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The educational materials
教育材料
presented here were developed by students
是由愛荷華州立大學食品科學和人類營養系的
and faculty of the department of food science
全體教員和學生開發出來
and human nutrition at Iowa State University.
并呈現在這里的
Funding for this project was provided by grants
這個項目的資金
from the American Cancer Society Midwest
是由美國中西部癌癥協會和
and the Lance Armstrong Foundation.
蘭斯阿姆斯特朗基金會撥款的
The materials are intended for educational use
這些材料是供教育使用的
and are not meant to provide medical advice.
并不提供醫療建議
We welcome your feedback about these materials;
我們也歡迎你們對這些材料提供反饋
please use the evaluation survey link on the
請使用我們主頁上的評估調查連接
home page to provide your comments and suggestions.
提供你們的評論和建議
This presentation will examine
這項陳述將
the prevalence and implications of malnutrition
研究營養不良
in children afflicted with cancer as well as
在患癌兒童中的患病率和對他們的影響
intervention methods for health professionals.
以及健康專業人士對該病的干預措施
There are few things in life that are as tragic
生活中很少有事情像
and heart breaking as a child diagnosed with a life
一個孩子被診斷得了絕癥那樣讓人悲痛和心碎
threatening illness. In the United States alone
2007年僅在美國
approximately 10400 children under the age of 15
就有將近10400個15歲以下的兒童
were diagnosed with cancer in 2007 and approximately
被診斷為患有癌癥
1545 of these children passed away from their disease.
其中約有1545個孩子因這種疾病死亡
Although this makes cancer the leading cause of death
盡管在孩子中
by disease among children advances in medical therapy
癌癥已經成為藥物治療疾病中的頭號殺手
and disease management have made long term survival
但是疾病管理已經
much more achievable. The overall cure rate for
使長期存活成為可能
childhood cancer now exceeds 70% and is projected to
現在兒童患癌的整體治愈率已經超過70%
soon reach 85% in industrialized nations; therefore
預計在工業化的國家將很快達到85%因此
major attention is being placed on reducing the
現在主要精力將集中在降低治療引起的副作用
side effects of therapy such as malnutrition.
例如，營養不良
Studies actually suggest that up to 46% of children with
實際上，調查顯示高達46%的患癌兒童
cancer experience malnutrition. Malnutrition is
患有營養不良
characterized by either a deficiency or an excess of
營養不良的特征是能量缺乏或者能量過剩
energy with measurable adverse effects on clinical
這會對臨床結果產生嚴重的副作用
outcome. It’s also really important to point out
需要指出的是，能量，
that energy, meaning calories, is the key component of
即卡路里是產生營養不良主要的原因
malnutrition, vitamin and mineral deficiencies also
維生素和礦物質缺乏也對
greatly contribute to overall malnutrition and health.
整體營養不良和健康有很大的影響
Children with cancer are particularly vulnerable to
患癌兒童尤其容易患營養不良
malnutrition because they require additional nutrients
因為患兒為了正常成長發育
in order to obtain proper growth and development and
以及與疾病抗爭
to fight off their disease.
需要額外的營養物質
Before we take a look at the causes of malnutrition
我認為在檢查兒童癌癥期
during childhood cancer and the corresponding side
導致營養不良的原因及其副作用之前
effects I think it is important to understand how to
重要的是要懂得如何評估孩子的營養狀況
assess the nutritional status of a child. There is
目前，我們對如何界定兒童營養不良一事
currently no consensus on how to define malnutrition
尚未達成共識
in children but the most common practices involved
但最常見的做法就是
plotting weight to height ratios. Weight and height
繪制體重身高比例圖
are usually plotted on standardized growth charts.
標準生長曲線圖上常常包括體重和身高
Once a child’s placement has been determined on the
一旦一個兒童在生長曲線圖上的位置被確定
growth chart this number can be converted to what is
此數字就可以轉換成所謂Z
known as a Z score. A Z score is a numerical summary
一個Z就是一個數字摘要
of each child’s placement relative to a reference
它總結了每個兒童相對于參考人口的定位
population and are used to compare and assess data
可以用來比較和評估不同年齡不同性別
between different ages and genders. Once a Z score
之間的數據 一旦Z確定了
is determined a child can be placed on what is
兒童就可定位在
known as a standard, normal distribution graph.
一個標準的正態分布圖上
This graph puts the average variable that is being
這個圖表的中心是被測量的平均變量
measured in the centre of a chart, any child
任何身高或體重Z 超過2個標準差的兒童
whose height or weight Z score is more than 2
無論其Z值是高于平均值
standard deviations greater or less than the mean is
或者低于平均值
considered to have significant growth abnormalities.
均被視為明顯的異常生長
Thus is the child fell 2 standard deviations below the
這就是為什么Z低于平均值的2個標準差
mean he or she would be considered to be malnourished.
的兒童會被視為營養不良
However, studies have shown that simple weight,
然而研究表明 簡單的體重和身高測量
height measurements are often inaccurate depending
往往是不準確的其數據也要取決于
on the type of tumor such as large solid tumors.
腫瘤類型，比如大型實體腫瘤
Other practices include tracking voluntary food intake
其他做法有跟蹤采食量
and comparing intake to the required or
將其攝入量與所需或推薦準則相比較
recommended guidelines. If the child was eating
如果兒童攝入的能量低于其預計能量
less than 70% of his or her estimated energy
需求的70％那么
requirements then he or she would be considered
將被視為營養不良
malnourished. Another way is to take anthropometric
另一種方法是對肱三頭肌皮褶厚度
measures of the tricep skin fold thickness to
進行人體測量，以確定人體內脂肪
determine adipose or fat energy reserves.
或脂肪的能量儲備
If less than the 5th percentile for age and
測量值不足其年齡和性別水平
sex the patient would be considered malnourished.
所需脂肪的百分之五的患者 將被視為營養不良
