Abstract

Simple SummaryA large number of studies report that medicinal herbs and many food ingredients protect against the development of liver disease because they possess antioxidant, anti-inflammatory, or anti-necrotic activities. This review focuses on the biological and beneficial effects of dietary betaine (trimethylglycine), a naturally occurring and crucial methyl donor, that restores methionine homeostasis in cells. We describe recent studies on betaine’s mechanism(s) of action as a therapeutic agent for improving indices of alcohol-induced and metabolic- associated liver disease. Due to its low cost, high tolerability, and efficacy, we suggest betaine as a promising therapeutic for clinical use to treat these aforementioned diseases as well as other liver-/non-liver-related diseases and conditions.Medicinal herbs and many food ingredients possess favorable biological properties that contribute to their therapeutic activities. One such natural product is betaine, a stable, nontoxic natural substance that is present in animals, plants, and microorganisms. Betaine is also endogenously synthesized through the metabolism of choline or exogenously consumed through dietary intake. Betaine mainly functions as (i) an osmolyte and (ii) a methyl-group donor. This review describes the major physiological effects of betaine in whole-body health and its ability to protect against both liver- as well as non-liver-related diseases and conditions. Betaine’s role in preventing/attenuating both alcohol-induced and metabolic-associated liver diseases has been well studied and is extensively reviewed here. Several studies show that betaine protects against the development of alcohol-induced hepatic steatosis, apoptosis, and accumulation of damaged proteins. Additionally, it can significantly prevent/attenuate progressive liver injury by preserving gut integrity and adipose function. The protective effects are primarily associated with the regulation of methionine metabolism through removing homocysteine and maintaining cellular SAM:SAH ratios. Similarly, betaine prevents metabolic-associated fatty liver disease and its progression. In addition, betaine has a neuroprotective role, preserves myocardial function, and prevents pancreatic steatosis. Betaine also attenuates oxidant stress, endoplasmic reticulum stress, inflammation, and cancer development. To conclude, betaine exerts significant therapeutic and biological effects that are potentially beneficial for alleviating a diverse number of human diseases and conditions.

Highlights

  • Many medicinal herbs and food ingredients possess therapeutic properties and a few of these have been developed as functional foods [1]

  • While betaine was first identified in the 19th century in beets (Beta vulgaris) [3,4], it is found at high concentrations in other food sources including wheat bran, wheat germ, and spinach, as well as in microorganisms and aquatic invertebrates [3]

  • We summarize the role of betaine in restoring normal hepatic function in diseases of diverse etiologies, with special references to alcohol-associated fatty liver disease (ALD) and MAFLD

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Summary

Introduction

Many medicinal herbs and food ingredients possess therapeutic properties and a few of these have been developed as functional foods [1]. Numerous scientific reports have shown that many of these natural products possess favorable biological properties that contribute to their therapeutic activities [2]. One such natural product is betaine, known as trimethylglycine, a stable, nontoxic natural substance that is present in animals, plants, and microorganisms. Betaine is endogenously synthesized through the metabolism of choline [3,4], or exogenously consumed through dietary intake [5]. Due to its essential biochemical functions, many microorganisms utilize betaine and have evolved different metabolic pathways for its biosynthesis and catabolism [6]

Dietary Betaine Uptake
Important Roles of Betaine
Disease Prevention by Betaine Administration
Stages of ALD
Betaine Protects against the Development of Alcohol-Induced Hepatic Steatosis
Betaine Prevents Other Indices of Early Alcohol-Induced Liver Damage
Betaine
Alterations in Gut–Liver and Adipose–Liver Axes in Promoting Hepatic Damage
Betaine Maintains Intestinal Epithelial Barrier Integrity
Betaine Maintains Adipose Function
Protective Effects of Betaine on Other Tissues
Anti-Cancer Effect of Betaine
Effects of Betaine on General Well-Being
Effects of Maternal Betaine Supplementation on Offspring
Safety Studies with Betaine
Findings
Conclusions and Future Perspectives
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