Cancer Causes & Control

, Volume 5, Issue 2, pp 177–187 | Cite as

Maternal diet and risk of astrocytic glioma in children: a report from the Childrens Cancer Group (United States and Canada)

  • Greta R. Bunin
  • René R. Kuijten
  • Carl P. Boesel
  • Jonathan D. Buckley
  • Anna T. Meadows
Research Papers


N-nitroso compounds and their precursors, nitrites and nitrates, have been hypothesized as risk factors, and vitamins C and E, which inhibit N-nitroso formation, as protective factors for brain tumors. A case-control study of maternal diet during pregnancy and risk of astrocytoma, the most common childhood brain tumor, was conducted by the Childrens Cancer Group. The study included 155 cases under age six at diagnosis and the same number of matched controls selected by random-digit dialing. A trned was observed for consumption of cured meats, which contain preformed nitrosamines (a class of N-nitroso compounds) and their precursors (adjusted odds ratio [OR] for highest quartile of intake relative to lowest=1.7,P trend=0.10). However, no strong trends were observed for nitrosamine (OR=0.8,P=0.60); nitrite (OR=1.3,P=0.54); nitrate (OR=0.7,P=0.43); vitamin C (OR=0.7,P=0.37); or vitamin E (OR=0.7,P=0.48). Iron supplements were associated with a significant decrease in risk (OR=0.5, 95 percent confidence interval=0.3–0.8). The effect of several dietary factors differed by income level, making interpretation of the results difficult. Future research should investigate the effect of dietary components not assessed in this study, as these may explain the disparate effects by income level. The results of this study provide limited support for the nitrosamine hypothesis.

Key words

Astrocytoma childhood brain tumors diet North America 


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  1. 1.
    Young JL Jr, Ries LG, Silverberg E, Horm JW, Miller RW. Cancer incidence, survival, and mortality for children younger than 15 years.Cancer 1986;58: 598–602.PubMedGoogle Scholar
  2. 2.
    Schoenberg BS, Christine BW, Whisnant JP. The descriptive epidemiology of primary intracranial neoplasms: The Connecticut experience.Am J Epidemiol 1976;104: 499–510.PubMedGoogle Scholar
  3. 3.
    Mealy J, Hall PV. Medulloblastoma in children: Survival and treatment.J Neurosurg 1977;46: 56–64.PubMedGoogle Scholar
  4. 4.
    Magee PN, Montesano R, Preussmann R. N-nitroso compounds and related carcinogens. In: Searle CE, ed.Chemical Carcinogens. Washington DC, USA: American Chemical Society, 1976; Monogr 173: 491–625.Google Scholar
  5. 5.
    Tannenbaum SR, Mergens W. Reaction of nitrite with vitamins C and E.Ann NY Acad Sci 1980;355: 267–77.PubMedGoogle Scholar
  6. 6.
    Wattenberg LW. Inhibition of neoplasia by minor dietary constituents.Cancer Res 1983;43 Suppl: 2448s-53s.PubMedGoogle Scholar
  7. 7.
    Preston-Martin S, Yu MC, Benton B, Henderson BE. N-nitroso compounds and childhood brain tumors: a case-control study.Cancer Res 1982;42: 5240–5.PubMedGoogle Scholar
  8. 8.
    Kuijten RR, Bunin GR, Nass CC, Meadows AT. Gestational and familial risk factors for childhood astrocytoma: Results of a case-control study.Cancer Res 1990;50: 2608–12.PubMedGoogle Scholar
  9. 9.
    Howe GR, Burch JD, Chiarelli AM, Risch HA, Choi BCK. An exploratory case-control study of brain tumors in children.Cancer Res 1989;49: 4349–52.PubMedGoogle Scholar
  10. 10.
    Burch JD, Craib KJP, Choi BCK, Miller AB, Risch HA, Howe GR. An exploratory case-control study of brain tumors in adults.JNCI 1987;78: 601–9.PubMedGoogle Scholar
  11. 11.
    Preston-Martin S, Mack W, Henderson BE. Risk factors for gliomas and meningiomas in males in Los Angeles Country.Cancer Res 1989;49: 6137–43.PubMedGoogle Scholar
  12. 12.
    Magram G, Schut L, Paoletri P, et al., eds. Brain stem gliomas. In:Neuro-Oncology. Boston, MA, USA: Kluwer Academic Publishers, 1991.Google Scholar
  13. 13.
    World Health Organization.International Classification of Diseases for Oncology. Geneva, Switzerland: WHO, 1979.Google Scholar
  14. 14.
    Ward EM, Kramer S, Meadows AT. The efficacy of random digit dialing in selecting matched controls for a case-control study of pediatric cancer.Am J Epidemiol 1984;120: 582–91.PubMedGoogle Scholar
  15. 15.
    Howe GR, Harrison L, Jain M. A short diet history for assessing dietary exposure to N-nitrosamines in epidemiologic studies.Am J Epidemiol 1986;124: 595–602.PubMedGoogle Scholar
  16. 16.
    Murphy SP, Subar AF, Block G. Vitamin E intakes and sources in the United States.Am J Clin Nutr 1990;52: 361–7.PubMedGoogle Scholar
  17. 17.
    Subar AF, Block G, James LD. Folate intake and food sources in the US population.Am J Clin Nutr 1989;50: 508–16.PubMedGoogle Scholar
  18. 18.
    Block G, Hartman AM, Dresser CM, Carroll MD, Gannon J, Gardner L. A data-based approach to diet questionnaire design and testing.Am J Epidemiol 1986;124: 453–69.PubMedGoogle Scholar
  19. 19.
    National Academy of Sciences.The Health Effects of Nitrate, Nitrite and N-nitroso Compounds. Part 1. Washington DC: Natl Acad Sci, 1981.Google Scholar
  20. 20.
    US Department of Agriculture, Agriculture Research Service.Composition of Foods: Raw, Processed, Prepared. Washington DC: US Government Printing Office, 1976–82; Agriculture Handbook no. 8.Google Scholar
  21. 21.
    Breslow NE, Day NE.Statistical Methods in Cancer Research. I. The Analysis of Case-control Studies. Lyon, France: International Agency for Research on Cancer, 1980; IARC Sci. Pub. 32.Google Scholar
  22. 22.
    Bunin GR, Kuijten RR, Buckley JD, Rorke LB, Meadows AT. Relation between maternal diet and subsequent primitive neuroectodermal brain tumors in young children.New Engl J Med 1993; in press.Google Scholar
  23. 23.
    Sarasua S, Savitz DA. Cured and broiled meat consumption in relation to childhood cancer.Cancer Causes Control 1993;5: 141–8.Google Scholar
  24. 24.
    Preston-Martin S, Bartsch H, Pignatelli B, Ohshima H, Wahrendorf J. Re: NldN-nitroso compounds and human cancer: a molecular epidemiologic approach”.Am J Epidemiol 1986;124: 155–6.PubMedGoogle Scholar
  25. 25.
    King MM, McCay PB. Modulation of tumor incidence and possible mechanisms of inhibition of mammary carcinogenesis by dictary antioxidants.Cancer Res 1983;43: s2485–90.Google Scholar
  26. 26.
    Stich HF, Rosin MP, Bryson L. Inhibition of mutagenicity of a model nitrosation reaction by naturally occurring phenolics, coffee and tea.Mutat Res 1982;95: 119–28.PubMedGoogle Scholar
  27. 27.
    Wilkins JR, Sinks TH. Parental occupation and intracranial neoplasms of childhood: results of a case-control interview study.Am J Epidemiol 1990;132: 275–92.PubMedGoogle Scholar
  28. 28.
    Zack M, Cannon S, Loyd D, et al. Cancer in children of parents exposed to hydrocarbon-related industries and occupations.Am J Epidemiol 1980;111: 329–36.PubMedGoogle Scholar

Copyright information

© Rapid Communications of Oxford Ltd 1994

Authors and Affiliations

  • Greta R. Bunin
    • 1
  • René R. Kuijten
    • 2
  • Carl P. Boesel
    • 3
  • Jonathan D. Buckley
    • 4
  • Anna T. Meadows
    • 1
  1. 1.Children's Hospital of PhiladelphiaUniversity of Pennsylvania, School of MedicinePhiladelphia(USA)
  2. 2.McKinsey & CompanyAmsterdamthe Netherlands
  3. 3.Columbus Children's HospitalColumbus(USA)
  4. 4.the University of Southern California School of MedicineLos Angeles(USA)

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