The association between dietary intakes of methionine, choline and betaine and breast cancer risk: A systematic review and meta-analysis.

Heleen Van Puyvelde, Niki Dimou, Aikaterini Katsikari, Blanca Iciar Indave Ruiz, Lode Godderis, Inge Huybrechts, Dirk De Bacquer

Journal: Cancer epidemiology 2023;83():102322

PMID: 36701983

Full Text on Elsevier Science View on PubMed

Abstract

BACKGROUND AND AIM

This study evaluates the associations between dietary intakes and circulating blood levels of methionine, choline or betaine and breast cancer risk, which remains currently unclear.

METHODS

Systematic searches for observational epidemiological studies were performed of the MEDLINE, Embase, and Web of Science databases through July, 2022. Two review authors independently screened titles and abstracts against the eligibility criteria at a first stage, and screened full texts of potentially eligible records at a second stage, followed by data extraction from qualified studies. Quality of evidence was assessed using the Newcastle-Ottawa scale quality assessment tool. Risk estimates were calculated using random-effects meta-analysis.

RESULTS

In total, 21 studies were selected for qualitative analyses and 18 studies were included in the meta-analyses. Random-effects analysis combining prospective cohort (N = 8) or case-control studies (N = 10) showed little evidence of an association between dietary intake of methionine or betaine and the risk of breast cancer. However, inconclusive evidence for a significant inverse association between choline intake and breast cancer risk was found in case-control studies (odds ratio [OR] estimates for highest vs. lowest intakes = 0.38; 95 % CI: 0.16-0.86) but not in prospective cohort studies (hazard ratio [HR] estimates for highest vs. lowest intakes = 1.01; 95 % CI: 0.92-1.12).

CONCLUSION

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.

Address: Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, C. Heymanslaan 10, 4K3, 9000 Ghent, Belgium; Research Foundation - Flanders (FWO), Egmontstraat 5, 1000 Brussels, Belgium; Department of Public Health and Primary Care, KU Leuven, Kapucijnenvoer 35 blok D box 7001, 3000 Leuven, Belgium.; Nutrition and Metabolism Branch, International Agency for Research on Cancer, 150 cours Albert Thomas, 69372 Lyon CEDEX 08, France. Electronic address: [email protected].; Nutrition and Metabolism Branch, International Agency for Research on Cancer, 150 cours Albert Thomas, 69372 Lyon CEDEX 08, France.; WHO Classification of Tumours, International Agency for Research on Cancer, 150 cours Albert Thomas, 69372 Lyon CEDEX 08, France. Electronic address: [email protected].; Department of Public Health and Primary Care, KU Leuven, Kapucijnenvoer 35 blok D box 7001, 3000 Leuven, Belgium; IDEWE (Externe dienst voor Preventie en Bescherming op het Werk), Interleuvenlaan 58, 3001 Heverlee, Belgium. Electronic address: [email protected].; Nutrition and Metabolism Branch, International Agency for Research on Cancer, 150 cours Albert Thomas, 69372 Lyon CEDEX 08, France. Electronic address: [email protected].; Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, C. Heymanslaan 10, 4K3, 9000 Ghent, Belgium. Electronic address: [email protected].

DOI: 10.1016/j.canep.2023.102322

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MeSH Terms: Humans, Female, Betaine, Choline, Methionine, Prospective Studies, Breast Neoplasms, Eating, Racemethionine