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

ABSTRACT Background Emerging 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 invest...

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Main Authors: 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, Chang Su, Dan Liu
Format: Article
Language:English
Published: Wiley 2025-04-01
Series:Journal of Cachexia, Sarcopenia and Muscle
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Online Access:https://doi.org/10.1002/jcsm.13796
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author 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
Chang Su
Dan Liu
author_facet 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
Chang Su
Dan Liu
author_sort Lian‐hong Chen
collection DOAJ
description ABSTRACT Background Emerging 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). Methods Participants 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. Results A 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). Conclusions Moderate 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.
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spelling doaj-art-55b3fc8e57314cfe9a587fb1b3bbaa622025-08-20T02:09:09ZengWileyJournal of Cachexia, Sarcopenia and Muscle2190-59912190-60092025-04-01162n/an/a10.1002/jcsm.13796Association of Dietary Choline Intake With Incidence of Frailty: A Nationwide Prospective Cohort Study From ChinaLian‐hong Chen0Jian‐feng Zhong1Ying‐ying Niu2Cheng‐ping Li3Jing Li4Zhi‐quan Diao5Hao‐yu Yan6Miao Xu7Wen‐qi Huang8Zhi‐tong Xu9Chang Su10Dan Liu11Department of Public Health and Preventive Medicine, School of Medicine Jinan University Guangzhou Guangdong ChinaDepartment of Public Health and Preventive Medicine, School of Medicine Jinan University Guangzhou Guangdong ChinaDepartment of Public Health and Preventive Medicine, School of Medicine Jinan University Guangzhou Guangdong ChinaDepartment of Public Health and Preventive Medicine, School of Medicine Jinan University Guangzhou Guangdong ChinaDepartment of Public Health and Preventive Medicine, School of Medicine Jinan University Guangzhou Guangdong ChinaDepartment of Public Health and Preventive Medicine, School of Medicine Jinan University Guangzhou Guangdong ChinaDepartment of Public Health and Preventive Medicine, School of Medicine Jinan University Guangzhou Guangdong ChinaDepartment of Public Health and Preventive Medicine, School of Medicine Jinan University Guangzhou Guangdong ChinaDepartment of Public Health and Preventive Medicine, School of Medicine Jinan University Guangzhou Guangdong ChinaDepartment of Public Health and Preventive Medicine, School of Medicine Jinan University Guangzhou Guangdong ChinaNational Institute for Nutrition and Health Chinese Center for Disease Control and Prevention Beijing ChinaDepartment of Epidemiology, School of Public Health Southern Medical University Guangzhou Guangdong ChinaABSTRACT Background Emerging 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). Methods Participants 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. Results A 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). Conclusions Moderate 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.https://doi.org/10.1002/jcsm.13796cohort studydietary cholinefrailty
spellingShingle 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
Chang Su
Dan Liu
Association of Dietary Choline Intake With Incidence of Frailty: A Nationwide Prospective Cohort Study From China
Journal of Cachexia, Sarcopenia and Muscle
cohort study
dietary choline
frailty
title Association of Dietary Choline Intake With Incidence of Frailty: A Nationwide Prospective Cohort Study From China
title_full Association of Dietary Choline Intake With Incidence of Frailty: A Nationwide Prospective Cohort Study From China
title_fullStr Association of Dietary Choline Intake With Incidence of Frailty: A Nationwide Prospective Cohort Study From China
title_full_unstemmed Association of Dietary Choline Intake With Incidence of Frailty: A Nationwide Prospective Cohort Study From China
title_short Association of Dietary Choline Intake With Incidence of Frailty: A Nationwide Prospective Cohort Study From China
title_sort association of dietary choline intake with incidence of frailty a nationwide prospective cohort study from china
topic cohort study
dietary choline
frailty
url https://doi.org/10.1002/jcsm.13796
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