Food as Medicine: How Diet Shapes the Prognosis of Childhood Leukemia?

A doctor performs a routine check-up on a young boy, using a stethoscope to listen to his heartbeat during a medical examination.

When parents or families learn their child has been diagnosed with leukemia, their experience is one of panic, but few realize that changes in nutrition might be beneficial. Most parents focus on treatments, medications, and hospital visits when facing childhood leukemia. But emerging research is showing us something remarkable that the food we eat plays a much bigger role in both preventing and fighting pediatric leukemia than we ever imagined. 

Relationship Between Cancer and Food

Cancer and food are two words you may not expect to have a direct correlation. Beyond the obvious connections like appetite changes during treatment or avoiding processed foods, diet actually helps strengthen the immune system's fight against pediatric leukemia, which makes up nearly 28% of all childhood cancers (Wang et al. 2021). While diet may not seem like an immediate health concern for children, studies indicate that one-third of all cancers are attributed to diet (Wang et al. 2021). In recent years, the incidence of this disease has been constantly increasing, emphasizing the need for further investigations, which have suggested the association between improper nutrition and the progression of tumors. Recent discoveries stress the critical importance of nutrition in the recovery and treatment of pediatric leukemia patients.

What is Pediatric Leukemia? 

In simple terms, pediatric leukemia is a cancer of the blood and bone marrow.  The most common type of pediatric leukemia is acute lymphoblastic leukemia, which accounts for around 75-80% of all cases and the other 15% being acute myeloid leukemia (AML) (Children's Mercy Kansas City, n.d.). Acute lymphoblastic leukemia is a form of blood cancer that causes altered white blood cell function. Acute lymphoblastic leukemia most often originates from mutations in the DNA of bone marrow cells, which progresses rapidly to produce immature blood cells instead of mature ones and continue to cause a plethora of pathologies (Children's Hospital of Philadelphia, n.d.). Numerous studies have shown that the predisposition to acute lymphoblastic leukemia is caused by maternal nutrition and inadequate nutrition treatments. All of these connect back to the foods we choose to eat.

The Maternal Nutrition Factor

While our understanding of the etiology (causes) of pediatric leukemia continues to evolve, research has revealed that certain cancers can develop within the embryo or womb. One example is B-cell acute lymphoblastic leukemia, in which pre-cancerous embryonic cells previously exist and survive based on their ability to catalyze the formation of tumors (Wang et al. 2021). Pre-cancerous cells can form during pregnancy and then lie dormant, waiting for the right conditions to become active. During this time, even minimal changes in maternal diet have been found to have effects that are carried by the fetus till adulthood. This discovery further stresses the necessity of maternal health and fetus development in relation to disease predisposition. 

Recent dietary associations with cancer risks have further defined the link between diet and disease. For example, a study on the Han Chinese population showed that a diet rich in bean curds and vegetables lowers risk, while cured meat often led to increased risk (Wang et al. 2021). A similar nationwide cohort study in Greece analyzed broader factors of maternal diet, such as fruits, vegetables, fish, seafood, and sugars and syrups, in the mothers of acute lymphoblastic leukemia patients (aged 59 months to 12 years) (Petridou et al. 2005). These reports found a higher risk of acute lymphoblastic leukemia for the children of mothers whose diets consisted of an increased intake of sugars, syrups, and meat/meat products. Conversely, a diet of vegetables, fruits, legumes, and seafood could lower the risk of acute lymphoblastic leukemia in youth. Perhaps, most surprisingly, this protective effect extends a year prior to the pregnancy, suggesting an overall healthy diet before and during pregnancy can significantly lower the risk of acute lymphoblastic leukemia in offspring. This means that women who maintain healthy eating habits even a year before are giving their children better protection against leukemia.

A vibrant array of fresh vegetables, herbs, and ingredients ready for a healthy meal prep, featuring colorful bell peppers, radishes, avocado, mozzarella balls, and a bowl of rice.

Nutritional Interventions During Treatment

Once a child develops leukemia, nutrition interventions become even more critical and simultaneously challenging. Chemotherapy treatments for acute lymphoblastic leukemia patients typically impact body composition and the patient’s nutritional status, making nutrition even more important for recovery. 

Children with poor nutrition face a greater likelihood of unfavorable outcomes. Nutritional deficiencies, often linked to socio-economic challenges, may increase susceptibility to disease and lower survival rates in pediatric cancer rates. A common immunity issue they face is malnutrition, which increases a child’s susceptibility to infections and also lowers a child’s chances of survival (Guzmán-León et al. 2024). On the other hand, obesity and spikes in weight can negatively impact BMI and drug response (Wang et al. 2021). This challenge is multiplied by the medication side effects of chemotherapy which can cause decreased oral food intake increasing the risk of malnutrition. Navigating the complexity of nutritional requirements in pediatric patients is difficult, which emphasizes the need for nutrition interventions to prevent malnutrition complications. Fortunately, research provides guidance on effective approaches.

New research shows that specific nutritional interventions can make a difference. Researchers reviewed twenty-five controlled trials and found that specific nutrient interventions can drastically improve treatment outcomes through decreased recovery times, increased hemoglobin levels, and improved hospitalization days (Guzmán-León et al. 2024). Their reports have shown that consumption of different compounds have their own unique benefits.  Some of these compounds include zinc and vitamin A, as well as vitamin E, which reduce the incidence of mucositis (inflammation of the mucous membranes). Glutamine significantly reduced the number of killer cells and reduced edema (swelling), while reducing hospital stays by 3.44 days (Guzmán-León et al. 2024). Even compounds as simple as honey, have shown significant improvement in hemoglobin levels, fewer febrile neutropenia episodes (fever episodes), and reduced recovery times (Guzmán-León et al. 2024). 

The research consistently shows that maintaining nutritional status during treatment not only helps children feel better but drastically improves immune function and reduces tumor growth. Due to the growing benefits, healthcare providers increasingly recognize that incorporating proper nutrition monitoring and creating tailored meal plans are essential components of cancer care (Barr & Stevens 2020). 

Conclusion

The awareness of the relationship between diet and pediatric leukemia represents a shift in how we approach pediatric cancer. Rather than viewing nutrition as merely supportive care, evidence increasingly positions it as a powerful tool for treatment enhancement and prognosis improvement. Current pediatric treatment protocols yield cure rates approaching 90%, but the focus is now shifting towards not just survival, but also reduced long-term complications (Murphy-Alford et al. 2020).

As research continues to reveal the complex mechanisms linking diet and cancer, we’re moving towards personalized nutrition interventions and improvements in maternal diet that may become standard components of leukemia care. The development of these nutritional guidelines is an urgent priority for pediatric oncology patients with researchers calling for more controlled trials that measure clinically valuable outcomes (Guzmán-León et al. 2024).  

For expecting mothers, this means embracing a diet rich in vegetables, fruits, legumes, and seafood while limiting processed meats and added sugars. For families navigating a leukemia diagnosis, it means working closely with healthcare teams to develop nutrition plans that support treatment and recovery.

The relationship between food and childhood leukemia represents more than just scientific discovery, it represents hope. In a situation where parents often feel helpless, nutrition offers something tangible they can control. The simple act of choosing what to put in our plates or what to feed our children is one of the most powerful tools against this disease, marking nutrition a major cornerstone of pediatric cancer care. 

Written by Hafsa Aslam and edited by Aldrin V. Gomes, PhD

References

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