(ChemotherapyAdvisor) – The longer a child is fed formula and the later the age solid foods are introduced, the greater the risk for developing acute lymphoblastic leukemia (ALL), a study presented during the 11th Annual AACR International Conference on Frontiers in Cancer Prevention Research has found.

“Our results highlight the role of energy balance in early life as critical contributors to risk for pediatric ALL,” according to Jeremy Schraw, a graduate student at The University of Texas at Austin, and colleagues. “The literature suggests multiple points of interaction between infant feeding patterns and leukemogenesis whereby diet may influence normal development of the immune system and levels of insulin-like growth factor 1 (IGF-1) in the serum.”

To examine the association between feeding practices on risk of ALL, they enrolled 142 incident cases of infant and childhood ALL in a case-control study at Texas Children’s Cancer Center; ages ranged from 0 to 14 years. The 248 controls were frequency matched on age, sex, race, and ethnicity.


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Cases were found to have been started on solid foods significantly later than controls, and more mothers of cases than control smoked during pregnancy.

“Compared to the controls, cases had longer duration of formula feeding, and upon analysis of the exclusive formula versus mixed breast and formula fed, mixed feeding groups had a longer duration of formula intake,” they reported.

A preliminary multivariate model showed each additional month of formula feeding was associated with a 16% increased risk of ALL (OR 1.16, 95% CI 1.08–1.25), and each additional month of delaying the age at introduction of solids with a 14% increased odds of ALL, after adjustment for covariates (OR 1.14, 95% CI: 1.04–1.26).

“In this ethnically diverse population, duration of formula feeding and age at introduction of solid foods were directly associated with increased odds of ALL,” they concluded. “Further research needs to address the factors influencing duration of formula feeding and delay in introduction of solids.”

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