Are dietary choline and betaine intakes determinants of total homocysteine concentration?
BACKGROUND
Elevated homocysteine concentrations are associated with an increased risk of cardiovascular disease and a decline in cognitive function. Intakes of choline and betaine, as methyl donors, may affect homocysteine concentrations.


OBJECTIVE
The objective was to examine whether choline and betaine intakes, assessed from food-frequency questionnaires, are associated with total plasma homocysteine concentrations under both fasting and post-methionine-load conditions in both pre- and post-folic acid fortification periods in the United States.


METHODS
We assessed the association between choline and betaine intakes and fasting and post-methionine-load homocysteine concentrations using the US Department of Agriculture revised food-composition tables and evaluated whether the associations varied by folic acid fortification periods in 1325 male and 1407 female participants in the sixth examination (1995-1998) of the Framingham Offspring Study.


RESULTS
A higher choline-plus-betaine intake was associated with lower concentrations of post-methionine-load homocysteine; the multivariate geometric means were 24.1 micromol/L (95% CI: 23.4, 24.9 micromol/L) in the top quintile of intake and 25.0 micromol/L (95% CI: 24.2, 25.7 micromol/L) in the bottom quintile (P for trend = 0.01). We found an inverse association between choline-plus-betaine intake and fasting homocysteine concentrations; the multivariate geometric mean fasting homocysteine concentrations were 9.6 micromol/L (95% CI: 9.3, 9.9 micromol/L) in the top quintile and 10.1 micromol/L (95% CI: 9.8, 10.4 micromol/L) in the bottom quintile (P for trend < 0.001). When we stratified by plasma folate and vitamin B-12 concentrations, the inverse association was limited to participants with low plasma folate or vitamin B-12 concentrations. In the postfortification period, the inverse association between choline-plus-betaine intake and either fasting or post-methionine-load homocysteine was no longer present.


CONCLUSIONS
Choline and betaine intakes were associated with both fasting and post-methionine-load total homocysteine concentrations, especially in participants with low folate and vitamin B-12 status. The inverse association between choline and betaine intakes and homocysteine concentrations was no longer present in the postfortification period.
Lee
Jung Eun
JE
Department of Food and Nutrition, Sookmyung Women's University, Seoul, Republic of Korea.
Jacques
Paul F
PF
Dougherty
Lauren
L
Selhub
Jacob
J
Giovannucci
Edward
E
Zeisel
Steven H
SH
Cho
Eunyoung
E
D001622:Betaine / Q000378:metabolism*; D002318:Cardiovascular Diseases / Q000453:epidemiology; D002794:Choline / Q000378:metabolism*; D003072:Cognition Disorders / Q000453:epidemiology; D004032:Diet; D005260:Female; D005492:Folic Acid / Q000378:metabolism / Q000494:pharmacology*; D006710:Homocysteine / Q000009:adverse effects / Q000097:blood*; D006801:Humans; D008297:Male; D008715:Methionine / Q000378:metabolism / Q000494:pharmacology; D014805:Vitamin B 12 / Q000378:metabolism; D025101:Vitamin B 6 / Q000378:metabolism
D006710:Homocysteine; D001622:Betaine; D025101:Vitamin B 6; D005492:Folic Acid; D008715:Methionine; D002794:Choline; D014805:Vitamin B 12