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Pérez-Saldivar ML, Flores-García MK, Núñez-Villegas N, Fajardo-Gutiérrez A, Medina-Sanson A, Jiménez-Hernández E, Martín-Trejo JA, López-Santiago N, Peñaloza-González JG, Cortés-Herrera B, Merino-Pasaye LE, Amador-Sánchez R, García-López LR, Pérez-Lorenzana H, Román-Zepeda PF, Castañeda-Echevarría A, López-Caballero MG, Martínez-Silva SI, Rivera-González J, Granados-Kraulles J, Flores-Botello J, Medrano-López F, Rodríguez-Vázquez MA, Torres-Valle D, Mora-Rico K, Mora-Ríos FG, R.García‐Cortés L, Salcedo-Lozada P, Flores-Lujano J, Núñez-Enríquez JC, Bekker-Méndez VC, Mata-Rocha M, Rosas-Vargas H, Duarte-Rodríguez DA, Jiménez-Morales S, Hidalgo-Miranda A, López-Carrillo L, Mejía-Aranguré JM. Maternal diet in pregnancy and acute leukemia in infants: a case-control study in Mexico City. Front Oncol 2024; 13:1165323. [PMID: 38260836 PMCID: PMC10802844 DOI: 10.3389/fonc.2023.1165323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Accepted: 12/08/2023] [Indexed: 01/24/2024] Open
Abstract
Introduction Epidemiological studies around the world on acute leukemia (AL) and risk factors in infants are scarce. Infant AL has been proposed to originate in utero, which facilitates its study by establishing a short exposure time in pregnant women to environmental and dietary factors that could contribute to the risk of or protection against leukemia. We hypothesized that maternal diet during pregnancy may be an important factor involved in AL in offspring. Methods We conducted a hospital-based case-control study from 2010 to 2019 on maternal diet during pregnancy in nine high-specialty public hospitals of different health institutions that diagnose and offer treatment to children with AL in Mexico City. Cases (n=109) were children ≤24 months of age with de novo diagnosis of AL, and controls (n=252) were children obtained in hospitals from second-level medical care matched for age, sex, and health institution. Maternal diet during pregnancy was obtained by a semiquantitative food frequency questionnaire. Unconditional logistic regression models were used to assess the association between food groups and infant AL. Potential confounders were assessed by constructing directed acyclic graphs (DAGs) with Dagitty software in which adjusted options were identified for the construction of unconditional logistic regression models. Results Cases were slightly predominantly female (52.3%). The years of education of the mother in cases and controls was 0-9 on average, and those who reported smoking cigarettes and consuming alcohol during pregnancy did so at a low frequency. Regarding the mother's diet, the main findings were that the consumption of allium vegetables during pregnancy was inversely associated with AL for medium and high consumption (OR=0.26, 95% CI 0.14-0.46; P-trend< 0.001). In contrast, the high consumption of high-fat dairy products had a positive association with AL (OR=2.37, 95% CI 1.30-4.34; P-trend<0.001). No association was found between consumption of topoisomerase II inhibitor foods during pregnancy and AL. Conclusion The results suggest that maternal intake during pregnancy of allium vegetables, specifically garlic, is inversely associated with the development of AL in children ≤24 months old. On the other hand, consumption of high-fat dairy products is positively associated with AL in children ≤24 months old.
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Affiliation(s)
- María Luisa Pérez-Saldivar
- Unidad de Investigación Médica en Epidemiología Clínica, Unidad Médica de Alta Especialidad (Unidad Médica de Alta Especialidad (UMAE)) Hospital de Pediatría, Centro Médico Nacional (Centro Médico Nacional (CMN)) Siglo XXI, Instituto Mexicano del Seguro Social (Instituto Mexicano del Seguro Social (IMSS)), Mexico City, Mexico
| | | | - Nancy Núñez-Villegas
- Servicio de Hematología Pediátrica, Hospital General “Gaudencio González Garza”, Centro Médico Nacional (CMN) “La Raza”, Instituto Mexicano del Seguro Social (IMSS), Mexico City, Mexico
| | - Arturo Fajardo-Gutiérrez
- Unidad de Investigación Médica en Epidemiología Clínica, Unidad Médica de Alta Especialidad (Unidad Médica de Alta Especialidad (UMAE)) Hospital de Pediatría, Centro Médico Nacional (Centro Médico Nacional (CMN)) Siglo XXI, Instituto Mexicano del Seguro Social (Instituto Mexicano del Seguro Social (IMSS)), Mexico City, Mexico
| | - Aurora Medina-Sanson
- Departamento de Hemato-Oncología, Hospital Infantil de México Federico Gómez, Secretaria de Salud (Secretaría de Salud (SSA)), Mexico City, Mexico
| | - Elva Jiménez-Hernández
- Servicio de Oncología, Hospital Pediátrico Moctezuma, Secretaría de Salud de la Ciudad de México (Secretaría de Salud de la Ciudad de México (SSCDMX)), Mexico City, Mexico
| | - Jorge Alfonso Martín-Trejo
- Servicio de Hematología, Unidad Médica de Alta Especialidad (UMAE) Hospital de Pediatría, Centro Médico Nacional (CMN) “Siglo XXI”, Instituto Mexicano del Seguro Social (IMSS), Mexico City, Mexico
| | - Norma López-Santiago
- Servicio de Hematología, Instituto Nacional de Pediatría (INP), Secretaría de Salud (SSA), Mexico City, Mexico
| | | | - Beatriz Cortés-Herrera
- Servicio de Hematología Pediátrica, Hospital General de México, Secretaría de Salud (SSA), Mexico City, Mexico
| | - Laura Elizabeth Merino-Pasaye
- Servicio de Hematología Pediátrica, Centro Médico Nacional (CMN)”20 de Noviembre”, Instituto de Seguridad Social al Servicio de los Trabajadores del Estado (Instituto de Seguridad Social al Servicio de los Trabajadores del Estado (ISSSTE)), Mexico City, Mexico
| | - Raquel Amador-Sánchez
- Servicio de Hematología Pediátrica, HGR No. 1 “Dr. Carlos Mac Gregor Sánchez Navarro” Instituto Mexicano del Seguro Social (IMSS), Mexico City, Mexico
| | - Luis Ramiro García-López
- Servicio de Pediatría, Hospital Pediátrico de Tacubaya, Secretaría de Salud de la Ciudad de México (SSCDMX), Mexico City, Mexico
| | - Héctor Pérez-Lorenzana
- Servicio de Cirugía Pediátrica, Hospital General “Gaudencio González Garza”, Centro Médico Nacional (CMN) “La Raza”, Instituto Mexicano del Seguro Social (IMSS), Mexico City, Mexico
| | - Pedro Francisco Román-Zepeda
- Servicio de Cirugía Pediátrica, Hospital General Regional (HGR) No. 1 “Dr. Carlos Mac Gregor Sánchez Navarro” Instituto Mexicano del Seguro Social (IMSS), Mexico City, Mexico
| | - Alejandro Castañeda-Echevarría
- Servicio de Pediatría, Hospital General de Zona Regional (HGZR) No. 25 Instituto Mexicano del Seguro Social (IMSS), Mexico City, Mexico
| | - María Guadalupe López-Caballero
- Coordinación Clínica y Pediatría, Hospital Pediátrico de Coyoacán, Secretaría de Salud de la Ciudad de México (SSCDMX), Mexico City, Mexico
| | - Sofía Irene Martínez-Silva
- Hospital Pediátrico de Iztapalapa, Secretaría de Salud de la Ciudad de México (SSCDMX), Mexico City, Mexico
| | - Juan Rivera-González
- Hospital General Dr. “Gustavo Baz Prada”, Instituto de Salud del Estado de México (ISEM), Estado de México, Mexico
| | - Jorge Granados-Kraulles
- Coordinación Clínica y Pediatría del Hospital General de Zona 76 Instituto Mexicano del Seguro Social (IMSS), Estado de México, Mexico
| | - Jesús Flores-Botello
- Coordinación Clínica y Pediatría, Hospital General “La Perla” ISEM, Estado de México, Mexico
| | - Francisco Medrano-López
- Coordinación Clínica y Pediatría, HGR No. 72 “Dr. Vicente Santos Guajardo”, Instituto Mexicano del Seguro Social (IMSS), Estado de México, Mexico
| | - María Adriana Rodríguez-Vázquez
- Coordinación Clínica y Pediatría del Hospital General de Zona 68, Instituto Mexicano del Seguro Social (IMSS), Estado de México, Mexico
| | - Delfino Torres-Valle
- Coordinación Clínica y Pediatría del Hospital General de Zona 71, Instituto Mexicano del Seguro Social (IMSS), Estado de México, Mexico
| | - Karina Mora-Rico
- Servicio de Cirugía Pediátrica, HGR 1° Octubre, Instituto de Seguridad Social al Servicio de los Trabajadores del Estado (ISSSTE), Mexico City, Mexico
| | - Félix G. Mora-Ríos
- Cirugía Pediátrica del Hospital Regional “General Ignacio Zaragoza”, Instituto de Seguridad Social al Servicio de los Trabajadores del Estado (ISSSTE), Mexico City, Mexico
| | - Luis R.García‐Cortés
- Delegación Regional Estado de México Oriente, Instituto Mexicano del Seguro Social (IMSS), Estado de México, Mexico
| | | | - Janet Flores-Lujano
- Unidad de Investigación Médica en Epidemiología Clínica, Unidad Médica de Alta Especialidad (Unidad Médica de Alta Especialidad (UMAE)) Hospital de Pediatría, Centro Médico Nacional (Centro Médico Nacional (CMN)) Siglo XXI, Instituto Mexicano del Seguro Social (Instituto Mexicano del Seguro Social (IMSS)), Mexico City, Mexico
| | - Juan Carlos Núñez-Enríquez
- Unidad de Investigación Médica en Epidemiología Clínica, Unidad Médica de Alta Especialidad (Unidad Médica de Alta Especialidad (UMAE)) Hospital de Pediatría, Centro Médico Nacional (Centro Médico Nacional (CMN)) Siglo XXI, Instituto Mexicano del Seguro Social (Instituto Mexicano del Seguro Social (IMSS)), Mexico City, Mexico
| | - Vilma Carolina Bekker-Méndez
- Unidad de Investigación Médica en Inmunología e Infectología, Hospital de Infectología “Dr. Daniel Méndez Hernández”, Centro Médico Nacional (CMN) “La Raza”, Instituto Mexicano del Seguro Social (IMSS), Mexico City, Mexico
| | - Minerva Mata-Rocha
- Laboratorio de Biología Molecular de las Leucemias, Unidad de Investigación en Genética Humana, Unidad Médica de Alta Especialidad (UMAE), Hospital de Pediatría, Centro Médico Nacional (CMN) “Siglo XXI”, Instituto Mexicano del Seguro Social (IMSS), Mexico City, Mexico
| | - Haydeé Rosas-Vargas
- Laboratorio de Genética, Unidad Médica de Alta Especialidad (Unidad Médica de Alta Especialidad (UMAE)) Hospital de Pediatría, Centro Médico Nacional (Centro Médico Nacional (CMN)) Siglo XXI, Instituto Mexicano del Seguro Social (IMSS), Mexico City, Mexico
| | - David Aldebarán Duarte-Rodríguez
- Unidad de Investigación Médica en Epidemiología Clínica, Unidad Médica de Alta Especialidad (Unidad Médica de Alta Especialidad (UMAE)) Hospital de Pediatría, Centro Médico Nacional (Centro Médico Nacional (CMN)) Siglo XXI, Instituto Mexicano del Seguro Social (Instituto Mexicano del Seguro Social (IMSS)), Mexico City, Mexico
| | - Silvia Jiménez-Morales
- Laboratorio de Innovación y Medicina de Precisión, Núcleo A. Instituto Nacional de Medicina Genómica (INMEGEN), Mexico City, Mexico
| | - Alfredo Hidalgo-Miranda
- Laboratorio de Innovación y Medicina de Precisión, Núcleo A. Instituto Nacional de Medicina Genómica (INMEGEN), Mexico City, Mexico
| | | | - Juan Manuel Mejía-Aranguré
- Facultad de Medicina, Universidad Nacional Autónoma de México (UNAM), Mexico City, Mexico
- Laboratorio Genómica Funcional del Cáncer, Instituto Nacional de Medicina Genómica (INMEGEN), Mexico City, Mexico
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Rangel-Moreno K, Mérida-Ortega Á, Gamboa-Loira B, Flores-García MK, Rothenberg SJ, López-Carrillo L. Dietary contribution to total urinary arsenic in Mexican women. Food Addit Contam Part A Chem Anal Control Expo Risk Assess 2022; 39:1453-1462. [PMID: 35793148 DOI: 10.1080/19440049.2022.2093982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Exposure to inorganic arsenic (iAs) damages health in many ways. The main routes of human exposure are consumption of contaminated water and diet, but evidence regarding the dietary contribution of iAs is limited. The objective of this work was to determine the foods and beverages that contribute to urinary total arsenic levels (TAs). This is a secondary analysis of an original study of breast cancer cases and population controls carried out in northern Mexico during the period 2007-2011, from which 1,462 women without a history of diabetes were selected. We estimated the consumption of the food and beverage groups with a frequency questionnaire. We measured the concentrations of urinary iAs metabolites by high performance liquid chromatography inductively coupled plasma mass spectrometry (HPLC-ICP-MS). Total arsenic ranged from 0.5 to 2,360 µg/g creatinine. After adjusting for covariates, we observed a positive association between TAs (with arsenobetaine) with non-bottled drinking water intake, as well as the consumption of root vegetables, vegetables and fruits rich in water, eggs, fish and shellfish. Our findings highlight the relevance of water consumption and some foods for TAs exposure. Food quality monitoring deserves attention in high-risk regions of arsenic contamination.
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Affiliation(s)
- Karla Rangel-Moreno
- Centro de Investigación en Salud Poblacional, Instituto Nacional de Salud Pública, Morelos, México
| | - Ángel Mérida-Ortega
- Centro de Investigación en Salud Poblacional, Instituto Nacional de Salud Pública, Morelos, México
| | - Brenda Gamboa-Loira
- Centro de Investigación en Salud Poblacional, Instituto Nacional de Salud Pública, Morelos, México
| | - M Karen Flores-García
- Centro de Investigación en Salud Poblacional, Instituto Nacional de Salud Pública, Morelos, México
| | - Stephen J Rothenberg
- Centro de Investigación en Salud Poblacional, Instituto Nacional de Salud Pública, Morelos, México
| | - Lizbeth López-Carrillo
- Centro de Investigación en Salud Poblacional, Instituto Nacional de Salud Pública, Morelos, México
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Flores-García MK, Mérida-Ortega Á, Denova-Gutiérrez E, López-Carrillo L. Dietary Patterns and Breast Cancer Risk in Women from Northern Mexico. Nutr Cancer 2020; 73:2763-2773. [PMID: 33356597 DOI: 10.1080/01635581.2020.1860241] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
We evaluated the association between dietary patterns and breast cancer (BC) subtypes among women from Northern Mexico. From a study of incident cases and population controls that was carried out from 2007 to 2011, a subsample of 509 cases matched 1:1 by age with 509 controls was selected. Information about expression of estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor 2 (HER2) was available from medical records to classify BC on luminal (ER + and/or PR+/HER2-), HER2+ (ER+/- and/or PR+/-/HER2+), or triple negative (ER- and PR-/HER2-). Dietary information was gathered using a semiquantitative food frequency questionnaire and a factor analysis was used to obtain dietary patterns. The association between each dietary pattern and BC molecular subtypes was assessed through conditional logistic regression models. Two dietary patterns were identified. The first (mainly characterized by meat, high fat, and sugary cereals) was positively associated with BC (odds ratio, OR = 12.62; 95% CI: 7.42, 21.45); the second (consisting of corn, legumes, and other vegetables) was inversely associated with BC (OR = 0.50; 95% CI: 0.40, 0.62). Both associations remained significant by BC molecular subtypes. These findings could contribute to the development of public health strategies for BC prevention.
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Affiliation(s)
- M Karen Flores-García
- Center for Nutrition and Health Research, National Institute of Public Health, Cuernavaca, Morelos, Mexico
| | - Ángel Mérida-Ortega
- Center for Population Health Research, National Institute of Public Health, Cuernavaca, Morelos, Mexico
| | - Edgar Denova-Gutiérrez
- Center for Nutrition and Health Research, National Institute of Public Health, Cuernavaca, Morelos, Mexico
| | - Lizbeth López-Carrillo
- Center for Population Health Research, National Institute of Public Health, Cuernavaca, Morelos, Mexico
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