Evidence map›Paper›PMID 41450885›Full record

SynthesisFrontiers in pediatrics2025

Protein supplementation in pediatric oncology: a systematic review revealing a lack of evidence and insights from other chronically and critically ill children.

Emma den Hartog, José van Tongeren, Elvira C van Dalen, Mirjam van den Brink, Emma J Verwaaijen, Wim J E Tissing

Abstract readSystematic Review
In one paragraph

Synthesis in Frontiers in pediatrics, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Observational
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Emma den HartogPrincess Máxima Center for Pediatric Oncology, Utrecht, Netherlands.
José van TongerenPrincess Máxima Center for Pediatric Oncology, Utrecht, Netherlands.
Elvira C van DalenPrincess Máxima Center for Pediatric Oncology, Utrecht, Netherlands.
Mirjam van den BrinkPrincess Máxima Center for Pediatric Oncology, Utrecht, Netherlands.
Emma J VerwaaijenPrincess Máxima Center for Pediatric Oncology, Utrecht, Netherlands.
Wim J E TissingPrincess Máxima Center for Pediatric Oncology, Utrecht, Netherlands.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background & aims: Exercise interventions may counteract adverse effects of childhood cancer (treatment) on anthropometrics, body composition and physical fitness. However, inadequate nutritional status and loss of muscle mass and strength might limit effectiveness. Protein supplementation might support muscle preservation and enhance the benefits of exercise but evidence on its effect in children with cancer is lacking. This review examined the potential effect of protein supplementation on anthropometrics, body composition, physical fitness and adverse effects in children with cancer from diagnosis until two years after end of treatment. Methods: PubMed/MEDLINE was searched for literature on childhood cancer and protein supplementation (14th of May 2025). Reports examining anthropometrics, body composition and/or physical fitness before and after the protein intervention and written in English were eligible. Another search was performed in chronically and critically ill children (14th of May 2025). Risk of bias was assessed using Cochrane Childhood Cancer criteria and for each outcome, we graded the quality of evidence using the Grading of Recommendations Assessment, Development and Evaluation methodology. Data were descriptively reported. Results: None of the studies in children with cancer could be included. Five studies were included with a total of 142 children (66 had cystic fibrosis, 6 Crohn's disease, 70 a prolonged pediatric intensive care unit stay). Protein supplementation interventions varied. All studies reported on anthropometrics and body composition. Four observational studies reported a significant improvement in at least one of the outcomes whereas one randomized controlled trial (RCT) found no significant changes. Of the three studies assessing physical fitness measurements, two observational studies reported a significant improvement in at least one of the outcomes while one RCT did not find a significant change. The three studies reporting on adverse effects were encouraging but this outcome deserves further investigation. Level of evidence was graded very low for all outcomes. Conclusions: Evidence on the potential of protein supplementation is scarce and not available in children with cancer. The limited evidence included in this review tentatively suggests that protein supplementation might aid in improving anthropometrics, body composition and physical fitness. Future controlled trials are needed to determine its feasibility and effectiveness in children with cancer.

Indexed as

adverse effectsanthropometricsbody compositionchronic illnesscritical illnesspediatric oncologyphysical fitnessprotein supplementation

Identifiers

PMID41450885
PMCPMC12728054

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.