4. Slater ME, Ross JA, Kelly AS, Dengel DR, Hodges JS, Sinaiko AR, Moran A, Lee J, Perkins JL, Chow LS, Baker KS, Steinberger J. 2015. Physical activity and cardiovascular risk factors in childhood cancer survivors. Pediatr Blood Cancer. Feb;62(2):305-310.
  5. Moyer-Mileur LJ, Ransdell L, Bruggers CS. 2009. Fitness of children with standard-risk acute lymphoblastic leukemia during maintenance therapy: response to a home-based exercise and nutrition program. J Pediatr Hematol Oncol. Apr;31(4):259-66