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Cancer Epidemiology Biomarkers & Prevention Vol. 14, 1433-1440, June 2005
© 2005 American Association for Cancer Research

Fruit and Vegetable Intake during Pregnancy and Risk for Development of Sporadic Retinoblastoma

Manuela A. Orjuela1, Lina Titievsky1, Xinhua Liu1, Marco Ramirez-Ortiz3,4, Veronica Ponce-Castaneda5, Evelia Lecona3, Evelyn Molina1, Katherine Beaverson2, David H. Abramson2 and Nancy E. Mueller6

1 Departments of Pediatrics and Environmental Health Sciences, Columbia University; 2 Ophthalmic Oncology Service, Department of Surgery, Pediatrics, Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, New York; 3 Departments of Ophthalmology and Social Work, Instituto Nacional de Pediatria; 4 Department of Ophthalmology, Hospital Infantil de Mexico; 5 Hospital Siglo XXI, Instituto Mexicano de Seguro Social, Mexico City, Distrito Federal, Mexico; and 6 Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts

Requests for reprints: Manuela Orjuela, Department of Environmental Health Sciences, Mailman School of Public Health at Columbia University, Room B106, 60 Haven Avenue, New York, NY 10032. Phone: 212-304-7279; Fax: 212-544-1943. E-mail: mao5{at}columbia.edu

Objective: Little is known about the causes of sporadic (noninherited) retinoblastoma. Rates seem to be somewhat higher among poorer populations in Mexico. Fruits and vegetables are important sources of carotenoids and folate. We examined whether decreased gestational maternal intake of fruits and vegetables may contribute to development of sporadic retinoblastoma.

Methods: At the Instituto Nacional de Pediatria in Mexico City, we conducted a hospital-based case-control study to evaluate prenatal maternal diet. We examined dietary intake of fruits and vegetables of mothers of 101 children with retinoblastoma and 172 control children using a dietary recall questionnaire and published food nutrient content tables.

Results: The reported number of mean daily servings of fruits and vegetables was lower among case mothers when compared with control mothers [vegetables: 2.28 in controls, 1.75 in cases (P < 0.01); fruits: 2.13 in controls, 1.59 in cases (P = 0.07)]. Mean daily maternal folate intake from both vegetables and fruits was higher in controls (103 µg) than in cases (48 µg; P < 0.05). Risk for having a child with retinoblastoma was increased for mothers consuming fewer than 2 daily servings of vegetables [odds ratios (OR), 3.4; 95% confidence interval (95% CI), 2.0-6.0] or with a low intake of folate (OR, 3.9; 95% CI, 2.1, 7.3), or lutein/zeaxanthin (OR, 2.6; 95% CI, 1.5-4.6) derived from fruits and vegetables.

Conclusions: Decreased intake of vegetables and fruits during pregnancy and the consequent decreased intake of nutrients such as folate and lutein/zeaxanthin, necessary for DNA methylation, synthesis, and retinal function, may increase risk for having a child with sporadic retinoblastoma.







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Copyright © 2005 by the American Association for Cancer Research.