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Maternal and infant diet play a role in acute leukemia development: An expanded systematic review and meta-analysis
M Karen Flores-García1, Gisela Flores-Collado1, Ángel Mérida-Ortega1
1Centro de Investigación en Salud Poblacional, Instituto Nacional de Salud Pública (INSP), Cuernavaca, Morelos, Mexico.
Insights
Maternal and infant diets impact acute leukemia (AL) risk. Processed meat and coffee consumption were linked to increased AL risk, while vegetables and maternal fruit intake showed protective effects.
Area of Science:
- Epidemiology
- Pediatric Oncology
- Nutritional Science
Background:
- Acute leukemia (AL), including acute lymphoid leukemia (ALL) and acute myeloid leukemia (AML), is a significant health concern, particularly in children.
- Emerging evidence suggests a potential link between diet and AL development.
- This review synthesizes existing research on infant and maternal dietary patterns in relation to AL risk.
Purpose of the Study:
- To systematically review and meta-analyze observational studies investigating the association between AL and dietary factors in children and their mothers.
- To expand upon previous reviews by including a comprehensive search of multiple databases.
Main Methods:
- An extensive electronic search was conducted across PubMed/Medline, Lilacs, Scopus, and Web of Science up to April 2022.
- Included studies were observational, examining AL (ALL/AML) in relation to child and/or maternal diet.
- Meta-analysis employed fixed effects models, with heterogeneity assessed using Q statistic and I2. Risk of bias was evaluated using the Newcastle-Ottawa scale.
Main Results:
- Fifteen studies (1 cohort, 14 case-control) were analyzed, focusing on maternal diet (9 studies), child diet (4 studies), or both (2 studies).
- Childhood consumption of processed meat showed a positive association with AL (OR=1.72), while vegetable intake was inversely associated (OR=0.61).
- Maternal fruit consumption was linked to lower ALL risk (OR=0.71), whereas maternal coffee intake was associated with increased AL (OR=1.20) and ALL (OR=1.31) risk.
Conclusions:
- The findings support a significant role for both maternal and early infant diet in the etiology of acute leukemia.
- Specific dietary components, such as processed meats, vegetables, fruits, and coffee, may influence AL risk.
- Further research into dietary interventions could be beneficial for AL prevention strategies.
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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