title: Choline and Betaine Intakes Are Not Associated with Cardiovascular Disease Mortality Risk in Japanese Men and Women.
abstract: BACKGROUND
  Dietary intakes of betaine and choline may reduce the risk of cardiovascular disease; however, epidemiologic evidence is limited. Seafood is a rich source of betaine and is a popular traditional food in Japan.
  
  
  OBJECTIVE
  We examined the associations of betaine and choline intakes with cardiovascular disease mortality in a population-based cohort study in Japan.
  
  
  METHODS
  Study subjects were 13,355 male and 15,724 female residents of Takayama City, Japan, who were aged ≥35 y and enrolled in 1992. Their diets were assessed by a validated food frequency questionnaire. Deaths from coronary heart disease and stroke were identified from death certificates over 16 y. Multivariable-adjusted HRs were computed by using Cox regression models.
  
  
  RESULTS
  During follow-up, we documented 308 deaths from coronary heart disease and 676 deaths from stroke (393 from ischemic and 153 from hemorrhagic strokes). Compared with the lowest quartile, the second, third, and highest quartiles of betaine intake were significantly associated with a decreased risk of mortality from coronary heart disease in men after controlling for covariates. The HRs were 0.58 (95% CI: 0.36, 0.93), 0.62 (95% CI: 0.39, 0.998), and 0.60 (95% CI: 0.37, 0.97), respectively. The trend was not statistically significant (P = 0.08). There was no significant association between betaine intake and the risk of mortality from ischemic stroke. In women, betaine intake was unrelated risk of mortality from coronary heart disease and stroke (P = 0.32 and 0.73, respectively, for interaction by sex). There was no significant association between choline intake and cardiovascular disease mortality risk in men or women.
  
  
  CONCLUSIONS
  Overall, we found no clear evidence of significant associations between choline and betaine intakes and cardiovascular disease mortality risk in Japanese men and women.
authors.affiliation: Department of Epidemiology and Preventive Medicine, Gifu University Graduate School of Medicine, Gifu, Japan; chisato@gifu-u.ac.jp.
authors.forename: Chisato
authors.initials: C
authors.lastname: Nagata
authors.affiliation: Department of Epidemiology and Preventive Medicine, Gifu University Graduate School of Medicine, Gifu, Japan;
authors.forename: Keiko
authors.initials: K
authors.lastname: Wada
authors.affiliation: Department of Epidemiology and Preventive Medicine, Gifu University Graduate School of Medicine, Gifu, Japan;
authors.forename: Takashi
authors.initials: T
authors.lastname: Tamura
authors.affiliation: Department of Epidemiology and Preventive Medicine, Gifu University Graduate School of Medicine, Gifu, Japan;
authors.forename: Kie
authors.initials: K
authors.lastname: Konishi
authors.affiliation: Department of Epidemiology and Preventive Medicine, Gifu University Graduate School of Medicine, Gifu, Japan;
authors.forename: Toshiaki
authors.initials: T
authors.lastname: Kawachi
authors.affiliation: Department of Epidemiology and Preventive Medicine, Gifu University Graduate School of Medicine, Gifu, Japan; Department of Food Science and Nutrition, Nagoya Women's University, Nagoya, Japan; and.
authors.forename: Michiko
authors.initials: M
authors.lastname: Tsuji
authors.affiliation: Department of Epidemiology and Preventive Medicine, Gifu University Graduate School of Medicine, Gifu, Japan; Department of Food and Nutrition, Gifu City Women's College, Gifu, Japan.
authors.forename: Kozue
authors.initials: K
authors.lastname: Nakamura
mesh_terms: D000328:Adult; D000818:Animals; D044466:Asian People; D001622:Betaine / Q000008:administration & dosage / Q000494:pharmacology*; D002794:Choline / Q000008:administration & dosage / Q000494:pharmacology*; D003327:Coronary Disease / Q000401:mortality* / Q000517:prevention & control; D004032:Diet; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D012307:Risk Factors; D020521:Stroke / Q000401:mortality* / Q000517:prevention & control
chemical_list: D001622:Betaine; D002794:Choline
keywords: betaine; choline; cohort studies; coronary heart disease; seafood; stroke