Sensitive measures of the nutritional status of children with cancer in hospital and in the field

Sensitive measures of nutritional status exist. Initial assessment must inc lude some measure that: is independent of tumour mass, particularly in chil dren with large solid tumours. Arm anthropometry, including triceps and bic eps skinfold thickness (SFT), and mid-upper-arm circumference (MUAC) are id eal in this situation, but MUAC is probably the simplest measure to use. In the clinical setting, a direct measure of fat-free body mass (FFBM) does n ot exist, but bio-electrical impedance (BIA) measures FFBM indirectly, and has many advantages, in particular its ease of use and immediate results. T he BIA analyzer is portable and hence can be used in the field as well as b y the bedside. Serum proteins and insulin-like growth factors are insuffici ently sensitive as nutritional indices and have only a minor role in nutrit ional assessment. (C) 1998 Wiley-Liss, Inc.