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Nutrition and Health (including climate and ecological aspects)

Dietary choline intake and non-alcoholic fatty liver disease (NAFLD) in U.S. adults: National Health and Nutrition Examination Survey (NHANES) 2017–2018

European Journal of Clinical Nutrition volume 77, pages 1160–1166 (2023)Cite this article

Subjects

Abstract

Background

Whether there is an association between dietary choline intake and non-alcoholic fatty liver disease (NAFLD) in American adults remains unclear.

Methods

Data came from the National Health and Nutrition Examination Survey 2017–2018. Choline intake was defined by the mean amounts of two 24 h dietary recalls, and choline intake was categorized into three groups according to the quartiles: inadequate (<P25), average (P25–P75), and optimal (>P75). Hepatic steatosis was assessed with FibroScan®, in which VCTE was employed with controlled attenuation to derive the controlled attenuation parameter (CAP), and NAFLD was defined as a CAP score ≥285 dB/m. Multivariable linear regression was performed to assess the linear relationship between choline intake and CAP. Multivariable logistics regression models were conducted to assess the association between choline intake status and NAFLD in the final sample and subgroup analysis was then performed in men and women.

Results

The amount of dietary choline was inversely associated with CAP score (β = −0.262, 95% CI: −0.280, −0.245). Compared to inadequate choline intake, optimal choline intake was related to a lower risk of NAFLD (OR: 0.705, 95% CI: 0.704–0.706) in the final sample. Subgroup analysis by gender revealed that the highest choline intake status was associated with a lower risk of NAFLD both in females (OR: 0.764, 95% CI: 0.762–0.766), and males (OR: 0.955, 95% CI: 0.953–0.958) when compared to the lowest choline intake.

Conclusions

With the latest NHANES data, we found that higher dietary choline was associated with a lower risk of NAFLD in American adults, and such a relationship exists in both females and males.

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Data availability

The NHANES dataset is publicly available online, accessible at cdc.gov/nchs/nhanes/index.htm (accessed on 8 March 2022).

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Author notes

  1. These authors contributed equally: Chen Chai, Lin Chen.

Authors and Affiliations

  1. Emergency Center, Hubei Clinical Research Center for Emergency and Resuscitation, Zhongnan Hospital of Wuhan University, Wuhan, 430071, China

    Chen Chai

  2. Emergency Department, Xiantao First People’s Hospital Affiliated to Changjiang University, Xiantao, China

    Lin Chen

  3. School of Public Health, Wuhan University, Wuhan, 430071, China

    Ming-Gang Deng, Yuehui Liang, Fang Liu & Jia-Qi Nie

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Contributions

CC: conceptualization, methodology, and writing - original draft; LC: data curation, formal analysis, and writing - review & editing; M-GD, YL, FL, and J-QN: writing - review & editing.

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Correspondence to Chen Chai.

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Informed consent was obtained from all subjects involved in the study. Study details are available online at cdc.gov/nchs/nhanes/irba98.htm.

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Chai, C., Chen, L., Deng, MG. et al. Dietary choline intake and non-alcoholic fatty liver disease (NAFLD) in U.S. adults: National Health and Nutrition Examination Survey (NHANES) 2017–2018. Eur J Clin Nutr 77, 1160–1166 (2023). https://doi.org/10.1038/s41430-023-01336-1

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