Tier 4 — mechanistic

Higher dietary choline and betaine intakes are associated with lower likelihood of central nervous system demyelination in Australian women

Paul Bailey, Hajar Mazahery, Lucinda J Black, Alison Daly, Yasmine Probst, Ingrid van der Mei, Eleanor Dunlop, Ausimmune/AusLong Investigators
European journal of nutrition 2026 65(2):56

Bibliography

PubMed
PMID 41689636
PubMed Central
PMC12906510
DOI
10.1007/s00394-026-03915-x
Funding
Reported funding/support: Deakin UniversityOpen Access funding enabled and organized by CAUL and its Member Institutions
Competing interests
Reported disclosure: Declarations. Competing interests: YP declares that she is a person living with multiple sclerosis. The other authors declare that there is no conflict of interest.

Study snapshot

DesignMulticenter case-control study
ModelHuman participants
SampleAusimmune participants with first demyelination and controls
InterventionHabitual dietary choline and/or betaine intake; no randomized TMG treatment
DurationDiet recalled around first clinical presentation
EndpointsFirst CNS demyelination; Sex differences

What the study showed, in plain terms

Published in 2026, this source examined human observational and biomarker research. Design: Multicenter case-control study. Sample/model: Ausimmune participants with first demyelination and controls. The exposure or intervention was Habitual dietary choline and/or betaine intake; no randomized TMG treatment. Follow-up or treatment period: Diet recalled around first clinical presentation.

Combined choline-plus-betaine intake was associated with lower odds of first demyelination in women, with no clear association in men.

Observational exposure analysis: residual confounding and reverse causation remain possible. Associations do not establish that betaine supplementation causes the same outcome. Diet recall, case selection or illness-related metabolite changes may introduce bias.

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Key findings

  • Combined choline-plus-betaine intake was associated with lower odds of first demyelination in women, with no clear association in men.
  • The recorded outcome domains were First CNS demyelination; Sex differences.
  • 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. Diet recall, case selection or illness-related metabolite changes may introduce bias.
  • 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: Accessible full-text extract plus indexed bibliographic data. Missing method details, funding information or participant denominators are not inferred.

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Editorial review

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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