Feasibility and Impact of a Multidisciplinary Lifestyle Intervention Among Overweight and Obese Childhood Cancer Survivors in a Low- and Middle-Income Setting.

BACKGROUND

Childhood cancer survivors (CCS) are at increased risk of obesity and related cardiometabolic complications. Evidence for multidisciplinary (MD) lifestyle interventions in CCS, particularly from low- and middle-income countries (LMICs), remains limited, and long-term adherence is poorly understood.

METHODS

We conducted a prospective single-arm interventional study among overweight and obese CCS attending a survivorship clinic at a tertiary cancer centre between January 2021 and June 2022. Participants received a structured MD intervention including dietary counselling, physical activity guidance and psychological support, with telephonic reinforcement up to 24 weeks. Outcomes assessed at 1 year included BMI z-score, physical activity, functional endurance (6-min walk test), dietary intake and sedentary behaviour. Factors associated with response were explored using logistic regression.

RESULTS

Sixty CCS (median age 15 years) were enrolled. At 1 year, mean BMI z-score decreased modestly from 2.13 ± 0.69 to 1.8 ± 0.7 (p = 0.01). Significant improvements were observed in physical activity levels, 6-min walk distance (507.8-600 m, p < 0.001) and sedentary time (11.5-9.0 h/day, p < 0.001). Dietary patterns showed reduced caloric and fat intake with improved protein consumption. Adherence to intervention components declined progressively after cessation of structured reinforcement at 24 weeks. Younger age and lower BMI at cancer diagnosis were associated with better response.

CONCLUSIONS

MD lifestyle interventions integrated into survivorship care are feasible in an LMIC setting and improved behavioural and functional outcomes, with modest reduction in BMI. Declining adherence over time emphasises need for sustained reinforcement strategies.