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Another systematic review of six prospective cohort studies with a total of 1,84,010 participants with 18,076 incident CVD events has found no positive relationship between dietary choline or betaine intake and CVD incidence (Meyer and Shea, 2017)

Although there was no effect on sperm motility or sperm density in the epididymis, there was a significant increase in the percentage of abnormal sperm in mice consuming 1.78 times the MHDD (based on a body surface comparison) and there was a reduction in the number of mating pairs producing a fifth litter at this dose, suggesting the potential for cumulative toxicity with chronic administration of acetaminophen near the upper limit of daily dosing

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