title: The association between betaine and choline intakes and the plasma concentrations of homocysteine in women.
abstract: BACKGROUND
  Elevated total homocysteine (tHcy), a risk factor for many chronic diseases, can be remethylated to methionine by folate. Alternatively, tHcy can be metabolized by other 1-carbon nutrients, ie, betaine and its precursor, choline.
  
  
  OBJECTIVE
  We aimed to assess the association between the dietary intakes of betaine and choline and the concentration of tHcy.
  
  
  METHODS
  We conducted a cross-sectional analysis in 1477 women by using linear regression models to predict mean fasting tHcy by intakes of of betaine and choline.
  
  
  RESULTS
  tHcy was 8% lower in the highest quintile of total betaine + choline intake than in the lowest quintile, even after control for folate intake (P for trend = 0.07). Neither choline nor betaine intake individually was significantly associated with tHcy. Choline from 2 choline-containing compounds, glycerophosphocholine and phosphocholine, was inversely associated with tHcy. These inverse associations were more pronounced in women with folate intake < 400 mug/d than in those with intakes >or=400 microg/d (P for interaction = 0.03 for phosphocholine) and in moderate alcohol drinkers (>or=15 g/d) than in nondrinkers or light drinkers (<15 g/d) (P for interaction = 0.02 for glycerophosphocholine and 0.04 for phosphocholine). The strongest dose response was seen in women with a low-methyl diet (high alcohol and low folate intake) (P for interaction = 0.002 for glycerophosphocholine and 0.001 for phosphocholine).
  
  
  CONCLUSIONS
  Total choline + betaine intake was inversely associated with tHcy, as was choline from 2 water-soluble choline-containing compounds. Remethylation of tHcy may be more dependent on the betaine pathway when methyl sources are low as a result of either inadequate folate intake or heavier alcohol consumption.
authors.affiliation: Department of Nutrition, Harvard School of Public Health, Department of Medicine, Brigham and Women's Hospital, Boston, MA 02115, USA. schiuve@hsph.harvard.edu
authors.forename: Stephanie E
authors.initials: SE
authors.lastname: Chiuve
authors.forename: Edward L
authors.initials: EL
authors.lastname: Giovannucci
authors.forename: Susan E
authors.initials: SE
authors.lastname: Hankinson
authors.forename: Steven H
authors.initials: SH
authors.lastname: Zeisel
authors.forename: Lauren W
authors.initials: LW
authors.lastname: Dougherty
authors.forename: Walter C
authors.initials: WC
authors.lastname: Willett
authors.forename: Eric B
authors.initials: EB
authors.lastname: Rimm
mesh_terms: D000328:Adult; D000428:Alcohol Drinking; D001622:Betaine / Q000008:administration & dosage* / Q000378:metabolism; D015415:Biomarkers / Q000097:blood; D002794:Choline / Q000008:administration & dosage* / Q000378:metabolism; D003430:Cross-Sectional Studies; D015930:Diet Records; D005260:Female; D005492:Folic Acid / Q000008:administration & dosage / Q000378:metabolism; D006710:Homocysteine / Q000097:blood*; D006801:Humans; D016014:Linear Models; D008082:Lipotropic Agents / Q000008:administration & dosage* / Q000378:metabolism; D008745:Methylation; D008875:Middle Aged; D011237:Predictive Value of Tests; D011795:Surveys and Questionnaires; D014803:Vitamin B Complex / Q000008:administration & dosage / Q000378:metabolism
chemical_list: D015415:Biomarkers; D008082:Lipotropic Agents; D006710:Homocysteine; D014803:Vitamin B Complex; D001622:Betaine; D005492:Folic Acid; D002794:Choline