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Dietary patterns, food groups, and nutrients as predictors of plasma choline and betaine in middle-aged and elderly men and women ^1,2,3

¹ From the Department of Public Health and Primary Health Care (SVK, GST, and SEV) and the Section of Pharmacology, Institute of Medicine (AU and PMU), University of Bergen, Bergen, Norway; Haukeland University Hospital, Bergen, Norway (PMU); and the Department of Nutrition, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Oslo, Norway (CAD)

² Supported by the Western Norway Regional Health Authority (Project no. 911177), the Research Council of Norway, the Foundation to Promote Research into Functional Vitamin B-12 Deficiency, the Freia Chocolade Fabriks Medical Foundation, and the Johan Throne Holst Foundation for Nutrition Research.

³ Reprints not available. Address correspondence to SV Konstantinova, Section for Epidemiology and Medical Statistics, Department of Public Health and Primary Health Care, University of Bergen, PO Box 7804, 5020 Bergen, Norway. E-mail: svetlana.konstantinova{at}isf.uib.no.

Background: Choline and betaine are linked to phospholipid and one-carbon metabolism. Blood concentrations or dietary intake of these quaternary amines have been related to the risk of chronic diseases, including cardiovascular disease and the metabolic syndrome.

Objective: We aimed to determine dietary predictors of plasma choline and betaine among middle-aged and elderly subjects recruited from an area without folic acid fortification.

Design: This is a population-based study of 5812 men and women aged 47–49 and 71–74 y, within the Hordaland Health Study cohort. Plasma concentrations per increasing quartile of intake of foods, beverages, and nutrients were assessed by multiple linear regression analysis, and dietary patterns were assessed by factor analysis.

Results: Plasma choline was predicted by egg consumption (0.16 µmol/L; P < 0.0001) and cholesterol intake (0.16 µmol/L; P < 0.0001), and betaine was predicted by consumption of high-fiber bread (0.65 µmol/L; P < 0.0001); high-fat dairy products (–0.70 µmol/L; P < 0.0001); complex carbohydrates, fiber, folate, and thiamine (0.66-1.44 µmol/L; P 0.0002 for all); and total energy (0.45 µmol/L; P = 0.004). Plasma choline was not significantly associated with any identified dietary patterns, whereas betaine was negatively associated with a Western dietary pattern with a high loading for meat, pizza, sugar, and fat (P < 0.0001).

Conclusion: In this population of middle-aged and elderly men and women, recruited from an area with relatively low folate intake, neither plasma choline nor betaine was positively associated with consumption of animal products, fruit, or vegetables, but each was positively associated with the intake of specific food items such as eggs (choline) and bread (betaine).