FREE NEJM E-TOC    HOME   |   SUBSCRIBE   |   CURRENT ISSUE   |   PAST ISSUES   |   COLLECTIONS   |   Search Term  Advanced Search

Sign in | Get NEJM's E-Mail Table of Contents — Free | Subscribe

Previous Volume 329:536-541 August 19, 1993 Number 8 Next

	Full Text Letters Add to Personal Archive Add to Citation Manager Notify a Friend E-mail When Cited PubMed Citation

ABSTRACT

Background It has been hypothesized that a high dietary intake of nitrosamines and their precursors, nitrites and nitrates, is a risk factor for brain tumors. Vitamins C and E inhibit the formation of nitrosamines and thus may be protective.

Methods We conducted a case-control study of maternal diet and the risk of primitive neuroectodermal tumors of the brain in children. The case patients were under the age of six years at diagnosis in 1986 to 1989. The controls were selected by random-digit telephone dialing and were matched for age and race to 166 case patients. Telephone interviews with the mothers included questions on the frequency of consumption of alcohol, vitamin and mineral supplements, and 53 foods during pregnancy.

Results Significant protective trends were observed for vegetables (odds ratio for the highest quartile group for intake relative to the lowest, 0.37; P for trend = 0.005), fruits and fruit juices (odds ratio, 0.28; P = 0.003), vitamin A (odds ratio, 0.59; P = 0.03), vitamin C (odds ratio, 0.42; P = 0.009), nitrate (odds ratio, 0.44; P = 0.002), and folate (odds ratio, 0.38; P = 0.005). A nonsignificant trend of increasing risk was observed for nitrosamine (odds ratio, 1.65; P = 0.15). The use of iron (odds ratio, 0.43; P = 0.004), calcium (odds ratio, 0.42; P = 0.05), and vitamin C (odds ratio, 0.35; P = 0.04) supplements at any time during the pregnancy and the use of multivitamins during the first six weeks (odds ratio, 0.56; P = 0.02) were associated with decreased risk. In multivariate analyses, folate, early multivitamin use, and iron supplements generally remained protective.

Conclusions These results do not support the hypothesis that nitrosamines have a role in the development of primitive neuroectodermal tumors in young children, but they do suggest that certain other aspects of maternal diet can influence the risk.

Source Information

From the Division of Oncology, Children's Hospital of Philadelphia, and the University of Pennsylvania School of Medicine, both in Philadelphia (G.R.B., R.R.K., L.B.R., A.T.M.); and the Department of Preventive Medicine, University of Southern California School of Medicine, Los Angeles (J.D.B.). Presented in part at the 25th Meeting of the Society for Epidemiologic Research, Minneapolis, June 9-12, 1992.

Address reprint requests to Dr. Bunin at the Children's Cancer Group, P.O. Box 60012, Arcadia, CA 91066-6012.

Full Text of this Article

Related Letters:

Maternal Diet and Primitive Neuroectodermal Brain Tumors in Children
Foreman N. K., Pearson A. D., Bunin G. R., Witman P. A., Meadows A. T.
Extract | Full Text  
N Engl J Med 1993; 329:1963, Dec 23, 1993. Correspondence

This article has been cited by other articles:

• Kim, Y.-I. (2008). Folic Acid Supplementation and Cancer Risk: Point. Cancer Epidemiol. Biomarkers Prev. 17: 2220-2225 [Full Text]  
• Bjorge, T., Cnattingius, S., Lie, R. T., Tretli, S., Engeland, A. (2008). Cancer Risk in Children with Birth Defects and in Their Families: A Population Based Cohort Study of 5.2 Million Children from Norway and Sweden. Cancer Epidemiol. Biomarkers Prev. 17: 500-506 [Abstract] [Full Text]  
• Semmler, A., Simon, M., Moskau, S., Linnebank, M. (2006). The Methionine Synthase Polymorphism c.2756A>G Alters Susceptibility to Glioblastoma Multiforme.. Cancer Epidemiol. Biomarkers Prev. 15: 2314-2316 [Abstract] [Full Text]  
• Bunin, G. R., Gallagher, P. R., Rorke-Adams, L. B., Robison, L. L., Cnaan, A. (2006). 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. 15: 1660-1667 [Abstract] [Full Text]  
• Bunin, G. R., Robison, L. L., Biegel, J. A., Pollack, I. F., Rorke-Adams, L. B. (2006). Parental Heat Exposure and Risk of Childhood Brain Tumor: A Children's Oncology Group Study. Am J Epidemiol 164: 222-231 [Abstract] [Full Text]  
• Orjuela, M. A., Titievsky, L., Liu, X., Ramirez-Ortiz, M., Ponce-Castaneda, V., Lecona, E., Molina, E., Beaverson, K., Abramson, D. H., Mueller, N. E. (2005). Fruit and Vegetable Intake during Pregnancy and Risk for Development of Sporadic Retinoblastoma. Cancer Epidemiol. Biomarkers Prev. 14: 1433-1440 [Abstract] [Full Text]  
• Kim, Y.-I. (2004). Will mandatory folic acid fortification prevent or promote cancer?. Am. J. Clin. Nutr. 80: 1123-1128 [Abstract] [Full Text]  
• Linet, M. S., Wacholder, S., Zahm, S. H. (2003). Interpreting Epidemiologic Research: Lessons From Studies of Childhood Cancer. Pediatrics 112: 218-232 [Full Text]  
• McKean-Cowdin, R., Pogoda, J. M, Lijinsky, W., Holly, E. A, Mueller, B. A, Preston-Martin, S. (2003). Maternal prenatal exposure to nitrosatable drugs and childhood brain tumours. Int J Epidemiol 32: 211-217 [Abstract] [Full Text]  
• Bunin, G. R., Gyllstrom, M. E., Brown, J. E., Kahn, E. B., Kushi, L. H. (2001). Recall of Diet during a Past Pregnancy. Am J Epidemiol 154: 1136-1142 [Abstract] [Full Text]  
• Zhang, L., Weddle, D. L., Thomas, P. E., Zheng, B., Castonguay, A., Schuller, H. M., Miller, M. S. (2000). Low Levels of Expression of Cytochromes P-450 in Normal and Cancerous Fetal Pancreatic Tissues of Hamsters Treated with NNK and/or Ethanol. Toxicol Sci 56: 313-323 [Abstract] [Full Text]  
• Legler, J. M., Ries, L. A. G., Smith, M. A., Warren, J. L., Heineman, E. F., Kaplan, R. S., Linet, M. S. (1999). Brain and Other Central Nervous System Cancers: Recent Trends in Incidence and Mortality. JNCI J Natl Cancer Inst 91: 1382-1390 [Abstract] [Full Text]  
• Packer, R. J., Cogen, P., Vezina, G., Rorke, L. B. (1999). Medulloblastoma: Clinical and biologic aspects. Neuro Oncol 1: 232-250 [Abstract]  
• Foreman, N. K., Pearson, A. D., Bunin, G. R., Witman, P. A., Meadows, A. T. (1993). Maternal Diet and Primitive Neuroectodermal Brain Tumors in Children. NEJM 329: 1963-1963 [Full Text]