SynthesisNutrients2017
Dietary Choline and Betaine and Risk of CVD: A Systematic Review and Meta-Analysis of Prospective Studies.
Synthesis in Nutrients, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 55 papers, 6 of them syntheses that pooled 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.
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.
Who cites it
55 citing papers in PubMed, 6 syntheses or guidelines pooled it, 125 citations in OpenAlex.
- Dietary Choline and Betaine Are Not Associated With the Risk of Type 2 Diabetes. A Systematic Review and Meta-Analysis of Observational Studies.Journal of diabetes research · 2026Pooled it
- Effect of egg consumption on circulating choline, betaine, and trimethylamine n-oxide in adults: a systematic review and meta-analysis of randomized controlled trials.Nutrition journal · 2025Pooled it
- Association of Gut Microbiota-Related Metabolites and Type 2 Diabetes in Two Puerto Rican Cohorts.Nutrients · 2024Pooled it
- Role of diet in stroke incidence: an umbrella review of meta-analyses of prospective observational studies.BMC medicine · 2022Pooled it
- Effect of Betaine on Reducing Body Fat-A Systematic Review and Meta-Analysis of Randomized Controlled Trials.Nutrients · 2019Pooled it
- The Effect of Red Palm Oil on Vitamin A Deficiency: A Meta-Analysis of Randomized Controlled Trials.Nutrients · 2017Pooled it
- Pilot trials of oral betaine in participants with metabolic dysfunction-associated steatotic liver disease and elevated alanine aminotransferase.Hepatology (Baltimore, Md.) · 2026Trial
- Changes in Choline Metabolites and Ceramides in Response to a DASH-Style Diet in Older Adults.Nutrients · 2023Trial
- Trial
- Effects of a diet based on the Dietary Guidelines on vascular health and TMAO in women with cardiometabolic risk factors.Nutrition, metabolism, and cardiovascular diseases : NMCD · 2022Trial
- Effects of 14-weeks betaine supplementation on pro-inflammatory cytokines and hematology status in professional youth soccer players during a competition season: a double blind, randomized, placebo-controlled trial.Journal of the International Society of Sports Nutrition · 2021Trial
- A Pilot Study on the Effects of l-Carnitine and Trimethylamine-N-Oxide on Platelet Mitochondrial DNA Methylation and CVD Biomarkers in Aged Women.International journal of molecular sciences · 2020Trial
- Trimethylamine-Nutrients · 2020Trial
- A Mediterranean diet does not alter plasma trimethylamine N-oxide concentrations in healthy adults at risk for colon cancer.Food & function · 2019Trial
- Choline status and related health outcomes in humans: A scoping review.Nutrition and health · 2026Article
- Choline supplementation in classic homocystinuria: impact on homocysteine and hepatic steatosis.Pediatric research · 2026Article
- Lifespan-Extending Endogenous Metabolites.Aging cell · 2026Review
- Metabolomic analyses of multiple biologic matrices reveal metabolic heterogeneity in diabetic complications.Acta diabetologica · 2025Article
- Choline Metabolism to the Proatherogenic Metabolite Trimethylamine Occurs Primarily in the Distal Colon Microbiome In Vitro.Metabolites · 2025Article
- Exercise-mimicking effects of betaine in chronic disease prevention and management.Frontiers in nutrition · 2025Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
2 authors at 1 institution in 1 country.
Funding
Abstract
Studies implicate choline and betaine metabolite trimethylamine N-oxide (TMAO) in cardiovascular disease (CVD). We conducted a systematic review and random-effects meta-analysis to quantify a summary estimated effect of dietary choline and betaine on hard CVD outcomes (incidence and mortality). Eligible studies were prospective studies in adults with comprehensive diet assessment and follow-up for hard CVD endpoints. We identified six studies that met our criteria, comprising 18,076 incident CVD events, 5343 CVD deaths, and 184,010 total participants. In random effects meta-analysis, incident CVD was not associated with choline (relative risk (RR): 1.00; 95% CI: 0.98, 1.02) or betaine (RR: 0.99; 95% CI: 0.98, 1.01) intake. Results did not vary by study outcome (incident coronary heart disease, stroke, total CVD) and there was no evidence for heterogeneity among studies. Only two studies provided data on phosphatidylcholine and CVD mortality. Random effects meta-analysis did not support an association between choline and CVD mortality (RR: 1.09, 95% CI: 0.89, 1.35), but one study supported a positive association and there was significant heterogeneity (
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Registered trials
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 OpenQuestion graph.