Dietary choline and betaine intakes and risk of cardiovascular diseases: review of epidemiological evidence

Abstract

BACKGROUND: Cardiovascular diseases (CVD) are the most important causes of human

mortality in the world. Higher intakes of choline and betaine have been shown to be associated
with lower plasma homocysteine levels (the putative CVD risk factor). This study aimed to
review the evidence on the association between dietary intakes of choline and betaine and
traditional/novel CVD risk factors.
METHODS: We searched in PubMed website from 1990 to 2009, with the use of following
keywords: "dietary choline and betaine, cardiovascular diseases, metabolic syndrome,
inflammation". The cross-sectional and prospective studies as well as the clinical trials were
recruited in this investigation.
RESULTS: Dietary intakes of “choline”/“choline and betaine” were not significantly associated
with CVD risk; however, the higher intakes of choline and betaine were associated with higher
serum concentrations of CRP, IL-6 and TNF-5. Individuals with high plasma choline levels were
obese and had elevated plasma triglycerides, HDL and non-HDL cholesterol levels; whereas
high plasma betaine levels were inversely associated with these biochemical markers. Both
choline and betaine supplementation resulted in increased blood lipid profiles.
CONCLUSION: Although dietary intakes of choline and betaine were not significantly
associated with CVD incidence, the long-term consumption of these nutrients have been shown
to prevent CVD mortality by decreasing inflammation and other risk factors.
Keywords: Choline, Betaine, Cardiovascular Diseases, Metabolic Syndrome, Inflammation