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Associations of dietary choline and betaine with all-cause mortality: a prospective study in a large Swedish cohort
Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, P. O. Box 459, Gothenburg, Sweden; Department of Life Sciences, Division of Food and Nutrition Science, Chalmers University of Technology, Gothenburg, Sweden.
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Section of Sustainable Health. Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, P. O. Box 459, Gothenburg, Sweden.ORCID iD: 0000-0001-9122-7240
Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, P. O. Box 459, Gothenburg, Sweden.
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Section of Sustainable Health.ORCID iD: 0000-0002-6677-1866
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2024 (English)In: European Journal of Nutrition, ISSN 1436-6207, E-ISSN 1436-6215, Vol. 63, p. 785-796Article in journal (Refereed) Published
Abstract [en]

Purpose: Investigate the association between choline and betaine intake and all-cause mortality in a large Swedish cohort.

Methods: Women (52,246) and men (50,485) attending the Västerbotten Intervention Programme 1990–2016 were included. Cox proportional hazard regression models adjusted for energy intake, age, BMI, smoking, education, and physical activity were used to estimate mortality risk according to betaine, total choline, phosphatidylcholine, glycerophosphocholine, phosphocholine, sphingomyelin, and free choline intakes [continuous (per 50 mg increase) and in quintiles].

Results: During a median follow-up of 16 years, 3088 and 4214 deaths were registered in women and men, respectively. Total choline intake was not associated with all-cause mortality in women (HR 1.01; 95% CI 0.97, 1.06; P = 0.61) or men (HR 1.01; 95% CI 0.98, 1.04; P = 0.54). Betaine intake was associated with decreased risk of all-cause mortality in women (HR 0.95; 95% CI 0.91, 0.98; P < 0.01) but not in men. Intake of free choline was negatively associated with risk of all-cause mortality in women (HR 0.98; 95% CI 0.96, 1.00; P = 0.01). No other associations were found between intake of the different choline compounds and all-cause mortality. In women aged ≥ 55 years, phosphatidylcholine intake was positively associated with all-cause mortality. In men with higher folate intake, total choline intake was positively associated with all-cause mortality.

Conclusion: Overall, our results do not support that intake of total choline is associated with all-cause mortality. However, some associations were modified by age and with higher folate intake dependent on sex. Higher intake of betaine was associated with lower risk of all-cause mortality in women.

Place, publisher, year, edition, pages
Springer Nature, 2024. Vol. 63, p. 785-796
Keywords [en]
Betaine, Choline, Mortality, Phosphatidylcholine, Prospective cohort, Västerbotten Intervention Programme
National Category
Nutrition and Dietetics
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URN: urn:nbn:se:umu:diva-219531DOI: 10.1007/s00394-023-03300-yISI: 001136188700002PubMedID: 38175250Scopus ID: 2-s2.0-85181520811OAI: oai:DiVA.org:umu-219531DiVA, id: diva2:1829579
Available from: 2024-01-19 Created: 2024-01-19 Last updated: 2024-04-26Bibliographically approved

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Winkvist, AnnaLindahl, BerntJohansson, Ingegerd

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