This was a very good study in that they attempted to adjust for various levels of choline intake stratified among different risk levels of PCa. One thing that stood out is the following paragraph between post-diagnostic and pre-diagnostic choline intake, which seems to make sense, the longer one has elevated choline intake, the greater the chance of association with lethal PCa. One thing this study implies-- stay out of the upper fifth quartile of choline consumption-- that group has 2x the number of lethal events than the lowest quartile.
We observed 271 lethal events during 33,679 person-years. Postdiagnostic choline intake was not statistically significantly associated with risk of lethal prostate cancer (HR: 1.69; 95% CI: 0.93, 3.09; P-trend = 0.20) (Table 5), and this relation was unchanged when we included red meat, milk, poultry, whole eggs, or fish in the multivariate model. However, the association became stronger after adjustment for prediagnostic intake of choline. Men in the fifth quintile of postdiagnostic choline had a risk of lethal prostate cancer nearly 2-fold that of men in the lowest quintile (HR: 1.98; 95% CI: 1.06, 3.70; P-trend = 0.08).
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