The Interplay of Dietary Choline and Methyl Donors in Modulating Maternal Inflammation: Insights from Project Viva

Inflammation during pregnancy is an important contributor to maternal and offspring morbidity and mortality. Evidence from both nonpregnant human and animal studies suggests that dietary choline can attenuate inflammation, but this has not yet been explored in human pregnancy.

This study explored the cross-sectional associations between maternal mid-pregnancy dietary choline intake and inflammation biomarkers, specifically IL-6, tumor necrosis factor- α (TNF-α), and C-reactive protein (CRP), while also examining the modifying effects of other methyl donor nutrients.

We analyzed data from 640 pregnant women enrolled in Project Viva, a longitudinal cohort study in Eastern Massachusetts. We assessed mid-pregnancy maternal dietary intake via a semiquantitative food frequency questionnaire, and measured inflammatory markers in maternal blood collected concurrently, namely IL-6, TNF-α, and CRP. We employed censored and linear regression models to assess associations of z-scored choline intake with log-transformed inflammatory markers and assessed potential interactions between choline intake and intakes of other methyl donor nutrients. We assessed unadjusted models and models adjusted for sociodemographic and dietary covariates.

We found no main effect of choline intake with IL-6, TNF-α, or CRP levels [for example, for IL-6, β = -0.02 pg/mL, 95% confidence interval (CI): -0.08, 0.05]. However, an interaction term demonstrated that greater combined intake of choline and other methyl donor nutrients was related to lower IL-6 (for example, for betaine, β interaction =-0.08 pg/mL, 95% CI: -0.14, -0.02). We did not observe similar interaction effects or TNF-α or CRP.

These findings highlight the interplay between choline and other dietary methyl donors in modulating inflammation status during pregnancy, specifically through IL-6. Higher intake of methyl donor nutrients may be necessary for any anti-inflammatory effects of choline, although further studies in this area are warranted.