Table 1. Characteristics of studies on choline and betaine consumption and cancer risk.
| First author year of publication (reference) | Cancer type | Country/design | Cases/Controls | Age(y)/sex | Follow-up (y) | Assessment of consumption/food item number/choline and betaine consumption calculation/nutrient database | Contrast (highest vs lowest) |
Ajusted OR/RR(95%CI) (highest vs lowest) |
Matched or adjusted variables | ||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Choline consumption only | Betaine consumption only | Choline plus Betaine consumption | Choline consumption only | Betaine consumtion only | Choline plus Betiane consumption | ||||||||
| Xu et al.6 | Breast cancer | USA; case-control (PB) | 1,508/1,556 | 20-98 F | NR | FFQ/100/frequency × portion-size/USDA database | Quintile >247.2 vs < 122.7mg/d | Quintile >179.71vs < 61.11mg/d | NR | 0.85(0.61–1.18) | 0.96(0.73–1.25) | NR | Age and daily energy intake |
| Ibiebele et al. 20107 | Esophageal Cancer | Australia; case-control (PB) | 881/1,507 | 18-79 M/F | NR | FFQ/135/-/USDA database | Quartile 1171 vs 380mg/d | Quartile 185 vs 85mg/d | NR | EAC: 1.25(0.91–1.72) ESCC: 1.39(0.88–2.30) | EAC: 0.79(0.58–1.07) ESCC: 1.30(0.83–1.99) | NR | Age, gender, education, BMI 1 y previously, frequency of heartburn or acid reflux 10 y prior to diagnosis, lifetime alcohol intake, pack-years of smoking, NSAID use, and total energy intake |
| Ying et al.8 | Lung Cancer | USA; case-control (HB) | 2,821/2,923 | no age restrictions M/F | NR | FFQ/214/frequency × nutrient content/USDA database | Quartile (highest vs lowest) | Quartile (highest vs lowest) | NR | 0.92(0.78–1.07) | 0.71(0.61–0.84) | NR | Sex, race/ethnicity, age, pack-years, total caloric intake, family cancer history, dust exposure, second-hand smoke, emphysema, hay fever, smoking status, asthma, addiction index, alcohol, time since smoking cessation |
| Zeng et al.9 | Nasopharyngeal Carcinoma | China; case-control (HB) | 600/600 | 30–75 M/F | NR | FFQ/78/frequency × portion-size/Chinese Food Composition Table | Quartile 285 vs 125mg/d | Quartile 539 vs 112mg/d | Quartile 761 vs 285mg/d | 0.42(0.29–0.61) | 0.50(0.35–0.72) | 0.44(0.30–0.64) | Age, BMI, occupation, marital status, educational level, household income, current smoking, current drinking, exposure to potential toxic substances, multivitamin supplement, chronic rhinitis history, physical activity, dietary folate intake and daily energy intake |
| Zhang et al.10 | Breast cancer | China; two stage case-control (HB) | stage 1: 438/438 stage 2: 369/369 Pooled: 807/807 | 25–70 F | NR | FFQ/81/frequency × portion-size/Chinese Food Composition Table | stage 1: Quartile >207.86 vs < 111.64mg/d stage 2: Quartile >232.24 vs < 123.66mg/d Pooled: Quartile >217.47 vs < 117.65mg/d | stage 1: Quartile >440.90 vs < 279.40 mg/d stage 2: Quartile >385.28 vs < 154.75 mg/d Pooled: Quartile >408.04 vs < 140.14 mg/d | stage 1: Quartile >627.38 vs < 279.40 mg/d stage 2: Quartile >600.19 vs < 314.00 mg/d Pooled: Quartile >615.63 vs < 297.57 mg/d | stage 1: 0.35(0.22–0.54) stage 2: 0.51(0.30–0.87) Pooled: 0.40(0.28–0.57) | stage 1: 0.60(0.39–0.92) stage 2: 0.45(0.25–0.80) Pooled: 0.58(0.42–0.80) | stage 1: 0.43(0.28–0.66) stage 2: 0.40(0.22–0.71) Pooled: 0.38(0.27–0.53) | Occupation, body mass index, age at menarche, live births and age at first live birth, mother/sister/daughter with breast cancer, passive smoking, alcohol consumption, physical activity, total energy intake and study stage |
| Lu et al.11 | Colorectal Cancer | China; case-control (MB) | 890/890 | 30–75 M/F | NR | FFQ/81/frequency × portion-size/Chinese Food Composition Table | Quartile >176.40 vs < 99.68mg/d | Quartile >323.10 vs < 116.70mg/d | Quartile >535.50 vs < 224.70mg/d | 0.54(0.37–0.80) | 0.92(0.65–1.29) | 0.91(0.65–1.28) | Age, sex, residence, marital status, education, income level, occupation, family history of cancer, smoking status, passive smoking, alcohol drinking, degree of physical activity, BMI, red meat, fish, beans and folate intake |
| Cho et al.12 | Breast cancer | USA; cohort | 1,032/89,631 | 26–46 F | 12 | FFQ/about 130/-/USDA database or other sources | Quintile 397 vs 267mg/d | Quintile 305 vs 114mg/d | NR | 0.88(0.72–1.07) | 0.99(0.79–1.22) | NR | Smoking, height, parity and age at first birth, body mass index, age at menarche, family history of breast cancer, history of benign breast disease, oral contraceptive use, and intakes of alcohol, energy, and animal fat |
| Kotsopoulos et al.13 | Epithelial ovarian cancer | USA; cohort | 526/159,431 | 25–55 F | 22 | FFQ/-/-/USDA database and other sources | Quintile NHS:≥ 338.8 vs < 249.5 mg/d NHSII: ≥367.3 vs < 269.7 mg/d | Quintile NHS: ≥127.3 vs < 70.5 mg/d NHSII: ≥138.9 vs >80.6 mg/d | Quintile NHS: ≥453.8 vs < 339.8 mg/d NHSII: ≥491.7 vs < 371.6 mg/d | 0.98(0.73–1.31) | 0.98(0.74–1.31) | 0.99(0.75–1.32) | Age at menarche and parity, duration of oral contraceptive use, tubal ligation, height, family history of breast or ovarian cancer, caffeine intake, hysterectomy, PMH/menopausal status, caloric intake, alcohol consumption and BMI |
| Lee et al.14 | Colorectal Cancer | USA; cohort | 987/46,315 | 40–75 M | 18 | FFQ/-/frequency × nutrient content/USDA database | Quintile (highest vs lowest) | Quintile (highest vs lowest) | NR | 0.97(0.79–1.20) | 0.94(0.77–1.16) | NR | Total energy intake, aspirin dose, pack-years of smoking before age 30, body mass index, family history of colorectal cancer, history of endoscopy, alcohol intake, and total folate |
| Cho et al.15 | Breast cancer | USA; cohort | 3,990/70,594 | 30–55 F | 20 | FFQ/about 130/frequency × nutrient content/Harvard University Food Composition Database and USDA database | Quintile 396 vs 260mg/d | Quintile 144 vs 71mg/d | NR | 1.10(0.99–1.22) | 0.98(0.89–1.09) | NR | Smoking status, height, parity and age at first birth,body mass index at age 18, weight change between age 18 and current, physical activity, age at menarche, family history of breast cancer, history of benign breast disease, use of post-menopausal hormones, and intakes of alcohol, energy, and folate |
| Cho et al.16 | Renal cell cancer | USA; cohort | NHS: 225/76,983 HPFS: 221/47,665 | NHS: 30–55 F HPFS: 40–75 M | F: 24 M: 22 | FFQ/about 131/frequency × nutrient content/USDA database and other sources | NHS: Quintile 399.8 vs 267.1mg/d HPFS: Quintile 471.7 vs 308.3mg/d Pooled: Quintile (highest vs lowest) | NHS: Quintile 138.4 vs 70.5mg/d HPFS: Quintile 186.4 vs 84.9mg/d Pooled: Quintile (highest vs lowest) | NR | NHS: 0.78(0.48–1.27) HPFS: 0.96(0.62–1.48) Pooled: 0.87(0.63–1.21) | NHS: 0.78(0.49–1.24) HPFS: 1.30(0.83–2.02) Pooled: 1.01(0.62–1.65) | NR | Age, smoking status, body mass index, history of hypertension, history of diabetes, physical activity, fruit intake, vegetable intake, and alcohol intake in NHS and HPFS and parity in NHS |
Abbreviations: EAC, esophageal adenocarcinoma; ESCC, esophageal squamous cell carcinoma; FFQ, food frequency questionnaire; HB, hospital-based; HPFS, The Health Professionals Follow-up Study; PB, population-based; MB, mixed based (including both hospital-based and population-based); NASID, Non-steroidal Anti-inflammatory Drugs; NHS, The Nurses’ Health Study; NHSII, The Nurses’ Health Study II; NR, no record; PMH, postmenopausal hormone; USDA, US Department of Agriculture.