Table 1.
Relative risks (RR) and 95% confidence intervals (CIs) of colorectal cancer according to quintiles of energy-adjusted dietary choline and betaine intake in the Health Professionals Follow-up Study
| Choline and Betaine* | Quintile of intake |
Ptrend | ||||
|---|---|---|---|---|---|---|
| 1 | 2 | 3 | 4 | 5 | ||
| Choline | ||||||
| Cumulative average | ||||||
| Age-adjusted RR | 1.00 | 1.00 (0.82-1.23) | 0.99 (0.80-1.21) | 1.09 (0.89-1.32) | 1.00 (0.81-1.22) | 0.81 |
| Multivariate RR† | 1.00 | 1.03 (0.84-1.27) | 1.01 (0.82-1.24) | 1.08 (0.88-1.32) | 0.97 (0.79-1.20) | 0.87 |
| Baseline | ||||||
| Multivariate RR† | 1.00 | 0.86 (0.70-1.06) | 0.89 (0.72-1.09) | 1.02 (0.83-1.24) | 0.92 (0.75-1.12) | 0.90 |
| 0-4 year lag | ||||||
| Multivariate RR† | 1.00 | 0.90 (0.71-1.14) | 1.04 (0.83-1.30) | 1.11 (0.89-1.38) | 0.96 (0.76-1.19) | 0.82 |
| 4-8 year lag | ||||||
| Multivariate RR† | 1.00 | 0.80 (0.61-1.05) | 1.04 (0.81-1.34) | 1.02 (0.79-1.32) | 0.91 (0.71-1.18) | >0.99 |
| 8-12 year lag | ||||||
| Multivariate RR† | 1.00 | 0.83 (0.60-1.14) | 0.92 (0.67-1.26) | 0.95 (0.70-1.31) | 1.08 (0.79-1.47) | 0.38 |
| 12-16 year lag | ||||||
| Multivariate RR† | 1.00 | 0.79 (0.52-1.20) | 0.78 (0.51-1.19) | 0.83 (0.55-1.25) | 0.91 (0.60-1.37) | 0.76 |
| Betaine | ||||||
| Cumulative average | ||||||
| Age-adjusted RR | 1.00 | 0.94 (0.77-1.15) | 0.87 (0.71-1.07) | 0.97 (0.80-1.18) | 0.83 (0.68-1.02) | 0.12 |
| Multivariate RR† | 1.00 | 0.99 (0.81-1.21) | 0.93 (0.75-1.13) | 1.07 (0.88-1.30) | 0.94 (0.77-1.16) | 0.79 |
| Baseline betaine | ||||||
| Multivariate RR† | 1.00 | 0.90 (0.74-1.10) | 1.04 (0.86-1.27) | 0.98 (0.80-1.20) | 0.95 (0.78-1.17) | 0.82 |
| 0-4 year lag | ||||||
| Multivariate RR† | 1.00 | 1.07 (0.85-1.33) | 1.09 (0.87-1.36) | 1.14 (0.92-1.43) | 1.06 (0.85-1.33) | 0.59 |
| 4-8 year lag | ||||||
| Multivariate RR† | 1.00 | 0.69 (0.53-0.90) | 0.85 (0.66-1.09) | 0.80 (0.62-1.03) | 0.92 (0.72-1.18) | 0.87 |
| 8-12 year lag | ||||||
| Multivariate RR† | 1.00 | 0.99 (0.72-1.36) | 1.20 (0.89-1.64) | 1.05 (0.76-1.45) | 0.91(0.65-1.27) | 0.55 |
| 12-16 year lag | ||||||
| Multivariate RR† | 1.00 | 1.03 (0.68-1.58) | 1.36 (0.91-2.04) | 1.03 (0.67-1.58) | 0.79 (0.49-1.27) | 0.25 |
|
Choline from individual
sources (cumulative average) |
||||||
| Choline from free choline | ||||||
| Multivariate RR† | 1.00 | 1.09 (0.88-1.34) | 0.99 (0.80-1.23) | 0.91 (0.73-1.14) | 1.07 (0.86-1.33) | 0.98 |
| Choline from glycerophosphocholine |
||||||
| Multivariate RR† | 1.00 | 1.01 (0.82-1.24) | 0.92 (0.75-1.13) | 0.95 (0.77-1.17) | 0.98 (0.80-1.20) | 0.81 |
| Choline from phosphocholine | ||||||
| Multivariate RR† | 1.00 | 0.83 (0.67-1.02) | 0.97 (0.79-1.19) | 0.95 (0.77-1.17) | 0.97 (0.78-1.19) | 0.79 |
| Choline from phosphatidylcholine |
||||||
| Multivariate RR† | 1.00 | 1.12 (0.91-1.38) | 1.00 (0.81-1.23) | 1.13 (0.92-1.38) | 0.97 (0.79-1.20) | 0.70 |
| Choline from sphingomyelin | ||||||
| Multivariate RR† | 1.00 | 1.05 (0.86-1.29) | 1.14 (0.93-1.38) | 0.96 (0.78-1.18) | 0.99 (0.80-1.21) | 0.61 |
Note: Cumulative average intakes were calculated from all available questionnaires up to the end of each 2-year follow-up interval. For example, choline intake in 1986 was used for analyses of colorectal cancer diagnosed from 1986 through 1990, and the average of choline intake in 1986 and 1990 was used for analyses of colorectal cancer diagnosed from 1990 through 1994. In the baseline analyses, we used only the baseline intake in 1986. We also performed analyses using varying lag times. For example, for latency of 0-4 years before diagnosis, we used choline intake in 1986 for cases diagnosed from 1986 through 1990, intake in 1990 for cases diagnosed from 1990 through 1994, and so forth. For latency of 4-8 years, we used choline intake in 1986 for cases diagnosed from 1990 through 1994, intake in 1990 for cases diagnosed from 1994 through 1998, and so forth. In latency analysis, number of cases differed; 0-4 year lag (n=813 cases), 4-8 year lag (n=614 cases), 8-12 year lag (n=408 cases), and 12-16 year lag (n=233 cases).
From foods only
Adjusted for total energy intake (continuous), aspirin dose (never, past, current use 1-2, 3-5, 6-14, ≥15 tablets/wk), pack-years of smoking before age 30 (never smoker, 1-4 years of smoking, 5-10 years, and ≥11 years of smoking), BMI (<23, 23-<25, 25-<30, 30-<35, and ≥35 kg/m2), family history of colorectal cancer (yes, no), history of endoscopy (yes, no), alcohol intake (never, 0.1-9.9 g/d, 10-14.9 g/d, 15-29.9 g/d, and ≥30 g/d), and total folate (<250, 250-<400, 400-<600, 600-<800, and ≥800 mcg/d).