Choline supplementation carries increased T2D risk in women but not in men
04 Oct 2020
Women with high dietary choline intake risk developing type 2 diabetes (T2D), an association that is not observed in men, according to a study.
The analysis used data from the Atherosclerosis Risk in Communities (ARIC) study, which involved 13,440 participants (mean age, 54 years; 55 percent female). Those with the highest vs lowest quartile of choline intake had a higher body mass index and higher intakes of alcohol, total calories, folate, vitamin B6, vitamin B12, animal fat, animal protein, and dietary magnesium. Choline intake was positively correlated with betaine intake.
A total of 1,396 participants developed T2D over a median follow-up of 9 years. Multivariable Cox proportional hazards models showed that incident T2D risk was associated with neither dietary choline (per 1 SD: hazard ratio [HR], 1.01, 95 percent confidence interval [CI], 0.87–1.16; highest vs lowest intake quartile: HR, 1.09, 95 percent CI, 0.84–1.42) nor dietary betaine intake (HR per 1 SD, 1.01, 95 percent CI, 0.94–1.10; highest vs lowest intake quartile: HR 1.06, 95 percent CI, 0.87–1.29).
When analysis was stratified by sex, the highest vs lowest dietary choline intake quartile conferred a modest increase in T2D risk in women (HR, 1.54, 95 percent CI, 1.06–2.25), while in men, the association was null (HR, 0.82, 95 percent CI, 0.57–1.17). Nevertheless, there was a nonsignificant interaction between high choline intake and sex on the risk of T2D (p=0.07).
Results obtained using logistic regression analysis were similar.
Present in red meat, eggs, beef, low-fat milk, chicken without skin, liver, and mustard, choline is involved in neurotransmission, lipid transport, and cell membrane phospholipid synthesis, among others. On the other hand, betaine, which is mainly found in bread, spinach, and cold breakfast cereals, is a main methyl donor in a variety of body cells. The present data should inform clinical trials on dietary choline and betaine supplementation in relation to the risk of T2D.