Tier 4 — mechanistic

Eggs, dietary cholesterol, choline, betaine, and diabetes risk in the Women's Health Initiative: a prospective analysis

James A Greenberg, Xinyin Jiang, Lesley F Tinker, Linda G Snetselaar, Nazmus Saquib, Aladdin H Shadyab
The American journal of clinical nutrition 2021 114(1):368-377

Bibliography

PubMed
PMID 33829251
PubMed Central
PMC8246612
DOI
10.1093/ajcn/nqab036
Funding
Reported funding/support: National Heart, Lung, and Blood Institute10.13039/100000050HHSN268201600018CHHSN268201600001CHHSN268201600002CHHSN268201600003CHHSN268201600004C
Competing interests
A competing-interest declaration was not available in the indexed record or accessible disclosure metadata.

Study snapshot

DesignProspective cohort
ModelHuman participants
Sample46263 Women's Health Initiative participants; 5480 incident diabetes cases
InterventionHabitual dietary choline and/or betaine intake; no randomized TMG treatment
Duration13.3 years
EndpointsDiabetes incidence; Dietary exposures

What the study showed, in plain terms

Published in 2021, this source examined human observational and biomarker research. Design: Prospective cohort. Sample/model: 46263 Women's Health Initiative participants; 5480 incident diabetes cases. The exposure or intervention was Habitual dietary choline and/or betaine intake; no randomized TMG treatment. Follow-up or treatment period: 13.3 years.

The analysis assessed eggs and methyl-donor nutrients; its main reported diabetes associations concerned eggs, cholesterol and choline rather than a tested betaine treatment.

Observational exposure analysis: residual confounding and reverse causation remain possible. Associations do not establish that betaine supplementation causes the same outcome.

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Key findings

  • The analysis assessed eggs and methyl-donor nutrients; its main reported diabetes associations concerned eggs, cholesterol and choline rather than a tested betaine treatment.
  • The recorded outcome domains were Diabetes incidence; Dietary exposures.
  • The exposure was observed rather than assigned as an isolated supplement treatment.

What this study can and cannot tell us

  • Observational exposure analysis: residual confounding and reverse causation remain possible. Associations do not establish that betaine supplementation causes the same outcome.
  • Confounding, dietary patterns, illness, medication use and reverse causation can influence an association. Blood or dietary concentrations do not identify the effect of starting a capsule.
  • Source basis: Indexed abstract and bibliographic data. Missing method details, funding information or participant denominators are not inferred.

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Editorial review

Reviewed by the Biohack Blueprint research team

Last verified

Dr. Khaled Mahmoud, MBBChCritical Care Medicine, Longevity Science & Editorial Direction Dr. Amr Yasser, PhDCardiometabolic, Musculoskeletal, Gut & Bioavailability Dr. Abdulla Mostafa, PhDCellular Senescence, Neurological, Mitochondrial & Brain-Ageing Biology