Tier 4
Qiangqiang He et al. · Current developments in nutrition · 2024
Nested case-control study. The choline-to-betaine ratio partly statistically mediated an association between a PEMT variant and digestive-system cancer.
Original sources: DOI · PubMed · Full text
Tier 4
Hui Zuo et al. · Journal of the American Heart Association · 2018
Three prospective cohort analyses. Circulating and dietary betaine were not consistently associated with atrial-fibrillation risk; the clearest associations concerned choline.
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Tier 2
Michael Lever et al. · Journal of clinical lipidology · 2014
Before-and-after drug study. Fenofibrate increased urinary betaine loss about threefold without a comparable rise in most other osmolytes.
Original sources: DOI · PubMed
Tier 4
Firoozeh Hosseini-Esfahani et al. · Metabolic syndrome and related disorders · 2023
Prospective cohort. Dietary betaine was not significantly associated with new type 2 diabetes, including subgroup analyses.
Original sources: DOI · PubMed
Tier 4
Xiang Gao et al. · PloS one · 2018
Cross-sectional study. Higher serum betaine was associated with lower adiposity measures mainly in men, with weaker or absent findings in women.
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Tier 4
Yu-Feng Du et al. · European journal of nutrition · 2017
Case-control biomarker study. Higher serum betaine was associated with lower breast-cancer odds, particularly at lower folate intake.
Original sources: DOI · PubMed
Tier 4
Ting-Yu Chang et al. · Nutrients · 2022
Case-control study. Lower methyl-donor intake was associated with visceral-obesity-related steatosis, and combined choline/betaine intake showed an inverse association.
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Tier 4
Ensiye Soleimani et al. · BMC endocrine disorders · 2023
Cross-sectional study. Betaine intake had mixed anthropometric associations and favorable selected lipid associations, with exploratory physical-activity interactions.
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Tier 4
Hailun Xie et al. · Nutrition & metabolism · 2023
Two nested case-control studies. Higher serum betaine was associated with greater total and lung-cancer risk, with a nonlinear pattern for digestive cancers.
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Tier 4
Rong-Zhu Huang et al. · Food & function · 2023
Prospective cohort. Higher serum betaine was associated with favorable blood pressure; hypertension associations were nonlinear and depended on baseline concentration.
Original sources: DOI · PubMed
Tier 4
Yu-Feng Du et al. · The British journal of nutrition · 2016
Case-control genetic interaction study. The main reported genotype interactions concerned choline intake; these findings do not establish a betaine-treatment effect.
Original sources: DOI · PubMed
Tier 4
F-f Zeng et al. · British journal of cancer · 2014
Matched case-control study. Higher betaine and choline intake was associated with lower nasopharyngeal-cancer odds.
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Tier 4
Rong-Huan Zhong et al. · Applied physiology, nutrition, and metabolism = Physiologie appliquee, nutrition et metabolisme · 2020
Prospective cohort. Higher baseline betaine was associated with more favorable body-composition changes, especially among men with relatively low initial levels.
Original sources: DOI · PubMed
Tier 4
Benjamin C Fu et al. · The American journal of clinical nutrition · 2020
Cross-sectional study. Lower betaine was associated with greater insulin resistance, while other choline-pathway metabolites had different cardiometabolic patterns.
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Tier 4
Linde van Lee et al. · Depression and anxiety · 2017
Pregnancy cohort analysis. Maternal betaine was not associated with antenatal depression/anxiety or postnatal mental well-being.
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Tier 4
Sumiya Aihemaitijiang et al. · Nutrients · 2026
Prospective mother-infant cohort. Higher maternal and cord-blood betaine was associated with lower birthweight; subgroup interaction evidence was not conclusive.
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Tier 4
Brian T F Wu et al. · PloS one · 2012
Prospective pregnancy cohort. Higher early-pregnancy maternal betaine and choline were associated with better infant cognitive-test scores.
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Tier 4
Kristin A Guertin et al. · Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology · 2017
Nested case-control study. Serum betaine was not significantly associated with colorectal-cancer risk; the positive association concerned choline.
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Tier 4
G W Dalmeijer et al. · European journal of clinical nutrition · 2008
Prospective cohort. Habitual dietary betaine was not significantly associated with cardiovascular-disease risk.
Original sources: DOI · PubMed
Tier 4
Paul Bailey et al. · European journal of nutrition · 2026
Multicenter case-control study. Combined choline-plus-betaine intake was associated with lower odds of first demyelination in women, with no clear association in men.
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Tier 4
Linde van Lee et al. · The American journal of clinical nutrition · 2016
Prospective birth cohort. Higher maternal betaine was associated with smaller infant size and less abdominal fat, including higher small-for-gestational-age odds.
Original sources: DOI · PubMed
Tier 4
Isis Trujillo-González et al. · The Journal of nutrition · 2026
Prospective mother-child cohort. Maternal betaine was not significantly associated with birth measurements but was associated with higher weight/adiposity measures later in childhood.
Original sources: DOI · PubMed
Tier 4
Jing-An Long et al. · The British journal of nutrition · 2021
Prospective cohort. Higher dietary betaine was associated with less loss of selected limb-muscle measurements.
Original sources: DOI · PubMed
Tier 4
Xiaoli Gong et al. · Diabetes, metabolic syndrome and obesity : targets and therapy · 2021
Prospective twin-pregnancy cohort. Higher maternal plasma betaine was associated with lower gestational-diabetes risk in dichorionic twin pregnancies.
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Tier 4
Michael Lever et al. · PloS one · 2012
Comparative observational cohorts. The relationship between urinary betaine loss and homocysteine differed with lipid levels and medication context.
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Tier 4
Jun Liang et al. · Diabetes, metabolic syndrome and obesity : targets and therapy · 2025
Nested case-control study. Betaine was lower in future diabetes cases, but the adjusted diabetes association was not significant; inverse insulin-resistance correlations remained.
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Tier 4
Zhen Li et al. · European journal of nutrition · 2025
Prospective cohort. Higher serum betaine was associated with lower uric acid and selected hyperuricemia comparisons; the overall quartile trend was borderline.
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Tier 4
Qiaoli Huang et al. · Food & function · 2026
Prospective birth cohort. Higher milk betaine was associated with better scores in several developmental domains; exploratory mixture modelling especially highlighted fine-motor scores.
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Tier 4
Zhiyi Zong et al. · BMC neurology · 2026
Prospective post-stroke cohort analysis. Lower baseline betaine was associated with less favorable neurological-recovery trajectories.
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Tier 4
Kallie Lamkin et al. · The British journal of nutrition · 2024
Case-control pregnancy study. Overall betaine intake was not significantly associated with gestational diabetes; an inverse association appeared in a parity subgroup.
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Tier 4
Maierheba Kuerbanjiang et al. · Scientific reports · 2024
Cross-sectional dietary study. The highest dietary-betaine group had lower odds of overweight/obesity; cereals supplied most estimated intake.
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Tier 4
Agata Muzsik-Kazimierska et al. · Nutrition research (New York, N.Y.) · 2022
Cross-sectional study. Women classified with fatty liver had lower betaine, choline and glutathione concentrations.
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Tier 4
Jung Eun Lee et al. · Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology · 2010
Prospective cohort. Dietary betaine and choline were not significantly associated with colorectal-cancer incidence.
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Tier 2
Yu-Feng Du et al. · The British journal of nutrition · 2019
Prospective pregnancy study. Higher maternal betaine was associated with lower infant birthweight, particularly in selected sex/homocysteine subgroups.
Original sources: DOI · PubMed
Tier 4
Xiang Gao et al. · Nutrition (Burbank, Los Angeles County, Calif.) · 2017
Cross-sectional study. Higher dietary choline/betaine was associated with lower insulin resistance; some male associations weakened after adjustment for trunk fat.
Original sources: DOI · PubMed
Tier 4
Eunyoung Cho et al. · Journal of the National Cancer Institute · 2007
Prospective endoscopy cohort. Betaine intake had a nonlinear inverse association with adenoma; the highest-versus-lowest comparison and overall trend were not clearly significant.
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Tier 4
Johanna M Seddon et al. · Ophthalmology · 2011
Discordant identical-twin case series. The twin with less severe macular degeneration tended to have higher dietary betaine intake in the disease-stage comparison.
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Tier 4
Hall Schartum-Hansen et al. · PloS one · 2013
Prospective patient biomarker analysis. Greater urinary betaine loss was associated with existing diabetes and subsequent diabetes development.
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Tier 4
Yui Murata et al. · Progress in neuro-psychopharmacology & biological psychiatry · 2020
Case-control biomarker study. Lower blood betaine and global DNA hypomethylation were observed in schizophrenia, with correlations between the measures.
Original sources: DOI · PubMed
Tier 2
Xinran Xu et al. · FASEB journal : official publication of the Federation of American Societies for Experimental Biology · 2009
Population-based cancer survival study. Higher betaine and selected choline intakes were associated with lower mortality after breast-cancer diagnosis.
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