Background It has been hypothesized that a high dietary intakeof nitrosamines and their precursors, nitrites and nitrates,is a risk factor for brain tumors. Vitamins C and E inhibitthe formation of nitrosamines and thus may be protective.
Methods We conducted a case-control study of maternal diet andthe risk of primitive neuroectodermal tumors of the brain inchildren. The case patients were under the age of six yearsat diagnosis in 1986 to 1989. The controls were selected byrandom-digit telephone dialing and were matched for age andrace to 166 case patients. Telephone interviews with the mothersincluded 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 relativeto the lowest, 0.37; P for trend = 0.005), fruits and fruitjuices (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 observedfor 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) supplementsat any time during the pregnancy and the use of multivitaminsduring the first six weeks (odds ratio, 0.56; P = 0.02) wereassociated with decreased risk. In multivariate analyses, folate,early multivitamin use, and iron supplements generally remainedprotective.
Conclusions These results do not support the hypothesis thatnitrosamines have a role in the development of primitive neuroectodermaltumors in young children, but they do suggest that certain otheraspects 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.
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