An Empirical Test of the Biodiversity Hypothesis: Exposure to Plant Diversity is Associated with a Reduced Risk of Childhood Acute Lymphoblastic Leukemia

Background:The biodiversity hypothesis posits that declining biodiversity may be responsible, at least in part, for the global increase in immune diseases. However, few studies have been able to demonstrate a link between exposure to biodiversity and specific health outcomes. Methods: We test whether exposure to plant diversity protects against childhood acute lymphoblastic leukemia (ALL) by promoting immune maturation. Our sample consisted of all children born in New Zealand from 1998-2011 (n=899,126; 264 ALL cases), which we followed from birth to age five. We calculated plant-diversity metrics using the Global Biodiversity Information Facility, which contains over two million geocoded plant records in New Zealand. Findings: Consistent with previous research, children who had always lived in an urban area, or who had an older mother, were at greater risk for ALL, whereas children with older siblings were at lower risk. In addition, we found that plant-diversity metrics based on the maximum number of plant genera a child was exposed to during the first two years of life were protective of ALL. Specifically, exposure to the highest tertile of plant diversity was associated with a reduction in ALL risk of 35% (95% CI: 11%-53%). Interpretation: Exposure to plant diversity, and associated microbial communities, may be a viable public-health intervention to reduce the risk of ALL and possibly other immune diseases. Funding Statement: Geoffrey Donovan acknowledges the receipt of a fellowship from the OECD Co-operative Research Programme: Biological Resource Management for Sustainable Agricultural Systems in 2019. No other funding was received. Declaration of Interests: The authors declare no competing financial interests. Ethics Approval Statement: Our study was classified as out of scope by the New Zealand Health and Disabilities Ethics Committee, approved by Statistics New Zealand (approval # MAA2019-07), and conducted in accordance with national and international ethical guidelines for observational studies.