Childhood folate, B6, B12, and food group intake and the risk of childhood brain tumors: results from an Australian case–control study
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The etiology of childhood brain tumors (CBT) is poorly understood, but dietary factors could be involved. In this case–control study of CBT, the possible associations of childhood intake of dietary and supplemental folate, vitamin B6, and vitamin B12 with the risk of CBT were investigated, along with various food groups.
Cases diagnosed between 2005 and 2010 were identified from 10 pediatric oncology centers in Australia and controls by nationwide random-digit dialling. For study children of ages 3–14 years, diet in the year before diagnosis (or recruitment) was assessed using food frequency questionnaires. Folate intake was adjusted for bioavailability, and dietary micronutrient intake was energy-adjusted. Micronutrients and food groups were analyzed using logistic regression adjusting for relevant confounders. Principal components analysis was conducted to assess food group intake patterns for analysis.
Food and micronutrient data were available for 216 cases and 523 controls. Folate intake was associated with a reduced risk of CBT overall (odds ratio for highest tertile vs. lowest: 0.63, 95 % confidence interval 0.41, 0.97) and particularly low-grade gliomas (odds ratio for highest tertile vs. lowest: 0.52, 95 % confidence interval 0.29, 0.92). Vitamin B6 and B12 intake was not associated with CBT risk, nor was processed meat.
High folate intake during childhood may reduce the risk of CBT. This potentially important finding needs to be corroborated in other studies. If replicated, these results could have important implications for public health recommendations regarding diet during childhood.
KeywordsChild Brain tumors Folate Neoplasms Micronutrients Processed meat Vitamins
The Aus-CBT consortium conducted the study, and the Telethon Kids Institute, University of Western Australia, was the coordinating center. Bruce Armstrong (Sydney School of Public Health, University of Sydney); Elizabeth Milne, Nicholas de Klerk, Carol Bower, Peter Dallas (Telethon Kids Institute); Frank van Bockxmeer (Royal Perth Hospital, University of WA); Rodney Scott and John Attia (University of Newcastle); Lin Fritschi (WA Institute for Medical Research); Lesley Ashton, Michelle Haber, and Murray Norris (Children’s Cancer Institute Australia for Medical Research, Lowy Cancer Research Centre, UNSW); Margaret Miller (Edith Cowan University); and Judith Thompson (WA Cancer Registry) were the research investigators. The authors acknowledge the contribution made by our clinical co-investigators who recruited and cared for study patients at each participating hospital: Nicholas Gottardo (Princess Margaret Hospital, Telethon Kids); John Heath and Elizabeth Smibert (Royal Children’s Hospital, Melbourne); Peter Downie (Monash Medical Centre, Melbourne); Tim Hassall and Ross Pinkerton (Royal Children’s Hospital Brisbane); Maria Kirby (Women’s and Children’s Hospital, Adelaide); Stewart Kellie and Luciano Dalla-Pozza (Children’s Hospital at Westmead); Frank Alvaro (John Hunter Hospital, Newcastle); Richard Cohn (Sydney Children’s Hospital); and John Daubenton (Royal Hobart Hospital). The authors also acknowledge the Clinical Research Associates at each hospital, the study coordinators: Jackie Mansour, Somer Dawson, Tamika Heiden, and Helen Bailey. We also acknowledge Peter Cosgrove for programming the estimation of dietary intake from the food frequency questionnaires. The National Health and Medical Research Council (NHMRC) funded Aus-ALL (Grant Number: 254539) and Aus-CBT (Grant Number: 404089). Elizabeth Milne and Carol Bower were supported by NHMRC Fellowships (#513910 and #634341, respectively) and by an NHMRC Program Grant (#572742). Funding for analysis in 2013–2014 was provided by donations from The Telethon Adventurers.
Conflict of interest
The authors declare that they have no conflict of interest.
- 10.Pogoda JM, Preston-Martin S, Howe G, Lubin F, Mueller BA, Holly EA, Filippini G, Peris-Bonet R, McCredie MR, Cordier S, Choi W (2009) An international case-control study of maternal diet during pregnancy and childhood brain tumor risk: a histology-specific analysis by food group. Ann Epidemiol 19:148–160CrossRefPubMedCentralPubMedGoogle Scholar
- 12.Australian Bureau of Statistics (2008) Information paper: an introduction to socio-economic indexes, 2006. Catalogue number 2039.0. Commonwealth of Australia. http://www.ausstats.abs.gov.au/Ausstats/subscriber.nsf/0/D729075E079F9FDECA2574170011B088/$File/20390_2006.pdf. Accessed 13 Jan 2012Google Scholar
- 13.Lassale C, Guilbert C, Keogh J, Syrette J, Lange K, Cox DN (2009) Estimating food intakes in Australia: validation of the Commonwealth Scientific and Industrial Research Organisation (CSIRO) food frequency questionnaire against weighed dietary intakes. J Hum Nutr Diet 22:559–566CrossRefPubMedGoogle Scholar
- 15.Food Standards Australia New Zealand (2008) AUSNUT 2007—Australian food, supplement and nutrient database for estimation of population nutrient intakes. FSANZ. http://www.foodstandards.gov.au/consumerinformation/ausnut2007/. Accessed 16 Oct 2014
- 16.Food Standards Australia New Zealand (2007) NUTTAB 2006—Australian food composition tables. FSANZ. http://www.foodstandards.gov.au/monitoringandsurveillance/nuttab2006/index.cfm. Accessed 16 Oct 2014
- 17.Australia New Zealand Food Standards (2009) Code —Standard 2.1.1—Cereals and Cereal Products—F2009C00811, Amendment No. 111–2009. Department of Health and Ageing, Commonwealth of Australia. http://www.comlaw.gov.au/Details/F2009C00811. Accessed 14 Aug 2013
- 19.National Health and Medical Research Council (2013) ‘Eat for Health’ educator guide: information for nutrition educators. Commonwealth of Australia, Department of Health and Ageing, CanberraGoogle Scholar
- 21.Jacobsen D (2001) Cellular mechanisms of homocysteine pathogenesis in atherosclerosis. In: Carmel R, Jacobsen D (eds) Homocysteine in health and disease. Cambridge University Press, Cambridge, pp 425–441Google Scholar
- 22.Ulrey CL, Liu L, Andrews LG, Tollefsbol TO (2005) The impact of metabolism on DNA methylation. Hum Mol Genet 14 Spec No 1:R139–R147Google Scholar
- 24.Northcott PA, Nakahara Y, Wu X, Feuk L, Ellison DW, Croul S, Mack S, Kongkham PN, Peacock J, Dubuc A, Ra YS, Zilberberg K, McLeod J, Scherer SW, Sunil Rao J, Eberhart CG, Grajkowska W, Gillespie Y, Lach B, Grundy R, Pollack IF, Hamilton RL, Van Meter T, Carlotti CG, Boop F, Bigner D, Gilbertson RJ, Rutka JT, Taylor MD (2009) Multiple recurrent genetic events converge on control of histone lysine methylation in medulloblastoma. Nat Genet 41:465–472CrossRefPubMedGoogle Scholar