Associations Between Mukbang Watching and Appetite, Nutrition, and Quality of Life in Pediatric Patients with Cancer: Intensive Longitudinal Study

Background: Malnutrition is prevalent among children with cancer and is often exacerbated by diminished appetite. To combat this, hospitalized children are increasingly adopting mukbang, a popular online eating show genre. Objective: This study aimed to assess the associations between mukbang watching and appetite, nutrition, and quality of life in children with cancer. Methods: From September 2022 to June 2023, an intensive longitudinal study involved 179 children undergoing radiotherapy or chemotherapy at 2 tertiary hospitals in Guangzhou, China. Daily mukbang watching and appetite data were collected for 5 consecutive days. Nutrition and quality of life were assessed pretreatment and posttreatment. Latent class analysis and generalized estimating equation (GEE) models were used. Sensitivity analyses were conducted by stratifying participants based on baseline appetite levels using adjusted GEE models. Results: Among participants, 63.7% (114/179) watched mukbang during hospitalization, forming low (C2), medium (C3), and high (C4) watching classes. The adjusted appetite GEE model indicated a significant interaction effect of time × class in both the medium (β=0.08, 95% CI 0.02-0.13; P=.006) and high classes (β=0.10, 95% CI 0.04-0.17; P=.003). No significant association was observed between mukbang watching and nutritional status over time. A significantly higher quality of life was observed in the medium (β=19.18, 95% CI 7.84-30.53; P=.001) and high (β=13.63, 95% CI 1.15-26.12; P=.03) classes compared to the never class, with significant negative interactions of time × class observed in the low (β=-7.58, 95% CI -14.78 to -0.37; P=.04) and medium classes (β=-14.00, 95% CI -22.06 to -5.94; P=.001). Sensitivity analyses confirmed that appetite maintenance was robust across baseline appetite subgroups. Conclusions: Medium- and high-frequency mukbang watching were associated with better appetite maintenance over time among children undergoing treatment. Medium and high classes showed higher overall quality of life compared to the never class; however, the low and medium classes exhibited greater declines over time. These findings suggest the potential for mukbang in appetite-related symptom management while highlighting the need to address the psychological gap between virtual stimulation and physical reality in future research.