Cancer is one of the leading causes of death in the pediatric population, although its incidence is lower than in adults. The disease and its treatment often cause changes in metabolism, loss of muscle mass, and an increased risk of malnutrition, so an accurate assessment of energy requirements is crucial. The aim of the study was to assess resting energy expenditure in children with cancer using indirect calorimetry, compare it with predicted values according to the Harris–Benedict equation, monitor changes in muscle mass and resting energy expenditure during treatment, and investigate the relationship between them. We included 14 children with cancer, aged 7 to 18 years, treated at the Pediatric Clinic of the University Medical Center Ljubljana in the study. Resting energy expenditure was measured using a Q-NRG® indirect calorimeter (Cosmed, Italy) at two time points (T0 and T1) over a period of 6 weeks, and body composition was assessed using bioimpedance analysis. The results showed that most children were not overweight (N = 9, 69 %), with no significant change in the proportion of overweight children between time points T0 and T1. The measured resting energy expenditure at T0 was statistically significantly higher than predicted, while at T1 there was no longer any difference. During the six weeks of monitoring, resting energy expenditure and muscle mass did not change significantly, but we confirmed a positive correlation between greater muscle mass and higher resting energy expenditure at T0 (p = 0.003) and at T1 (p < 0,001). We can conclude that the Harris–Benedict equation does not allow for a reliable estimate of resting energy expenditure in children with cancer at the start of treatment. Indirect calorimetry is a more accurate approach, but identifying long-term changes would require a study with longer follow-up and a larger number of children included in the study.
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