Subjects with the highest average intake of choline and betaine had levels of inflammatory markers at least 20 per cent lower than subjects with the lowest average intakes, report the researchers in the American Journal of Clinical Nutrition. Chronic inflammation has been linked to range of conditions linked to heart disease, osteoporosis, cognitive decline and Alzheimer's, and type-2 diabetes. Researchers from Harokopio University and the University of Athens also report a link to levels of the amino acid homocysteine, and the data appears to be in line with intervention studies using high dose betaine or choline supplementation, which have reported homocysteine reductions of up to 20 per cent (betaine, 1.5 to 6 grams per day). Few studies have investigated the effects of choline and betaine in terms of disease prevention because food composition databases were not available until only recently. The new study has taken advantage of these databases and reports that people with increased intake of choline, and its oxidation product betaine (found naturally in vegetables such as spinach), have lower levels of homocysteine. "Our results support an association between choline and betaine intakes and the inflammation process in free-eating and apparently healthy adults," wrote lead author Paraskevi Detopoulou. Study details The Athens-based researchers surveyed 1514 men and 1528 women aged between 18 and 89 taking part in the ATTICA Study with no cardiovascular disease. Dietary intakes were assessed using a validated food-frequency questionnaire (FFQ), while blood samples were taken to measure levels of the inflammatory markers C-reactive protein (CRP), interleukin-6 (IL-6), and tumour necrosis factor-alpha (TNF-alpha). Detopoulou and co-workers report that the highest average intake of choline (above 310 mg per day) was associated with CRP, IL-6, and TNF-alpha levels 22, 26 and six per cent lower, respectively, than in people with the lowest average intake (less than 250 mg per day). Similarly, the highest average betaine intake (more than 360 mg per day) were associated with CRP, TNF-alpha, and homocysteine levels 19, 12 and 10 per cent lower, respectively, than in people with the lowest average intake (less than 260 mg per day). Recommended daily intakes of choline were set in 1998 at values of 550 milligrams per day for men and 425 milligrams a day for women. "Further studies are needed to confirm or refute our findings," stated the researchers. Independent comment In a corresponding editorial, Steven Zeisel from the University of North Carolina at Chapel Hill said: "The finding that both choline and betaine had an effect suggests that the response was mediated by some common pathway, possibly methylation and the removal of homocysteine." Zeisel noted several potential mechanisms which may explain the observations from this and other studies: "It is possible that epigenetic mechanisms, via the methylation of promoter regions of genes involved in inflammation, are responsible for the observed association between dietary choline and betaine and inflammation. "Exposure to oxidative stress is a potent trigger for inflammation. Betaine is formed from choline within the mitochondria, and this oxidation contributes to mitochondrial redox status," he continued. "If the association between choline and betaine and inflammation can be confirmed in studies of other populations, an interesting new dietary approach may be available for reducing chronic diseases associated with inflammation," he concluded. Choline is classified as an essential nutrient and is usually associated with the B vitamin group. It is found in meat, milk, eggs and vegetables like spinach. Source: American Journal of Clinical Nutrition February 2008, Volume 87, Number 2, Pages 424-430 "Dietary choline and betaine intakes in relation to concentrations of inflammatory markers in healthy adults: the ATTICA study" Authors: P. Detopoulou, D.B. Panagiotakos, S. Antonopoulou, C. Pitsavos, C. Stefanadis Editorial: American Journal of Clinical Nutrition February 2008, Volume 87, Number 2, Pages 277-278 "Is there a new component of the Mediterranean diet that reduces inflammation?" Author: S.H. Zeisel
