Methyl group donors and intermediates of one-carbon metabolism affect DNA synthesis and DNA methylation, and may thereby affect prostate carcinogenesis. Choline, the precursor of betaine, and the one-carbon metabolite sarcosine have been associated with increased prostate cancer risk. Within JANUS, a prospective cohort in Norway (n 5 317,000) with baseline serum samples, we conducted a nested case-control study among 3,000 prostate cancer cases and 3,000 controls. Using conditional logistic regression, odds ratios (ORs) and 95% confidence intervals (CIs) for prostate cancer risk were estimated according to quintiles of circulating betaine, dimethylglycine (DMG), sarcosine, glycine and serine. High sarcosine and glycine concentrations were associated with reduced prostate cancer risk of borderline significance (sarcosine: highest vs. lowest quintile OR 5 0.86, CI 5 0.72-1.01, p trend 5 0.03; glycine: OR 5 0.83, CI 5 0.70-1.00, p trend 5 0.07). Serum betaine, DMG and serine were not associated with prostate cancer risk. However, individuals with a high glycine/serine ratio were at decreased prostate cancer risk (OR 5 0.74, CI 5 0.69-0.85, p trend < 0.001). This population-based study suggested that men with high serum sarcosine or glycine concentrations have modestly reduced prostate cancer risk. Ratios of metabolites reflecting one-carbon balance may be associated with prostate cancer risk, as demonstrated for the glycine/serine ratio, and should be explored in future studies.The folate-mediated one-carbon metabolism, which involves B-vitamins as enzymatic cofactors, is characterized by the transfer of methyl groups and may affect carcinogenesis by influencing methylation and synthesis of DNA.1 Betaine and its precursor choline may act as methyl group sources, 2 whereas intermediates involved in the transfer of one-carbon units may be hypothesized to reflect bioavailability of methyl groups.3 These factors may therefore affect the development and growth of cancer and should be investigated when studying the role of one-carbon metabolism in carcinogenesis. Interestingly, a high S-adenosylmethionine/S-adenosylhomocysteine ratio, which facilitates transmethylation reactions, has been associated with carcinogenesis. 4 Similarly, it may be hypothesized that ratios of one-carbon metabolites, which might reflect one-carbon balance, are related to carcinogenesis.Prostate cancer is the second most frequently diagnosed cancer among men globally. 5 Results from observational studies suggest that high concentrations of circulating folate or high vitamin B12 status are associated with increased prostate cancer risk, although reported associations were modest and sometimes inconsistent.6-8 Although increased prostate cancer risk was suggested in one trial among subjects receiving folic acid supplements, 9 recent meta-analyses did not suggest an association with increased prostate cancer risk. 10,11 Nevertheless, an observational population-based study previously showed