Cancer is a growing health problem in children. Increases in childhood cancer incidence since the 1960s have been reported. However, causes of malignant tumors in the young are mostly unknown, partly due to their rare occurrence. Diet is one of the main modifiable risk factors for many degenerative diseases, including cancer. More than 30% of adult cancers are preventable or delayed by diet, being physically active and having a healthy body weight. Most studies were performed on adults and thus the role of diet in childhood cancer is less well-understood. However, increasing evidence suggests that early life dietary factors like prolonged and frequent breastfeeding, maternal diet during pregnancy and vitamin intake during pregnancy may impart benefit for reduced childhood cancer risk. Although increasing evidence suggests adverse health effects of early life exposure to trans-fatty acids (TFA), hitherto no studies explored the effect of prenatal and early life TFA exposure on childhood cancers.
The main hypothesis of the EnTrance study is that high TFA exposures during fetal development have adverse effects on the risk of childhood cancers, and that reduced exposure to TFA due to Danish policy change that took place in 2003 had beneficial effects in preventing childhood cancers. To investigate this hypothesis, we will work on two broad objectives: 1: In a unique societal experiment in which the Danish trans-fat-policy changes – legislations to abandon trans-fat in Danish products were launched already in 2003 and effective from January 1st 2004 – the risk for childhood cancers will be compared between children born in the years before and after the abandonment. 2: Additionally, reliable biomarkers of TFA will be measured from neonatal TFA concentrations in stored dried blood spots (DBS) and compared for individuals who develop childhood cancer and matched controls.
This study takes advantage of a TFA elimination policy that was adopted and put in force on 31st of March 2003, making it illegal to use fat with more than 2% of TFA. By comparing individual risk for cancer in children born before and after abandonment of trans-fat, we propose to investigate the role of prenatal industrial TFA exposure on childhood cancer risk. Therefore, approximately 125.000 individuals from the trans-fat exposed group born between 01.01.2000 and 31.03.2003, and approximately 127.000 individuals from the non-exposed group born between 01.10.2004 and 31.12.2007 will be compared. In addition, neonatal TFA measured from DBS from 700 individuals who develop childhood leukemia and 700 matched controls will be compared using a validated gas chromatography methodology.
This study will contribute in disentangling the role of prenatal exposure to TFA in the development of childhood cancers and will allow the knowledge to be used in prevention strategies towards a reduction of the occurrence of cancer in children.
EnTrance is funded by Børnecancerfonden.