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TMAO enhances cholesterol accumulation in macrophages, has been associated with increased cardiovascular disease risk (150 The incidence of acute myocardial infarction was examined in 1981 male patients with stable angina pectoris follow-up during 7.5 years, and subjected to a 169-item food frequency questionnaire to monitor the dietary choline intake, showed that increased intakes of energy-adjusted choline, PC, and sphingomyelin were associated with a higher risk of incident acute myocardial infarction ( Several studies have reported an inverse association between dietary choline supplementation and both the incidence and severity of non-alcoholic fatty liver disease (NAFLD) or steatohepatitis (NASH) ( 3.2 Cognitive decline and Alzheimers disease Recent human and animal research has emphasized the importance of choline intake in preventing neurodegenerative diseases such as Alzheimers disease ( In the context of fetal alcohol spectrum disorders (FASDs), 625 mg of choline was administered to school-aged children (510 years old, n=29 choline and n=26 placebo) for six months (NCT01911299), showing no effect on cognitive performance ( In the adult population, a double-blind randomized clinical trial examined choline dietary supplementation on cognitive and immune function in 97 healthy older adults over six months (NCT01672359) ( The effect on cognitive function has also been examined in 36 individuals with Type 2 diabetes mellitus and mild cognitive impairment assessed by the Mini-Mental State Examination (MMSE) score

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The Sequential Organ Failure Assessment (SOFA) score [14] was calculated on admission and each day during the five following days

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