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Abstract
BackgroundSeveral studies have assessed the association between dietary choline and betaine and cardiovascular disease (CVD), but their results are inconsistent. The present study aimed to determine the association between dietary intake of choline and betaine and the risk of CVD in the general population over a 10.6-year period of follow-up.MethodsThe present cohort study was conducted on participants in the third wave of the Tehran Lipid and Glucose Study (2006–2008) and was followed-up until March 2018. Dietary intake of choline and betaine was calculated using the United States Department of Agriculture (USDA) database. Patients’ medical records were used to collect data on CVD.ResultsIn this study, 2606 subjects with no previous CVD participated and were followed-up for a median of 10.6 years. During the follow-up periods, 187 incidences of CVD were detected. Results of the Cox proportional hazards regression indicated that neither energy-adjusted total choline nor betaine was associated with the incidence of CVD. Among individual choline forms, only higher intake of free choline (FC) was associated with a lower risk of CVD (HR: 0.64, 95% CI: 0.42–0.98). There was no significant association between each 10 mg/d increase in choline and betaine content of each food category and CVD.ConclusionOur investigation indicates no association between energy-adjusted total choline and betaine and a 10.6-year risk of CVD among adults. Besides, we found no relationship between individual choline forms (except FC) and CVD. We also found energy-adjusted choline and betaine obtained from food categories were not associated with the risk of CVD.
Highlights
Cardiovascular disease (CVD) is a global health concern and is the leading cause of death in most countries
Choline is synthesized in low amounts by humans; consuming choline from dietary sources such as eggs, meat, dairy products, whole grains, and vegetables is essential for providing adequate choline levels and maintaining optimal body functions [7, 8]
Some studies have reported that a gut microbiota-related metabolite of choline, i.e., trimethylamine N-oxide (TMAO), is associated with an increased risk of cardiovascular disease (CVD) incidents and mortality [9,10,11]
Summary
Cardiovascular disease (CVD) is a global health concern and is the leading cause of death in most countries. Several studies have indicated an inverse association between dietary choline and betaine, a metabolite of choline, with some risk factors for CVD such as inflammatory markers [12] and hyperhomocysteinemia [13], but their results on the association with CVD are conflicting [14,15,16]. Whether there is an association between choline and betaine and the risk of CVD is unclear [17]. Several studies have assessed the association between dietary choline and betaine and cardiovascular disease (CVD), but their results are inconsistent. The present study aimed to determine the association between dietary intake of choline and betaine and the risk of CVD in the general population over a 10.6-year period of follow-up
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