Paternal intake of folate and vitamins B6 and B12 before conception and risk of childhood acute lymphoblastic leukemia
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We investigated whether paternal dietary intake of folate before conception is associated with the risk of childhood acute lymphoblastic leukemia (ALL) in a nationwide case–control study.
Data on dietary folate intake during the 6 months before the child’s conception were collected from 285 case fathers and 595 control fathers using a dietary questionnaire. Nutrient intake was quantified using a customized computer software package based on Australian food composition databases. Data on folate intake were analyzed using unconditional logistic regression, adjusting for study-matching variables, total energy, and potentially confounding variables. In a subset of 229 cases and 420 controls, data on vitamin B6 and vitamin B12 intake were also analyzed.
No consistent associations were seen with paternal dietary intake of folate or vitamin B6. Higher levels of paternal dietary vitamin B12 were appeared to be associated with an increased risk of childhood ALL, with those in the highest tertile of consumption having an OR of 1.51 (0.97, 2.36). The use of supplements containing folate and vitamins B6 or B12 was rare.
We did not find any biologically plausible evidence that paternal nutrition in the period leading up to conception was associated with childhood ALL. Our finding for vitamin B12 may be a chance finding, given the number of analyses performed, or be attributable to participation bias because parents with a tertiary education had the lowest level of B12 intake and tertiary education was more common among control than case parents.
KeywordsEpidemiology Child Leukemia Folate Vitamin B6 Vitamin B12
Acute lymphoblastic leukemia
Australian Study of Causes of Acute Lymphoblastic Leukaemia in Children
Dietary folate equivalents
Food frequency questionnaire
Random digit dialling
The Aus-ALL consortium conducted the study and the Telethon Kids Institute (Formally Telethon Institute for Child Health Research; TICHR), University of Western Australia, was the coordinating center. Bruce K. Armstrong (Sydney School of Public Health), Elizabeth Milne (TICHR), Frank M. van Bockxmeer (Royal Perth Hospital), Michelle Haber (Children’s Cancer Institute Australia), Rodney J. Scott (University of Newcastle), John Attia (University of Newcastle), Murray D. Norris (Children’s Cancer Institute Australia), Carol Bower (TICHR), Nicholas H. de Klerk (TICHR), Lin Fritschi (WA Institute for Medical Research), Ursula R. Kees (TICHR), Margaret Miller (Edith Cowan University), Judith R Thompson (WA Cancer Registry) were the research investigators, and Helen D. Bailey (TICHR) was the project coordinator. The clinical investigators were Frank Alvaro (John Hunter Hospital, Newcastle), Catherine Cole (Princess Margaret Hospital for Children, Perth), Luciano Dalla Pozza (Children’s Hospital at Westmead, Sydney), John Daubenton (Royal Hobart Hospital, Hobart), Peter Downie (Monash Medical Centre, Melbourne), Liane Lockwood (Royal Children’s Hospital, Brisbane), Maria Kirby (Women’s and Children’s Hospital, Adelaide), Glenn Marshall (Sydney Children’s Hospital, Sydney), Elizabeth Smibert (Royal Children’s Hospital, Melbourne), and Ram Suppiah (previously Mater Children’s Hospital, Brisbane). The authors wish to acknowledge the contribution made by our Clinical Co-Investigators and Clinical Research Associates who recruited and cared for study patients at each participating hospital, and Mr Peter Cosgrove for programming the estimation of dietary intake from the food frequency questionnaires. The authors also thank the parents and children who participated in Aus-ALL.
Conflict of interest
The authors declare no conflict of interest. Aus-ALL was funded by The National Health and Medical Research Council (NHMRC) Grant 254539. Helen Bailey was supported by NHMRC Postgraduate Scholarship 513934, Elizabeth Milne by NHMRC Career Development Award 513910, and Carol Bower by NHMRC Research Fellowship 634341.
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