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Exploring food preparation practices in families with and without school-aged childhood cancer survivors

  • Margaret Raber (a1) (a2), Karla Crawford (a1), Tom Baranowski (a3), Shreela V Sharma (a2), Vanessa Schick (a2), Christine Markham (a2), Michael Roth (a1) and Joya Chandra (a1)...



Survival rates for paediatric cancers have increased dramatically since the 1970s, but childhood cancer survivors (CCS) are at increased risk for several chronic diseases throughout life. Nutrition interventions promoting healthy family meals may support wellness for survivors, but little research has explored CCS family food preparation habits. The goal of the present study was to describe and compare food preparation practices of CCS and non-CCS families.




Typical evening meal preparation events were observed and recorded in participant homes. Recordings and notes were analysed using the Healthy Cooking Index (HCI), a measure of nutrition-optimizing food preparation practices relevant to survivor wellness. Demographics, BMI and nutrient composition of prepared meals were also collected.


Forty parents with a CCS or non-CCS child aged 5–17 years were recruited.


There were no major differences between the CCS and non-CCS families with regard to summative HCI score or specific food preparation behaviours. Meals prepared by CCS and non-CCS families had similar nutrient compositions.


The study revealed areas for practical nutrition intervention in CCS and non-CCS families. Future studies should consider adopting and tailoring nutrition intervention methods that have been successful in non-CCS communities.


Corresponding author

*Corresponding author: Email


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1. Miller, KD, Siegel, RL, Lin, CC et al. (2016) Cancer treatment and survivorship statistics, 2016. CA Cancer J Clin 66, 271289.
2. Diller, L, Chow, EJ, Gurney, JG et al. (2009) Chronic disease in the Childhood Cancer Survivor Study cohort: a review of published findings. J Clin Oncol 27, 23392355.
3. Oeffinger, KC, Mertens, AC, Sklar, CA et al. (2003) Obesity in adult survivors of childhood acute lymphoblastic leukemia: a report from the Childhood Cancer Survivor Study. J Clin Oncol 21, 13591365.
4. Barnea, D, Raghunathan, N, Friedman, DN et al. (2015) Obesity and metabolic disease after childhood cancer. Oncology (Williston Park) 29, 849855.
5. Zhang, FF & Parsons, SK (2015) Obesity in childhood cancer survivors: call for early weight management. Adv Nutr 6, 611619.
6. Zhang, FF, Saltzman, E, Kelly, MJ et al. (2015) Comparison of childhood cancer survivors’ nutritional intake with US dietary guidelines. Pediatr Blood Cancer 62, 14611467.
7. Robien, K, Ness, KK, Klesges, LM et al. (2008) Poor adherence to dietary guidelines among adult survivors of childhood acute lymphoblastic leukemia. J Pediatr Hematol Oncol 30, 815822.
8. Cohen, J, Wakefield, CE, Fleming, CA et al. (2012) Dietary intake after treatment in child cancer survivors. Pediatr Blood Cancer 58, 752757.
9. Guenther, PM, Casavale, KO, Reedy, J et al. (2013) Update of the Healthy Eating Index: HEI-2010. J Acad Nutr Diet 113, 569580.
10. Banfield, EC, Liu, Y, Davis, JS et al. (2016) Poor adherence to US dietary guidelines for children and adolescents in the National Health and Nutrition Examination Survey population. J Acad Nutr Diet 116, 2127.
11. Waters, E, de Silva-Sanigorski, A, Burford, BJ et al. (2011) Interventions for preventing obesity in children. Cochrane Database Syst Rev issue 12, CD001871.
12. Cohen, JE, Wakefield, CE & Cohn, RJ (2016) Nutritional interventions for survivors of childhood cancer. Cochrane Database Syst Rev issue 8, CD009678.
13. Aldhafiri, F, Al-Nasser, A, Al-Sugair, A et al. (2012) Obesity and metabolic syndrome in adolescent survivors of standard risk childhood acute lymphoblastic leukemia in Saudi Arabia. Pediatr Blood Cancer 59, 133137.
14. Long, KA & Marsland, AL (2011) Family adjustment to childhood cancer: a systematic review. Clin Child Fam Psychol Rev 14, 5788.
15. Fleming, CA, Cohen, J, Murphy, A et al. (2015) Parent feeding interactions and practices during childhood cancer treatment. A qualitative investigation. Appetite 89, 219225.
16. Cohen, J, Wakefield, CE, Tapsell, LC et al. (2015) Exploring the views of parents regarding dietary habits of their young cancer-surviving children. Support Care Cancer 23, 463471.
17. Cohen, J, Wakefield, CE, Fleming, CA et al. (2012) Dietary intake after treatment in child cancer survivors. Pediatr Blood Cancer 58, 752757.
18. Zhang, FF, Kelly, MJ & Must, A (2017) Early nutrition and physical activity interventions in childhood cancer survivors. Curr Obes Rep 6, 168177.
19. Raber, M, Patterson, M, Jia, W et al. (2018) Utility of eButton images for identifying food preparation behaviors and meal-related tasks in adolescents. Nutr J 17, 32.
20. Sun, M, Fernstrom, JD, Jia, W et al. (2010) A wearable electronic system for objective dietary assessment. J Am Diet Assoc 110, 4547.
21. Raber, M, Chandra, J, Upadhyaya, M et al. (2016) An evidence-based conceptual framework of healthy cooking. Prev Med Rep 4, 2328.
22. Co-Reyes, E, Li, R, Huh, W et al. (2012) Malnutrition and obesity in pediatric oncology patients: causes, consequences, and interventions. Pediat Blood Cancer 59, 11601167.
23. Ogden, CL, Kuczmarski, RJ, Flegal, KM et al. (2002) Centers for Disease Control and Prevention 2000 growth charts for the United States: improvements to the 1977 National Center for Health Statistics version. Pediatrics 109, 4560.
24. US Census Bureau (2016) American fact finder. (accessed July 2018).
25. De Wit, JB, Stok, FM, Smolenski, DJ et al. (2015) Food culture in the home environment: family meal practices and values can support healthy eating and self-regulation in young people in four European countries. Appl Psychol Health Well Being 7, 2240.
26. Hammons, AJ & Fiese, BH (2011) Is frequency of shared family meals related to the nutritional health of children and adolescents? Pediatrics 127, e1565e1574.
27. Hersch, D, Perdue, L, Ambroz, T et al. (2014) The impact of cooking classes on food-related preferences, attitudes, and behaviors of school-aged children: a systematic review of the evidence, 2003–2014. Prev Chronic Dis 11, E193.
28. Reicks, M, Kocher, M & Reeder, J (2017) Impact of cooking and home food preparation interventions among adults: a systematic review (2011–2016). J Nutr Educ Behav 50, 148172.e1.
29. Fulkerson, JA, Friend, S, Horning, M et al. (2018) Family home food environment and nutrition-related parent and child personal and behavioral outcomes of the healthy home offerings via the mealtime environment (HOME) plus program: a randomized controlled trial. J Acad Nutr Diet 118, 240251.
30. Badr, H, Chandra, J, Paxton, RJ et al. (2013) Health-related quality of life, lifestyle behaviors, and intervention preferences of survivors of childhood cancer. J Cancer Surviv 7, 523534.
31. Badr, H, Paxton, RJ, Ater, JL et al. (2011) Health behaviors and weight status of childhood cancer survivors and their parents: similarities and opportunities for joint interventions. J Am Diet Assoc 111, 19171923.
32. Adam, M, Young-Wolff, KC, Konar, E et al. (2015) Massive open online nutrition and cooking course for improved eating behaviors and meal composition. Int J Behav Nutr Phys Act 12, 143.
33. Li, R, Raber, M & Chandra, J (2015) Developing a healthy web-based cookbook for pediatric cancer patients and survivors: rationale and methods. JMIR Res Protoc 4, e37.


Exploring food preparation practices in families with and without school-aged childhood cancer survivors

  • Margaret Raber (a1) (a2), Karla Crawford (a1), Tom Baranowski (a3), Shreela V Sharma (a2), Vanessa Schick (a2), Christine Markham (a2), Michael Roth (a1) and Joya Chandra (a1)...


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