Time-Restricted Eating and Prebiotic Supplementation in Young Adult Pediatric Cancer Survivors

Pediatric cancer has historically been a leading cause of child mortality, however, over the past several decades, survival rates have increased from 58% in the 1970’s to a current 5-year survival rate of 85%. Despite long term remission, PCS experience chronic disease at an earlier age than matched controls which may be a result of increased biological aging, or inflammaging, in this population. Anti-cancer treatment may initiate inflammaging promoting systemic inflammation and gut dysbiosis and cardiometabolic disease risk. Dietary behavior may further enhance inflammaging in the years following diagnosis and treatment. This dissertation project explores lifestyle interventions, particularly as it relates to diet, on markers of cardiometabolic disease risk, inflammation and gut microbiome in PCS. First, a systematic review of the literature as it pertains to diet and exercise interventions in PCS and markers of cardiometabolic risk, inflammation and gut microbiome will be presented. Second, the feasibility, and acceptability of TRE with and without a prebiotic supplement in young adult PCS will be examined. Additionally, preliminary effects related to cardiometabolic risk will be explored. Finally, the preliminary effect of TRE with and without a prebiotic related the gut microbiome, metabolites related to the gut microbiome, satiety hormones and inflammatory markers will be examined. This dissertation will provide crucial information on current research centered on lifestyle behavioral interventions in PCS, explore if TRE with and without a prebiotic supplement may provide a novel and accessible easy to implement solution for chronic disease risk reduction in this vulnerable population and provide guidance on future direction for interventions related to diet in PCS.