Association between dietary total choline and abdominal aorta calcification among older US adults: A cross‐sectional study of the National Health and Nutrition Examination Survey

Abstract Background Numerous studies indicate a potential bidirectional association between dietary choline intake and its derivative, betaine, and subclinical atherosclerosis. However, little research has been conducted on the relationship between dietary choline and severe abdominal aortic calcification (SAAC). Methods This cross‐sectional study analyzed population‐based data from the National Health and Nutrition Examination Survey (2013–2014). Choline intake and food sources were measured using two 24‐h dietary‐recall interviews. The abdominal aortic calcification score was measured using a dual‐emission x‐ray absorptiometry scan. To assess the relationship between choline intake and SAAC, the study utilized restricted cubic spline and a multivariable logistic regression model. Results Among the 2640 individuals included in the study, 10.9% had SAAC. After adjusting for all selected covariates, compared with the lowest quartile of dietary choline, the odds ratios of SAAC for the second‐quartile, third‐quartile, and fourth‐quartile dietary choline intake were 0.63 (95% confidence interval [CI], 0.43–0.93), 0.63 (95% CI, 0.42–0.94), and 0.77 (95% CI, 0.5–1.16), respectively. The study found an L‐shaped relationship between dietary choline and SAAC in the dose‐response analysis. Subgroup analyses did not demonstrate any statistically significant interaction effects for any subgroup. Conclusion The study found that a higher intake of dietary choline is associated with a lower prevalence of SAAC. The dose‐response analysis revealed an L‐shaped relationship between dietary choline and SAAC. However, further studies are warranted to investigate the direct role of choline in the development of SAAC.