Betaine and choline status modify the effects of folic acid and creatine supplementation on arsenic methylation in a ran
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ORIGINAL CONTRIBUTION
Betaine and choline status modify the effects of folic acid and creatine supplementation on arsenic methylation in a randomized controlled trial of Bangladeshi adults Anne K. Bozack1,2 · Caitlin G. Howe2,3 · Megan N. Hall4,5,6 · Xinhua Liu7 · Vesna Slavkovich2 · Vesna Ilievski2 · Angela M. Lomax‑Luu2 · Faruque Parvez2 · Abu B. Siddique8 · Hasan Shahriar8 · Mohammad N. Uddin8 · Tariqul Islam8 · Joseph H. Graziano2 · Mary V. Gamble2 Received: 24 March 2020 / Accepted: 28 August 2020 © Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Purpose Methylation of ingested inorganic arsenic (InAs) to monomethyl- (MMAs) and dimethyl-arsenical species (DMAs) facilitates urinary arsenic elimination. Folate and creatine supplementation influenced arsenic methylation in a randomized controlled trial. Here, we examine if baseline status of one-carbon metabolism nutrients (folate, choline, betaine, and vitamin B12) modified the effects of FA and creatine supplementation on changes in homocysteine, guanidinoacetate (GAA), total blood arsenic, and urinary arsenic metabolite proportions and indices. Methods Study participants (N = 622) received 400 or 800 μg FA, 3 g creatine, 400 μg FA + 3 g creatine, or placebo daily for 12 weeks. Results Relative to placebo, FA supplementation was associated with greater mean increases in %DMAs among participants with betaine concentrations below the median than those with levels above the median (FDR
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