The association of dietary choline and betaine with the risk of type 2 diabetes: The atherosclerosis risk in communities (aric) study

Daniel T. Dibaba; Karen C. Johnson; Anna M. Kucharska-Newton; Katie Meyer; Steven H. Zeisel; Aurelian Bidulescu

doi:10.2337/dc20-0733

The association of dietary choline and betaine with the risk of type 2 diabetes: The atherosclerosis risk in communities (aric) study

Daniel T. Dibaba, Karen C. Johnson, Anna M. Kucharska-Newton, Katie Meyer, Steven H. Zeisel, Aurelian Bidulescu

Research output: Contribution to journal › Article › peer-review

9 Scopus citations

Abstract

OBJECTIVE To examine the association between dietary intake of choline and betaine and the risk of type 2 diabetes. RESEARCH DESIGN AND METHODS Among 13,440 Atherosclerosis Risk in Communities (ARIC) study participants, the prospective longitudinal association between dietary choline and betaine intake and the risk of type 2 diabetes was assessed using interval-censored Cox pro-portional hazards and logistic regression models adjusted for baseline potential confounding variables. RESULTS Among 13,440 participants (55% women, mean age 54 [SD 7.4] years), 1,396 developed incident type 2 diabetes during median follow-up of 9 years from 1987 to 1998. There was no statistically significant association between every 1-SD increase in dietary choline and risk of type 2 diabetes (hazard ratio [HR] 1.01 [95% CI 0.87, 1.16]) nor between dietary betaine intake and the risk of type 2 diabetes (HR 1.01 [0.94, 1.10]). Those in the highest quartile of dietary choline intake did not have a statistically significant higher risk of type 2 diabetes than those in the lowest choline quartile (HR 1.09 [0.84, 1.42]); similarly, dietary betaine intake was not associated with the risk of type 2 diabetes comparing the highest quartile to the lowest (HR 1.06 [0.87, 1.29]). Among women, there was a higher risk of type 2 diabetes, comparing the highest to lowest dietary choline quartile (HR 1.54 [1.06, 2.25]), while in men, the association was null (HR 0.82 [0.57, 1.17]). Nevertheless, there was a nonsignificant interaction between high choline intake and sex on the risk of type 2 diabetes (P 5 0.07). The results from logistic regression were similar. CONCLUSIONS Overall and among male participants, dietary choline or betaine intakes were not associated with the risk of type 2 diabetes. Among female participants, there was a trend for a modestly higher risk of type 2 diabetes among those with the highest as compared with the lowest quartile of dietary choline intake. Our study should inform clinical trials on dietary choline and betaine supplementation in relationship with the risk of type 2 diabetes.

Original language	English
Pages (from-to)	2840-2846
Number of pages	7
Journal	Diabetes Care
Volume	43
Issue number	11
DOIs	https://doi.org/10.2337/dc20-0733
State	Published - Nov 2020

Bibliographical note

Funding Information:
Acknowledgments. The authors thank the staff and participants of the ARIC study for the important contributions. A complete list of principal ARIC study staff can be found in Am J Epidemiol 1989;129:687–702. Funding. The ARIC study is carried out as a collaborative study supported by National Heart, Lung, and Blood Institute contracts N01-HC-55015, N01-HC-55016, N01-HC-55018, N01-HC-55019, N01-HC-55020,N01-HC-55021,andN01-HC-55022. Laboratory testing and biospecimen collection at ARIC visit 6 was supported by the National Institute of Diabetes and Digestive and Kidney Diseases of the National Institutes of Health (NIH) (grant R01DK089174). A.B. was supported in part by two NIH Center for Scientific Review institutional training grants (HL07055 and DK07686). S.H.Z. was supported by research grants from the U.S. Department of Agriculture (58-1235-5-126) and the NIH Center for Scientific Review (DK55865 and DK56350). Duality of Interest. No potential conflicts of interest relevant to this article were reported. Author Contributions. D.T.D. conceived the current study, conducted data analysis, interpreted the results, and drafted the manuscript. A.B. led the study on dietary choline and betaine data collection/compositions, provided the data sets, and contributed to the revisions on the successive versions of the manuscript. D.T.D., K.C.J., A.M.K.-N., K.M., and S.H.Z. critically reviewed and revised the manuscript. All authors approvedthe finalversionofthemanuscript.A.B. and D.T.D. are the guarantors of this work and, as such, had full access to all of the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis.

Funding Information:
The ARIC study is carried out as a collaborative study supported by National Heart, Lung, and Blood Institute contracts N01-HC-55015, N01-HC-55016, N01-HC-55018, N01-HC-55019, N01-HC-55020, N01-HC-55021, and N01-HC-55022. Laboratory testing and biospecimen collection at ARIC visit 6 was supported by the National Institute of Diabetes and Digestive and Kidney Diseases of the National Institutes of Health (NIH) (grant R01DK089174). A.B. was supported in part by two NIH Center for Scientific Review institutional training grants (HL07055 and DK07686). S.H.Z. was supported by research grants from the U.S. Department of Agriculture (58-1235-5-126) and the NIH Center for Scientific Review (DK55865 and DK56350).

Publisher Copyright:
© 2020 by the American Diabetes Association.

ASJC Scopus subject areas

Internal Medicine
Endocrinology, Diabetes and Metabolism
Advanced and Specialized Nursing

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10.2337/dc20-0733

Cite this

@article{38d3463cebc348db8be6082c7a61f362,

title = "The association of dietary choline and betaine with the risk of type 2 diabetes: The atherosclerosis risk in communities (aric) study",

abstract = "OBJECTIVE To examine the association between dietary intake of choline and betaine and the risk of type 2 diabetes. RESEARCH DESIGN AND METHODS Among 13,440 Atherosclerosis Risk in Communities (ARIC) study participants, the prospective longitudinal association between dietary choline and betaine intake and the risk of type 2 diabetes was assessed using interval-censored Cox pro-portional hazards and logistic regression models adjusted for baseline potential confounding variables. RESULTS Among 13,440 participants (55% women, mean age 54 [SD 7.4] years), 1,396 developed incident type 2 diabetes during median follow-up of 9 years from 1987 to 1998. There was no statistically significant association between every 1-SD increase in dietary choline and risk of type 2 diabetes (hazard ratio [HR] 1.01 [95% CI 0.87, 1.16]) nor between dietary betaine intake and the risk of type 2 diabetes (HR 1.01 [0.94, 1.10]). Those in the highest quartile of dietary choline intake did not have a statistically significant higher risk of type 2 diabetes than those in the lowest choline quartile (HR 1.09 [0.84, 1.42]); similarly, dietary betaine intake was not associated with the risk of type 2 diabetes comparing the highest quartile to the lowest (HR 1.06 [0.87, 1.29]). Among women, there was a higher risk of type 2 diabetes, comparing the highest to lowest dietary choline quartile (HR 1.54 [1.06, 2.25]), while in men, the association was null (HR 0.82 [0.57, 1.17]). Nevertheless, there was a nonsignificant interaction between high choline intake and sex on the risk of type 2 diabetes (P 5 0.07). The results from logistic regression were similar. CONCLUSIONS Overall and among male participants, dietary choline or betaine intakes were not associated with the risk of type 2 diabetes. Among female participants, there was a trend for a modestly higher risk of type 2 diabetes among those with the highest as compared with the lowest quartile of dietary choline intake. Our study should inform clinical trials on dietary choline and betaine supplementation in relationship with the risk of type 2 diabetes.",

author = "Dibaba, {Daniel T.} and Johnson, {Karen C.} and Kucharska-Newton, {Anna M.} and Katie Meyer and Zeisel, {Steven H.} and Aurelian Bidulescu",

note = "Funding Information: Acknowledgments. The authors thank the staff and participants of the ARIC study for the important contributions. A complete list of principal ARIC study staff can be found in Am J Epidemiol 1989;129:687–702. Funding. The ARIC study is carried out as a collaborative study supported by National Heart, Lung, and Blood Institute contracts N01-HC-55015, N01-HC-55016, N01-HC-55018, N01-HC-55019, N01-HC-55020,N01-HC-55021,andN01-HC-55022. Laboratory testing and biospecimen collection at ARIC visit 6 was supported by the National Institute of Diabetes and Digestive and Kidney Diseases of the National Institutes of Health (NIH) (grant R01DK089174). A.B. was supported in part by two NIH Center for Scientific Review institutional training grants (HL07055 and DK07686). S.H.Z. was supported by research grants from the U.S. Department of Agriculture (58-1235-5-126) and the NIH Center for Scientific Review (DK55865 and DK56350). Duality of Interest. No potential conflicts of interest relevant to this article were reported. Author Contributions. D.T.D. conceived the current study, conducted data analysis, interpreted the results, and drafted the manuscript. A.B. led the study on dietary choline and betaine data collection/compositions, provided the data sets, and contributed to the revisions on the successive versions of the manuscript. D.T.D., K.C.J., A.M.K.-N., K.M., and S.H.Z. critically reviewed and revised the manuscript. All authors approvedthe finalversionofthemanuscript.A.B. and D.T.D. are the guarantors of this work and, as such, had full access to all of the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis. Funding Information: The ARIC study is carried out as a collaborative study supported by National Heart, Lung, and Blood Institute contracts N01-HC-55015, N01-HC-55016, N01-HC-55018, N01-HC-55019, N01-HC-55020, N01-HC-55021, and N01-HC-55022. Laboratory testing and biospecimen collection at ARIC visit 6 was supported by the National Institute of Diabetes and Digestive and Kidney Diseases of the National Institutes of Health (NIH) (grant R01DK089174). A.B. was supported in part by two NIH Center for Scientific Review institutional training grants (HL07055 and DK07686). S.H.Z. was supported by research grants from the U.S. Department of Agriculture (58-1235-5-126) and the NIH Center for Scientific Review (DK55865 and DK56350). Publisher Copyright: {\textcopyright} 2020 by the American Diabetes Association.",

year = "2020",

month = nov,

doi = "10.2337/dc20-0733",

language = "English",

volume = "43",

pages = "2840--2846",

number = "11",

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TY - JOUR

T1 - The association of dietary choline and betaine with the risk of type 2 diabetes

T2 - The atherosclerosis risk in communities (aric) study

AU - Dibaba, Daniel T.

AU - Johnson, Karen C.

AU - Kucharska-Newton, Anna M.

AU - Meyer, Katie

AU - Zeisel, Steven H.

AU - Bidulescu, Aurelian

N1 - Funding Information: Acknowledgments. The authors thank the staff and participants of the ARIC study for the important contributions. A complete list of principal ARIC study staff can be found in Am J Epidemiol 1989;129:687–702. Funding. The ARIC study is carried out as a collaborative study supported by National Heart, Lung, and Blood Institute contracts N01-HC-55015, N01-HC-55016, N01-HC-55018, N01-HC-55019, N01-HC-55020,N01-HC-55021,andN01-HC-55022. Laboratory testing and biospecimen collection at ARIC visit 6 was supported by the National Institute of Diabetes and Digestive and Kidney Diseases of the National Institutes of Health (NIH) (grant R01DK089174). A.B. was supported in part by two NIH Center for Scientific Review institutional training grants (HL07055 and DK07686). S.H.Z. was supported by research grants from the U.S. Department of Agriculture (58-1235-5-126) and the NIH Center for Scientific Review (DK55865 and DK56350). Duality of Interest. No potential conflicts of interest relevant to this article were reported. Author Contributions. D.T.D. conceived the current study, conducted data analysis, interpreted the results, and drafted the manuscript. A.B. led the study on dietary choline and betaine data collection/compositions, provided the data sets, and contributed to the revisions on the successive versions of the manuscript. D.T.D., K.C.J., A.M.K.-N., K.M., and S.H.Z. critically reviewed and revised the manuscript. All authors approvedthe finalversionofthemanuscript.A.B. and D.T.D. are the guarantors of this work and, as such, had full access to all of the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis. Funding Information: The ARIC study is carried out as a collaborative study supported by National Heart, Lung, and Blood Institute contracts N01-HC-55015, N01-HC-55016, N01-HC-55018, N01-HC-55019, N01-HC-55020, N01-HC-55021, and N01-HC-55022. Laboratory testing and biospecimen collection at ARIC visit 6 was supported by the National Institute of Diabetes and Digestive and Kidney Diseases of the National Institutes of Health (NIH) (grant R01DK089174). A.B. was supported in part by two NIH Center for Scientific Review institutional training grants (HL07055 and DK07686). S.H.Z. was supported by research grants from the U.S. Department of Agriculture (58-1235-5-126) and the NIH Center for Scientific Review (DK55865 and DK56350). Publisher Copyright: © 2020 by the American Diabetes Association.

PY - 2020/11

Y1 - 2020/11

N2 - OBJECTIVE To examine the association between dietary intake of choline and betaine and the risk of type 2 diabetes. RESEARCH DESIGN AND METHODS Among 13,440 Atherosclerosis Risk in Communities (ARIC) study participants, the prospective longitudinal association between dietary choline and betaine intake and the risk of type 2 diabetes was assessed using interval-censored Cox pro-portional hazards and logistic regression models adjusted for baseline potential confounding variables. RESULTS Among 13,440 participants (55% women, mean age 54 [SD 7.4] years), 1,396 developed incident type 2 diabetes during median follow-up of 9 years from 1987 to 1998. There was no statistically significant association between every 1-SD increase in dietary choline and risk of type 2 diabetes (hazard ratio [HR] 1.01 [95% CI 0.87, 1.16]) nor between dietary betaine intake and the risk of type 2 diabetes (HR 1.01 [0.94, 1.10]). Those in the highest quartile of dietary choline intake did not have a statistically significant higher risk of type 2 diabetes than those in the lowest choline quartile (HR 1.09 [0.84, 1.42]); similarly, dietary betaine intake was not associated with the risk of type 2 diabetes comparing the highest quartile to the lowest (HR 1.06 [0.87, 1.29]). Among women, there was a higher risk of type 2 diabetes, comparing the highest to lowest dietary choline quartile (HR 1.54 [1.06, 2.25]), while in men, the association was null (HR 0.82 [0.57, 1.17]). Nevertheless, there was a nonsignificant interaction between high choline intake and sex on the risk of type 2 diabetes (P 5 0.07). The results from logistic regression were similar. CONCLUSIONS Overall and among male participants, dietary choline or betaine intakes were not associated with the risk of type 2 diabetes. Among female participants, there was a trend for a modestly higher risk of type 2 diabetes among those with the highest as compared with the lowest quartile of dietary choline intake. Our study should inform clinical trials on dietary choline and betaine supplementation in relationship with the risk of type 2 diabetes.

AB - OBJECTIVE To examine the association between dietary intake of choline and betaine and the risk of type 2 diabetes. RESEARCH DESIGN AND METHODS Among 13,440 Atherosclerosis Risk in Communities (ARIC) study participants, the prospective longitudinal association between dietary choline and betaine intake and the risk of type 2 diabetes was assessed using interval-censored Cox pro-portional hazards and logistic regression models adjusted for baseline potential confounding variables. RESULTS Among 13,440 participants (55% women, mean age 54 [SD 7.4] years), 1,396 developed incident type 2 diabetes during median follow-up of 9 years from 1987 to 1998. There was no statistically significant association between every 1-SD increase in dietary choline and risk of type 2 diabetes (hazard ratio [HR] 1.01 [95% CI 0.87, 1.16]) nor between dietary betaine intake and the risk of type 2 diabetes (HR 1.01 [0.94, 1.10]). Those in the highest quartile of dietary choline intake did not have a statistically significant higher risk of type 2 diabetes than those in the lowest choline quartile (HR 1.09 [0.84, 1.42]); similarly, dietary betaine intake was not associated with the risk of type 2 diabetes comparing the highest quartile to the lowest (HR 1.06 [0.87, 1.29]). Among women, there was a higher risk of type 2 diabetes, comparing the highest to lowest dietary choline quartile (HR 1.54 [1.06, 2.25]), while in men, the association was null (HR 0.82 [0.57, 1.17]). Nevertheless, there was a nonsignificant interaction between high choline intake and sex on the risk of type 2 diabetes (P 5 0.07). The results from logistic regression were similar. CONCLUSIONS Overall and among male participants, dietary choline or betaine intakes were not associated with the risk of type 2 diabetes. Among female participants, there was a trend for a modestly higher risk of type 2 diabetes among those with the highest as compared with the lowest quartile of dietary choline intake. Our study should inform clinical trials on dietary choline and betaine supplementation in relationship with the risk of type 2 diabetes.

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The association of dietary choline and betaine with the risk of type 2 diabetes: The atherosclerosis risk in communities (aric) study

Abstract

Bibliographical note

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UN SDGs

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