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===Cardiovascular diseases and cancer=== Choline deficiency can cause [[fatty liver]], which increases cancer and cardiovascular disease risk. Choline deficiency also decreases SAM production, which partakes in [[DNA methylation]] β this decrease may also contribute to [[carcinogenesis]]. Thus, deficiency and its association with such diseases has been studied.<ref name=eu/> However, [[observational studies]] of free populations have not convincingly shown an association between low choline intake and cardiovascular diseases or most cancers.<ref name=lpi/><ref name=eu/> Studies on [[prostate cancer]] have been contradictory.<ref>{{cite journal | vauthors = Richman EL, Kenfield SA, Stampfer MJ, Giovannucci EL, Zeisel SH, Willett WC, Chan JM | title = Choline intake and risk of lethal prostate cancer: incidence and survival | journal = The American Journal of Clinical Nutrition | volume = 96 | issue = 4 | pages = 855β63 | date = October 2012 | pmid = 22952174 | pmc = 3441112 | doi = 10.3945/ajcn.112.039784 }}</ref><ref>{{cite journal | vauthors = Han P, Bidulescu A, Barber JR, Zeisel SH, Joshu CE, Prizment AE, Vitolins MZ, Platz EA | title = Dietary choline and betaine intakes and risk of total and lethal prostate cancer in the Atherosclerosis Risk in Communities (ARIC) Study | journal = Cancer Causes & Control | volume = 30 | issue = 4 | pages = 343β354 | date = April 2019 | pmid = 30825046 | pmc = 6553878 | doi = 10.1007/s10552-019-01148-4 }}</ref>
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