Maternal and infant diet play a role in acute leukemia development: An expanded systematic review and meta-analysis.
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BACKGROUND: The most common subtypes of acute leukemia (AL) are acute lymphoid leukemia (ALL), and acute myeloid leukemia (AML). Among those less than 15 years old, ALL is the most common subtype. It has recently been proposed that diet may play an important role in the development of AL. This review expands on the existing systematic reviews and meta-analyses published on infant and maternal diet in relation to AL. METHODS: An electronic search was carried out in four databases (Pubmed/Medline Lilacs, Scopus and Web of Science), through April 2022. Observational epidemiological studies that reported the association between AL (ALL and/or AML) and the food consumed by children (<18 years), their mother or both were included. Fixed effects models were used for meta-analysis and heterogeneity between studies was assessed using the Q statistic test and I2 estimation. The risk of bias was assessed using the Newcastle-Ottawa scale. RESULTS: A total of 15 studies were included (1 cohort and 14 case-control), of which 9 exclusively evaluated the maternal diet, 4 child diet, and 2 that evaluated both. Our results showed that children's consumption of processed meat was positively associated with AL (OR = 1.72; 95 % CI 1.08, 2.72), whereas the consumption of vegetables was found to be inversely associated with AL (OR = 0.61; 95 % CI % 0.39, 0.92). Furthermore, maternal fruit consumption was inversely associated with ALL (OR = 0.71; 95 % CI 0.59-0.83), while coffee consumption was positively associated with AL (OR = 1.20; 95 % CI 1.00, 1.44) and ALL (OR = 1.31; 95 % CI: 1.10, 1.56). CONCLUSIONS: Our results support that maternal and early infant diet play a role in the development of AL.