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Flores-García MK, Flores-Collado G, Mérida-Ortega Á, Ugalde-Resano R, González-Rocha A, Denova-Gutiérrez E, Muñoz-Aguirre P, Zapata-Tarrés M, López-Carrillo L. Maternal and infant diet play a role in acute leukemia development: An expanded systematic review and meta-analysis. Clin Nutr ESPEN 2025; 66:515-522. [PMID: 40023373 DOI: 10.1016/j.clnesp.2025.02.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2024] [Revised: 02/02/2025] [Accepted: 02/25/2025] [Indexed: 03/04/2025]
Abstract
BACKGROUND The most common subtypes of acute leukemia (AL) are acute lymphoid leukemia (ALL), and acute myeloid leukemia (AML). Among those less than 15 years old, ALL is the most common subtype. It has recently been proposed that diet may play an important role in the development of AL. This review expands on the existing systematic reviews and meta-analyses published on infant and maternal diet in relation to AL. METHODS An electronic search was carried out in four databases (Pubmed/Medline Lilacs, Scopus and Web of Science), through April 2022. Observational epidemiological studies that reported the association between AL (ALL and/or AML) and the food consumed by children (<18 years), their mother or both were included. Fixed effects models were used for meta-analysis and heterogeneity between studies was assessed using the Q statistic test and I2 estimation. The risk of bias was assessed using the Newcastle-Ottawa scale. RESULTS A total of 15 studies were included (1 cohort and 14 case-control), of which 9 exclusively evaluated the maternal diet, 4 child diet, and 2 that evaluated both. Our results showed that children's consumption of processed meat was positively associated with AL (OR = 1.72; 95 % CI 1.08, 2.72), whereas the consumption of vegetables was found to be inversely associated with AL (OR = 0.61; 95 % CI % 0.39, 0.92). Furthermore, maternal fruit consumption was inversely associated with ALL (OR = 0.71; 95 % CI 0.59-0.83), while coffee consumption was positively associated with AL (OR = 1.20; 95 % CI 1.00, 1.44) and ALL (OR = 1.31; 95 % CI: 1.10, 1.56). CONCLUSIONS Our results support that maternal and early infant diet play a role in the development of AL.
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Affiliation(s)
- M Karen Flores-García
- Centro de Investigación en Salud Poblacional, Instituto Nacional de Salud Pública (INSP), Cuernavaca, Morelos, Mexico
| | - Gisela Flores-Collado
- Centro de Investigación en Salud Poblacional, Instituto Nacional de Salud Pública (INSP), Cuernavaca, Morelos, Mexico
| | - Ángel Mérida-Ortega
- Centro de Investigación en Salud Poblacional, Instituto Nacional de Salud Pública (INSP), Cuernavaca, Morelos, Mexico
| | - Rodrigo Ugalde-Resano
- Centro de Investigación en Salud Poblacional, Instituto Nacional de Salud Pública (INSP), Cuernavaca, Morelos, Mexico
| | - Alejandra González-Rocha
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública (INSP), Mexico City, Mexico
| | - Edgar Denova-Gutiérrez
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública (INSP), Mexico City, Mexico
| | - Paloma Muñoz-Aguirre
- Centro de Investigación en Salud Poblacional, Instituto Nacional de Salud Pública (INSP), Cuernavaca, Morelos, Mexico
| | | | - Lizbeth López-Carrillo
- Centro de Investigación en Salud Poblacional, Instituto Nacional de Salud Pública (INSP), Cuernavaca, Morelos, Mexico.
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Onyije FM, Dolatkhah R, Olsson A, Bouaoun L, Deltour I, Erdmann F, Bonaventure A, Scheurer ME, Clavel J, Schüz J. Risk factors for childhood brain tumours: A systematic review and meta-analysis of observational studies from 1976 to 2022. Cancer Epidemiol 2024; 88:102510. [PMID: 38056243 PMCID: PMC10835339 DOI: 10.1016/j.canep.2023.102510] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Revised: 11/24/2023] [Accepted: 11/27/2023] [Indexed: 12/08/2023]
Abstract
BACKGROUND Childhood brain tumours (CBTs) are the leading cause of cancer death in children under the age of 20 years globally. Though the aetiology of CBT remains poorly understood, it is thought to be multifactorial. We aimed to synthesize potential risk factors for CBT to inform primary prevention. METHODS We conducted a systematic review and meta-analysis of epidemiological studies indexed in the PubMed, Web of Science, and Embase databases from the start of those resources through 27 July 2023. We included data from case-control or cohort studies that reported effect estimates for each risk factor around the time of conception, during pregnancy and/or during post-natal period. Random effects meta-analysis was used to estimate summary effect sizes (ES) and 95% confidence intervals (CIs). We also quantified heterogeneity (I2) across studies. FINDINGS A total of 4040 studies were identified, of which 181 studies (85 case-control and 96 cohort studies) met our criteria for inclusion. Of all eligible studies, 50% (n = 91) were conducted in Europe, 32% (n = 57) in North America, 9% (n = 16) in Australia, 8% (n = 15) in Asia, 1% (n = 2) in South America, and none in Africa. We found associations for some modifiable risk factors including childhood domestic exposures to insecticides (ES 1.44, 95% CI 1.20-1.73) and herbicides (ES 2.38, 95% CI 1.31-4.33). Maternal domestic exposure to insecticides (ES 1.45, 95% CI 1.09-1.94), maternal consumption of cured meat (ES 1.51, 95% CI 1.05-2.17) and coffee ≥ 2 cups/day (ES 1.45, 95% 95% CI 1.07-1.95) during pregnancy, and maternal exposure to benzene (ES 2.22; 95% CI 1.01-4.88) before conception were associated with CBTs in case-control studies. Also, paternal occupational exposure to pesticides (ES 1.48, 95% CI 1.23-1.77) and benzene (ES 1.74, 95% CI 1.10-2.76) before conception and during pregnancy were associated in case-control studies and in combined analysis. On the other hand, assisted reproductive technology (ART) (ES 1.32, 95% CI 1.05-1.67), caesarean section (CS) (ES 1.12, 95% CI 1.01-1.25), paternal occupational exposure to paint before conception (ES 1.56, 95% CI 1.02-2.40) and maternal smoking > 10 cigarettes per day during pregnancy (ES 1.18, 95% CI 1.00-1.40) were associated with CBT in cohort studies. Maternal intake of vitamins and folic acid during pregnancy was inversely associated in cohort studies. Hormonal/infertility treatment, breastfeeding, child day-care attendance, maternal exposure to electric heated waterbed, tea and alcohol consumption during pregnancy were among those not associated with CBT in both case-control and cohort studies. CONCLUSION Our results should be interpreted with caution, especially as most associations between risk factors and CBT were discordant between cohort and case-control studies. At present, it is premature for any CBT to define specific primary prevention guidelines.
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Affiliation(s)
- Felix M Onyije
- Environment and Lifestyle Epidemiology Branch, International Agency for Research on Cancer (IARC/WHO), 25 avenue Tony Garnier, CS 90627, 69366 LYON CEDEX 07, France.
| | - Roya Dolatkhah
- Environment and Lifestyle Epidemiology Branch, International Agency for Research on Cancer (IARC/WHO), 25 avenue Tony Garnier, CS 90627, 69366 LYON CEDEX 07, France
| | - Ann Olsson
- Environment and Lifestyle Epidemiology Branch, International Agency for Research on Cancer (IARC/WHO), 25 avenue Tony Garnier, CS 90627, 69366 LYON CEDEX 07, France
| | - Liacine Bouaoun
- Environment and Lifestyle Epidemiology Branch, International Agency for Research on Cancer (IARC/WHO), 25 avenue Tony Garnier, CS 90627, 69366 LYON CEDEX 07, France
| | - Isabelle Deltour
- Environment and Lifestyle Epidemiology Branch, International Agency for Research on Cancer (IARC/WHO), 25 avenue Tony Garnier, CS 90627, 69366 LYON CEDEX 07, France
| | - Friederike Erdmann
- Research Group Aetiology and Inequalities in Childhood Cancer, Division of Childhood Cancer Epidemiology Institute of Medical Biostatistics, Epidemiology, and Informatics (IMBEI), University Medical Center Mainz, Langenbeckstraβe 1, 55131 Mainz, Germany
| | - Audrey Bonaventure
- Epidemiology of Childhood and Adolescent Cancers Team, Université Paris Cité and Université Sorbonne Paris Nord, Inserm, INRAE, Center for Research in Epidemiology and StatisticS (CRESS), Villejuif, France
| | - Michael E Scheurer
- Department of Pediatrics, Hematology-Oncology, Baylor College of Medicine and Texas Children's Hospital Cancer Center, Houston, TX, United States
| | - Jacqueline Clavel
- Epidemiology of Childhood and Adolescent Cancers Team, Université Paris Cité and Université Sorbonne Paris Nord, Inserm, INRAE, Center for Research in Epidemiology and StatisticS (CRESS), Villejuif, France; National Registry of Childhood Cancers, Hôpital Paul Brousse, Groupe Hospitalier Universitaire Paris-Sud, Assistance Publique Hôpitaux de Paris (AP-HP), Villejuif, France; Centre Hospitalier Régional Universitaire de Nancy, Vandoeuvre-lès-Nancy, France
| | - Joachim Schüz
- Environment and Lifestyle Epidemiology Branch, International Agency for Research on Cancer (IARC/WHO), 25 avenue Tony Garnier, CS 90627, 69366 LYON CEDEX 07, France
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Pérez-Saldivar ML, Flores-García MK, Núñez-Villegas N, Fajardo-Gutiérrez A, Medina-Sanson A, Jiménez-Hernández E, Martín-Trejo JA, López-Santiago N, Peñaloza-González JG, Cortés-Herrera B, Merino-Pasaye LE, Amador-Sánchez R, García-López LR, Pérez-Lorenzana H, Román-Zepeda PF, Castañeda-Echevarría A, López-Caballero MG, Martínez-Silva SI, Rivera-González J, Granados-Kraulles J, Flores-Botello J, Medrano-López F, Rodríguez-Vázquez MA, Torres-Valle D, Mora-Rico K, Mora-Ríos FG, R.García‐Cortés L, Salcedo-Lozada P, Flores-Lujano J, Núñez-Enríquez JC, Bekker-Méndez VC, Mata-Rocha M, Rosas-Vargas H, Duarte-Rodríguez DA, Jiménez-Morales S, Hidalgo-Miranda A, López-Carrillo L, Mejía-Aranguré JM. Maternal diet in pregnancy and acute leukemia in infants: a case-control study in Mexico City. Front Oncol 2024; 13:1165323. [PMID: 38260836 PMCID: PMC10802844 DOI: 10.3389/fonc.2023.1165323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Accepted: 12/08/2023] [Indexed: 01/24/2024] Open
Abstract
Introduction Epidemiological studies around the world on acute leukemia (AL) and risk factors in infants are scarce. Infant AL has been proposed to originate in utero, which facilitates its study by establishing a short exposure time in pregnant women to environmental and dietary factors that could contribute to the risk of or protection against leukemia. We hypothesized that maternal diet during pregnancy may be an important factor involved in AL in offspring. Methods We conducted a hospital-based case-control study from 2010 to 2019 on maternal diet during pregnancy in nine high-specialty public hospitals of different health institutions that diagnose and offer treatment to children with AL in Mexico City. Cases (n=109) were children ≤24 months of age with de novo diagnosis of AL, and controls (n=252) were children obtained in hospitals from second-level medical care matched for age, sex, and health institution. Maternal diet during pregnancy was obtained by a semiquantitative food frequency questionnaire. Unconditional logistic regression models were used to assess the association between food groups and infant AL. Potential confounders were assessed by constructing directed acyclic graphs (DAGs) with Dagitty software in which adjusted options were identified for the construction of unconditional logistic regression models. Results Cases were slightly predominantly female (52.3%). The years of education of the mother in cases and controls was 0-9 on average, and those who reported smoking cigarettes and consuming alcohol during pregnancy did so at a low frequency. Regarding the mother's diet, the main findings were that the consumption of allium vegetables during pregnancy was inversely associated with AL for medium and high consumption (OR=0.26, 95% CI 0.14-0.46; P-trend< 0.001). In contrast, the high consumption of high-fat dairy products had a positive association with AL (OR=2.37, 95% CI 1.30-4.34; P-trend<0.001). No association was found between consumption of topoisomerase II inhibitor foods during pregnancy and AL. Conclusion The results suggest that maternal intake during pregnancy of allium vegetables, specifically garlic, is inversely associated with the development of AL in children ≤24 months old. On the other hand, consumption of high-fat dairy products is positively associated with AL in children ≤24 months old.
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Affiliation(s)
- María Luisa Pérez-Saldivar
- Unidad de Investigación Médica en Epidemiología Clínica, Unidad Médica de Alta Especialidad (Unidad Médica de Alta Especialidad (UMAE)) Hospital de Pediatría, Centro Médico Nacional (Centro Médico Nacional (CMN)) Siglo XXI, Instituto Mexicano del Seguro Social (Instituto Mexicano del Seguro Social (IMSS)), Mexico City, Mexico
| | | | - Nancy Núñez-Villegas
- Servicio de Hematología Pediátrica, Hospital General “Gaudencio González Garza”, Centro Médico Nacional (CMN) “La Raza”, Instituto Mexicano del Seguro Social (IMSS), Mexico City, Mexico
| | - Arturo Fajardo-Gutiérrez
- Unidad de Investigación Médica en Epidemiología Clínica, Unidad Médica de Alta Especialidad (Unidad Médica de Alta Especialidad (UMAE)) Hospital de Pediatría, Centro Médico Nacional (Centro Médico Nacional (CMN)) Siglo XXI, Instituto Mexicano del Seguro Social (Instituto Mexicano del Seguro Social (IMSS)), Mexico City, Mexico
| | - Aurora Medina-Sanson
- Departamento de Hemato-Oncología, Hospital Infantil de México Federico Gómez, Secretaria de Salud (Secretaría de Salud (SSA)), Mexico City, Mexico
| | - Elva Jiménez-Hernández
- Servicio de Oncología, Hospital Pediátrico Moctezuma, Secretaría de Salud de la Ciudad de México (Secretaría de Salud de la Ciudad de México (SSCDMX)), Mexico City, Mexico
| | - Jorge Alfonso Martín-Trejo
- Servicio de Hematología, Unidad Médica de Alta Especialidad (UMAE) Hospital de Pediatría, Centro Médico Nacional (CMN) “Siglo XXI”, Instituto Mexicano del Seguro Social (IMSS), Mexico City, Mexico
| | - Norma López-Santiago
- Servicio de Hematología, Instituto Nacional de Pediatría (INP), Secretaría de Salud (SSA), Mexico City, Mexico
| | | | - Beatriz Cortés-Herrera
- Servicio de Hematología Pediátrica, Hospital General de México, Secretaría de Salud (SSA), Mexico City, Mexico
| | - Laura Elizabeth Merino-Pasaye
- Servicio de Hematología Pediátrica, Centro Médico Nacional (CMN)”20 de Noviembre”, Instituto de Seguridad Social al Servicio de los Trabajadores del Estado (Instituto de Seguridad Social al Servicio de los Trabajadores del Estado (ISSSTE)), Mexico City, Mexico
| | - Raquel Amador-Sánchez
- Servicio de Hematología Pediátrica, HGR No. 1 “Dr. Carlos Mac Gregor Sánchez Navarro” Instituto Mexicano del Seguro Social (IMSS), Mexico City, Mexico
| | - Luis Ramiro García-López
- Servicio de Pediatría, Hospital Pediátrico de Tacubaya, Secretaría de Salud de la Ciudad de México (SSCDMX), Mexico City, Mexico
| | - Héctor Pérez-Lorenzana
- Servicio de Cirugía Pediátrica, Hospital General “Gaudencio González Garza”, Centro Médico Nacional (CMN) “La Raza”, Instituto Mexicano del Seguro Social (IMSS), Mexico City, Mexico
| | - Pedro Francisco Román-Zepeda
- Servicio de Cirugía Pediátrica, Hospital General Regional (HGR) No. 1 “Dr. Carlos Mac Gregor Sánchez Navarro” Instituto Mexicano del Seguro Social (IMSS), Mexico City, Mexico
| | - Alejandro Castañeda-Echevarría
- Servicio de Pediatría, Hospital General de Zona Regional (HGZR) No. 25 Instituto Mexicano del Seguro Social (IMSS), Mexico City, Mexico
| | - María Guadalupe López-Caballero
- Coordinación Clínica y Pediatría, Hospital Pediátrico de Coyoacán, Secretaría de Salud de la Ciudad de México (SSCDMX), Mexico City, Mexico
| | - Sofía Irene Martínez-Silva
- Hospital Pediátrico de Iztapalapa, Secretaría de Salud de la Ciudad de México (SSCDMX), Mexico City, Mexico
| | - Juan Rivera-González
- Hospital General Dr. “Gustavo Baz Prada”, Instituto de Salud del Estado de México (ISEM), Estado de México, Mexico
| | - Jorge Granados-Kraulles
- Coordinación Clínica y Pediatría del Hospital General de Zona 76 Instituto Mexicano del Seguro Social (IMSS), Estado de México, Mexico
| | - Jesús Flores-Botello
- Coordinación Clínica y Pediatría, Hospital General “La Perla” ISEM, Estado de México, Mexico
| | - Francisco Medrano-López
- Coordinación Clínica y Pediatría, HGR No. 72 “Dr. Vicente Santos Guajardo”, Instituto Mexicano del Seguro Social (IMSS), Estado de México, Mexico
| | - María Adriana Rodríguez-Vázquez
- Coordinación Clínica y Pediatría del Hospital General de Zona 68, Instituto Mexicano del Seguro Social (IMSS), Estado de México, Mexico
| | - Delfino Torres-Valle
- Coordinación Clínica y Pediatría del Hospital General de Zona 71, Instituto Mexicano del Seguro Social (IMSS), Estado de México, Mexico
| | - Karina Mora-Rico
- Servicio de Cirugía Pediátrica, HGR 1° Octubre, Instituto de Seguridad Social al Servicio de los Trabajadores del Estado (ISSSTE), Mexico City, Mexico
| | - Félix G. Mora-Ríos
- Cirugía Pediátrica del Hospital Regional “General Ignacio Zaragoza”, Instituto de Seguridad Social al Servicio de los Trabajadores del Estado (ISSSTE), Mexico City, Mexico
| | - Luis R.García‐Cortés
- Delegación Regional Estado de México Oriente, Instituto Mexicano del Seguro Social (IMSS), Estado de México, Mexico
| | | | - Janet Flores-Lujano
- Unidad de Investigación Médica en Epidemiología Clínica, Unidad Médica de Alta Especialidad (Unidad Médica de Alta Especialidad (UMAE)) Hospital de Pediatría, Centro Médico Nacional (Centro Médico Nacional (CMN)) Siglo XXI, Instituto Mexicano del Seguro Social (Instituto Mexicano del Seguro Social (IMSS)), Mexico City, Mexico
| | - Juan Carlos Núñez-Enríquez
- Unidad de Investigación Médica en Epidemiología Clínica, Unidad Médica de Alta Especialidad (Unidad Médica de Alta Especialidad (UMAE)) Hospital de Pediatría, Centro Médico Nacional (Centro Médico Nacional (CMN)) Siglo XXI, Instituto Mexicano del Seguro Social (Instituto Mexicano del Seguro Social (IMSS)), Mexico City, Mexico
| | - Vilma Carolina Bekker-Méndez
- Unidad de Investigación Médica en Inmunología e Infectología, Hospital de Infectología “Dr. Daniel Méndez Hernández”, Centro Médico Nacional (CMN) “La Raza”, Instituto Mexicano del Seguro Social (IMSS), Mexico City, Mexico
| | - Minerva Mata-Rocha
- Laboratorio de Biología Molecular de las Leucemias, Unidad de Investigación en Genética Humana, Unidad Médica de Alta Especialidad (UMAE), Hospital de Pediatría, Centro Médico Nacional (CMN) “Siglo XXI”, Instituto Mexicano del Seguro Social (IMSS), Mexico City, Mexico
| | - Haydeé Rosas-Vargas
- Laboratorio de Genética, Unidad Médica de Alta Especialidad (Unidad Médica de Alta Especialidad (UMAE)) Hospital de Pediatría, Centro Médico Nacional (Centro Médico Nacional (CMN)) Siglo XXI, Instituto Mexicano del Seguro Social (IMSS), Mexico City, Mexico
| | - David Aldebarán Duarte-Rodríguez
- Unidad de Investigación Médica en Epidemiología Clínica, Unidad Médica de Alta Especialidad (Unidad Médica de Alta Especialidad (UMAE)) Hospital de Pediatría, Centro Médico Nacional (Centro Médico Nacional (CMN)) Siglo XXI, Instituto Mexicano del Seguro Social (Instituto Mexicano del Seguro Social (IMSS)), Mexico City, Mexico
| | - Silvia Jiménez-Morales
- Laboratorio de Innovación y Medicina de Precisión, Núcleo A. Instituto Nacional de Medicina Genómica (INMEGEN), Mexico City, Mexico
| | - Alfredo Hidalgo-Miranda
- Laboratorio de Innovación y Medicina de Precisión, Núcleo A. Instituto Nacional de Medicina Genómica (INMEGEN), Mexico City, Mexico
| | | | - Juan Manuel Mejía-Aranguré
- Facultad de Medicina, Universidad Nacional Autónoma de México (UNAM), Mexico City, Mexico
- Laboratorio Genómica Funcional del Cáncer, Instituto Nacional de Medicina Genómica (INMEGEN), Mexico City, Mexico
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Kintossou AK, Blanco-Lopez J, Iguacel I, Pisanu S, Almeida CCB, Steliarova-Foucher E, Sierens C, Gunter MJ, Ladas EJ, Barr RD, Van Herck K, Kozlakidis Z, Huybrechts I. Early Life Nutrition Factors and Risk of Acute Leukemia in Children: Systematic Review and Meta-Analysis. Nutrients 2023; 15:3775. [PMID: 37686807 PMCID: PMC10489830 DOI: 10.3390/nu15173775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Revised: 08/15/2023] [Accepted: 08/24/2023] [Indexed: 09/10/2023] Open
Abstract
Acute leukemia commonly occurs in young children with peak incidence at the age of 2-5 years. However, the etiology is still unclear and many preventable risk factors still deserve to be reviewed. The focus of this systematic review and meta-analysis is to summarize the evidence concerning early life nourishment (breastfeeding, early life diet), neonatal vitamin K administration and the risk of acute leukemia. All epidemiological studies published up to June 2023 and assessing diet-related risk factors for childhood acute leukemia were identified in two electronic databases (PubMed and Web of Science), with no limits on publication year or language. A total of 38 studies (37 case-control studies and 1 study with pooled analysis) were included. The published risk estimates were combined into a meta-analysis using the Generic Inverse Variance method. The current evidence shows that breastfeeding (yes vs. no) has a protective effect against acute lymphoblastic leukemia (odds ratio = 0.85; 95% CI, 0.76-0.94). Evidence related to the role of other studied factors (foods and supplements) is inconclusive. Further research into the potential role of diet in early life and the risk of acute leukemia is needed to develop prevention strategies at population level. Review Registration: PROSPERO registration no. CRD42019128937.
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Affiliation(s)
- Ambroise Kouame Kintossou
- International Agency for Research on Cancer, 69007 Lyon, France; (A.K.K.); (E.S.-F.); (Z.K.); (I.H.)
- Biobank, Pasteur Institute of Côte d’Ivoire, Abidjan 01 BP 490, Côte d’Ivoire
| | - Jessica Blanco-Lopez
- International Agency for Research on Cancer, 69007 Lyon, France; (A.K.K.); (E.S.-F.); (Z.K.); (I.H.)
| | - Isabel Iguacel
- Faculty of Health Sciences, University of Zaragoza, 50009 Zaragoza, Spain;
| | - Silvia Pisanu
- Section of Microbiology and Virology, Department of Biomedical Sciences, University of Cagliari, 09124 Cagliari, Italy;
| | | | - Eva Steliarova-Foucher
- International Agency for Research on Cancer, 69007 Lyon, France; (A.K.K.); (E.S.-F.); (Z.K.); (I.H.)
| | - Ciska Sierens
- Department of Public Health and Primary Care, Ghent University, 9000 Ghent, Belgium; (C.S.); (K.V.H.)
| | - Marc J. Gunter
- Faculty of Medicine, School of Public Health, Imperial College London, London SW7 2AZ, UK;
| | - Elena J. Ladas
- Division of Hematology, Oncology and Stem Cell Transplantation, Department of Pediatrics, Columbia University Irving Medical Center, New York, NY 10032, USA;
| | - Ronald D. Barr
- Departments of Pediatrics, Pathology and Medicine, McMaster University, Hamilton, ON L8S 4L7, Canada;
| | - Koen Van Herck
- Department of Public Health and Primary Care, Ghent University, 9000 Ghent, Belgium; (C.S.); (K.V.H.)
| | - Zisis Kozlakidis
- International Agency for Research on Cancer, 69007 Lyon, France; (A.K.K.); (E.S.-F.); (Z.K.); (I.H.)
| | - Inge Huybrechts
- International Agency for Research on Cancer, 69007 Lyon, France; (A.K.K.); (E.S.-F.); (Z.K.); (I.H.)
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Blanco-Lopez J, Iguacel I, Pisanu S, Almeida CCB, Steliarova-Foucher E, Sierens C, Gunter MJ, Ladas EJ, Barr RD, Van Herck K, Huybrechts I. Role of Maternal Diet in the Risk of Childhood Acute Leukemia: A Systematic Review and Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:5428. [PMID: 37048042 PMCID: PMC10093835 DOI: 10.3390/ijerph20075428] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Revised: 03/23/2023] [Accepted: 04/05/2023] [Indexed: 06/19/2023]
Abstract
Many studies have investigated the etiology of acute leukemia, one of the most common types of cancer in children; however, there is a lack of clarity regarding preventable risk factors. This systematic review and meta-analysis aimed to summarize the current evidence regarding the role of maternal dietary factors in the development of childhood leukemia. All epidemiological studies published until July 2022 that evaluated maternal dietary risk factors for childhood acute leukemia were identified in two electronic databases (PubMed and Web of Science) without limits of publication year or language. A total of 38 studies (1 prospective cohort study, 34 case-control studies and 3 studies with pooled analysis) were included. The published risk estimates were combined into a meta-analysis, using the Generic Inverse Variance method. The maternal consumption of fruits (two or more daily servings vs. less) was inversely associated with acute lymphoblastic leukemia (odds ratio = 0.71; 95% CI, 0.59-0.86), whereas maternal coffee intake (higher than two cups per day vs. no consumption) was associated with an increased risk of acute lymphoblastic leukemia (odds ratio = 1.45; 95% CI, 1.12-1.89). Despite these findings, more high-quality research from cohort studies and the identification of causal factors are needed to develop evidence-based and cost-effective prevention strategies applicable at the population level. Review Registration: PROSPERO registration no. CRD42019128937.
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Affiliation(s)
| | - Isabel Iguacel
- Faculty of Health Sciences, University of Zaragoza, 50009 Zaragoza, Spain
| | - Silvia Pisanu
- Department of Biomedical Sciences, Section of Microbiology and Virology, University of Cagliari, 09124 Cagliari, Italy
| | | | | | - Ciska Sierens
- Department of Public Health and Primary Care, Ghent University, 9000 Ghent, Belgium
| | - Marc J Gunter
- Faculty of Medicine, School of Public Health, Imperial College London, London SW7 2AZ, UK
| | - Elena J Ladas
- Division of Hematology, Oncology, and Stem Cell Transplantation, Department of Pediatrics, Columbia University Irving Medical Center, New York, NY 10032, USA
| | - Ronald D Barr
- Departments of Pediatrics, Pathology and Medicine, McMaster University, Hamilton, ON L8S 4L7, Canada
| | - Koen Van Herck
- Department of Public Health and Primary Care, Ghent University, 9000 Ghent, Belgium
| | - Inge Huybrechts
- International Agency for Research on Cancer, 69007 Lyon, France
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Andrade MA, Barbosa CH, Shah MA, Ahmad N, Vilarinho F, Khwaldia K, Silva AS, Ramos F. Citrus By-Products: Valuable Source of Bioactive Compounds for Food Applications. Antioxidants (Basel) 2022; 12:antiox12010038. [PMID: 36670900 PMCID: PMC9855225 DOI: 10.3390/antiox12010038] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2022] [Revised: 12/14/2022] [Accepted: 12/20/2022] [Indexed: 12/28/2022] Open
Abstract
Citrus production produces about 15 million tons of by-products/waste worldwide every year. Due to their high content of bioactive compounds, several extraction techniques can be applied to obtain extracts rich in valuable compounds and further application into food applications. Distillation and solvent extraction continues to be the most used and applied extraction techniques, followed by newer techniques such as microwave-assisted extraction and pulsed electric field extraction. Although the composition of these extracts and essential oils directly depends on the edaphoclimatic conditions to which the fruit/plant was exposed, the main active compounds are D-limonene, carotenoids, and carbohydrates. Pectin, one of the most abundant carbohydrates present in Citrus peels, can be used as a biodegradable polymer to develop new food packaging, and the extracted bioactive compounds can be easily added directly or indirectly to foods to increase their shelf-life. One of the applications is their incorporation in active food packaging for microbiological and/or oxidation inhibition, prolonging foods' shelf-life and, consequently, contributing to reducing food spoilage. This review highlights some of the most used and effective extraction techniques and the application of the obtained essential oils and extracts directly or indirectly (through active packaging) to foods.
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Affiliation(s)
- Mariana A. Andrade
- Department of Food and Nutrition, National Institute of Health Doutor Ricardo Jorge, Av. Padre Cruz, 1649-016 Lisbon, Portugal
- Faculty of Pharmacy, University of Coimbra, Coimbra, Azinhaga de Santa Comba, 3000-548 Coimbra, Portugal
- REQUIMTE/LAQV, Rua D. Manuel II, Apartado 55142, 4051-401 Oporto, Portugal
| | - Cássia H. Barbosa
- Department of Food and Nutrition, National Institute of Health Doutor Ricardo Jorge, Av. Padre Cruz, 1649-016 Lisbon, Portugal
- MEtRICs, Departamento de Ciências e Tecnologia da Biomassa, Departamento de Química, NOVA School of Science and Technology, Universidade NOVA de Lisboa, FCT NOVA, Campus de Caparica, 2829-516 Caparica, Portugal
| | | | - Nazir Ahmad
- Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, Universitas Gadjah Mada, Sekip Utara, Yogyakarta 55281, Indonesia
| | - Fernanda Vilarinho
- Department of Food and Nutrition, National Institute of Health Doutor Ricardo Jorge, Av. Padre Cruz, 1649-016 Lisbon, Portugal
| | - Khaoula Khwaldia
- Laboratoire des Substances Naturelles, Institut National de Recherche et d’Analyse Physico-Chimique, INRAP, Pôle Technologique de Sidi Thabet, Tunis 2020, Tunisia
| | - Ana Sanches Silva
- Faculty of Pharmacy, University of Coimbra, Coimbra, Azinhaga de Santa Comba, 3000-548 Coimbra, Portugal
- National Institute for Agricultural and Veterinary Research (INIAV), I.P., Rua dos Lagidos, Lugar da Madalena, 4485-655 Vairão, Portugal
- Center for Study in Animal Science (CECA), ICETA, University of Oporto, 4051-401 Oporto, Portugal
- Associate Laboratory for Animal and Veterinary Sciences (AL4AnimalS), 1300-477 Lisbon, Portugal
| | - Fernando Ramos
- Faculty of Pharmacy, University of Coimbra, Coimbra, Azinhaga de Santa Comba, 3000-548 Coimbra, Portugal
- REQUIMTE/LAQV, Rua D. Manuel II, Apartado 55142, 4051-401 Oporto, Portugal
- Correspondence:
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Groves FD, Watkins BT, Roberts DJ, Tucker TC, Shen T, Flood TJ. Birth Weight and Risk of Childhood Acute Lymphoblastic Leukemia in Arizona, Illinois, and Kentucky. South Med J 2019; 111:579-584. [PMID: 30285262 DOI: 10.14423/smj.0000000000000873] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVE To confirm the previously reported increased risk of leukemia among macrosomic children (those with birth weight >4 kg). METHODS Birth certificates of Arizona, Illinois, and Kentucky children diagnosed as having acute lymphoblastic leukemia (ALL) before age 5 years were matched with birth certificates from leukemia-free children of the same sex, race, and ethnicity who were born in the same county on or about the same day. Odds ratios (ORs) for ALL among children of low (<2.5 kg) or high (>4 kg) birth weight were calculated by conditional logistic regression. RESULTS Children with high birth weight had an elevated risk of ALL in the first 5 years of life (OR 1.28, 95% confidence interval [CI] 1.01-1.61). The excess risk was confined to non-Hispanic whites (OR 1.77, 95% CI 1.27-2.48), both boys (OR 1.57, 95% CI 1.01-2.45) and girls (OR 2.10, 95% CI 1.26-3.52). CONCLUSIONS This study confirms the association between high birth weight and ALL previously reported by other studies in children of European ancestry. The literature on maternal risk factors for both macrosomia and ALL is reviewed, with maternal overnutrition emerging as a plausible risk factor for both outcomes.
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Affiliation(s)
- Frank D Groves
- From the Department of Epidemiology and Population Health, School of Public Health and Information Sciences, University of Louisville, Louisville, Kentucky, Department of Epidemiology, College of Public Health, University of Kentucky, Lexington, the Illinois State Cancer Registry, Springfield, and the Arizona Cancer Registry, Phoenix
| | - Brittany T Watkins
- From the Department of Epidemiology and Population Health, School of Public Health and Information Sciences, University of Louisville, Louisville, Kentucky, Department of Epidemiology, College of Public Health, University of Kentucky, Lexington, the Illinois State Cancer Registry, Springfield, and the Arizona Cancer Registry, Phoenix
| | - Daniel J Roberts
- From the Department of Epidemiology and Population Health, School of Public Health and Information Sciences, University of Louisville, Louisville, Kentucky, Department of Epidemiology, College of Public Health, University of Kentucky, Lexington, the Illinois State Cancer Registry, Springfield, and the Arizona Cancer Registry, Phoenix
| | - Thomas C Tucker
- From the Department of Epidemiology and Population Health, School of Public Health and Information Sciences, University of Louisville, Louisville, Kentucky, Department of Epidemiology, College of Public Health, University of Kentucky, Lexington, the Illinois State Cancer Registry, Springfield, and the Arizona Cancer Registry, Phoenix
| | - Tiefu Shen
- From the Department of Epidemiology and Population Health, School of Public Health and Information Sciences, University of Louisville, Louisville, Kentucky, Department of Epidemiology, College of Public Health, University of Kentucky, Lexington, the Illinois State Cancer Registry, Springfield, and the Arizona Cancer Registry, Phoenix
| | - Timothy J Flood
- From the Department of Epidemiology and Population Health, School of Public Health and Information Sciences, University of Louisville, Louisville, Kentucky, Department of Epidemiology, College of Public Health, University of Kentucky, Lexington, the Illinois State Cancer Registry, Springfield, and the Arizona Cancer Registry, Phoenix
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Abstract
Folate has been studied in relation to many diseases, especially cancer. Although it has been postulated to exert a dual effect on development of cancer, its role remains to be clearly defined. Its effect on cancer is the result of gene-nutrient interaction between the genes in folate metabolic pathway and dietary folate availability; mutations in genes of folate metabolism have been shown to alter individual susceptibility to certain childhood cancers as well as response to cancer chemotherapy. Although mandatory fortification of food items with folate has been initiated in some countries, many countries are yet to adopt this due to concerns about undesired adverse effects of high folate levels on health, especially cancer. However, initial reports suggest that folate fortification has led to reduction in incidence of certain childhood cancers such as neuroblastoma, wilms tumour and leukaemias. Despite studies showing folate depletion during antifolate chemotherapy and higher toxicity of chemotherapy in folate-depleted individuals, folate supplementation during cancer chemotherapy is not routinely recommended. Studies investigating the precise effect of folate supplementation during chemotherapy on both short- and long-term outcomes of cancer are needed to arrive at a consensus guideline.
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Affiliation(s)
- Nirmalya Roy Moulik
- Department of Pediatrics, Division of Pediatric Hematology-Oncology, King George's Medical University, Lucknow, India
| | - Archana Kumar
- Department of Pediatrics, Division of Pediatric Hematology-Oncology, King George's Medical University, Lucknow, India
| | - Suraksha Agrawal
- Department of Medical Genetics, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India
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Dessypris N, Karalexi MA, Ntouvelis E, Diamantaras AA, Papadakis V, Baka M, Hatzipantelis E, Kourti M, Moschovi M, Polychronopoulou S, Sidi V, Stiakaki E, Petridou ET. Association of maternal and index child's diet with subsequent leukemia risk: A systematic review and meta analysis. Cancer Epidemiol 2017; 47:64-75. [PMID: 28130996 DOI: 10.1016/j.canep.2017.01.003] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2016] [Revised: 01/05/2017] [Accepted: 01/07/2017] [Indexed: 01/20/2023]
Abstract
BACKGROUND Exploring the effect of maternal and/or childhood diet on offspring leukemogenesis is challenging, given differences in food group categories, their potentially variable impact depending on time window of exposure and the multiple leukemia subtypes. We opted to quantitatively synthesize published data on the association of maternal/child diet with leukemia risk. METHODS Medline was searched until June 30th, 2016 for eligible articles on the association of childhood leukemia with consumption of (i) food groups, excluding alcoholic and non-alcoholic beverages, and (ii) specific dietary supplements before/during index pregnancy and childhood. RESULTS Eighteen studies of case-control design (N=11,720 cases/18,721 controls) were included, of which nine assessed maternal dietary components, five index child's and four both, mainly focusing on acute lymphoblastic leukemia (ALL). Statistically significant inverse estimates for ALL were found (2 studies, 413 cases, 490 controls) for fruit (OR: 0.81, 95% CI: 0.67, 0.99); vegetables (OR: 0.51, 95% CI: 0.28, 0.94); legumes (OR: 0.76, 95% CI: 0.62, 0.94); fish (OR: 0.27, 95% CI: 0.14, 0.53, among the 0-4year old; 2 studies 215 cases, 215 controls); preconception folic acid supplementation (OR: 0.69, 95%CI: 0.50-0.95; published meta analysis plus 2 studies, 3511 cases, 6816 controls); and use of vitamins during pregnancy (OR: 0.81, 95%CI: 0.74-0.88; published meta analysis plus one study, 5967 cases, 8876 controls). The associations (2 studies) of the remaining food groups and maternal dietary supplements consumption during pregnancy as well as of childhood diet and supplements intake (2-4 studies) were non significant. CONCLUSIONS Maternal consumption of specific food groups comprising"healthy" items of the Mediterranean diet, preconception use of folic acid and intake of vitamins during pregnancy were associated with decreased ALL risk. Further research is needed, however preferably with homogeneous dietary information and data on immunophenotypic/cytogenetic subtypes to also explore the interaction of specific macro- and micronutrients intake with gene polymorphisms.
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Affiliation(s)
- Nick Dessypris
- Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, University of Athens, Greece
| | - Maria A Karalexi
- Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, University of Athens, Greece
| | - Evangelos Ntouvelis
- Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, University of Athens, Greece
| | - Andreas-Antonios Diamantaras
- Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, University of Athens, Greece; Neurologische Klinik, Klinikum Mittelbaden Rastatt, Rastatt, Germany
| | - Vassilios Papadakis
- Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, University of Athens, Greece
| | - Margarita Baka
- Department of Pediatric Hematology-Oncology, "Pan.&Agl. Kyriakou" Children's Hospital, Athens, Greece
| | - Emmanuel Hatzipantelis
- 2nd Department of Pediatrics, Aristotelion University of Thessaloniki, AHEPA General Hospital, Thessaloniki, Greece
| | - Maria Kourti
- Department of Pediatric Hematology and Oncology, Hippokration Hospital, Thessaloniki, Greece
| | - Maria Moschovi
- Haematology-Oncology Unit, First Department of Pediatrics, Athens University Medical School, "Aghia Sophia" Children's Hospital, Athens, Greece
| | - Sophia Polychronopoulou
- Department of Pediatric Haematology-Oncology, "Aghia Sophia" Children's Hospital, Athens, Greece
| | - Vasiliki Sidi
- Department of Pediatric Hematology and Oncology, Hippokration Hospital, Thessaloniki, Greece
| | - Eftichia Stiakaki
- Department of Pediatric Hematology-Oncology, University Hospital of Heraklion, Heraklion, Greece
| | - Eleni Th Petridou
- Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, University of Athens, Greece.
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Whitehead TP, Metayer C, Wiemels JL, Singer AW, Miller MD. Childhood Leukemia and Primary Prevention. Curr Probl Pediatr Adolesc Health Care 2016; 46:317-352. [PMID: 27968954 PMCID: PMC5161115 DOI: 10.1016/j.cppeds.2016.08.004] [Citation(s) in RCA: 76] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Leukemia is the most common pediatric cancer, affecting 3800 children per year in the United States. Its annual incidence has increased over the last decades, especially among Latinos. Although most children diagnosed with leukemia are now cured, many suffer long-term complications, and primary prevention efforts are urgently needed. The early onset of leukemia-usually before 5 years of age-and the presence at birth of "pre-leukemic" genetic signatures indicate that pre- and postnatal events are critical to the development of the disease. In contrast to most pediatric cancers, there is a growing body of literature-in the United States and internationally-that has implicated several environmental, infectious, and dietary risk factors in the etiology of childhood leukemia, mainly for acute lymphoblastic leukemia, the most common subtype. For example, exposures to pesticides, tobacco smoke, solvents, and traffic emissions have consistently demonstrated positive associations with the risk of developing childhood leukemia. In contrast, intake of vitamins and folate supplementation during the preconception period or pregnancy, breastfeeding, and exposure to routine childhood infections have been shown to reduce the risk of childhood leukemia. Some children may be especially vulnerable to these risk factors, as demonstrated by a disproportionate burden of childhood leukemia in the Latino population of California. The evidence supporting the associations between childhood leukemia and its risk factors-including pooled analyses from around the world and systematic reviews-is strong; however, the dissemination of this knowledge to clinicians has been limited. To protect children's health, it is prudent to initiate programs designed to alter exposure to well-established leukemia risk factors rather than to suspend judgment until no uncertainty remains. Primary prevention programs for childhood leukemia would also result in the significant co-benefits of reductions in other adverse health outcomes that are common in children, such as detriments to neurocognitive development.
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Affiliation(s)
- Todd P Whitehead
- Department of Epidemiology, School of Public Health, University of California, Berkeley, CA; Center for Integrative Research on Childhood Leukemia and the Environment, University of California, Berkeley, CA.
| | - Catherine Metayer
- Department of Epidemiology, School of Public Health, University of California, Berkeley, CA; Center for Integrative Research on Childhood Leukemia and the Environment, University of California, Berkeley, CA
| | - Joseph L Wiemels
- Center for Integrative Research on Childhood Leukemia and the Environment, University of California, Berkeley, CA; Department of Epidemiology and Biostatistics, School of Medicine, University of California, San Francisco, CA
| | - Amanda W Singer
- Department of Epidemiology, School of Public Health, University of California, Berkeley, CA
| | - Mark D Miller
- Center for Integrative Research on Childhood Leukemia and the Environment, University of California, Berkeley, CA; Western States Pediatric Environmental Health Specialty Unit, University of California, San Francisco, CA
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11
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Saneei P, Willett W, Esmaillzadeh A. Red and processed meat consumption and risk of glioma in adults: A systematic review and meta-analysis of observational studies. JOURNAL OF RESEARCH IN MEDICAL SCIENCES : THE OFFICIAL JOURNAL OF ISFAHAN UNIVERSITY OF MEDICAL SCIENCES 2015; 20:602-612. [PMID: 26600837 PMCID: PMC4621656 DOI: 10.4103/1735-1995.165970] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/22/2015] [Revised: 05/08/2005] [Accepted: 07/24/2015] [Indexed: 11/04/2022]
Abstract
BACKGROUND These findings from several observational studies, investigated the association between red meat consumption and gliomas, were inconsistent. We conducted a systematic review and meta-analysis of observational studies to summarize available date on the relation between meat intake and risk of glioma. MATERIALS AND METHODS A systematic literature search of relevant reports published until May 2014 of the PubMed/Medline, ISI Web of Knowledge, Excerpta Medica database, Ovid database, Google Scholar, and Scopus databases was conducted. From 723 articles yielded in the preliminary literature search, data from eighteen publications (14 case-control, three cohort, and one nested case-control study) on unprocessed red meat, processed meat, and/or total red meat consumption in relation to glioma in adults were included in the analysis. Quality assessment of studies was performed. Random effects model was used to conduct the meta-analysis. RESULTS We found a positive significant association between unprocessed red meat intake and risk of glioma (relative risk [RR] = 1.30; 95% confidence interval [CI]: 1.08-1.58) after excluding three studies with uncertain type of brain cancer. This analysis included only one cohort study which revealed no relation between unprocessed red meat intake and glioma (RR = 1.75; 95% CI: 0.35-8.77). Consumption of processed meats was not related to increased risk of glioma in population-based case-control studies (RR = 1.26; 95% CI: 1.05-1.51) and reduced risk in hospital-based case-controls (RR = 0.79; 95% CI: 0.65-0.97). No significant association was seen between processed red meat intake and risk of glioma in cohort studies (RR: 1.08; 95% CI: 0.84-1.37). Total red meat consumption was not associated with risk of adult glioma in case-control or cohort studies. CONCLUSION In this meta-analysis of 18 observational studies, we found a modest positive association between unprocessed red meat intake and risk of gliomas based almost entirely on case-control studies. Processed red meat was overall not associated with risk of gliomas in case-control or cohort studies.
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Affiliation(s)
- Parvane Saneei
- Food Security Research Center, Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Walter Willett
- Department of Nutrition and Epidemiology, Harvard School of Public Health, Boston, USA
| | - Ahmad Esmaillzadeh
- Food Security Research Center, Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
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12
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Metayer C, Milne E, Dockerty JD, Clavel J, Pombo-de-Oliveira MS, Wesseling C, Spector LG, Schüz J, Eleni P, Sameera E, Armstrong BK, Jérémie R, Koifman S, Kaatsch P, Moschovi M, Rashed WM, Selvin S, McCauley K, Hung RJ, Kang AY, Infante-Rivard C. Maternal supplementation with folic acid and other vitamins and risk of leukemia in offspring: a Childhood Leukemia International Consortium study. Epidemiology 2014; 25:811-822. [PMID: 25207954 PMCID: PMC5903563 DOI: 10.1097/ede.0000000000000141] [Citation(s) in RCA: 63] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
BACKGROUND Maternal prenatal supplementation with folic acid and other vitamins has been inconsistently associated with a reduced risk of childhood acute lymphoblastic leukemia (ALL). Little is known regarding the association with acute myeloid leukemia (AML), a rarer subtype. METHODS We obtained original data on prenatal use of folic acid and vitamins from 12 case-control studies participating in the Childhood Leukemia International Consortium (enrollment period: 1980-2012), including 6,963 cases of ALL, 585 cases of AML, and 11,635 controls. Logistic regression was used to estimate pooled odds ratios (ORs) and 95% confidence intervals (CIs), adjusted for child's age, sex, ethnicity, parental education, and study center. RESULTS Maternal supplements taken any time before conception or during pregnancy were associated with a reduced risk of childhood ALL; odds ratios were 0.85 (95% CI = 0.78-0.92) for vitamin use and 0.80 (0.71-0.89) for folic acid use. The reduced risk was more pronounced in children whose parents' education was below the highest category. The analyses for AML led to somewhat unstable estimates; ORs were 0.92 (0.75-1.14) and 0.68 (0.48-0.96) for prenatal vitamins and folic acid, respectively. There was no strong evidence that risks of either types of leukemia varied by period of supplementation (preconception, pregnancy, or trimester). CONCLUSIONS Our results, based on the largest number of childhood leukemia cases to date, suggest that maternal prenatal use of vitamins and folic acid reduces the risk of both ALL and AML and that the observed association with ALL varied by parental education, a surrogate for lifestyle and sociodemographic characteristics.
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Affiliation(s)
- Catherine Metayer
- University of California, Berkeley, School of Public Health, 1995 University Avenue, Suite 460, Berkeley, California, 94704-1070 United States
| | - Elizabeth Milne
- Telethon Institute for Child Health Research, Centre for Child Health Research, University of Western Australia, 100 Roberts Road, Subiaco, Western Australia, 6008; PO Box 855, West Perth, Western Australia, 6872
| | - John D. Dockerty
- Dean's Department and Department of Preventive and Social Medicine, Dunedin School of Medicine, University of Otago, PO Box 913, Dunedin, New Zealand
| | - Jacqueline Clavel
- Inserm, CESP Centre for Research in Epidemiology and Population Health, Environmental Epidemiology of Cancer Team, Université Paris-Sud, UMRS 1018, F-94807, 16 avenue Paul Vaillant-Couturier, F-94807 Villejuif Cedex, France
| | - Maria S. Pombo-de-Oliveira
- Pediatric Hematology-Oncology Program, Research Program, Instituto Nacional de Cancer, Rua André Cavalcanti, 37; 6° andar, CEP 20231050, Rio de Janeiro, Brazil
| | - Catharina Wesseling
- Central American Institute for Studies on Toxic Substances (IRET), Universidad Nacional P.O. Box 86-3000 Heredia, Costa Rica
| | - Logan G. Spector
- Division of Epidemiology Clinical Research, Department of Pediatrics and Masonic Cancer Center, University of Minnesota, 420 Delaware Street, SE, MMC 715, Minneapolis, Minnesota, 55455, United States
| | - Joachim Schüz
- International Agency for Research on Cancer, Section of Environment and Radiation, 150 Cours Albert Thomas, 69372 Lyon Cedex 08, France
| | - Petridou Eleni
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Medical School, 75 M. Asias Str. Goudi, Athens 115 27, Greece
| | - Ezzat Sameera
- Research Department, Children's Cancer Hospital 57357- Egypt, 1 Seket Al-Emam St., el Sayeda Zeinab, Cairo 11441, Egypt
| | - Bruce K. Armstrong
- Sydney School of Public Health, University of Sydney, Room 207, Queen Elizabeth II Research Institute D02, NSW, 2006, Australia
| | - Rudant Jérémie
- Inserm, CESP Centre for Research in Epidemiology and Population Health, Environmental Epidemiology of Cancer Team, Université Paris-Sud, UMRS 1018, F-94807, 16 avenue Paul Vaillant-Couturier, F-94807 Villejuif Cedex, France
| | - Sergio Koifman
- National School of Public Health, Oswaldo Cruz Foundation (FIOCRUZ), Ministry of Health, Rio de Janeiro, Brazil
| | - Peter Kaatsch
- German Childhood Cancer Registry (GCCR) at the Institute for Medical Biostatistics, Epidemiology and Informatics, University Medical Centre, Johannes Gutenberg University Mainz, 55101 Mainz, Germany
| | - Maria Moschovi
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Medical School, 75 M. Asias Str. Goudi, Athens 115 27, Greece
| | - Wafaa M. Rashed
- Research Department, Children's Cancer Hospital 57357- Egypt, 1 Seket Al-Emam St., el Sayeda Zeinab, Cairo 11441, Egypt
| | - Steve Selvin
- University of California, Berkeley, School of Public Health, 1995 University Avenue, Suite 460, Berkeley, California, 94704-1070 United States
| | - Kathryn McCauley
- University of California, Berkeley, School of Public Health, 1995 University Avenue, Suite 460, Berkeley, California, 94704-1070 United States
| | - Rayjean J. Hung
- Lunenfeld-Tanenbaum Research Institute of Mount Sinai Hospital, 60 Murray Street, Toronto, Ontario M5T 3L9, Canada
| | - Alice Y. Kang
- University of California, Berkeley, School of Public Health, 1995 University Avenue, Suite 460, Berkeley, California, 94704-1070 United States
| | - Claire Infante-Rivard
- Department of Epidemiology, Biostatistics, and Occupational Health, Faculty of Medicine, McGill University, 1020 Pine Avenue West, Montréal, Province of Québec, Canada, H3A 1A2
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Abstract
Hepatocellular carcinoma (HCC) is a major cause of cancer death worldwide, accounting for over half a million deaths per year. The geographic pattern of HCC incidence is parallel to exposure to viral etiologic factors. Its incidence is increasing, ranging between 3% and 9% annually depending on the geographical location, and variability in the incidence rates correspond closely to the prevalence and pattern of the primary etiologic factors. Chronic infections with hepatitis B viruses or hepatitis C viruses have both been recognized as human liver carcinogens with a combined attributable fraction of at least 75% of all HCC cases. Multiple non-viral factors have been implicated in the development of HCC. Increased body mass index and diabetes with subsequent development of non-alcoholic steatohepatitis represent significant risk factors for HCC. Other non-viral causes of HCC include iron overload syndromes, alcohol use, tobacco, oral contraceptive, aflatoxin, pesticides exposure and betel quid chewing, a prevalent habit in the developing world. Wilson disease, α-1 antitrypsin deficiency, Porphyrias, autoimmune hepatitis, Schistosoma japonicum associated with positive hepatitis B surface antigen, and thorotrast-ray are also contributing hepatocellualar carcinoma. In addition, primary biliary cirrhosis, congestive liver disease and family history of liver cancer increase the risk of HCC incident. In conclusion, clarification of relevant non-viral causes of HCC will help to focus clinicians on those risk factors that are modifiable. The multilevel preventative approach will hopefully lead to a reduction in incidence of non-viral HCC, and a decrease in the patient morbidity and mortality as well as the societal economic burden associated with HCC.
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Affiliation(s)
- Manal A Hamed
- Manal A Hamed, Sanaa A Ali, Therapeutic Chemistry Department, Pharmaceutical and Drug Industries Division, National Research Centre, Dokki, Giza 12622, Egypt
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Hamed MA, Ali SA. Non-viral factors contributing to hepatocellular carcinoma. World J Hepatol 2013; 5:311-322. [PMID: 23805355 PMCID: PMC3692972 DOI: 10.4254/wjh.v5.i6.311] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2013] [Revised: 05/10/2013] [Accepted: 05/18/2013] [Indexed: 02/06/2023] Open
Abstract
Hepatocellular carcinoma (HCC) is a major cause of cancer death worldwide, accounting for over half a million deaths per year. The geographic pattern of HCC incidence is parallel to exposure to viral etiologic factors. Its incidence is increasing, ranging between 3% and 9% annually depending on the geographical location, and variability in the incidence rates correspond closely to the prevalence and pattern of the primary etiologic factors. Chronic infections with hepatitis B viruses or hepatitis C viruses have both been recognized as human liver carcinogens with a combined attributable fraction of at least 75% of all HCC cases. Multiple non-viral factors have been implicated in the development of HCC. Increased body mass index and diabetes with subsequent development of non-alcoholic steatohepatitis represent significant risk factors for HCC. Other non-viral causes of HCC include iron overload syndromes, alcohol use, tobacco, oral contraceptive, aflatoxin, pesticides exposure and betel quid chewing, a prevalent habit in the developing world. Wilson disease, α-1 antitrypsin deficiency, Porphyrias, autoimmune hepatitis, Schistosoma japonicum associated with positive hepatitis B surface antigen, and thorotrast-ray are also contributing hepatocellualar carcinoma. In addition, primary biliary cirrhosis, congestive liver disease and family history of liver cancer increase the risk of HCC incident. In conclusion, clarification of relevant non-viral causes of HCC will help to focus clinicians on those risk factors that are modifiable. The multilevel preventative approach will hopefully lead to a reduction in incidence of non-viral HCC, and a decrease in the patient morbidity and mortality as well as the societal economic burden associated with HCC.
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Affiliation(s)
- Manal A Hamed
- Manal A Hamed, Sanaa A Ali, Therapeutic Chemistry Department, Pharmaceutical and Drug Industries Division, National Research Centre, Dokki, Giza 12622, Egypt
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15
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Diamantaras AA, Dessypris N, Sergentanis TN, Ntouvelis E, Athanasiadou-Piperopoulou F, Baka M, Fragandrea I, Moschovi M, Polychronopoulou S, Stiakaki E, Panagiotakos D, Petridou E. Nutrition in early life and risk of childhood leukemia: a case-control study in Greece. Cancer Causes Control 2013; 24:117-124. [PMID: 23179662 DOI: 10.1007/s10552-012-0097-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2012] [Accepted: 11/03/2012] [Indexed: 12/23/2022]
Abstract
PURPOSE There is a paucity of findings concerning the role of diet in childhood leukemogenesis, whereas the results are equivocal and the studies heterogeneous with regard to food items examined. This case-control study investigates the association of childhood leukemia with food groups, macronutrient consumption, total energy intake and adherence to Mediterranean diet among children aged 5-14 years in Greece. METHODS A total of 139 consecutive, incident leukemia cases out of which 121 were acute lymphoblastic leukemia were derived from the Nationwide Registry for Childhood Hematological Malignancies along with one : one age- and gender-matched hospital controls. Information on socio-demographic, maternal and child variables and dietary habits was obtained through in-person interviews with the guardians/children. Multiple logistic regression was performed with adjustment for birth weight and possible confounding variables. RESULTS Higher consumption of added lipids was associated with an increased risk of childhood leukemia, whereas consumption of milk and dairy products with reduced risk. From the macronutrient analysis, a borderline trend linking high protein intake with reduced childhood leukemia risk was observed. CONCLUSION Consumption of milk and dairy products in the first year of life may protect against childhood leukemia possibly through vitamin D actions, while added lipids may increase the risk through various mechanisms. These results offer a holistic evaluation of children's nutrition and suggest that dietary habits in the early years of life may contribute to the prevention of childhood leukemia.
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Affiliation(s)
- Andreas-Antonios Diamantaras
- Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, University of Athens, 75 M. Asias Str. Goudi, Athens, Greece
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Janakiram NB, Rao CV. iNOS-selective inhibitors for cancer prevention: promise and progress. Future Med Chem 2012; 4:2193-204. [PMID: 23190107 PMCID: PMC3588580 DOI: 10.4155/fmc.12.168] [Citation(s) in RCA: 63] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Nitric oxide (NO) is involved in various physiological functions and its role in tumorigenesis has been well studied. A large majority of human and experimental tumors appear to progress owing to NO resulting from iNOS, further stimulated by proinflammatory cytokines. Conversely, in some cases, NO is associated with induction of apoptosis and tumor regression. This dichotomy of NO is largely explained by the complexity of signaling pathways in tumor cells, which respond to NO very differently depending on its concentration. In addition, NO alters many signaling pathways through chemical modifications, such as the addition of S-nitrosothiols and nitrosotyrosine to target proteins altering various biological pathways. Hence, iNOS inhibitors are designed and developed to inhibit various organ site cancers including the colon. Here, we review iNOS expression, generation of NO, involvement of NO in altering signaling pathways, and iNOS select inhibitors and their possible use for the prevention and treatment of various cancers.
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Affiliation(s)
- Naveena B Janakiram
- Center for Cancer Prevention & Drug Development, Medical Oncology, Department of Medicine, PCS Oklahoma Cancer Center, University of Oklahoma Health Sciences, Oklahoma City, OK 73104, USA
| | - Chinthalapally V Rao
- Center for Cancer Prevention & Drug Development, Medical Oncology, Department of Medicine, PCS Oklahoma Cancer Center, University of Oklahoma Health Sciences, Oklahoma City, OK 73104, USA
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17
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Milne E, Greenop KR, Bower C, Miller M, van Bockxmeer FM, Scott RJ, de Klerk NH, Ashton LJ, Gottardo NG, Armstrong BK. Maternal Use of Folic Acid and Other Supplements and Risk of Childhood Brain Tumors. Cancer Epidemiol Biomarkers Prev 2012; 21:1933-41. [DOI: 10.1158/1055-9965.epi-12-0803] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Linabery AM, Johnson KJ, Ross JA. Childhood cancer incidence trends in association with US folic acid fortification (1986-2008). Pediatrics 2012; 129:1125-33. [PMID: 22614769 PMCID: PMC3362910 DOI: 10.1542/peds.2011-3418] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE Epidemiologic evidence indicates that prenatal vitamin supplementation reduces risk for some childhood cancers; however, a systematic evaluation of population-based childhood cancer incidence trends after fortification of enriched grain products with folic acid in the United States in 1996-1998 has not been previously reported. Here we describe temporal trends in childhood cancer incidence in association with US folic acid fortification. METHODS Using Surveillance, Epidemiology, and End Results program data (1986-2008), we calculated incidence rate ratios and 95% confidence intervals to compare pre- and postfortification cancer incidence rates in children aged 0 to 4 years. Incidence trends were also evaluated by using joinpoint and loess regression models. RESULTS From 1986 through 2008, 8829 children aged 0 to 4 years were diagnosed with malignancies, including 3790 and 3299 in utero during the pre- and postfortification periods, respectively. Pre- and postfortification incidence rates were similar for all cancers combined and for most specific cancer types. Rates of Wilms tumor (WT), primitive neuroectodermal tumors (PNETs), and ependymomas were significantly lower postfortification. Joinpoint regression models detected increasing WT incidence from 1986 through 1997 followed by a sizable decline from 1997 through 2008, and increasing PNET incidence from 1986 through 1993 followed by a sharp decrease from 1993 through 2008. Loess curves indicated similar patterns. CONCLUSIONS These results provide support for a decrease in WT and possibly PNET incidence, but not other childhood cancers, after US folic acid fortification.
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Affiliation(s)
- Amy M. Linabery
- Division of Pediatric Epidemiology and Clinical Research, Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota
| | - Kimberly J. Johnson
- Brown School, Department of Pediatrics, Washington University in St Louis, St Louis, Missouri
| | - Julie A. Ross
- Division of Pediatric Epidemiology and Clinical Research, Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota;,University of Minnesota Cancer Center, Minneapolis, Minnesota
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Human safety controversies surrounding nitrate and nitrite in the diet. Nitric Oxide 2012; 26:259-66. [DOI: 10.1016/j.niox.2012.03.011] [Citation(s) in RCA: 207] [Impact Index Per Article: 15.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2012] [Revised: 03/22/2012] [Accepted: 03/24/2012] [Indexed: 01/28/2023]
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Ciappio ED, Mason JB, Crott JW. Maternal one-carbon nutrient intake and cancer risk in offspring. Nutr Rev 2012; 69:561-71. [PMID: 21967157 DOI: 10.1111/j.1753-4887.2011.00424.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Dietary intake of one-carbon nutrients, particularly folate, vitamin B(2) (riboflavin), vitamin B(6) , vitamin B(12) , and choline have been linked to the risk of cancers of the colon and breast in both human and animal studies. More recently, experimental and epidemiological data have emerged to suggest that maternal intake of these nutrients during gestation may also have an impact on the risk of cancer in offspring later in life. Given the plasticity of DNA methylation in the developing embryo and the established role of one-carbon metabolism in supporting biological methylation reactions, it is plausible that alterations in maternal one-carbon nutrient availability might induce subtle epigenetic changes in the developing embryo and fetus that persist into later life, altering the risk of tumorigenesis throughout the lifespan. This review summarizes the current literature on maternal one-carbon nutrient intake and offspring cancer risk, with an emphasis on cancers of the colon and breast, and discusses specific epigenetic modifications that may play a role in their pathogenesis.
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Affiliation(s)
- Eric D Ciappio
- Vitamins and Carcinogenesis Laboratory, Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, Massachusetts 02111, USA
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Mohr SB, Garland CF, Gorham ED, Grant WB, Garland FC. Ultraviolet B and incidence rates of leukemia worldwide. Am J Prev Med 2011; 41:68-74. [PMID: 21665065 DOI: 10.1016/j.amepre.2011.04.003] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2010] [Revised: 04/08/2011] [Accepted: 04/12/2011] [Indexed: 01/27/2023]
Abstract
BACKGROUND Recent research has suggested a relationship between vitamin D deficiency and risk of leukemia. PURPOSE Using data from the UN cancer database, GLOBOCAN, this study will determine whether a relationship exists for latitude and ultraviolet B (UVB) irradiance with incidence rates of leukemia in 175 countries. METHODS Multiple regression was used to analyze the independent association between UVB and age-adjusted incidence rates of leukemia in 139 countries in 2002. This study controlled for dietary data on intake of energy from animal sources and per capita healthcare expenditures. The analyses were performed in 2009. RESULTS People residing in the highest-latitude countries had the highest rates of leukemia in both men (R(2)=0.34, p<0.0001) and women (R(2)=0.24, p<0.0001). In men, UVB was independently inversely associated with leukemia incidence rates (p≤0.001), whereas animal energy consumption (p=0.02) and per capita healthcare expenditures (p≤0.0001) were independently positively associated (R(2) for model=0.61, p≤0.0001). In women, UVB adjusted for cloud cover was independently inversely associated with leukemia incidence rates (p≤0.01), whereas animal energy consumption (p≤0.05) and per capita healthcare expenditures (p=0.0002) were independently positively associated (R(2) for model=0.51, p<0.0001). CONCLUSIONS Countries with low UVB had higher age-adjusted incidence rates of leukemia. This suggests the possibility that low serum 25-hydroxyvitamin D status, because of lower levels of UVB, somehow might predict the development of leukemia.
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Affiliation(s)
- Sharif B Mohr
- Division of Epidemiology, Department of Family and Preventive Medicine, University of California San Diego, La Jolla, 92093-0631, USA
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Weng HH, Tsai SS, Wu TN, Sung FC, Yang CY. Nitrates in drinking water and the risk of death from childhood brain tumors in Taiwan. JOURNAL OF TOXICOLOGY AND ENVIRONMENTAL HEALTH. PART A 2011; 74:769-78. [PMID: 21541879 DOI: 10.1080/15287394.2011.567951] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Abstract
The objective of this study was to (1) examine the relationship between nitrate (NO₃-N) levels in public water supplies and risk of death from childhood brain tumors (CBT) and (2) determine whether calcium (Ca) and magnesium (Mg) levels in drinking water might modify the effects of NO₃-N on development of CBT. A matched cancer case-control study was used to investigate the relationship between the risk of death attributed to CBT and exposure to NO₃-N in drinking water in Taiwan. All CBT deaths of Taiwan residents from 1999 through 2008 were obtained from the Bureau of Vital Statistics of the Taiwan Provincial Department of Health. Controls were deaths from other causes and were pair-matched to the cases by gender, year of birth, and year of death. Information on the levels of nitrate-nitrogen NO₃-N, Ca, and Mg in drinking water were collected from Taiwan Water Supply Corporation. The municipality of residence for CBT cases and controls was presumed to be the source of the subject's NO₃-N, Ca, and Mg exposure via drinking water. Relative to individuals whose NO₃-N exposure level was ≤ 0.31 ppm, and the adjusted odds ration (OR) (95% confidence interval [CI]) for CBT occurrence was 1.4 (1.07-1.84) for individuals who resided in municipalities served by drinking water with a NO₃-N exposure > 0.31 ppm. No significant effect modification was observed by Ca and Mg intake via drinking water. Data suggest that exposure to NO₃-N in drinking water is associated with a higher risk of CBT development in Taiwan.
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Affiliation(s)
- Hsu-Huei Weng
- Department of Diagnostic Radiology, Chang Gung Memorial Hospital at Chiayi, Chang Gung University College of Medicine, Taiwan
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Maternal consumption of coffee and tea during pregnancy and risk of childhood ALL: results from an Australian case-control study. Cancer Causes Control 2010; 22:207-18. [PMID: 21113653 DOI: 10.1007/s10552-010-9688-1] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2010] [Accepted: 11/08/2010] [Indexed: 10/18/2022]
Abstract
OBJECTIVES To investigate whether maternal coffee and/or tea consumption during the last 6 months of pregnancy was associated with risk of childhood ALL. METHODS Data on coffee and tea drinking during pregnancy from 337 case mothers and 697 control mothers were analyzed using unconditional multivariable logistic regression. A meta-analysis of our findings with those of previous studies was also conducted. RESULTS There was little evidence of an overall association between maternal coffee consumption and risk of ALL: OR 0.89 (95% CI 0.61, 1.30), although there was some suggestion that higher levels of intake might increase the risk in children of non-smoking mothers: OR for 2+ cups/day = 1.44 (95% CI 0.85, 2.42); this was supported by our meta-analysis. Risk was also elevated among cases with chromosomal translocations. The overall OR for maternal tea consumption was 0.82 (95% CI 0.56, 1.18), although the OR for T-cell ALL was 0.21 (95% CI 0.08, 0.51). Among ALL cases with translocations, the ORs for tea consumption tended to be elevated: OR = 1.70 (95% CI 0.79-3.68) for 2+ cups/day. CONCLUSIONS The observed increased risk associated with coffee and tea consumption may be confined to ALL with translocations. These associations should be explored further in large international consortia.
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Thornburg KL, Shannon J, Thuillier P, Turker MS. In utero life and epigenetic predisposition for disease. ADVANCES IN GENETICS 2010; 71:57-78. [PMID: 20933126 DOI: 10.1016/b978-0-12-380864-6.00003-1] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Regulatory regions of the human genome can be modified through epigenetic processes during prenatal life to make an individual more likely to suffer chronic diseases when they reach adulthood. The modification of chromatin and DNA contributes to a larger well-documented process known as "programming" whereby stressors in the womb give rise to adult onset diseases, including cancer. It is now well known that death from ischemic heart disease is related to birth weight; the lower the birth weight, the higher the risk of death from cardiovascular disease as well as type 2 diabetes and osteoporosis. Recent epidemiological data link rapid growth in the womb to metabolic disease and obesity and also to breast and lung cancers. There is increasing evidence that "marked" regions of DNA can become "unmarked" under the influence of dietary nutrients. This gives hope for reversing propensities for cancers and other diseases that were acquired in the womb. For several cancers, the size and shape of the placenta are associated with a person's cardiovascular and cancer risks as are maternal body mass index and height. The features of placental growth and nutrient transport properties that lead to adult disease have been little studied. In conclusion, several cancers have their origins in the womb, including lung and breast cancer. More research is needed to determine the epigenetic processes that underlie the programming of these diseases.
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Affiliation(s)
- Kent L Thornburg
- Department of Medicine, Division of Cardiovascular Medicine, Oregon Health & Science University, Portland, Oregon, USA
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Linabery AM, Puumala SE, Hilden JM, Davies SM, Heerema NA, Roesler MA, Ross JA. Maternal vitamin and iron supplementation and risk of infant leukaemia: a report from the Children's Oncology Group. Br J Cancer 2010; 103:1724-8. [PMID: 20978510 PMCID: PMC2994226 DOI: 10.1038/sj.bjc.6605957] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Background: Prenatal supplementation has been inversely associated with childhood, but not with infant, leukaemia. Methods: Mothers of 443 cases of infant leukaemia diagnosed during 1996–2006 and 324 frequency-matched controls completed interviews. Associations were evaluated by unconditional logistic regression. Results: We observed no associations between prenatal vitamin (odds ratio (OR)=0.79, 95% confidence interval (CI): 0.44–1.42) or iron supplementation (OR=1.07, 95% CI: 0.75–1.52) and infant leukaemia after adjustment for race/ethnicity and income. Similar results were observed for leukaemia subtypes analysed separately. Conclusion The observed null associations may be attributable to high supplementation rates and/or national fortification programmes.
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Affiliation(s)
- A M Linabery
- Division of Pediatric Epidemiology and Clinical Research, Department of Pediatrics, University of Minnesota, 420 Delaware Street SE, MMC 422, Minneapolis, MN 55455, USA
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Milne E, Royle JA, Miller M, Bower C, de Klerk NH, Bailey HD, van Bockxmeer F, Attia J, Scott RJ, Norris MD, Haber M, Thompson JR, Fritschi L, Marshall GM, Armstrong BK. Maternal folate and other vitamin supplementation during pregnancy and risk of acute lymphoblastic leukemia in the offspring. Int J Cancer 2010; 126:2690-9. [PMID: 19839053 DOI: 10.1002/ijc.24969] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
The Australian Study of Causes of Acute Lymphoblastic Leukemia in Children (Aus-ALL) was designed to test the hypothesis, raised by a previous Western Australian study, that maternal folic acid supplementation during pregnancy might reduce the risk of childhood acute lymphoblastic leukemia (ALL). Aus-ALL was a national, population-based, multicenter case-control study that prospectively recruited 416 cases and 1,361 controls between 2003 and 2007. Detailed information was collected about maternal use of folic acid and other vitamin supplements before and during the index pregnancy. Data were analyzed using logistic regression, adjusting for matching factors and potential confounders. A meta-analysis with the results of previous studies of folic acid supplementation was also conducted. We found weak evidence of a protective effect of maternal folate supplementation before pregnancy against risk of childhood ALL, but no evidence for a protective effect of its use during pregnancy. A meta-analysis including this and 2 other studies, but not the study that raised the hypothesis, also found little evidence that folate supplementation during pregnancy protects against ALL: the summary odds ratios (ORs) for folate supplementation were 1.06 [95% confidence interval (CI): 0.77-1.48] with reference to no folate supplementation and 1.02 (95% CI: 0.86-1.20) with reference to no vitamin supplementation. For vitamin supplementation in general, the summary OR from a meta-analysis of 5 studies-including Aus-ALL-was 0.83 (95% CI: 0.73-0.94). Vitamin supplementation in pregnancy may protect against childhood ALL, but this effect is unlikely to be large or, if real, specifically due to folate.
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Affiliation(s)
- Elizabeth Milne
- Telethon Institute for Child Health Research, Centre for Child Health Research, West Perth, Western Australia 6872, Australia.
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zur Hausen H. Childhood leukemias and other hematopoietic malignancies: Interdependence between an infectious event and chromosomal modifications. Int J Cancer 2009; 125:1764-70. [DOI: 10.1002/ijc.24365] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Kwan ML, Jensen CD, Block G, Hudes ML, Chu LW, Buffler PA. Maternal diet and risk of childhood acute lymphoblastic leukemia. Public Health Rep 2009; 124:503-14. [PMID: 19618787 DOI: 10.1177/003335490912400407] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE Intrauterine environmental factors, including maternal diet, may play an etiologic role in acute lymphoblastic leukemia (ALL), a common childhood cancer. Expanding on previous findings from phase 1 of the Northern California Childhood Leukemia Study (NCCLS), a population-based case-control study, we sought to further elucidate and replicate the relationships between maternal diet and ALL risk. METHODS We matched 282 case-control sets of children (205 pairs and 77 triplets) from phases 1 and 2 of the NCCLS on sex, date of birth, mother's race, Hispanic racial/ethnic status, and county of residence at birth. We used an interviewer-administered food frequency questionnaire to obtain information on maternal dietary intake in the 12 months prior to pregnancy. RESULTS Risk of ALL was inversely associated with maternal consumption of vegetable (adjusted odds ratio [AOR] = 0.65, 95% confidence interval [CI] 0.50, 0.84); protein sources (AOR = 0.55, 95% CI 0.32, 0.96); fruit (AOR = 0.81, 95% CI 0.65, 1.00); and legume food groups (AOR = 0.75, 95% CI 0.59, 0.95). The risk reduction was strongest for consumption of the protein sources and vegetable food groups, independent of the child's diet up to age 2 years, and consistent across phases 1 and 2 of data collection for vegetable consumption. CONCLUSIONS These data suggest that it may be prudent for women to consume a diet rich in vegetables and adequate in protein prior to and during pregnancy as a possible means of reducing childhood ALL risk in their offspring.
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Affiliation(s)
- Marilyn L Kwan
- Kaiser Permanente, Division of Research, Oakland, CA 94612, USA.
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Buffler PA, Kwan ML, Reynolds P, Urayama KY. Environmental and Genetic Risk Factors for Childhood Leukemia: Appraising the Evidence. Cancer Invest 2009. [DOI: 10.1081/cnv-46402] [Citation(s) in RCA: 150] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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Pogoda JM, Preston-Martin S, Howe G, Lubin F, Mueller BA, Holly EA, Filippini G, Peris-Bonet R, McCredie MRE, Cordier S, Choi W. An international case-control study of maternal diet during pregnancy and childhood brain tumor risk: a histology-specific analysis by food group. Ann Epidemiol 2009; 19:148-60. [PMID: 19216997 PMCID: PMC2832584 DOI: 10.1016/j.annepidem.2008.12.011] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2008] [Revised: 12/07/2008] [Accepted: 12/11/2008] [Indexed: 12/30/2022]
Abstract
PURPOSE Maternal dietary data from an international collaborative case-control study on childhood brain tumors were used to evaluate associations between histology-specific risk and consumption of specific food groups during pregnancy. METHODS Nine study centers from seven countries contributed 1218 cases and 2223 controls. Most cases were diagnosed between 1982 and 1992 and ranged in age from 0 to 19 years. Dietary consumption was measured as average grams per day. RESULTS Foods generally associated with increased risk were cured meats, eggs/dairy, and oil products; foods generally associated with decreased risk were yellow-orange vegetables, fresh fish, and grains. The cured meat association was specific to astrocytomas (odds ratio [OR] range=1.8-2.5 across astrocytoma subtypes for 4th vs. 1st quartile of consumption, p trends CONCLUSIONS These results suggest the need for dietary analysis not only by brain tumor histology, but also by specific foods within a broad food group.
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Affiliation(s)
- Janice M Pogoda
- USC/Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, CA, USA.
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Cured meat, vegetables, and bean-curd foods in relation to childhood acute leukemia risk: a population based case-control study. BMC Cancer 2009; 9:15. [PMID: 19144145 PMCID: PMC2653540 DOI: 10.1186/1471-2407-9-15] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2008] [Accepted: 01/13/2009] [Indexed: 11/23/2022] Open
Abstract
Background Consumption of cured/smoked meat and fish leads to the formation of carcinogenic N-nitroso compounds in the acidic stomach. This study investigated whether consumed cured/smoked meat and fish, the major dietary resource for exposure to nitrites and nitrosamines, is associated with childhood acute leukemia. Methods A population-based case-control study of Han Chinese between 2 and 20 years old was conducted in southern Taiwan. 145 acute leukemia cases and 370 age- and sex-matched controls were recruited between 1997 and 2005. Dietary data were obtained from a questionnaire. Multiple logistic regression models were used in data analyses. Results Consumption of cured/smoked meat and fish more than once a week was associated with an increased risk of acute leukemia (OR = 1.74; 95% CI: 1.15–2.64). Conversely, higher intake of vegetables (OR = 0.55; 95% CI: 0.37–0.83) and bean-curd (OR = 0.55; 95% CI: 0.34–0.89) was associated with a reduced risk. No statistically significant association was observed between leukemia risk and the consumption of pickled vegetables, fruits, and tea. Conclusion Dietary exposure to cured/smoked meat and fish may be associated with leukemia risk through their contents of nitrites and nitrosamines among children and adolescents, and intake of vegetables and soy-bean curd may be protective.
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Tower RL, Spector LG. The Epidemiology of Childhood Leukemia with a Focus on Birth Weight and Diet. Crit Rev Clin Lab Sci 2008; 44:203-42. [PMID: 17453918 DOI: 10.1080/10408360601147536] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Leukemia is the most common childhood cancer and a major source of morbidity and mortality. The etiology of childhood leukemia remains largely unknown. Cytogenetic abnormalities determine disease subtypes, prognosis, clinical presentation, and course and may help in discovering etiological factors. Epidemiologic investigations of leukemia are complicated by many factors, including the rarity of the disease, necessitating careful study design. Two emerging areas of interest in leukemia etiology are birth weight and diet. High birth weight has been associated with increased risk of childhood leukemia. The biological mechanism behind this association may involve insulin-like growth factor I (IGF-I), which is associated with high birth weight. IGF-I may act by increasing the absolute number of stem cells available for transformation, stimulating the growth of cells that are already transformed, or a combination of effects. Diet has been linked with leukemia. Maternal dietary DNA topoisomerase II (DNAt2) inhibitor intake is associated with infant acute myeloid leukemia (AML) with the MLL gene translocation. Increased intake of fruits and vegetables has been associated with decreased leukemia risk and, relatedly, lack of maternal folate supplementation has been associated with increased childhood leukemia risk, possibly by causing DNA hypomethylation and increased DNA strand breaks. Methylenetetrahydrofolate reductase (MTHFR) gene polymorphisms modify this risk.
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Affiliation(s)
- Richard L Tower
- Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota 55455, USA
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Blair CK, Roesler M, Xie Y, Gamis AS, Olshan AF, Heerema NA, Robison LL, Ross JA. Vitamin supplement use among children with Down's syndrome and risk of leukaemia: a Children's Oncology Group (COG) study. Paediatr Perinat Epidemiol 2008; 22:288-95. [PMID: 18426524 PMCID: PMC3365502 DOI: 10.1111/j.1365-3016.2008.00928.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Vitamin supplements have been proposed for children with Down's syndrome (DS) with claims of improving cognitive abilities, or immune or thyroid function. Several studies have shown decreased levels of zinc in this population. Because children with DS have a 50-fold increased risk of developing acute leukaemia during the first 5 years of life, we explored the relation between child vitamin and herbal supplement use and the risk of leukaemia in a case-control study. During the period 1997-2002, we enrolled 158 children with DS aged 0-18 years that were diagnosed with acute lymphoblastic leukaemia (ALL) (n = 97) or acute myeloid leukaemia (AML) (n = 61) at participating Children's Oncology Group institutions. We enrolled 173 DS children without leukaemia (controls), selected from the cases' primary care clinic and frequency-matched on age. Data were collected via telephone interviews with mothers of the index child regarding use of multivitamins, zinc, vitamin C, iron and herbal supplements, including age at first use, frequency and duration. Among controls, 57% reported regular multivitamin use (>/=3 times/week for >/=3 months) compared with 48% of ALL cases and 61% of AML cases. We found no evidence of an association between children's regular multivitamin use and ALL or AML (adjusted odds ratios [OR] = 0.94 [95% CI 0.52, 1.70] and 1.90 [0.73, 4.91] respectively). There was a suggestion of an increased risk for AML associated with regular multivitamin use during the first year of life or for an extended duration (ORs = 2.38 [0.94, 5.76] and 2.59 [1.02, 6.59] respectively). Despite being the largest study of DS-leukaemia, our sample size was small, resulting in imprecise effect estimates. Future research should include larger sample sizes as well as a full assessment of diet including vitamin supplementation to adequately examine the relation between nutritional status and childhood leukaemia.
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Affiliation(s)
- Cindy K. Blair
- University of Minnesota Cancer Center,Division of Pediatric Epidemiology & Clinical Research, Department of Pediatrics, University of Minnesota, Minneapolis, MN
| | - Michelle Roesler
- University of Minnesota Cancer Center,Division of Pediatric Epidemiology & Clinical Research, Department of Pediatrics, University of Minnesota, Minneapolis, MN
| | - Yang Xie
- Division of Pediatric Epidemiology & Clinical Research, Department of Pediatrics, University of Minnesota, Minneapolis, MN
| | | | - Andrew F. Olshan
- Department of Epidemiology, University of North Carolina, Chapel Hill, North Carolina
| | - Nyla A. Heerema
- Department of Pathology, Ohio State University, Columbus, OH
| | - Leslie L Robison
- Department of Epidemiology and Cancer Control, St. Jude Children’s Research Hospital, Memphis, TN
| | - Julie A. Ross
- University of Minnesota Cancer Center,Division of Pediatric Epidemiology & Clinical Research, Department of Pediatrics, University of Minnesota, Minneapolis, MN,To whom correspondence should be addressed: Dr. Julie Ross, Department of Pediatrics, MMC 422, 420 Delaware St. S.E., Minneapolis, MN 55455, Telephone: 612-626-2902, Fax: 612-626-4842,
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Goh YI, Koren G. Prenatal supplementation with multivitamins and the incidence of pediatric cancers: clinical and methodological considerations. Pediatr Blood Cancer 2008; 50:487-9; discussion 498. [PMID: 18064661 DOI: 10.1002/pbc.21403] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Cancer is the second leading cause of death in children. Research has been undertaken to identify risk factors associated with pediatric cancers. Nevertheless one single cause has not been isolated. Recent studies have suggested that prenatal multivitamin consumption may be associated with the prevention of pediatric cancers. It has been shown previously that prenatal multivitamin ingestion is associated with a decrease in congenital anomalies. The following review summarizes the available knowledge associating prenatal multivitamin consumption with the prevention of pediatric cancers.
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Affiliation(s)
- Y Ingrid Goh
- Motherisk Program, Division of Clinical Pharmacology and Toxicology, The Hospital for Sick Children, Toronto, Canada
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de Klerk N, Milne E. Overview of recent studies on childhood leukaemia, intra-uterine growth and diet. RADIATION PROTECTION DOSIMETRY 2008; 132:255-258. [PMID: 19124554 DOI: 10.1093/rpd/ncn303] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Many studies have looked at the association between birth weight and risk of acute lymphoblastic leukaemia in children, but few have been able to examine the growth by incorporating estimates of gestational age. Recent results suggest that increased growth is associated with increased risk of childhood leukaemia. Evidence is also gathering that certain dietary intakes, possibly folate, in mothers, are also related to leukaemia occurrence. If these associations are real, they may be operating through growth factor pathways.
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Affiliation(s)
- Nicholas de Klerk
- Telethon Institute for Child Health Research and Centre for Child Health Research, University of Western Australia, 100 Roberts Road, Subiaco, WA 6008, Australia.
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Sebranek JG, Bacus JN. Cured meat products without direct addition of nitrate or nitrite: what are the issues? Meat Sci 2007; 77:136-47. [PMID: 22061404 DOI: 10.1016/j.meatsci.2007.03.025] [Citation(s) in RCA: 267] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2007] [Revised: 03/29/2007] [Accepted: 03/30/2007] [Indexed: 11/27/2022]
Abstract
The growing popularity of food products marketed in the United States as "natural" and "organic" has resulted in a proliferation of marketing efforts to meet consumer demands for these foods. Because natural and organic foods are not permitted to use chemical preservatives, the traditional curing agents used for cured meats, nitrate and/or nitrite, cannot be added to natural and organic processed meat products. However, alternative processes that utilize ingredients with high nitrate content, such as vegetable-based ingredients, and a nitrate-reducing starter culture can produce processed meats with very typical cured meat properties. Because it is not possible to analytically measure the amount of nitrite produced by this process, several potential issues deserve consideration. Regulations, for example, should permit labeling that accurately reflects the process and products, manufacturing procedures must be standardized to achieve product consistency, marketing efforts should clearly communicate the nature of these products to consumers, product quality must be maintained, and microbiological safety must be assured.
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Affiliation(s)
- Joseph G Sebranek
- Department of Animal Science, Department of Food Science and Human Nutrition, 215 Meat Laboratory, Iowa State University, Ames, IA 50011, United States
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37
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Goh YI, Bollano E, Einarson TR, Koren G. Prenatal Multivitamin Supplementation and Rates of Pediatric Cancers: A Meta-Analysis. Clin Pharmacol Ther 2007; 81:685-91. [PMID: 17314929 DOI: 10.1038/sj.clpt.6100100] [Citation(s) in RCA: 77] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Prenatal supplementation of folic acid has been shown to decrease the risk of several congenital malformations. Several studies have recently suggested a potential protective effect of folic acid on certain pediatric cancers. The protective role of prenatal multivitamins has not been elucidated. We conducted a systematic review and meta-analysis to assess the potential protective effect of prenatal multivitamins on several pediatric cancers. Medline, PubMed, EMBASE, Toxline, Healthstar, and Cochrane databases were searched for studies published in all languages from 1960 to July 2005 on multivitamin supplementation and pediatric cancers. References from all articles collected were reviewed for additional articles. Two blinded independent reviewers assessed the articles for inclusion and exclusion. Rates of cancers in women supplemented with multivitamins were compared with unsupplemented women using a random effects model. Sixty-one articles were identified in the initial search, of which, seven articles met the inclusion criteria. There was an apparent protective effect for leukemia (odds ratio (OR)=0.61, 95% confidence interval (CI)=0.50-0.74), pediatric brain tumors (OR=0.73, 95% CI=0.60-0.88) and neuroblastoma (OR=0.53, 95% CI=0.42-0.68). In conclusion, maternal ingestion of prenatal multivitamins is associated with a decreased risk for pediatric brain tumors, neuroblastoma, and leukemia. Presently, it is not known which constituent(s) among the multivitamins confer this protective effect.
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Affiliation(s)
- Y I Goh
- Department of Pharmaceutical Sciences, University of Toronto, and The Motherisk Program, Division of Clinical Pharmacology/Toxicology, The Hospital for Sick Children, Toronto, Ontario, Canada
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Bunin GR, Gallagher PR, Rorke-Adams LB, Robison LL, Cnaan A. Maternal Supplement, Micronutrient, and Cured Meat Intake during Pregnancy and Risk of Medulloblastoma during Childhood: A Children's Oncology Group Study. Cancer Epidemiol Biomarkers Prev 2006; 15:1660-7. [PMID: 16985028 DOI: 10.1158/1055-9965.epi-06-0254] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
We conducted a case-control study of medulloblastoma/primitive neuroectodermal tumors of brain (PNET) to pursue findings related to vitamin and mineral supplements, micronutrients, and cured meat consumption during gestation. Mothers of 315 cases ages <6 years at diagnosis in 1991 to 1997 identified from the United States and Canada through the Children's Oncology Group and mothers of 315 controls selected by random-digit dialing were interviewed. In the periconception period of the index pregnancy, case mothers were less likely than control mothers to report use of multivitamins [adjusted odds ratio (OR), 0.7; 95% confidence interval (95% CI), 0.4-1.0; P = 0.08] and to be in the highest quartile of iron and folate intake from food and supplements combined (adjusted OR for iron, 0.5; 95% CI, 0.3-0.9; P(trend) = 0.008; adjusted OR for folate, 0.5; 95% CI, 0.3-0.9; P(trend) = 0.007). Case and control mothers had similar intakes of cured meats, although case mothers were more likely to have the combination of high cured meat and low vitamin C intake (OR, 1.5; 95% CI, 1.0-2.3; P = 0.08). The results of the study add to the evidence of a protective role for multivitamins, suggest a possible role for micronutrients early in pregnancy, and generally do not support an association between cured meats and medulloblastoma/PNET.
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Affiliation(s)
- Greta R Bunin
- c/o Donna Correia, CureSearch, Children's Oncology Group, 440 East Huntington Drive, Arcadia, CA 91006, USA
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Dietrich M, Block G, Pogoda JM, Buffler P, Hecht S, Preston-Martin S. A review: dietary and endogenously formed N-nitroso compounds and risk of childhood brain tumors. Cancer Causes Control 2006; 16:619-35. [PMID: 16049800 DOI: 10.1007/s10552-005-0168-y] [Citation(s) in RCA: 54] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2004] [Accepted: 01/05/2005] [Indexed: 12/12/2022]
Abstract
Maternal dietary exposure to N-nitroso compounds (NOC) or to their precursors during pregnancy has been associated with risk of childhood brain tumors. Cured meat is one source of exposure to dietary NOC and their precursors. Most epidemiological studies that have examined the role of maternal consumption of cured meats during pregnancy have found a significant positive association between maternal intake of cured meat and the risk of childhood brain tumor (CBT). NOC consist of two main groups, N-nitrosamines and N-nitrosamides. The carcinogenicity profiles of NOC suggest that N-nitrosamides rather than N-nitrosamines are the compounds that may be associated with CBT and that they should be investigated more closely in epidemiological studies. We present a review of the chemical and carcinogenic properties of NOC in connection with the findings of case-control studies. This approach may be helpful in determining the essential information that must be collected in future epidemiological studies on CBT.
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Affiliation(s)
- Marion Dietrich
- School of Public Health, University of California-Berkeley, Berkeley, CA 94720-7360, USA.
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40
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Bunin GR, Kushi LH, Gallagher PR, Rorke-Adams LB, McBride ML, Cnaan A. Maternal Diet During Pregnancy and its Association with Medulloblastoma in Children: A Children’s Oncology Group Study (United States). Cancer Causes Control 2005; 16:877-91. [PMID: 16132798 DOI: 10.1007/s10552-005-3144-7] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2005] [Accepted: 03/03/2005] [Indexed: 10/25/2022]
Abstract
Fruit, vegetables, vitamin C, and folate during pregnancy have been suggested as protective factors for medulloblastoma/primitive neuroectodermal tumor (PNET), a common brain tumor in children. The authors sought to replicate these findings and investigate other aspects of diet. Mothers of 315 cases under age six at diagnosis and 315 controls were interviewed about their pregnancy diet. The authors observed modest, inverse associations for fruits/juices (odds ratio (OR) for highest compared to lowest category = 0.6, 95% confidence interval (CI): 0.3, 1.1) and vitamin C (OR = 0.6, 95% CI: 0.4, 1.1). In contrast to the previous study, folate and vegetables showed no association. As hypothesized, cured meats were not associated with medulloblastoma/PNET, in contrast to other childhood brain tumors. An inverse association with non-fresh peaches and similar fruits (OR = 0.5, 95% CI: 0.3, 0.8) and a positive association with non-chocolate candy (OR = 1.7, 95% CI: 1.0, 3.0) replicated previous findings. French fries (OR = 2.4, 95% CI: 1.2, 4.9) and chili peppers (OR = 1.8, 95% CI: 1.0, 3.0) were associated with medulloblastoma/PNET. The results suggest that some aspects of diet are worthy of further research.
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Affiliation(s)
- Greta R Bunin
- Oncology, Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA.
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41
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Abstract
Pregnancy sickness, a suite of "symptoms" that frequently co-occur during pregnancy, may be an adaptation providing behavioral prophylaxis against infection. Maternal immunosupression, necessary for tolerance of the fetus, results in gestational vulnerability to pathogens. Throughout the period of maximal vulnerability, dietary behavior is significantly altered via changes in nausea susceptibility and olfaction and the development of marked aversions and cravings. Of food types, meat is both the most likely to carry pathogens and the principal target of gestational aversions and pregnancy taboos. Because meat was prominent in ancestral human diets but hygienic procedures that effectively eliminate the risk of meat-borne infection are recent, such pathogens likely constituted a source of selective pressure on pregnant females throughout human history. Both the relatively low protein and energy demands of the first trimester and the existense of nonmeat alternatives would have allowed for the evolution of time-limited gestational meat-avoidance mechanisms.Complementing these mechanisms, gestational cravings target substances that may influence immune functioning and affect the availability of iron in the gastro-intestinal tract, thereby limiting the proliferation of iron-dependent pathogens. Clinical and ethnographic findings are examined in light of these proposals, and directions for future research are outlined.
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42
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Kilic B, Cassens R, Borchert L. Effect of Turkey Meat, Phosphate, Sodium Lactate, Carrageenan, and Konjac on Residual Nitrite in Cured Meats. J Food Sci 2002. [DOI: 10.1111/j.1365-2621.2002.tb11353.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Pereira RA, Koifman S. Associação entre fatores da dieta e tumores de cérebro em adultos: uma revisão da literatura. CAD SAUDE PUBLICA 2001. [DOI: 10.1590/s0102-311x2001000600003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Desenvolveu-se uma revisão da literatura científica publicada entre 1986 e 1999, sobre a associação entre fatores da dieta e os tumores de cérebro em adultos, com o objetivo de descrever as associações observadas e discutir os aspectos metodológicos que possam influenciar os resultados observados. De um modo geral, os estudos revisados parecem apontar na direção de uma associação moderada entre os fatores da dieta e os tumores de cérebro; há evidências de que o consumo de compostos N-nitroso possa favorecer o desenvolvimento desses tumores, e de que o consumo de vegetais e frutas pode ter papel na sua inibição. A participação dos respondentes substitutos nos estudos analisados, pode ter introduzido viés de memória nas informações levantadas e contribuído para a inconsistência dos achados. As investigações epidemiológicas sobre a associação da dieta com estes tumores devem considerar a análise de outros fatores alimentares, além dos compostos N-nitroso. É necessário precisar os períodos de exposição que devem ser investigados e contar com criteriosa metodologia, de modo a prevenir a ocorrência de tendenciosidades relacionadas com a seleção dos controles e minimizar os efeitos do viés de memória.
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44
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Haorah J, Zhou L, Wang X, Xu G, Mirvish SS. Determination of total N-nitroso compounds and their precursors in frankfurters, fresh meat, dried salted fish, sauces, tobacco, and tobacco smoke particulates. JOURNAL OF AGRICULTURAL AND FOOD CHEMISTRY 2001; 49:6068-78. [PMID: 11743810 DOI: 10.1021/jf010602h] [Citation(s) in RCA: 61] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
Total N-nitroso compounds (NOC) and NOC precursors (NOCP) were determined in extracts of food and tobacco products. Following Walters' method, NOC were decomposed to NO with refluxing HBr/HCl/HOAc/EtOAc and NO was measured by chemiluminescence. NOC were determined after sulfamic acid treatment to destroy nitrite, and NOCP were determined after treatment with 110 mM nitrite and then sulfamic acid. Analysis without HBr gave results < or =20% of those with HBr. This NOC method was efficient for nitrosamines but not nitrosoureas. The standard nitrosation for determining NOCP gave high yields for readily nitrosated amines, including 1-deoxy-1-fructosylvaline, but not for simple amines, dipeptides, and alkylureas. Mean NOC and NOCP results were (respectively, in micromol/kg of product) 5.5 and 2700 for frankfurters, 0.5 and 660 for fresh meat, 5.8 and 5800 for salted, dried fish, and 660 and 2900 for chewing tobacco (all for aqueous extracts) and 220 and 20000 nmol/cigarette for MeCN extracts of cigarette smoke filter pads.
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Affiliation(s)
- J Haorah
- Eppley Institute for Research in Cancer, University of Nebraska Medical Center, Omaha, Nebraska 68198, USA
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45
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Pogoda JM, Preston-Martin S. Maternal cured meat consumption during pregnancy and risk of paediatric brain tumour in offspring: potentially harmful levels of intake. Public Health Nutr 2001; 4:183-9. [PMID: 11299090 DOI: 10.1079/phn200060] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVE To describe the relationship between specific levels of nitrite intake from cured meat consumption during pregnancy and the relative risk of paediatric brain tumours in the offspring. DESIGN Exposure data were previously collected for a population-based case-control study of paediatric brain tumours; data on nitrite content were obtained by a comprehensive literature review of surveys of residual nitrite content in cured meats published in the USA and Canada. The level of nitrite intake for each mother was predicted by year of pregnancy based on survey results. Dose-response was evaluated both categorically and continuously using polynomial and quadratic spline regression. SETTING The US west coast: Los Angeles County, the San Francisco-Oakland Bay Area and the Seattle-Puget Sound area. SUBJECTS There were 540 cases diagnosed between 1984 and 1990 at ages varying from 0 to 19 years, and 801 controls frequency-matched by geographic area, age and birth year. RESULTS In general, survey results suggest a trend of decreasing nitrite levels in cured meats over time. We observed a moderate increase in brain tumour risk in the offspring of mothers with relatively low levels of nitrite consumption from cured meats during pregnancy, and a two- to three-fold risk increase in offspring of mothers who consumed 3 mg day-1 nitrite from cured meats (about 125 g day-1 of cured meat consumption throughout the pregnancy). CONCLUSIONS A substantial risk of paediatric brain tumour appears to be associated with relatively high levels of maternal cured meat consumption during pregnancy. A more scientifically valid approach than a literature review to estimate nitrite intake from cured meats and data from a large group of highly exposed subjects would be useful in determining potentially harmful levels.
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Affiliation(s)
- J M Pogoda
- 1Statology, 10355 Pine Cone Way, Truckee, CA 96161, USA.
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46
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Blot WJ, Henderson BE, Boice JD. Childhood cancer in relation to cured meat intake: review of the epidemiological evidence. Nutr Cancer 2001; 34:111-8. [PMID: 10453449 DOI: 10.1207/s15327914nc340115] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
Over the past two decades a series of epidemiological studies have examined the relationship between consumption of cured meats during pregnancy and the subsequent risk of brain tumors, as well as other cancers, in the offspring. The research was prompted in large part by experimental investigations showing that transplacental exposure to certain N-nitroso compounds, i.e., nitrosoureas, could produce brain tumors in laboratory animals. Fourteen such epidemiological studies, 13 of which used the case-control approach, are reviewed here. Most of the studies showed no significant association between total cured meat intake and childhood cancer risk but more found positive than negative relationships. Furthermore, several studies reported significant positive associations for maternal and sometimes childhood or paternal consumption of one or more cured meats, with odds ratios of twofold or greater reported among the highest consumers. On the other hand, a correlation analysis found no positive concordance between temporal trends from the 1970s to 1990s in childhood brain cancer rates and cured meat consumption, inasmuch as cancer rates rose over time while residual nitrite levels in cured meats fell sharply. Because of the potential for bias, especially recall bias, and/or confounding, the relatively weak magnitude of the associations reported, and the inconsistency between study findings, at this time it cannot be concluded that eating cured meat has increased the risk of childhood brain cancer or any other cancers. Moreover, although N-nitroso compounds are sometimes found in cured meats or may be formed endogenously, there is no empirical evidence that eating cured meats results in human neural nitrosourea exposure. Nevertheless, the hypothesis that eating nitrite-cured meats may influence childhood and perhaps adult brain cancer cannot be dismissed. Unbiased evaluation of the hypothesis may derive from the conduct of cohort studies, where the interview-derived information on cured meat intake precedes, or is not otherwise associated with, the diagnosis of cancer.
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Affiliation(s)
- W J Blot
- International Epidemiology Institute, Rockville, MD 20850, USA
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Kilic B, Cassens RG, Borchert LL. Influence of turkey meat on residual nitrite in cured meat products. J Food Prot 2001; 64:235-9. [PMID: 11271773 DOI: 10.4315/0362-028x-64.2.235] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
A response surface experimental design was employed to estimate residual nitrite level at various initial nitrite concentrations, percent turkey meat in the formula, and heat quantity (F) values using a typical wiener as the test system. Pork and mechanically separated turkey were used as the meat ingredients. Residual nitrite and pH were measured at day 1, 7 days, 14 days, and 49 days after processing. Protein, fat, salt, moisture, and CIE (L*a*b*) color values were also determined. Results showed that the effect of turkey meat on residual nitrite level was significant (P < 0.01). An increased amount of turkey meat in the formula resulted in lower residual nitrite levels at a fixed pH. The residual nitrite level was initially proportional to initial nitrite concentration, but it became a nonsignificant factor during longer storage time. Differences in heat quantity had a significant effect (P < 0.05) on residual nitrite level initially. Greater heat quantity decreased residual nitrite level in finished cured meat products at a fixed pH. However, this effect became nonsignificant during longer storage. Reduction of residual nitrite in wieners because of turkey meat addition at a fixed pH was due to characteristics of the turkey tissue, but the mechanism of action remains unknown. It was also established that commercial wieners had a higher pH if poultry meat was included in the formulation.
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Affiliation(s)
- B Kilic
- University of Wisconsin-Madison, Department of Aninmal Sciences, 53706, USA
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48
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Dineen N, Kerry J, Lynch P, Buckley D, Morrissey P, Arendt E. Reduced nitrite levels and dietary α-tocopheryl acetate supplementation: effects on the colour and oxidative stability of cooked hams. Meat Sci 2000; 55:475-82. [DOI: 10.1016/s0309-1740(00)00008-5] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/1999] [Revised: 11/05/1999] [Accepted: 01/05/2000] [Indexed: 11/29/2022]
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49
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Lubin F, Farbstein H, Chetrit A, Farbstein M, Freedman L, Alfandary E, Modan B. The role of nutritional habits during gestation and child life in pediatric brain tumor etiology. Int J Cancer 2000; 86:139-43. [PMID: 10728608 DOI: 10.1002/(sici)1097-0215(20000401)86:1<139::aid-ijc22>3.0.co;2-c] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Our aim was to evaluate the role of maternal nutritional habits during the period of gestation and of children subsequent diet in the etiology of pediatric brain tumors. All cases of incident nervous system tumors under age 18, diagnosed between 1984 and 1993 (n = 300) in Israel were identified. Two matched population controls per case were selected (n = 574). Personal interviews, using a semi-quantified three-step food frequency questionnaire, were performed. Univariate analysis showed that increased child consumption of vegetable fat [p trend 0.01; 95% confidence interval (CI) 1.1-3.2], carbohydrates (p trend 0.05; CI 1.0-5.9), and vitamin E (p trend 0.05; CI 1.0-3.3), were significantly associated with brain tumor risk. No associations were found with nitrate, nitrite or vitamin C. A significant positive association with potassium consumption (p trend 0.01; CI 1.1-3.7) was noted during gestation. Results of multivariate analysis showed that the only persisting associations were with vegetable fat (OR = 1.36; CI 1.06-1.73) in the child diet and potassium intake during gestation (OR = 1.44; CI 1.04-1.99). In conclusion, nutritional associations with pediatric brain tumor etiology, remain unsubstantiated.
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Affiliation(s)
- F Lubin
- Department of Clinical Epidemiology, Chaim Sheba Medical Center, Tel Hashomer, Israel.
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50
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Cancers des enfants et contaminants de l’environnement. Canadian Journal of Public Health 1998. [DOI: 10.1007/bf03405097] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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