Risk factors for childhood brain tumours: A systematic review and meta-analysis of observational studies from 1976 to 2022

BACKGROUND

Childhood brain tumours (CBTs) are the leading cause of cancer death in children under the age of 20 years globally. Though the aetiology of CBT remains poorly understood, it is thought to be multifactorial. We aimed to synthesize potential risk factors for CBT to inform primary prevention.

METHODS

We conducted a systematic review and meta-analysis of epidemiological studies indexed in the PubMed, Web of Science, and Embase databases from the start of those resources through 27 July 2023. We included data from case-control or cohort studies that reported effect estimates for each risk factor around the time of conception, during pregnancy and/or during post-natal period. Random effects meta-analysis was used to estimate summary effect sizes (ES) and 95% confidence intervals (CIs). We also quantified heterogeneity (I2) across studies.

FINDINGS

A total of 4040 studies were identified, of which 181 studies (85 case-control and 96 cohort studies) met our criteria for inclusion. Of all eligible studies, 50% (n = 91) were conducted in Europe, 32% (n = 57) in North America, 9% (n = 16) in Australia, 8% (n = 15) in Asia, 1% (n = 2) in South America, and none in Africa. We found associations for some modifiable risk factors including childhood domestic exposures to insecticides (ES 1.44, 95% CI 1.20-1.73) and herbicides (ES 2.38, 95% CI 1.31-4.33). Maternal domestic exposure to insecticides (ES 1.45, 95% CI 1.09-1.94), maternal consumption of cured meat (ES 1.51, 95% CI 1.05-2.17) and coffee ≥ 2 cups/day (ES 1.45, 95% 95% CI 1.07-1.95) during pregnancy, and maternal exposure to benzene (ES 2.22; 95% CI 1.01-4.88) before conception were associated with CBTs in case-control studies. Also, paternal occupational exposure to pesticides (ES 1.48, 95% CI 1.23-1.77) and benzene (ES 1.74, 95% CI 1.10-2.76) before conception and during pregnancy were associated in case-control studies and in combined analysis. On the other hand, assisted reproductive technology (ART) (ES 1.32, 95% CI 1.05-1.67), caesarean section (CS) (ES 1.12, 95% CI 1.01-1.25), paternal occupational exposure to paint before conception (ES 1.56, 95% CI 1.02-2.40) and maternal smoking > 10 cigarettes per day during pregnancy (ES 1.18, 95% CI 1.00-1.40) were associated with CBT in cohort studies. Maternal intake of vitamins and folic acid during pregnancy was inversely associated in cohort studies. Hormonal/infertility treatment, breastfeeding, child day-care attendance, maternal exposure to electric heated waterbed, tea and alcohol consumption during pregnancy were among those not associated with CBT in both case-control and cohort studies.

CONCLUSION

Our results should be interpreted with caution, especially as most associations between risk factors and CBT were discordant between cohort and case-control studies. At present, it is premature for any CBT to define specific primary prevention guidelines.

1H NMR to analyse the lipid profile in the glyceride fraction of different categories of Iberian dry-cured hams

The extraordinary organoleptic qualities of Iberian ham derive from the singular producing pig breed and from the traditional rearing conditions, both of which define its lipid content and composition. In this work ¹H NMR spectroscopy is used for the first time to analyse the lipid profile of Iberian hams as determinant of quality. Quantification of fatty acids is readily obtained from the spectra, with the monounsaturated fatty acids standing out, especially in the higher quality hams. Unprecedently, triacylglyceride hydrolysis products formed during the curing process can also be directly detected and quantified. Furthermore, chemometric analysis of the NMR data allows to classify Iberian hams according to the pig's crossbreed and feeding regime. Principal component analysis shows fatty acid unsaturation and triacylglyceride hydrolysis as discriminating variables. ¹H NMR spectroscopy has thus revealed as a convenient and powerful tool for the lipid analysis and classification of Iberian hams and for detection of fraud.

Quality characteristics of pork loin cured with green nitrite source and some organic acids

This study was conducted to improve the quality characteristics of cured meat with natural nitrite. Control and treatment were conducted as follows: nitrite free, marinated with sodium nitrite and ascorbic acid, marinated with only fermented spinach (FS), and marinated with FS adding ascorbic acid, malic acid, citric acid, and tartaric acid. Treatments were pickled with regulated brine (8% salt and 0.08% nitrite). Cured meat with FS adding ascorbic acid, malic acid, and citric acid had higher redness values than sodium nitrite with ascorbic acid on cooked meat. There was a positive effect on lipid oxidation except for citric acid. Protein degradation appeared more in malic acid and tartaric acid treatment than others. Residual nitrite level was lower when adding organic acids. Among various organic acid, ascorbic acid had the highest efficient on quality properties of cured meat. Thus, ascorbic acid was a proper ingredient when curing meat product.

Mechanisms of the bactericidal effects of nitrate and nitrite in cured meats

For cured meat products, nitrite is recognized for its antimicrobial effects against pathogenic bacteria, even though the specific inhibitory mechanisms are not well known. Nitrite contributes to oxidative stress by being the precursor of peroxynitrite (ONOO^-), which is the major strong oxidant. Thus, bacterial stress (highly pH-very low partial pressure of oxygen-dependent) is enhanced by the nitrate-nitrite-peroxynitrite system which is also highly pH- and low partial pressure of oxygen-dependent. Nitrite is a hurdle technology which effectiveness depends on several other hurdle technologies including sodium chloride (accelerating the autoxidation of oxymyoglobin and promote peroxynitrite formation), ascorbate (increasing ONOO^- synthesis), and Aw. In this environment, certain species are more resistant than others to acidic, oxidative, and nitrative stresses. The most resistant are gram-negative aerobic/facultative anaerobic bacteria (Escherichia coli, Salmonella), and the most fragile are gram-positive anaerobic bacteria (Clostridium botulinum). This position review highlights the major chemical mechanisms involved, the active molecules and their actions on bacterial metabolisms in the meat ecosystem.

Meat intake, methods and degrees of cooking and breast cancer risk in the MCC-Spain study

OBJECTIVE

To analyse the relationship of the risk of breast cancer (BC) to meat intake, preference regarding degree of cooking ('doneness') and cooking methods, using data from a population-based case-control study (MCC-Spain).

STUDY DESIGN

1006 Histologically confirmed incident BC cases and 1370 controls were recruited in 10 Spanish provinces. Participants were 23-85 years old. They answered an epidemiological survey and a food frequency questionnaire. BC risk was assessed overall, by menopausal status and by pathological subtypes, using logistic and multinomial regression mixed models adjusted for known confounding factors and including province as a random effects term.

MAIN OUTCOME MEASURES

Breast cancer and pathological subtype.

RESULTS

High total intake of meat (ORQ4-Q1 (95% IC) = 1.39 (1.03-1.88)) was associated with increased BC risk among post-menopausal women. Similar results were found for processed/cured meat (ORQ4-Q1 (95% IC) = 1.47 (1.10-1.97)), and this association was particularly strong for triple-negative tumours (ER-, PR- and HER2-) (ORQ4-Q1 (95% IC) = 2.52 (1.15-5.49)). Intakes of well-done (ORwell-donevsrare (95% CI) = 1.62 (1.15-2.30)) and stewed (OR (95% CI) = 1.49 (1.20-1.84)) red meat were associated with increased BC risk, with a high risk observed for HR+ tumours (ER+/PR+ and HER2-). Pan-fried/bread-coated fried white meat, but not doneness preference, was associated with an increased BC risk for all women (OR (95% CI) = 1.38 (1.14-1.65)), with a stronger association for pre-menopausal women (OR (95% CI) = 1.78 (1.29-2.46)).

CONCLUSION

The risk of developing BC could be reduced by moderating the consumption of well-done or stewed red meat, pan-fried/bread-coated fried white meat and, especially, processed/cured meat.