(P10-057-24) Cross-Sectional Association of Maternal Mid-pregnancy Dietary Choline Intake With Interleukin-6 Varies by Intake of Vitamin B12 and Betaine: Evidence From Project Viva

Objectives: Previous work in animal models and humans demonstrates a beneficial impact of choline intake on inflammation, but this relationship has not yet been explored in pregnancy. The aim of this analysis was to examine the cross-sectional relationships of prenatal choline intake with mid-pregnancy markers of inflammation.

Methods: We studied 697 pregnant women from Project Viva, a cohort recruited in eastern Massachusetts. We estimated choline intake using a validated food frequency questionnaire administered at mean 27.8 ± SD 1.3 weeks and adjusted for total energy intake using the residuals method. We used previously assayed biomarkers of inflammation in maternal blood collected at the same timepoint, and natural log transformed values, as appropriate, for analysis. Using multivariable linear and tobit regression, we estimated associations of choline intake with interleukin-6 (IL-6), C-reactive protein (CRP), and tumor necrosis factor (TNF)-alpha, while adjusting for maternal education, pre-pregnancy BMI, age at enrollment, parity, gestational weeks at blood draw, and contemporaneous dietary intake of betaine, omega-3 polyunsaturated fatty acids, saturated fat, vitamin B12, and folate. We also explored interactions and stratified by intake of other methyl-donor nutrients.

Results: Mean estimated dietary choline intake was 325 ± 64 mg/d (range: 145, 594), well below the Adequate Intake (AI) level of 450 mg/d in pregnancy. In both unadjusted and multivariable models, we did not find any associations of ordinal quartiles of choline intake, or the 4^th vs. 1^st-3^rd quartiles, with inflammation biomarkers. When we stratified the results by intake of methyl donor nutrients, betaine, and B12 (above or below the median intakes), women in the above median group for B12 who also consumed over 364 mg/d (the cutoff for the 4^th quartile) of choline had 30.9% lower IL-6 when compared to women consuming < 282 mg/d choline in the first quartile (p = 0.02). We also observed this choline/IL-6 relationship in with above median betaine intakes.

Conclusions: Although choline was not associated with inflammation markers during pregnancy in the full sample, among women with intake of other methyl donor nutrients above the sample-specific media, those in the top quartile of choline consumption had lower concurrent IL-6. The threshold level seen in this analysis is notable as average choline intakes were well below the AI, indicating a need for better nutrition education and messaging for women of reproductive age.

Funding Sources: Research reported was supported by the National Institutes of Health under award 2 T32 HD087137, R01HD034568 and R24ES030894. Content is solely the responsibility of the authors and does not necessarily represent the official views of the Eunice Kennedy Shriver National Institute of Child Health and Human Development or the National Institutes of Health.