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

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