Clinical and Laboratory ObservationsLow Levels of Energy Expenditure in Childhood Cancer Survivors Implications for Obesity PreventionZhang, Fang Fang MD, PhD*†; Roberts, Susan B. PhD‡; Parsons, Susan K. MD, MRP§∥¶; Must, Aviva PhD#; Kelly, Michael J. MD¶**; Wong, William W. PhD††; Saltzman, Edward MD‡Author Information *Department of Nutrition Sciences, Friedman School of Nutrition Science and Policy †Nutritional Epidemiology Program ‡Energy Metabolism Laboratory, Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University §Institute for Clinical Research and Health Policy Studies **Division of Pediatric Hematology Oncology, The Floating Hospital for Children, Tufts Medical Center Departments of ∥Medicine ¶Pediatrics #Public Health and Community Medicine, Tufts University School of Medicine, Boston, MA ††Baylor College of Medicine, USDA/ARS Children’s Nutrition Research Center, Houston, TX All phases of this study were supported by the Boston Nutrition Obesity Research Center Grant Number P30DK46200, the National Center for Research Resources Grant Number UL1 RR025752, the National Center for Advancing Translational Sciences, and the National Institutes of Health Grant Number UL1 TR000073. The authors declare no conflict of interest. Reprints: Fang Fang Zhang, MD, PhD, Department of Nutrition Science, Friedman School of Nutrition Science and Policy, Tufts University, 150 Harrison Ave, Boston, MA 20111 (e-mail: [email protected]). Received February 4, 2014 Accepted August 1, 2014 Journal of Pediatric Hematology/Oncology: April 2015 - Volume 37 - Issue 3 - p 232-236 doi: 10.1097/MPH.0000000000000250 Buy Metrics Abstract Childhood cancer survivors are at an increased risk of obesity but causes for this elevated risk are uncertain. We evaluated total energy expenditure in childhood cancer survivors using the doubly labeled water method in a cross-sectional study of 17 survivors of pediatric leukemia or lymphoma (median age, 11.5 y). Mean total energy expenditure was 2073 kcal/d, which was nearly 500 kcal/d lower than estimated energy requirements with recommended levels of physical activity. This energy gap is likely to contribute to the risk of obesity in this population and future trials are needed to assess implications and potential treatment strategies. Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved.