Choline Intake and Risk of Lethal Prostate Cancer: Incidence and Survival

Am J Clin Nutr. 2012 Oct;96(4):855-63. doi: 10.3945/ajcn.112.039784. Epub 2012 Sep 5.

Abstract

Background: Meat, milk, and eggs have been inconsistently associated with the risk of advanced prostate cancer. These foods are sources of choline-a nutrient that may affect prostate cancer progression through cell membrane function and one-carbon metabolism. No study has examined dietary choline and the risk of lethal prostate cancer.

Objective: Our objective was to examine whether dietary choline, choline-containing compounds, and betaine (a choline metabolite) increase the risk of lethal prostate cancer.

Design: We prospectively examined the intake of these nutrients and the risk of lethal prostate cancer among 47,896 men in the Health Professionals Follow-Up Study. In a case-only survival analysis, we examined the postdiagnostic intake of these nutrients and the risk of lethal prostate cancer among 4282 men with an initial diagnosis of nonmetastatic disease during follow-up. Diet was assessed with a validated questionnaire 6 times during 22 y of follow-up.

Results: In the incidence analysis, we observed 695 lethal prostate cancers during 879,627 person-years. Men in the highest quintile of choline intake had a 70% increased risk of lethal prostate cancer (HR: 1.70; 95% CI: 1.18, 2.45; P-trend = 0.005). In the case-only survival analysis, we observed 271 lethal cases during 33,679 person-years. Postdiagnostic choline intake was not statistically significantly associated with the risk of lethal prostate cancer (HR for quintile 5 compared with quintile 1: 1.69; 95% CI: 0.93, 3.09; P-trend = 0.20).

Conclusion: Of the 47,896 men in our study population, choline intake was associated with an increased risk of lethal prostate cancer.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Aged
  • Betaine / administration & dosage
  • Betaine / adverse effects
  • Choline / administration & dosage
  • Choline / adverse effects*
  • Cohort Studies
  • Diet / adverse effects*
  • Disease Progression
  • Follow-Up Studies
  • Health Personnel
  • Humans
  • Incidence
  • Male
  • Middle Aged
  • Phosphatidylcholines / administration & dosage
  • Phosphatidylcholines / adverse effects
  • Phosphorylcholine / administration & dosage
  • Phosphorylcholine / adverse effects
  • Prospective Studies
  • Prostatic Neoplasms / epidemiology
  • Prostatic Neoplasms / etiology*
  • Prostatic Neoplasms / mortality*
  • Prostatic Neoplasms / physiopathology
  • Risk
  • Sphingomyelins / administration & dosage
  • Sphingomyelins / adverse effects
  • Survival Analysis
  • United States / epidemiology

Substances

  • Phosphatidylcholines
  • Sphingomyelins
  • Phosphorylcholine
  • Betaine
  • Choline