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American Journal of Clinical Nutrition, Vol. 88, No. 1, 248, July 2008
© 2008 American Society for Nutrition

LETTER TO THE EDITOR

Reply to S Slow et al

Paraskevi Detopoulou, Demosthenes Panagiotakos and Smaragdi Antonopoulou

Department of Dietetics and Nutrition Science
Harokopio University
46 Paleon Polemiston St
Attica 166 74
Greece
E-mail: d.b.panagiotakos{at}usa.net

Christos Pitsavos and Christodoulos Stefanadis

First Cardiology Clinic
School of Medicine
University of Athens
Athens
Greece

Dear Sir:

The comments presented by Slow et al highlight some mechanisms linking the dietary intake of betaine to concentrations of inflammatory markers. In our article (1), we referred in some detail to the role of betaine as an osmolyte. Betaine's fundamental role in human health is well recognized (2), and its action as an osmolyte may provide an additional antiinflammatory mechanism. Indeed, betaine can have immunomodulating effects on osmotically stressed cells (such as suppression of cyclooxygenase 2), can protect cells against premature apoptosis, and can regulate cell volume (3). This may also explain the extra benefit of diets high in both choline and betaine in comparison with diets that are only choline rich, as we found in our study (1).

Regarding the measurement of betaine and choline intakes, no national values are available, as in the case of New Zealand (4, 5); therefore, we used international food-composition tables (6). In this case, the generalization of reference values for these markers to the total population is difficult; however, the strength of the effect sizes of the investigated associations is, mainly, unbiased. Nevertheless, this does not mask the emerging need for national values of various nutrients for every country. Moreover, it can be hypothesized that the relations of betaine intake with other lifestyle and anthropometric characteristics may be influenced by the specific particularities of the studied population. Thus, additional multiethnic studies are needed to shed light on the relatively new field of physiologic ranges of dietary betaine intake and health-related variables.

ACKNOWLEDGMENTS

No conflicts of interest were reported.

REFERENCES

  1. Detopoulou P, Panagiotakos DB, Antonopoulou S, Pitsavos C, Stefanadis C. Dietary choline and betaine intakes in relation to concentrations of inflammatory markers in healthy adults: the ATTICA study. Am J Clin Nutr 2008;87:424–30.[Abstract/Free Full Text]
  2. Craig SA. Betaine in human nutrition. Am J Clin Nutr 2004;80:539–49.[Abstract/Free Full Text]
  3. Zhang F, Warskulat U, Wettstein M, Haussinger D. Identification of betaine as an osmolyte in rat liver macrophages (Kupffer cells). Gastroenterology 1996;110:1543–52.[Medline]
  4. Slow S, Donaggio M, Cressey P, Lever M, George PM, Chambers ST. The betaine content of New Zealand foods and estimated intake in New Zealand diet. J Food Comp Anal 2005;18:473–85.
  5. deZwart F, Slow S, Payne R, et al. Glycine betaine and glycine analogues in common foods. Food Chem 2003;83:197–204.
  6. Howe JC, Williams JR, Holden JM. USDA database for the choline content of common foods. Washington, DC: US Department of Agriculture, 2004.




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