Maternal and childhood consumption of coffee, tea and cola beverages in association with childhood leukemia: a meta-analysis.
OBJECTIVE
To systematically review studies and meta-analyze the literature on the association of maternal and/or index child's coffee, tea, and cola consumption with subsequent development of childhood leukemia and its major subtypes.


METHODS
Eligible studies were identified through a detailed algorithm and hand-search of eligible articles' references; thereafter, summary-effect estimates were calculated by leukemia subtype and dose-response meta-analyses were performed.


RESULTS
Twelve case-control studies, comprising a total of 3649 cases and 5705 controls, were included. High maternal coffee consumption was positively associated with acute lymphoblastic leukemia (ALL; OR: 1.43, 95%CI: 1.22-1.68) and acute myeloid leukemia (AML; OR: 2.52, 95%CI: 1.59-3.57). Any or low to moderate maternal cola consumption was also positively associated with overall leukemia (AL) and ALL, A linear trend between coffee and cola consumption and childhood leukemia was observed in the dose-response analyses. On the contrary, low to moderate tea consumption was inversely associated with AL (OR: 0.85, 95%CI: 0.75-0.97), although the trend was non-significant. A null association between offspring's cola consumption and leukemia was noted.


CONCLUSIONS
Our findings confirm the detrimental association between maternal coffee consumption and childhood leukemia risk and provide indications for a similar role of maternal cola intake. In contrast, an inverse association with tea was found, implying that other micronutrients contained in this beverage could potentially counterbalance the deleterious effects of caffeine. Further research should focus on the intake of specific micronutrients, different types of coffee and tea, specific immunophenotypes of the disease, and the modifying effect of genetic polymorphisms.
Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, University of Athens, Greece.
Thomas P
TP
Thomopoulos
Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, University of Athens, Greece.
Evangelos
E
Ntouvelis
Program Medical Neurosciences, Charité-Universitätsmedizin, Berlin, Germany.
Andreas-Antonios
AA
Diamantaras
Department of Immunology and Histocompatibility "Aghia Sofia" Children's Hospital, Athens, Greece.
Marianna
M
Tzanoudaki
Department of Pediatric Hematology-Oncology, "Pan.& Agl. Kyriakou" Children's Hospital, Athens, Greece.
Margarita
M
Baka
2nd Department of Pediatrics, Aristotelion University of Thessaloniki, AHEPA General Hospital, Thessaloniki, Greece.
Emmanuel
E
Hatzipantelis
Department of Pediatric Hematology and Oncology, Hippokration Hospital, Thessaloniki, Greece.
Maria
M
Kourti
Department of Pediatric Haematology-Oncology, "Aghia Sophia" Children's Hospital, Athens, Greece.
Sophia
S
Polychronopoulou
Department of Pediatric Hematology and Oncology, Hippokration Hospital, Thessaloniki, Greece.
Vasiliki
V
Sidi
Department of Pediatric Hematology-Oncology, University Hospital of Heraklion, Heraklion, Greece.
Eftichia
E
Stiakaki
Haematology-Oncology Unit, First Department of Pediatrics, Athens University Medical School, "Aghia Sophia" Children's Hospital, Athens, Greece.
Maria
M
Moschovi
Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, University of Athens, Greece.
Maria
M
Kantzanou
Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, University of Athens, Greece. Electronic address: epetrid@med.uoa.gr.
Eleni Th
ET
Petridou
D001628:Beverages / Q000009:adverse effects*; D002110:Caffeine / Q000009:adverse effects; D016022:Case-Control Studies; D002648:Child; D003069:Coffee / Q000009:adverse effects*; D005260:Female; D006801:Humans; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000453:epidemiology*; D011247:Pregnancy; D012306:Risk; D013662:Tea / Q000009:adverse effects
D003069:Coffee; D013662:Tea; D002110:Caffeine
Caffeinated beverages; Childhood acute leukemia; Childhood nutrition; Coffee; Cola; Maternal nutrition; Tea