Caregivers play an essential role in helping children maintain adequate nutrition during their cancer treatment. But treatment-related side effects, such as nausea and poor appetite, can make feeding a child particularly challenging. Nutrition priorities also shift throughout treatment and beyond.
In a small pilot study, researchers from Drexel University and Children's Hospital of Philadelphia tested a culinary medicine program designed specifically for caregivers of children undergoing cancer treatment. The study, recently published in Integrative Cancer Therapies , found that families thought the program was useful and acceptable, despite the significant demands they were already managing during their child's cancer treatment. Overall satisfaction with the intervention was high and engagement was encouraging.
"Caregivers particularly valued the practical culinary guidance, accessible recipes and individualized coaching," said Brandy-Joe Milliron, PhD , an associate professor in Drexel's College of Nursing and Health Professions , and lead author of the study. "These findings provide an important signal that families are interested in nutrition and culinary support that goes beyond simply providing information."
The caregiver participants valued opportunities to build practical skills that can help them manage treatment-related side effects in the short term while also supporting healthy eating habits that remain relevant as their child's needs change over time.
Ten pairs of caregivers and their children participated in the remotely-delivered culinary medicine program – called "Caregivers' Kitchen" – for eight weeks. The program combined four live virtual culinary workshops and four individualized caregiver coaching calls designed to help families address treatment-related nutrition challenges while also building skills they could carry forward beyond treatment.
Tracey Jubelirer, MD , who leads the Integrative Oncology program at Children's Hospital of Philadelphia, explained that caregivers often face many challenges with feeding a child during treatment.
"They need to ensure their child gets enough nutrition while also managing symptoms such as nausea, appetite and taste changes, weight loss or gain as well as general stresses of feeding a child," Jubelirer said. "As children complete treatment and move into recovery, the focus may shift to supporting healthy growth, maintaining a healthy weight and building eating habits that support long-term health."
The findings suggest that families may benefit from culinary and nutrition support that can adapt to both realities. Teaching caregivers what to prepare is important but helping them understand how to adjust foods and meals to their child's current symptoms, and how those choices may evolve as treatment ends, may be just as valuable, since nutrition can be much more complicated than simply knowing which foods are healthy.
"Families also told us that scheduling and lengthy assessments could be burdensome, so those lessons are directly informing a more flexible version of the program for our next study," Milliron said.
Participant feedback, such as making the culinary sessions more flexible and self-paced while retaining the individualized coaching, will be integrated into the next iteration of Caregivers' Kitchen.
Caregivers found the individualized coaching helpful because it gave them an opportunity to talk through their particular challenges, identify realistic goals and think about how the nutrition and culinary information could work for their child and their family. That individualized format was well suited for when nutrition needs change substantially over the course of treatment and survivorship. It reinforced that personalized support is an important complement to culinary guidance, according to Milliron.
The research team cautioned that because this was a small pilot study, the findings did not provide evidence that the program improves clinical outcomes. Rather, it highlights this type of intervention is promising and warrants a larger, rigorous trial, which is in the works according to the researchers. They plan to examine whether the intervention will have meaningful outcomes for the children – such as dietary intake and treatment related complications, body composition and weight – and the caregivers, including confidence, preparedness and distress when managing their child's nutrition.
"Ultimately, we hope to determine whether a practical, family-centered culinary medicine intervention can become a useful part of supportive care throughout active treatment into healthy survivorship," Milliron said.
The intervention was developed and delivered by a multidisciplinary team with expertise spanning cancer survivorship and nutrition research, pediatric oncology, medical culinary education, oncology dietetics and culinary research and innovation. In addition to Milliron and Jubelirer, Khulood Salman and Jonathan Deutsch, PhD, of Drexel University; Haley Schlecter, Paige Mountain and Gabrielle Longo, of Children's Hospital of Philadelphia contributed to this research.
This pilot study was funded by Wit You Against Childhood Cancer.
Read the full study here: https://journals.sagepub.com/doi/10.1177/15347354261476641
