Schoeman, JudyKellerman, Ilde-MariéNdlovu, SandileLadas, Elena J.Rogers, Paul C.Naidu, GitaRowe, BianceDu Plessis, JanHerholdt, MariechenThomas, KarlaVanemmenes, BarryMathews, RemaUys, RonelleBüchner, AnéOmar, Fareed E.Reynders, David T.Kruger, Mariana2025-08-212025-08Schoeman, J., Kellerman, I.-M., Ndlovu, S. et al. 2025, 'Prevalence of chronic and acute malnutrition and association with overall three-year survival in newly diagnosed children with cancer in South Africa', Journal of Human Nutrition and Dietetics, vol. 38, no. 4, art. e70082, art. 10.1111/jhn.70082.0952-3871 (print)1365-277X (online)10.1111/jhn.70082http://hdl.handle.net/2263/103951DATA AVAILABILITY STATEMENT : The data that support the findings of this study are available on request from the corresponding author. The data are not publicly available due to privacy or ethical restrictions.INTRODUCTION : This study investigated the prevalence of malnutrition at childhood cancer diagnosis in South Africa and the association with 1-year post-diagnosis overall survival (OS). METHOD : Nutritional status was prospectively assessed for newly diagnosed children with cancer. Chronic undernutrition was defined as two standard deviations (SDs) or more below zero for height/length-for-age (HAZ), and acute as underweight (weight-for-age [WAZ], and wasted as body mass index for age [BAZ] and mid-upper arm circumference for age [MUAC/A]). The association between the nutritional status at diagnosis and age, sex, disease group and 1-year post-diagnosis OS was analysed with Cox regression and hazard ratios (HRs). RESULTS : Less than 15% were chronically malnourished (stunted: 14.3%) and up to 24.3% acutely undernourished (wasted: 24.3% MUAC-Z and BAZ 8.1%), 11.6% underweight, of 320 patients at cancer diagnosis). More females than males were underweight (12.2% vs. 4.5%; p = 0.027). Children of 5 years of age and older had a higher prevalence of wasting (18.7%) than children under 5 years of age (3.9%) (p < 0.001) at diagnosis, with significant improvement 6 months after diagnosis. Stunting was significantly associated with poorer OS at 3 years after a cancer diagnosis (HR 1.8; 95% CI 1.1, 2.8; p = 0.011). CONCLUSION : MUAC/A identified more children with undernutrition than other nutritional parameters. Stunting was significantly associated with poorer OS 3 years and EFS 2 years after a cancer diagnosis. Optimal nutritional support should be provided for South African children, especially those with acute and chronic malnutrition, to improve OS. SUMMARY Acute malnutrition had a higher prevalence at diagnosis than chronic malnutrition. The prevalence of patients with acute malnutrition decreased during the first 6 months of treatment. Stunting at diagnosis was significantly associated with a worse overall survival 3 years after diagnosis.en© 2025 The British Dietetic Association Ltd. This is the pre-peer reviewed version of the following article : 'Prevalence of chronic and acute malnutrition and association with overall three-year survival in newly diagnosed children with cancer in South Africa', Journal of Human Nutrition and Dietetics, vol. 38, no. 4, art. e70082, art. 10.1111/jhn.70082.. The definite version is available at : https://wileyonlinelibrary.com/journal/jhn.MalnutritionChildhood cancer3-year survivalSouth Africa (SA)Acute malnutritionChronic malnutritionLongitudinal growthNutritional statusOverall survivalPostprint Article