Evidence mapPaperPMID 40189218Full record

ArticleJournal of cachexia, sarcopenia and muscle2025

Association of Dietary Choline Intake With Incidence of Frailty: A Nationwide Prospective Cohort Study From China.

Lian-Hong Chen, Jian-Feng Zhong, Ying-Ying Niu, Cheng-Ping Li, Jing Li, Zhi-Quan Diao, Hao-Yu Yan, Miao Xu, Wen-Qi Huang, Zhi-Tong Xu and 2 more

Abstract read
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Article in Journal of cachexia, sarcopenia and muscle, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Observational
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Lian-Hong ChenDepartment of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, Guangdong, China.
Jian-Feng ZhongDepartment of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, Guangdong, China.
Ying-Ying NiuDepartment of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, Guangdong, China.
Cheng-Ping LiDepartment of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, Guangdong, China.
Jing LiDepartment of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, Guangdong, China.
Zhi-Quan DiaoDepartment of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, Guangdong, China.
Hao-Yu YanDepartment of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, Guangdong, China.
Miao XuDepartment of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, Guangdong, China.
Wen-Qi HuangDepartment of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, Guangdong, China.
Zhi-Tong XuDepartment of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, Guangdong, China.
Chang SuNational Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, China.
Dan LiuDepartment of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, Guangdong, China.ORCID https://orcid.org/0009-0004-6245-6027

Funding

Construction of High-level University of Guangdong G624330422National Natural Science Foundation of China 82003443
6 · The paper itself

Abstract

backgroundEmerging evidence suggests that dietary choline is a modifiable nutritional factor linked to various health outcomes. However, most existing studies have focused on isolated health conditions, lacking a comprehensive assessment of overall health status. This study aimed to investigate the association between total dietary choline intake and frailty incidence among Chinese adults, considering its derivatives, soluble forms (water-soluble and lipid-soluble) and food sources (animal-derived and plant-derived).

methodsParticipants without frailty at baseline were enrolled from the China Health and Nutrition Survey (CHNS), with follow-up from 2004 to 2016. Dietary intake was assessed using three consecutive 24-h dietary recalls to estimate total dietary choline intake, its derivatives, soluble forms and food sources. Frailty status was evaluated using a frailty index (FI), with frailty defined as an FI > 0.21. Cox proportional hazards regression and restricted cubic splines were used to analyse the associations between dietary choline intake and frailty incidence.

resultsA total of 10 310 participants (mean age: 46.4 years [SD: 14.5]; 52.6% female) were eligible. During a median follow-up of 6.1 years, 1150 incident frailty cases were recorded. Cox models with penalized splines showed an L-shaped association between total dietary choline intake and frailty incidence. Compared with participants in the lowest quartile of total choline intake, those in the 2nd to 4th quartiles had lower odds of frailty, with hazard ratios (HRs) of 0.84 (95% CI: 0.71, 0.98), 0.80 (95% CI: 0.67, 0.95) and 0.75 (95% CI: 0.61, 0.93), respectively. Intake of lipid-soluble choline in the 2nd to 4th quartiles was associated with an 18% (HR: 0.82; 95% CI: 0.69, 0.98) to 23% (HR: 0.77; 95% CI: 0.63, 0.95) reduction in the odds of frailty. Participants in the 3rd to 4th quartiles of phosphatidylcholine intake exhibited 19% (HR: 0.81; 95% CI: 0.68, 0.96) to 23% (HR: 0.77; 95% CI: 0.63, 0.94) lower odds of frailty. Choline intake from plant-derived food sources was significantly associated with reduced odds of frailty (HR: 0.83; 95% CI: 0.69, 0.99).

conclusionsModerate to high dietary choline intake (171.00-464.99 mg/day), particularly phosphatidylcholine (145.20-304.93 mg/day), may be associated with reduced odds of frailty.

Indexed as

CholineDietFrailtyAdultAgedChinaFemaleHumansIncidenceMaleMiddle AgedProspective StudiesCholinecohort studydietary cholinefrailty

Identifiers

PMID40189218
PMCPMC11972690

What Socratic holds

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.