Dietary Folate, Alcohol Consumption, and Risk of Non-Hodgkin Lymphoma

Abstract:

Dietary deficiency of folate and other micronutrients involved in the one-carbon metabolism (i.e., vitamins B ₂ , B ₆ , B ₁₂ , and methionine) have been related to several diseases, including cancers, but results on non-Hodgkin lymphoma (NHL) are controversial. A hospital-based case-control study was conducted in Italy, in 1999–2002. Cases were 190 incident, histologically confirmed NHL aged 18–84 years. Controls were 484 subjects admitted to hospitals for acute, non-neoplastic diseases supposed to be unrelated to alcohol consumption or to diet modification. Dietary habits, including alcohol drinking, were assessed by a validated food-frequency questionnaire. Nutrient intakes were computed using the Italian food composition database. Odds ratios (ORs) and corresponding 95% confidence intervals for tertiles of nutrients' intake were computed using the energy-adjusted residual models. No significant association emerged between NHL risk and intakes of folate (OR = 0.9), vitamin B ₂ (OR = 0.9), vitamin B ₆ (OR = 0.8), and methionine (OR = 0.7). However, a significant inverse association was observed for all the nutrients examined among abstainers and former drinkers, whereas no relations between one-carbon nutrients and NHL risk emerged among current alcohol drinkers. Our findings support the possibility of an antagonist effect of alcohol on the one-carbon metabolism in NHL etiology. However, the lack of an overall effect for one-carbon nutrients and the small sample size suggested caution in interpreting our results.

Acknowledgments and Notes

This work was supported by grants from A.I.R.C. (Italian Association for Cancer Research) and the Italian League Against Cancer. The authors wish to thank Drs. A. Pinto, V. Canzonieri, and M. Crovatto for the collaboration to the study, Mrs. O. Volpato for study coordination, Drs. G. Laconca, M. Grimaldi, and S. Desicato for their help in data collection. We are also deeply thankful to Drs. R. Mele, A. Grandi, L. Forner, P. Ascierto, R. Magri, and R. Di Lauro for providing hospital control patients.

Notes

^a : Adjusted for age (in quinquennia and continuous term), gender, center (Aviano/Pordenone, Naples), and education (< 7 yr, 7–11 yr, ≥ 12 yr).

^b : Reference category.

^a : Adjusted for age (in quinquennia and continuous term), gender, center (Aviano/Pordenone, Naples), education (< 7 yr, 7–11 yr, ≥ 12 yr), and total energy intake (continuous term).

^b : Reference category.

^c : Between strata of drinking habits.