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Nutrition in acute and chronic diseases

Dietary choline and sphingomyelin choline moiety intake and risk of colorectal cancer: a case-control study

European Journal of Clinical Nutrition volume 77, pages 905–910 (2023)Cite this article

Subjects

Abstract

Introduction

Phospholipids are possible favorable agents for colorectal cancer (CRC). Choline has been inversely related to CRC risk but findings are inconsistent. We assessed the effect of dietary sphingomyelin (SM) choline moiety and total choline intake on risk of CRC.

Method

This analysis is based on a multicenter case–control study conducted between 1992 and 1996 in Italy. A total of 6107 subjects were enrolled, including 1225 colon cancer cases, 728 rectal cancer cases and 4154 hospital-based controls. We applied data on the composition of foods in terms of SM choline moiety and choline intake on dietary information collected through a validated food-frequency questionnaire. Odds ratio (OR) for energy-adjusted tertiles of SM choline moiety and choline were estimated through logistic regression models adjusted for sex, age, center, education, alcohol consumption, body mass index, family history of CRC, and physical activity.

Results

Choline was inversely related to CRC risk (OR for the highest versus the lowest tertile: 0.85; 95% confidence interval [CI]: 0.73–0.99), with a significant trend in risk. The OR for an increment of one standard deviation of energy-adjusted choline intake was 0.93 (95% CI: 0.88–0.98). The association was consistent in colon and rectal cancer and also across colon subsites. SM choline moiety was not associated with CRC risk (OR for the highest versus the lowest tertile: 0.96, 95% CI 0.84–1.11).

Conclusion

This study shows an inverse association between choline intake and CRC but not with SM choline moiety.

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Data availability

Data are available upon reasonable request from the corresponding author.

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Acknowledgements

The authors would like to thank Dr. Alfred H. Merrill Jr for his expert advice during the initial conceptualization of the study.

Funding

This work was supported by the Italian Foundation for Cancer Research (AIRC).

Author information

Authors and Affiliations

  1. Department of Clinical Sciences and Community Health, University of Milan, 20133, Milan, Italy

    Marta Rossi, Claudio Pelucchi & Carlo La Vecchia

  2. Stony Brook Cancer Center, Stony Brook University, Stony Brook, NY, USA

    Malak Khalifeh, Yusuf Hannun, Chiara Luberto & Paolo Boffetta

  3. Department of Medicine, University of Udine, 33100, Udine, Italy

    Federica Fiori, Maria Parpinel & Giulia Collatuzzo

  4. Unit of Cancer Epidemiology, Centro di Riferimento Oncologico, National Cancer Institute IRCCS, 33108, Aviano, Italy

    Diego Serraino

  5. Department of Medical and Surgical Sciences, Alma Mater Studiorum, Università di Bologna, 40126, Bologna, Italy

    Eva Negri & Paolo Boffetta

  6. Department of Gastroenterology and Clinical Nutrition, Policlinico di Monza, 20900, Monza, Italy

    Attilio Giacosa

  7. Epidemiology and Biostatistics Unit, Istituto Nazionale dei Tumori IRCCS, Fondazione G. Pascale, 80131, Naples, Italy

    Anna Crispo

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Contributions

MR and PB conceived the study; DS, EN, AG, AC, and CLV collected the original data; MR, FF, and MP developed the assessment of exposure, with input from YH and CL; MR analyzed the data, with input from MK, CLV, CP and PB; MR, MK and GC drafted the manuscript, with input from YH, CL, CLV and PB; all authors reviewed and approved the final version of the manuscript.

Corresponding author

Correspondence to Paolo Boffetta.

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Competing interests

The authors declare no competing interests.

Ethical approval

The study protocol was submitted to the Board of Ethics of the participating hospitals and received the approval required at the time of data collection. The Ethics Committees of the Hospital “Niguarda Ca’ Granda”, Milan, provided the study approval (1125/194). Informed consent was obtained from all individual participants included in the study. This study was performed in line with the principles of the Declaration of Helsinki.

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Rossi, M., Khalifeh, M., Fiori, F. et al. Dietary choline and sphingomyelin choline moiety intake and risk of colorectal cancer: a case-control study. Eur J Clin Nutr 77, 905–910 (2023). https://doi.org/10.1038/s41430-023-01298-4

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