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Dietary choline and betaine assessed by food-frequency questionnaire in relation to plasma total homocysteine concentration in the Framingham Offspring Study^1,2,3

¹ From the Channing Laboratory, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (EC, GAC, and WCW); the Departments of Nutrition (WCW and LD) and Epidemiology (GAC and WCW), Harvard School of Public Health; Boston, MA; the Department of Nutrition, University of North Carolina, Chapel Hill, NC (SHZ); and the US Department of Agriculture Human Nutrition Research Center on Aging, Tufts University, Boston, MA (PJ and JS)

Background:Epidemiologic studies of choline and betaine intakes have been sparse because a food-composition database was not available until recently. The physiologic relevance of a variation in dietary choline and betaine in the general population and the validity of intake assessed by food-frequency questionnaire (FFQ) have not been evaluated.

Objective:This study was conducted to examine the physiologic relevance and validity of choline and betaine intakes measured by an FFQ.

Design:We examined the relations between choline and betaine intakes measured by FFQ and plasma total homocysteine (tHcy) concentrations in 1960 participants from the Framingham Offspring Study.

Results:Higher intakes of dietary choline and betaine were related to lower tHcy concentrations independent of other determinants, including folate and other B vitamins. For the lowest and highest quintiles of dietary choline plus betaine, the multivariate geometric means for tHcy were 10.9 and 9.9 µmol/L (P for trend < 0.0001). The inverse association was manifested primarily in participants with low folate intakes (P for interaction < 0.0001). Among participants with folate intakes 250 µg/d, the geometric mean tHcy concentrations in the lowest and highest quintiles of choline plus betaine intakes were 12.4 and 10.2 µmol/L (P for trend < 0.0001). Except for choline from phosphatidylcholine, individual forms of choline were inversely associated with tHcy concentrations.

Conclusions:Our findings provide support for a physiologically important variation in choline and betaine intakes in the general population and for the validity of intake measured by FFQ.

Key Words: Choline • betaine • phosphocholine • glycerophosphocholine • phosphatidylcholine • lecithin • sphingomyelin • homocysteine • methylation • Framingham Offspring Study

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