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Trial Lecture – time and place
See Trial Lecture.
Adjudication committee
- First opponent: Professor Arja Harila, Uppsala University, Sweden
- Second opponent: Dr. Raquel Revuelta Iniesta, University of Exeter, UK
- Third member and chair of the evaluation committee: Professor Jarle Breivik, University of Oslo
Chair of the Defence
Professor Kjetil Røysland, University of Oslo
Principal Supervisor
Associate Professor Christine Henriksen, University of Oslo
Summary
In her research, Janne Anita Kvammen assessed the nutritional status of three groups of severely ill pediatric patients. Paper I assessed 28 children aged 2-18 years hospitalized for an allogeneic hematopoietic stem cell transplantation. Paper II assessed 19 children aged 2-18 years with intestinal failure dependent on home parenteral nutrition and 50 healthy children. In paper III, 50 survivors of childhood brain tumors with a median age of 25.5 years and a median follow-up time of 19.5 years were studied. Anthropometrics, diet records, dual-energy x-ray absorptiometry measurements, and blood samples were analyzed.
The results revealed a risk of stunted growth and overweight in the studied groups. In intestinal failure and brain tumor survivors, decreased bone mineral density was found. Parenteral nutrition was the primary source of nutrition in children undergoing stem cell transplantation and in intestinal failure patients and entailed insufficient calcium, phosphate, and trace elements. Brain tumor survivors had low calcium and vitamin D intake, and one in four had vitamin D insufficiency.
In children undergoing stem cell transplantation, results indicated lower energy requirement during the first weeks post-transplant than in a healthy situation. In contrast, intestinal failure patients had similar energy intake to healthy children. In brain tumor survivors, being overweight was frequent despite lower energy intake than customarily expected. Metabolic changes after cancer treatment could be a possible explanation.
Overall, these studies underline the need to regularly assess nutritional status and integrate individual advice regarding nutrition into the treatment and follow-up of severely ill pediatric patients. Routines for bone mineral density surveillance should be implemented in patient care. Further studies on parenteral nutrition and which nutritional and lifestyle interventions are most effective in optimizing nutritional status and health are warranted.
Additional information
Contact the research support staff.