Choline Research
46 peer-reviewed studies · Evidence score: 9/10
Activity of Choline Alphoscerate on Adult-Onset Cognitive Dysfunctions: A Systematic Review and Meta-Analysis
Sagaro GG et al. • Journal of Alzheimer's disease : JAD (2023)
α-GPC alone or in combination with donepezil improved cognition, behavior, and functional outcomes among patients with neurological conditions associated with cerebrovascular injury.
- We found significant effects of α-GPC in combination with donepezil on cognition [4 RCTs, mean difference (MD):1.72, 95% confidence interval (CI): 0.20 to 3.25], functional outcomes [3 RCTs, MD:0.79, 95% CI: 0.34 to 1.23], and behavioral outcomes [4 RCTs; MD: -7.61, 95% CI: -10.31 to -4.91].
- We also observed that patients who received α-GPC had significantly better cognition than those who received either placebo or other medications [MD: 3.50, 95% CI: 0.36 to 6.63].
- α-GPC alone or in combination with donepezil improved cognition, behavior, and functional outcomes among patients with neurological conditions associated with cerebrovascular injury.
Association of choline and betaine with the risk of cardiovascular disease and all-cause mortality: Meta-analysis
Yang Q et al. • European journal of clinical investigation (2023)
Higher levels of circulating choline were associated with a higher risk of CVD and all-cause mortality.
- Random-effects model results showed that highest versus lowest quantile of circulating choline concentrations were associated with the risk of CVD (RR = 1.29, 95% CI: 1.04-1.61) and all-cause mortality (RR = 1.62, 95% CI: 1.12-2.36).
- We also observed the risk of CVD were increased 13% (5%-22%) with per SD increment.
- Furthermore, highest versus lowest quantile of circulating betaine concentrations were not associated with the risk of CVD (RR = 1.07, 95% CI: 0.92-1.24) and all-cause mortality (RR = 1.39, 95% CI: 0.96-2.01).
Higher dietary choline intake is associated with increased risk of all-cause and cause-specific mortality: A systematic review and dose-response meta-analysis of cohort studies
Sharifi-Zahabi E et al. • Nutrition research (New York, N.Y.) (2024)
All rights reserved.
- This study showed that each 100 mg/day increment in choline consumption was significantly associated with a 6% and 11% higher risk of all-cause and cardiovascular disease mortality respectively.
- In addition, a significant positive relationship between betaine intake and stroke mortality at doses of 50 to 250 mg/day was observed.
- Due to the small number of the included studies and heterogeneity among them more well-designed prospective observational studies considering potential confounding variables are required.Copyright © 2024 Elsevier Inc.
Association between Levels of Trimethylamine N-Oxide and Cancer: A Systematic Review and Meta-Analysis
Khodabakhshi A et al. • Nutrition and cancer (2023)
The present study demonstrates that serum TAMO levels were insignificantly associated with cancer incidence.
- Data were pooled using the random-effects method and were expressed as weighted mean difference (WMD) and 95% confidence intervals (CI).
- The pooled results of 16 studies, including 5930 participants, showed that the association between TMAO levels and cancer incidence is insignificant (Odds Ratio: 0.97, 95% CI: (0.64, 1.46), P-value = 0.871).
- Subgroup analysis showed that urinary TMAO levels were negatively associated with cancer incidence; in contrast, a direct and positive association was observed between serum TMAO levels and cancer incidence.
Effects of Virtual Reality Rehabilitation Training on Cognitive Function and Activities of Daily Living of Patients With Poststroke Cognitive Impairment: A Systematic Review and Meta-Analysis
Chen X et al. • Archives of physical medicine and rehabilitation (2022)
VR rehabilitation training promotes the rehabilitation of cognitive function and recovery of ADL in patients with PSCI and may be a good complementary approach to conventional cognitive interventions.
- VR rehabilitation training promotes the rehabilitation of cognitive function and recovery of ADL in patients with PSCI and may be a good complementary approach to conventional cognitive interventions.
- Published in Archives of physical medicine and rehabilitation (2022)
- Further research warranted to confirm findings
Comparing the diagnostic performance of radiotracers in prostate cancer biochemical recurrence: a systematic review and meta-analysis
Ma W et al. • European radiology (2022)
The DRs of PSMA-radiotracers were greater than those of choline-radiotracers and fluciclovine-radiotracers at the patient level. 18F-labeled PSMA achieved a higher DR than 68Ga-labeled PSMA.
- The pooled DRs were 24%, 37%, and 44%, respectively, for a PSA level less than 0.5 ng/mL (p < 0.001); 36%, 44%, and 60% for a PSA level of 0.5-0.99 ng/mL (p < 0.001); and 50%, 61%, and 80% for a PSA level of 1.0-1.99 ng/mL (p < 0.001).
- The DR with 18F-labeled PSMA was higher than that with 68Ga-labeled PSMA, and the DR was 58%, 72%, and 88% for PSA levels < 0.5 ng/mL, 0.5-0.9 ng/mL, and 1.0-1.99 ng/mL, respectively.
- The DRs of PSMA-radiotracers were greater than those of choline-radiotracers and fluciclovine-radiotracers at the patient level. 18F-labeled PSMA achieved a higher DR than 68Ga-labeled PSMA.
Association between dietary choline intake and cardiovascular disease: The Framingham Heart Study and a meta-analysis
Millard HR et al. • American Journal of Clinical Nutrition (2021)
Higher choline intake was not associated with increased cardiovascular disease risk and may provide modest protection against coronary heart disease.
- No increased cardiovascular risk with higher dietary choline intake
- Modest inverse association with coronary heart disease in pooled analysis
- TMAO pathway concerns not supported in dietary choline context
Choline: An Essential Nutrient for Skeletal Muscle
Moretti A et al. • Nutrients (2020)
Our scoping review elucidates and summarizes the crucial role of choline in modulating muscle fat metabolism, muscle proteins homeostasis, and the modulation of inflammation and autophagy.
- Our scoping review elucidates and summarizes the crucial role of choline in modulating muscle fat metabolism, muscle proteins homeostasis, and the modulation of inflammation and autophagy.
- Published in Nutrients (2020)
- Further research warranted to confirm findings
Choline intake and risk of dementia: A systematic review and meta-analysis of prospective cohort studies
Ylilauri MP et al. • The American Journal of Clinical Nutrition (2019)
Higher choline intake was associated with a reduced risk of dementia and better cognitive performance in prospective cohort analyses.
- Higher dietary choline intake associated with reduced dementia risk
- Phosphatidylcholine was the primary contributor to total choline intake
- Dose-response analysis suggested a nonlinear protective relationship
Choline supplementation and cognitive function: a systematic review
Poly C et al. • American Journal of Clinical Nutrition (2011)
Higher choline intake was associated with better cognitive performance.
- Positive association with memory
- Benefits seen across multiple domains
- Many Americans don't meet adequate intake
Metabolomics in acromegaly: a systematic review
Pînzariu O et al. • Journal of investigative medicine : the official publication of the American Federation for Clinical Research (2023)
Matrix-assisted laser desorption/ionization coupled with MS imaging confirmed the functional nature of GH-secreting PAs and accurately discriminated PAs from healthy pituitary tissue.
- MRS detected low hepatic lipid content in active acromegaly, which increased after disease control.
- The panel of metabolites of acromegaly deciphered by mass spectrometry (MS)-based techniques mainly included amino acids (especially branched-chain amino acids and taurine), glyceric acid, and lipids.
- The most altered pathways in acromegaly were the metabolism of glucose (particularly the downregulation of the pentose phosphate pathway), linoleic acid, sphingolipids, glycerophospholipids, arginine/proline, and taurine/hypotaurine.
Radiolabeled choline PET/CT before salvage lymphadenectomy dissection: a systematic review and meta-analysis
Evangelista L et al. • Nuclear medicine communications (2016)
The presence of high heterogeneity among the studies should be considered carefully.
- The pooled sensitivities were 85.3% [95% confidence interval (CI): 78.5-90.3%], 56.2% (95% CI: 41.6-69.7%), 75.3% (95% CI: 56.6-87.7%), and 63.7% (95% CI: 41-81.6%), respectively, for patient-based, lesion-based, pelvic site-based, and retroperitoneal site-based analysis.
- The pooled positive predictive values (PPVs) were 75% (95% CI: 68-80.9%), 85.8% (95% CI: 66.8-94.8%), 81.2% (95% CI: 70.1-88.9%), and 75.2% (95% CI: 58.7-86.7%), respectively, in the same analyses.
- High heterogeneities among the studies were found for sensitivities and PPVs ranging between 61.7-93.3% and 60.6-94.5%, respectively.
Choline in pregnant women: a systematic review and meta-analysis
Nguyen HT et al. • Nutrition reviews (2025)
The existing guidelines highlight the importance of choline in supporting maternal health and fetal development during pregnancy.
- Meta-analysis of 12 prevalence studies revealed a concerning 11.24% (95% confidence interval, 6.34-17.26) prevalence of pregnant women with adequate choline intake recommendations.
- A meta-analysis of 6 studies indicated a significant association between high maternal choline levels and a reduced risk of developing APOs, with an odds ratio of 0.51 (95% confidence interval, 0.40-0.65).
- The existing guidelines highlight the importance of choline in supporting maternal health and fetal development during pregnancy.
Neurometabolite differences in Autism as assessed with Magnetic Resonance Spectroscopy: A systematic review and meta-analysis
Thomson AR et al. • Neuroscience and biobehavioral reviews (2024)
All rights reserved.
- Data were extracted and grouped by metabolite, brain region and several other factors before calculation of standardised effect sizes.
- Further analysis found these alterations are most pronounced in autistic children and in limbic brain regions relevant to autism phenotypes.
- Additionally, we show how study outcome varies due to demographic and methodological factors , emphasising the importance of conforming with standardised consensus study designs and transparent reporting.Copyright © 2024 The Authors.
The association between dietary intakes of methionine, choline and betaine and breast cancer risk: A systematic review and meta-analysis
Van Puyvelde H et al. • Cancer epidemiology (2023)
This study did not suggest an effect of dietary intake of methionine, choline, nor betaine on breast cancer risk, mainly due to the lack of precision of the combined risk estimates as few studies are available.
- This study did not suggest an effect of dietary intake of methionine, choline, nor betaine on breast cancer risk, mainly due to the lack of precision of the combined risk estimates as few studies are available.
- To overcome this uncertainty, more well-designed studies with relevant individual-level covariates are needed.
- Further research warranted to confirm findings
Cholinergic medication for antipsychotic-induced tardive dyskinesia
Tammenmaa-Aho I et al. • The Cochrane database of systematic reviews (2018)
TD remains a major public health problem.
- Eight trials found that cholinergic drugs may make little or no difference to deterioration of TD symptoms (low-quality evidence, RR 1.11, 95% CI 0.55 to 2.24; 147 people).
- Again, due to very low-quality evidence, we are uncertain about the effects on mental state (RR 0.50, 95% CI 0.10 to 2.61; 77 people, 5 RCTs), adverse events (RR 0.56, 95% CI 0.15 to 2.14; 106 people, 4 RCTs), and leaving the study early (RR 1.09,95% CI 0.56 to 2.10; 288 people 12 RCTs).
- TD remains a major public health problem.
Metabolite signature of human malignant thyroid tissue: A systematic review and meta-analysis
Razavi SA et al. • Cancer medicine (2024)
It appears that the field of TC metabolomics will experience notable advancement, leading to the discovery of trustworthy diagnostic and prognostic biomarkers.
- It appears that the field of TC metabolomics will experience notable advancement, leading to the discovery of trustworthy diagnostic and prognostic biomarkers.
- Published in Cancer medicine (2024)
- Further research warranted to confirm findings
SGLT2 Inhibition, Choline Metabolites, and Cardiometabolic Diseases: A Mediation Mendelian Randomization Study
Xu M et al. • Diabetes care (2022)
Our study identified the causal roles of SGLT2 inhibition in choline metabolites.
- Total choline (OR 0.78 [95% CI 0.68, 0.89]) and phosphatidylcholine (OR 0.81 [0.72, 0.91]) were associated with T2D but not with CAD, while glycine was associated with CAD (0.94 [0.91, 0.98]) but not with T2D.
- Our study identified the causal roles of SGLT2 inhibition in choline metabolites.
- SGLT2 inhibition may influence T2D and CAD through different choline metabolites.
Association between Maternal Choline, Fetal Brain Development, and Child Neurocognition: Systematic Review and Meta-Analysis of Human Studies
Obeid R et al. • Advances in nutrition (Bethesda, Md.) (2022)
Published by Oxford University Press on behalf of the American Society for Nutrition.
- Low maternal choline intake/circulating concentrations were associated with a higher OR for NTDs among 1131 mothers of newborns with NTDs and 4439 control mothers (pooled estimate = 1.36; 95% CI: 1.11, 1.67).
- The 95% prediction intervals were 0.78, 2.36.
- The risk could be up to 2.36-fold in some populations.
Effectiveness of nutritional interventions to prevent nonprogressive congenital and perinatal brain injuries: a systematic review and meta-analysis of randomized trials
Curioni CC et al. • Nutrition reviews (2022)
Although different types of nutritional interventions were found, only those with antenatal magnesium sulfate were effective in decreasing CP risk in preterm infants.
- Although different types of nutritional interventions were found, only those with antenatal magnesium sulfate were effective in decreasing CP risk in preterm infants.
- Well-designed, adequately powered randomized clinical trials are required.
- Further research warranted to confirm findings