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(PDF) Plasma free choline, betaine and cognitive performance: the Hordaland Health Study
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Choline is essential for neurodevelopment and brain function. We studied the associations between cognitive function and plasma concentrations of free choline and betaine. In a" /> <meta name="twitter:image" content="http://a.academia-assets.com/images/twitter-card.jpeg" /> <meta property="fb:app_id" content="2369844204" /> <meta property="og:type" content="article" /> <meta property="og:url" content="https://www.academia.edu/14850025/Plasma_free_choline_betaine_and_cognitive_performance_the_Hordaland_Health_Study" /> <meta property="og:title" content="Plasma free choline, betaine and cognitive performance: the Hordaland Health Study" /> <meta property="og:image" content="http://a.academia-assets.com/images/open-graph-icons/fb-paper.gif" /> <meta property="og:description" content="Choline and betaine are nutrients involved in one-carbon metabolism. Choline is essential for neurodevelopment and brain function. 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window.loswp.work = {"work":{"id":14850025,"created_at":"2015-08-11T07:03:32.069-07:00","from_world_paper_id":140804316,"updated_at":"2024-11-14T05:01:12.222-08:00","_data":{"grobid_abstract":"Choline and betaine are nutrients involved in one-carbon metabolism. Choline is essential for neurodevelopment and brain function. We studied the associations between cognitive function and plasma concentrations of free choline and betaine. In a cross-sectional study, 2195 subjects (55 % women), aged 70-74 years, underwent extensive cognitive testing including the Kendrick Object Learning Test (KOLT), Trail Making Test (part A, TMT-A), modified versions of the Digit Symbol Test (m-DST), Block Design (m-BD), Mini-Mental State Examination (m-MMSE) and Controlled Oral Word Association Test (COWAT). Compared with low concentrations, high choline (.8·4 mmol/l) was associated with better test scores in the TMT-A (56·0 v. 61·5, P¼ 0·004), m-DST (10·5 v. 9·8, P¼ 0·005) and m-MMSE (11·5 v. 11·4, P¼ 0·01). A generalised additive regression model showed a positive dose -response relationship between the m-MMSE and choline (P¼0·012 from a corresponding linear regression model). Betaine was associated with the KOLT, TMT-A and COWAT, but after adjustments for potential confounders, the associations lost significance. Risk ratios (RR) for poor test performance roughly tripled when low choline was combined with either low plasma vitamin B 12 (# 257 pmol/l) concentrations (RR KOLT ¼ 2·6, 95 % CI 1·1, 6·1; RR m-MMSE ¼ 2·7, 95 % CI 1·1, 6·6; RR COWAT ¼ 3·1, 95 % CI 1·4, 7·2) or high methylmalonic acid (MMA) ($3·95 mmol/l) concentrations (RR m-BD ¼ 2·8, 95 % CI 1·3, 6·1). Low betaine (# 31·1 mmol/l) combined with high MMA was associated with elevated RR on KOLT (RR KOLT ¼ 2·5, 95 % CI 1·0, 6·2). Low plasma free choline concentrations are associated with poor cognitive performance. There were significant interactions between low choline or betaine and low vitamin B 12 or high MMA on cognitive performance.","publication_date":"2013,,","publication_name":"British Journal of Nutrition","grobid_abstract_attachment_id":"43844826"},"document_type":"paper","pre_hit_view_count_baseline":null,"quality":"high","language":"en","title":"Plasma free choline, betaine and cognitive performance: the Hordaland Health Study","broadcastable":true,"draft":null,"has_indexable_attachment":true,"indexable":true}}["work"]; window.loswp.workCoauthors = [33816925]; window.loswp.locale = "en"; window.loswp.countryCode = "SG"; window.loswp.cwvAbTestBucket = ""; window.loswp.designVariant = "ds_vanilla"; window.loswp.fullPageMobileSutdModalVariant = "full_page_mobile_sutd_modal"; window.loswp.useOptimizedScribd4genScript = false; window.loginModal = {}; window.loginModal.appleClientId = 'edu.academia.applesignon'; window.userInChina = "false";</script><script defer="" src="https://accounts.google.com/gsi/client"></script><div class="ds-loswp-container"><div class="ds-work-card--grid-container"><div class="ds-work-card--container js-loswp-work-card"><div class="ds-work-card--cover"><div class="ds-work-cover--wrapper"><div class="ds-work-cover--container"><button class="ds-work-cover--clickable js-swp-download-button" data-signup-modal="{"location":"swp-splash-paper-cover","attachmentId":43844826,"attachmentType":"pdf"}"><img alt="First page of “Plasma free choline, betaine and cognitive performance: the Hordaland Health Study”" class="ds-work-cover--cover-thumbnail" src="https://0.academia-photos.com/attachment_thumbnails/43844826/mini_magick20190215-23332-1hns0u4.png?1550252829" /><img alt="PDF Icon" class="ds-work-cover--file-icon" src="//a.academia-assets.com/images/single_work_splash/adobe_icon.svg" /><div class="ds-work-cover--hover-container"><span class="material-symbols-outlined" style="font-size: 20px" translate="no">download</span><p>Download Free PDF</p></div><div class="ds-work-cover--ribbon-container">Download Free PDF</div><div class="ds-work-cover--ribbon-triangle"></div></button></div></div></div><div class="ds-work-card--work-information"><h1 class="ds-work-card--work-title">Plasma free choline, betaine and cognitive performance: the Hordaland Health Study</h1><div class="ds-work-card--work-authors ds-work-card--detail"><a class="ds-work-card--author js-wsj-grid-card-author ds2-5-body-md ds2-5-body-link" data-author-id="33816925" href="https://uib.academia.edu/IngvarBjelland"><img alt="Profile image of Ingvar Bjelland" class="ds-work-card--author-avatar" src="//a.academia-assets.com/images/s65_no_pic.png" />Ingvar Bjelland</a></div><div class="ds-work-card--detail"><p class="ds-work-card--detail ds2-5-body-sm">2013, British Journal of Nutrition</p><div class="ds-work-card--work-metadata"><div class="ds-work-card--work-metadata__stat"><span class="material-symbols-outlined" style="font-size: 20px" translate="no">visibility</span><p class="ds2-5-body-sm" id="work-metadata-view-count">…</p></div><div class="ds-work-card--work-metadata__stat"><span class="material-symbols-outlined" style="font-size: 20px" translate="no">description</span><p class="ds2-5-body-sm">9 pages</p></div><div class="ds-work-card--work-metadata__stat"><span class="material-symbols-outlined" style="font-size: 20px" translate="no">link</span><p class="ds2-5-body-sm">1 file</p></div></div><script>(async () => { const workId = 14850025; 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if (!viewCountBody) { throw new Error('Failed to find work views element'); } viewCountBody.textContent = `${commaizedViewCount} views`; } catch (error) { // Remove the whole views element if there was some issue parsing. document.getElementById('work-metadata-view-count')?.parentNode?.remove(); throw new Error(`Failed to parse view count: ${viewCount}`, error); } }; // If the DOM is still loading, wait for it to be ready before updating the view count. if (document.readyState === "loading") { document.addEventListener('DOMContentLoaded', () => { updateViewCount(viewCount); }); // Otherwise, just update it immediately. } else { updateViewCount(viewCount); } })();</script></div><p class="ds-work-card--work-abstract ds-work-card--detail ds2-5-body-md">Choline and betaine are nutrients involved in one-carbon metabolism. Choline is essential for neurodevelopment and brain function. We studied the associations between cognitive function and plasma concentrations of free choline and betaine. In a cross-sectional study, 2195 subjects (55 % women), aged 70-74 years, underwent extensive cognitive testing including the Kendrick Object Learning Test (KOLT), Trail Making Test (part A, TMT-A), modified versions of the Digit Symbol Test (m-DST), Block Design (m-BD), Mini-Mental State Examination (m-MMSE) and Controlled Oral Word Association Test (COWAT). Compared with low concentrations, high choline (.8·4 mmol/l) was associated with better test scores in the TMT-A (56·0 v. 61·5, P¼ 0·004), m-DST (10·5 v. 9·8, P¼ 0·005) and m-MMSE (11·5 v. 11·4, P¼ 0·01). A generalised additive regression model showed a positive dose -response relationship between the m-MMSE and choline (P¼0·012 from a corresponding linear regression model). Betaine was associated with the KOLT, TMT-A and COWAT, but after adjustments for potential confounders, the associations lost significance. Risk ratios (RR) for poor test performance roughly tripled when low choline was combined with either low plasma vitamin B 12 (# 257 pmol/l) concentrations (RR KOLT ¼ 2·6, 95 % CI 1·1, 6·1; RR m-MMSE ¼ 2·7, 95 % CI 1·1, 6·6; RR COWAT ¼ 3·1, 95 % CI 1·4, 7·2) or high methylmalonic acid (MMA) ($3·95 mmol/l) concentrations (RR m-BD ¼ 2·8, 95 % CI 1·3, 6·1). Low betaine (# 31·1 mmol/l) combined with high MMA was associated with elevated RR on KOLT (RR KOLT ¼ 2·5, 95 % CI 1·0, 6·2). Low plasma free choline concentrations are associated with poor cognitive performance. There were significant interactions between low choline or betaine and low vitamin B 12 or high MMA on cognitive performance.</p><div class="ds-work-card--button-container"><button class="ds2-5-button js-swp-download-button" data-signup-modal="{"location":"continue-reading-button--work-card","attachmentId":43844826,"attachmentType":"pdf","workUrl":"https://www.academia.edu/14850025/Plasma_free_choline_betaine_and_cognitive_performance_the_Hordaland_Health_Study"}">See full PDF</button><button class="ds2-5-button ds2-5-button--secondary js-swp-download-button" data-signup-modal="{"location":"download-pdf-button--work-card","attachmentId":43844826,"attachmentType":"pdf","workUrl":"https://www.academia.edu/14850025/Plasma_free_choline_betaine_and_cognitive_performance_the_Hordaland_Health_Study"}"><span class="material-symbols-outlined" style="font-size: 20px" translate="no">download</span>Download PDF</button></div><div class="ds-signup-banner-trigger-container"><div class="ds-signup-banner-trigger ds-signup-banner-trigger-control"></div></div><div class="ds-signup-banner ds-signup-banner-control"><div id="ds-signup-banner-close-button"><button class="ds2-5-button ds2-5-button--secondary ds2-5-button--inverse"><span class="material-symbols-outlined" style="font-size: 20px" translate="no">close</span></button></div><div class="ds-signup-banner-ctas"><img src="//a.academia-assets.com/images/academia-logo-capital-white.svg" /><h4 class="ds2-5-heading-serif-sm">Sign up for access to the world's latest research</h4><button class="ds2-5-button ds2-5-button--inverse ds2-5-button--full-width js-swp-download-button" data-signup-modal="{"location":"signup-banner"}">Sign up for free<span class="material-symbols-outlined" style="font-size: 20px" translate="no">arrow_forward</span></button></div><div class="ds-signup-banner-divider"></div><div class="ds-signup-banner-reasons"><div class="ds-signup-banner-reasons-item"><span class="material-symbols-outlined" style="font-size: 24px" translate="no">check</span><span>Get notified about relevant papers</span></div><div class="ds-signup-banner-reasons-item"><span class="material-symbols-outlined" style="font-size: 24px" translate="no">check</span><span>Save papers to use in your research</span></div><div class="ds-signup-banner-reasons-item"><span class="material-symbols-outlined" style="font-size: 24px" translate="no">check</span><span>Join the discussion with peers</span></div><div class="ds-signup-banner-reasons-item"><span class="material-symbols-outlined" style="font-size: 24px" translate="no">check</span><span>Track your impact</span></div></div></div><script>(() => { // Set up signup banner show/hide behavior: // 1. 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Loss of cholinergic neurons is associated with impaired cognitive function, particularly memory loss and Alzheimer disease (AD). Brain atrophy and white-matter hyperintensity (WMH) are also associated with impaired cognitive function and AD. Objective: The objective was to determine whether a relation exists between dietary choline intake, cognitive function, and brain morphology in a large, nondemented community-based cohort. Design: A dementia-free cohort of 1391 subjects (744 women, 647 men; age range: 36-83 y; mean 6 SD age: 60.9 6 9.29 y) from the Framingham Offspring population completed a food-frequency questionnaire administered from 1991 to 1995 (exam 5; remote intake) and from 1998 to 2001 (exam 7; concurrent intake). Participants underwent neuropsychological evaluation and brain MRI at exam 7. Four neuropsychological factors were constructed: verbal memory (VM), visual memory (VsM), verbal learning, and executive function. MRI measures included WMH volume (WMHV). Results: Performance on the VM and VsM factors was better with higher concurrent choline intake in multivariable-adjusted models for VM (average change in neuropsychological factor per 1-unit change in choline = 0.60; 95% CI: 0.29, 0.91; P , 0.01) and VsM (0.66; 95% CI: 0.19, 1.13; P , 0.01). Remote choline intake was inversely related to log-transformed WMHV (average change in log WMHV per 1-unit change in choline = 20.05; 95% CI: 20.10, 20.01; P = 0.02). Furthermore, an inverse association was observed between remote higher choline intake and presence of large WMVH (OR: 0.56; 95% CI: 0.34, 0.92; P = 0.01). Conclusion: In this community-based population of nondemented individuals, higher concurrent choline intake was related to better cognitive performance, whereas higher remote choline intake was associated with little to no WMHV.</p><div class="ds-related-work--ctas"><button class="ds2-5-text-link ds2-5-text-link--inline js-swp-download-button" data-signup-modal="{"location":"wsj-grid-card-download-pdf-modal","work_title":"The relation of dietary choline to cognitive performance and white-matter hyperintensity in the Framingham Offspring Cohort1,2","attachmentId":40300610,"attachmentType":"pdf","work_url":"https://www.academia.edu/18868967/The_relation_of_dietary_choline_to_cognitive_performance_and_white_matter_hyperintensity_in_the_Framingham_Offspring_Cohort1_2","alternativeTracking":true}"><span class="material-symbols-outlined" style="font-size: 18px" translate="no">download</span><span class="ds2-5-text-link__content">Download free PDF</span></button><a class="ds2-5-text-link ds2-5-text-link--inline js-wsj-grid-card-view-pdf" href="https://www.academia.edu/18868967/The_relation_of_dietary_choline_to_cognitive_performance_and_white_matter_hyperintensity_in_the_Framingham_Offspring_Cohort1_2"><span class="ds2-5-text-link__content">View PDF</span><span class="material-symbols-outlined" style="font-size: 18px" translate="no">chevron_right</span></a></div></div><div class="ds-related-work--container js-wsj-grid-card" data-collection-position="1" data-entity-id="14784144" data-sort-order="default"><a class="ds-related-work--title js-wsj-grid-card-title ds2-5-body-md ds2-5-body-link" href="https://www.academia.edu/14784144/Neither_short_term_nor_long_term_administration_of_oral_choline_alters_metabolite_concentrations_in_human_brain">Neither short-term nor long-term administration of oral choline alters metabolite concentrations in human brain</a><div class="ds-related-work--metadata"><a class="js-wsj-grid-card-author ds2-5-body-sm ds2-5-body-link" data-author-id="33748550" href="https://independent.academia.edu/JensFrahm">Jens Frahm</a></div><p class="ds-related-work--metadata ds2-5-body-xs">Biological Psychiatry, 1999</p><p class="ds-related-work--abstract ds2-5-body-sm">Background: This study reexamined conflicting proton magnetic resonance spectroscopy (MRS) reports of increased or unaffected choline-containing compounds (Cho) in human brain in response to a single dose of 50 mg/kg choline bitartrate. Methods: The present work was based on a well-established strategy for quantitative proton MRS (2.0 T, STEAM localization sequence, TR/TE/TM ϭ 6000/20/10 ms, LCModel automated spectral evaluation) that allows the determination of cerebral metabolite concentrations rather than T1-weighted resonance intensity ratios. Moreover, the investigations were extended to a possible long-term effect of oral choline by monitoring the continuous ingestion of 2 ϫ 16 g of lecithin per day for 4 weeks. Six young healthy volunteers participated in each study and metabolite concentrations were determined in standardized locations in gray matter, white matter, cerebellum, and thalamus. Results: Neither for short-term nor for long-term administration of choline do the data reveal statistically significant deviations from the basal concentrations of Cho, total N-acetyl-containing compounds (neuronal markers), total creatine, and myo-inositol (glial marker) in any of the investigated brain regions. Conclusions: Previous reports of increased Cho are not confirmed.</p><div class="ds-related-work--ctas"><button class="ds2-5-text-link ds2-5-text-link--inline js-swp-download-button" data-signup-modal="{"location":"wsj-grid-card-download-pdf-modal","work_title":"Neither short-term nor long-term administration of oral choline alters metabolite concentrations in human brain","attachmentId":43897973,"attachmentType":"pdf","work_url":"https://www.academia.edu/14784144/Neither_short_term_nor_long_term_administration_of_oral_choline_alters_metabolite_concentrations_in_human_brain","alternativeTracking":true}"><span class="material-symbols-outlined" style="font-size: 18px" translate="no">download</span><span class="ds2-5-text-link__content">Download free PDF</span></button><a class="ds2-5-text-link ds2-5-text-link--inline js-wsj-grid-card-view-pdf" href="https://www.academia.edu/14784144/Neither_short_term_nor_long_term_administration_of_oral_choline_alters_metabolite_concentrations_in_human_brain"><span class="ds2-5-text-link__content">View PDF</span><span class="material-symbols-outlined" style="font-size: 18px" translate="no">chevron_right</span></a></div></div><div class="ds-related-work--container js-wsj-grid-card" data-collection-position="2" data-entity-id="7197819" data-sort-order="default"><a class="ds-related-work--title js-wsj-grid-card-title ds2-5-body-md ds2-5-body-link" href="https://www.academia.edu/7197819/Lack_of_effect_of_oral_choline_supplement_on_the_concentrations_of_choline_metabolites_in_human_brain">Lack of effect of oral choline supplement on the concentrations of choline metabolites in human brain</a><div class="ds-related-work--metadata"><a class="js-wsj-grid-card-author ds2-5-body-sm ds2-5-body-link" data-author-id="12481390" href="https://independent.academia.edu/Tu%C3%A2nHo%C3%A0ng">Tuân Hoàng</a></div><p class="ds-related-work--metadata ds2-5-body-xs">Magnetic Resonance in Medicine, 1998</p><p class="ds-related-work--abstract ds2-5-body-sm">Recent reports suggest that oral choline supplement may alter the cerebral choline/creatine (Cho/Cr) ratio and might be used to treat neurodegenerative disorders of cholinergic transmission. Using both 1H and 31P MRS, we reexamined the Cho/Cr ratio and quantified cerebral choline and its major constituents: phosphoethanolamine (PE), phosphorylcholine (PC), glycerophosphorylethanolamine (GPE), and glycero-phosphorylcholine (GPC). In the four brain locations examined, no significant increases in Cho/Cr, [Cho], or in its major constituents were found in response to an oral challenge of 50 mg/kg of choline bitartrate. Oral choline did not significantly affect human cerebral metabolism in the short term.</p><div class="ds-related-work--ctas"><button class="ds2-5-text-link ds2-5-text-link--inline js-swp-download-button" data-signup-modal="{"location":"wsj-grid-card-download-pdf-modal","work_title":"Lack of effect of oral choline supplement on the concentrations of choline metabolites in human brain","attachmentId":48565841,"attachmentType":"pdf","work_url":"https://www.academia.edu/7197819/Lack_of_effect_of_oral_choline_supplement_on_the_concentrations_of_choline_metabolites_in_human_brain","alternativeTracking":true}"><span class="material-symbols-outlined" style="font-size: 18px" translate="no">download</span><span class="ds2-5-text-link__content">Download free PDF</span></button><a class="ds2-5-text-link ds2-5-text-link--inline js-wsj-grid-card-view-pdf" href="https://www.academia.edu/7197819/Lack_of_effect_of_oral_choline_supplement_on_the_concentrations_of_choline_metabolites_in_human_brain"><span class="ds2-5-text-link__content">View PDF</span><span class="material-symbols-outlined" style="font-size: 18px" translate="no">chevron_right</span></a></div></div><div class="ds-related-work--container js-wsj-grid-card" data-collection-position="3" data-entity-id="86242460" data-sort-order="default"><a class="ds-related-work--title js-wsj-grid-card-title ds2-5-body-md ds2-5-body-link" href="https://www.academia.edu/86242460/Is_dietary_choline_intake_related_to_dementia_and_Alzheimers_disease_risk_results_from_the_Framingham_Heart_Study">Is dietary choline intake related to dementia and Alzheimer's disease risk: results from the Framingham Heart Study</a><div class="ds-related-work--metadata"><a class="js-wsj-grid-card-author ds2-5-body-sm ds2-5-body-link" data-author-id="32884040" href="https://independent.academia.edu/PaulJacques4">Paul Jacques</a></div><p class="ds-related-work--metadata ds2-5-body-xs">The American Journal of Clinical Nutrition</p><p class="ds-related-work--abstract ds2-5-body-sm">Background The positive association of choline for cognition has been reported in both animal and human studies, yet the association of choline with the risk of incident dementia or Alzheimer&#39;s disease (AD) in humans is unclear. Objectives Our objective was to test the hypothesis that lower (higher) dietary choline intake is associated with increased (decreased) risk of incident dementia or AD. Design Data from the Framingham Heart Study (FHS) Offspring Cohort Exam 5 to Exam 9 were used. Participants were free of dementia and stroke with valid self-report 126-item Harvard food-frequency questionnaire (FFQ) at Exam 5. The intakes of total choline, its contributing compounds, and betaine were estimated based on a published nutrient database. The intakes were updated at each exam to represent the cumulative average intake across the five exams. The associations between dietary choline intake and incident dementia and AD were examined in the mixed effect Cox proportional hazard mode...</p><div class="ds-related-work--ctas"><button class="ds2-5-text-link ds2-5-text-link--inline js-swp-download-button" data-signup-modal="{"location":"wsj-grid-card-download-pdf-modal","work_title":"Is dietary choline intake related to dementia and Alzheimer's disease risk: results from the Framingham Heart Study","attachmentId":90740045,"attachmentType":"pdf","work_url":"https://www.academia.edu/86242460/Is_dietary_choline_intake_related_to_dementia_and_Alzheimers_disease_risk_results_from_the_Framingham_Heart_Study","alternativeTracking":true}"><span class="material-symbols-outlined" style="font-size: 18px" translate="no">download</span><span class="ds2-5-text-link__content">Download free PDF</span></button><a class="ds2-5-text-link ds2-5-text-link--inline js-wsj-grid-card-view-pdf" href="https://www.academia.edu/86242460/Is_dietary_choline_intake_related_to_dementia_and_Alzheimers_disease_risk_results_from_the_Framingham_Heart_Study"><span class="ds2-5-text-link__content">View PDF</span><span class="material-symbols-outlined" style="font-size: 18px" translate="no">chevron_right</span></a></div></div><div class="ds-related-work--container js-wsj-grid-card" data-collection-position="4" data-entity-id="22194848" data-sort-order="default"><a class="ds-related-work--title js-wsj-grid-card-title ds2-5-body-md ds2-5-body-link" href="https://www.academia.edu/22194848/Dietary_patterns_food_groups_and_nutrients_as_predictors_of_plasma_choline_and_betaine_in_middle_aged_and_elderly_men_and_women">Dietary patterns, food groups, and nutrients as predictors of plasma choline and betaine in middle-aged and elderly men and women</a><div class="ds-related-work--metadata"><a class="js-wsj-grid-card-author ds2-5-body-sm ds2-5-body-link" data-author-id="32787263" href="https://independent.academia.edu/CDrevon">Christian Drevon</a></div><p class="ds-related-work--metadata ds2-5-body-xs">American Journal of Clinical Nutrition, 2008</p><p class="ds-related-work--abstract ds2-5-body-sm">Dietary patterns, food groups, and nutrients as predictors of plasma choline and betaine in middle-aged and elderly men and women 1-3 ABSTRACT 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 mol/L; P 0.0001) and cholesterol intake (0.16 mol/L; P 0.0001), and betaine was predicted by consumption of high-fiber bread (0.65 mol/L; P 0.0001); high-fat dairy products (Ҁ0.70 mol/L; P 0.0001); complex carbohydrates, fiber, folate, and thiamine (0.66-1.44 mol/L; P ͨ 0.0002 for all); and total energy (0.45 mol/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).</p><div class="ds-related-work--ctas"><button class="ds2-5-text-link ds2-5-text-link--inline js-swp-download-button" data-signup-modal="{"location":"wsj-grid-card-download-pdf-modal","work_title":"Dietary patterns, food groups, and nutrients as predictors of plasma choline and betaine in middle-aged and elderly men and women","attachmentId":42850372,"attachmentType":"pdf","work_url":"https://www.academia.edu/22194848/Dietary_patterns_food_groups_and_nutrients_as_predictors_of_plasma_choline_and_betaine_in_middle_aged_and_elderly_men_and_women","alternativeTracking":true}"><span class="material-symbols-outlined" style="font-size: 18px" translate="no">download</span><span class="ds2-5-text-link__content">Download free PDF</span></button><a class="ds2-5-text-link ds2-5-text-link--inline js-wsj-grid-card-view-pdf" href="https://www.academia.edu/22194848/Dietary_patterns_food_groups_and_nutrients_as_predictors_of_plasma_choline_and_betaine_in_middle_aged_and_elderly_men_and_women"><span class="ds2-5-text-link__content">View PDF</span><span class="material-symbols-outlined" style="font-size: 18px" translate="no">chevron_right</span></a></div></div><div class="ds-related-work--container js-wsj-grid-card" data-collection-position="5" data-entity-id="27492429" data-sort-order="default"><a class="ds-related-work--title js-wsj-grid-card-title ds2-5-body-md ds2-5-body-link" href="https://www.academia.edu/27492429/Choline_and_betaine_in_health_and_disease">Choline and betaine in health and disease</a><div class="ds-related-work--metadata"><a class="js-wsj-grid-card-author ds2-5-body-sm ds2-5-body-link" data-author-id="33009349" href="https://independent.academia.edu/PerUeland">Per Magne Ueland</a></div><p class="ds-related-work--metadata ds2-5-body-xs">Journal of Inherited Metabolic Disease, 2011</p><p class="ds-related-work--abstract ds2-5-body-sm">Choline is an essential nutrient, but is also formed by de novo synthesis. Choline and its derivatives serve as components of structural lipoproteins, blood and membrane lipids, and as a precursor of the neurotransmitter acetylcholine. Pre-and postnatal choline availability is important for neurodevelopment in rodents. Choline is oxidized to betaine that serves as an osmoregulator and is a substrate in the betaine-homocysteine methyltransferase reaction, which links choline and betaine to the folatedependent one-carbon metabolism. Choline and betaine are important sources of one-carbon units, in particular, during folate deficiency. Choline or betaine supplementation in humans reduces concentration of total homocysteine (tHcy), and plasma betaine is a strong predictor of plasma tHcy in individuals with low plasma concentration of folate and other B vitamins (B 2 , B 6 , and B 12 ) in combination TT genotype of the methylenetetrahydrofolate reductase 677 C->T polymorphism. The link to one-carbon metabolism and the recent availability of food composition data have motivated studies on choline and betaine as risk factors of chronic diseases previously studied in relation to folate and homocysteine status. High intake and plasma level of choline in the mother seems to afford reduced risk of neural tube defects. Intake of choline and betaine shows no consistent relation to cancer or cardiovascular risk or risk factors, whereas an unfavorable cardiovascular risk factor profile was associated with high choline and low betaine concentrations in plasma. Thus, choline and betaine showed opposite relations with key components of metabolic syndrome, suggesting a disruption of mitochondrial choline oxidation to betaine as part of the mitochondrial dysfunction in metabolic syndrome.</p><div class="ds-related-work--ctas"><button class="ds2-5-text-link ds2-5-text-link--inline js-swp-download-button" data-signup-modal="{"location":"wsj-grid-card-download-pdf-modal","work_title":"Choline and betaine in health and disease","attachmentId":47749158,"attachmentType":"pdf","work_url":"https://www.academia.edu/27492429/Choline_and_betaine_in_health_and_disease","alternativeTracking":true}"><span class="material-symbols-outlined" style="font-size: 18px" translate="no">download</span><span class="ds2-5-text-link__content">Download free PDF</span></button><a class="ds2-5-text-link ds2-5-text-link--inline js-wsj-grid-card-view-pdf" href="https://www.academia.edu/27492429/Choline_and_betaine_in_health_and_disease"><span class="ds2-5-text-link__content">View PDF</span><span class="material-symbols-outlined" style="font-size: 18px" translate="no">chevron_right</span></a></div></div><div class="ds-related-work--container js-wsj-grid-card" data-collection-position="6" data-entity-id="98291485" data-sort-order="default"><a class="ds-related-work--title js-wsj-grid-card-title ds2-5-body-md ds2-5-body-link" href="https://www.academia.edu/98291485/Variations_in_plasma_choline_and_metabolite_concentrations_in_healthy_adults">Variations in plasma choline and metabolite concentrations in healthy adults</a><div class="ds-related-work--metadata"><a class="js-wsj-grid-card-author ds2-5-body-sm ds2-5-body-link" data-author-id="15656584" href="https://ubc.academia.edu/RogerDyer">Roger Dyer</a></div><p class="ds-related-work--metadata ds2-5-body-xs">Clinical Biochemistry, 2018</p><p class="ds-related-work--abstract ds2-5-body-sm">Background: Plasma concentrations of choline and its metabolites might serve as biomarkers for the health outcomes of several pathological states such as cardiovascular disease and cancer. However, information about the reliability of biomarkers of choline status is limited. We investigated biological variations in repeated measures of choline and metabolites in healthy adults to assess them as biomarkers. Methods: Blood samples were collected after an overnight fast at three-time points 12 days apart from 40 adults (mean age, 33 y; male, n = 21). A subset (n = 19; [male, n = 8]) provided one additional sample after a breakfast meal. Plasma free choline, betaine and dimethylglycine were measured using liquid chromatographytandem mass spectrometry, and plasma phosphatidylcholine, sphingomyelin and lysophosphatidylcholine were measured using high-performance liquid chromatography. Results: The biological variations observed for choline and metabolites were ≤ 13% for adult fasting samples. This corresponded to intra-class correlations (ICC) that ranged from 0.593 to 0.770 for fasting values for choline and metabolites. A similar ICC range was also obtained between fasting and post-prandial states. Although most post-prandial concentrations of choline and metabolites were significantly higher (P < .05) than fasting, all fell within a calculated reference interval. The participants were correctly classified in tertiles for fasting and postprandial states for choline (68%) and metabolites (range = 32% phosphatidylcholine and 79% for sphingomyelin). Conclusions: These findings indicate that biological variations of choline and metabolites are low in healthy adults and values from a single blood sample can be used as a biomarker. However, choosing phosphatidylcholine as a biomarker is less reliable.</p><div class="ds-related-work--ctas"><button class="ds2-5-text-link ds2-5-text-link--inline js-swp-download-button" data-signup-modal="{"location":"wsj-grid-card-download-pdf-modal","work_title":"Variations in plasma choline and metabolite concentrations in healthy adults","attachmentId":99683437,"attachmentType":"pdf","work_url":"https://www.academia.edu/98291485/Variations_in_plasma_choline_and_metabolite_concentrations_in_healthy_adults","alternativeTracking":true}"><span class="material-symbols-outlined" style="font-size: 18px" translate="no">download</span><span class="ds2-5-text-link__content">Download free PDF</span></button><a class="ds2-5-text-link ds2-5-text-link--inline js-wsj-grid-card-view-pdf" href="https://www.academia.edu/98291485/Variations_in_plasma_choline_and_metabolite_concentrations_in_healthy_adults"><span class="ds2-5-text-link__content">View PDF</span><span class="material-symbols-outlined" style="font-size: 18px" translate="no">chevron_right</span></a></div></div><div class="ds-related-work--container js-wsj-grid-card" data-collection-position="7" data-entity-id="81217557" data-sort-order="default"><a class="ds-related-work--title js-wsj-grid-card-title ds2-5-body-md ds2-5-body-link" href="https://www.academia.edu/81217557/Effects_of_choline_on_health_across_the_life_course_a_systematic_review">Effects of choline on health across the life course: a systematic review</a><div class="ds-related-work--metadata"><a class="js-wsj-grid-card-author ds2-5-body-sm ds2-5-body-link" data-author-id="32379194" href="https://radboudumc.academia.edu/SirwanDarweesh">Sirwan Darweesh</a></div><p class="ds-related-work--metadata ds2-5-body-xs">Nutrition reviews, 2015</p><p class="ds-related-work--abstract ds2-5-body-sm">Choline is a precursor of both betaine and acetylcholine and might, therefore, influence cardiovascular and cognitive outcomes. There has been concern, however, that it may influence blood lipid levels because it is an essential component of very-low-density lipoproteins. The aim was to systematically review, using PRISMA guidelines, the literature pertaining to the effects of choline on body composition and on metabolic, cardiovascular, respiratory, and neurological outcomes in different life stages. The MEDLINE, Embase, Cochrane Central, Web of Science, PubMed, and Google Scholar databases were searched up to July 2014. Fifty relevant articles were identified. These comprised trials and cohort, case-control, and cross-sectional studies that assessed blood levels of choline, dietary intake of choline, and supplementation with choline in a population free of diseases at baseline. There is some observational evidence that choline during pregnancy may be beneficial for the neurologica...</p><div class="ds-related-work--ctas"><button class="ds2-5-text-link ds2-5-text-link--inline js-swp-download-button" data-signup-modal="{"location":"wsj-grid-card-download-pdf-modal","work_title":"Effects of choline on health across the life course: a systematic review","attachmentId":87339356,"attachmentType":"pdf","work_url":"https://www.academia.edu/81217557/Effects_of_choline_on_health_across_the_life_course_a_systematic_review","alternativeTracking":true}"><span class="material-symbols-outlined" style="font-size: 18px" translate="no">download</span><span class="ds2-5-text-link__content">Download free PDF</span></button><a class="ds2-5-text-link ds2-5-text-link--inline js-wsj-grid-card-view-pdf" href="https://www.academia.edu/81217557/Effects_of_choline_on_health_across_the_life_course_a_systematic_review"><span class="ds2-5-text-link__content">View PDF</span><span class="material-symbols-outlined" style="font-size: 18px" translate="no">chevron_right</span></a></div></div><div class="ds-related-work--container js-wsj-grid-card" data-collection-position="8" data-entity-id="27492462" data-sort-order="default"><a class="ds-related-work--title js-wsj-grid-card-title ds2-5-body-md ds2-5-body-link" href="https://www.academia.edu/27492462/Choline_concentrations_in_human_maternal_and_cord_blood_and_intelligence_at_5_y_of_age">Choline concentrations in human maternal and cord blood and intelligence at 5 y of age</a><div class="ds-related-work--metadata"><a class="js-wsj-grid-card-author ds2-5-body-sm ds2-5-body-link" data-author-id="33009349" href="https://independent.academia.edu/PerUeland">Per Magne Ueland</a></div><p class="ds-related-work--metadata ds2-5-body-xs">The American journal of clinical nutrition, 2008</p><p class="ds-related-work--abstract ds2-5-body-sm">Animal studies indicate that maternal prenatal choline supplementation leads to permanent enhancement of attention and spatial memory abilities in offspring, whereas dietary choline restriction during pregnancy impairs cognitive function in offspring. The association between gestational choline concentrations and neurodevelopmental outcome in humans has not been studied. Our objective was to assess the relation between maternal and cord blood choline concentrations and child intelligence quotient (IQ) scores at 5 y of age. With data and samples from a prospective study (n = 404 maternal-child pairs), serum concentrations of free and total choline were measured in maternal serum at 4 gestational age intervals (16-18 wk, 24-26 wk, 30-32 wk, and 36-38 wk) and in cord blood. Child IQ at 5 y of age was assessed with the Wechsler Preschool and Primary Scale of Intelligence-Revised. Multiple regression techniques were used to estimate the relation between choline concentrations and Full Sc...</p><div class="ds-related-work--ctas"><button class="ds2-5-text-link ds2-5-text-link--inline js-swp-download-button" data-signup-modal="{"location":"wsj-grid-card-download-pdf-modal","work_title":"Choline concentrations in human maternal and cord blood and intelligence at 5 y of age","attachmentId":47749190,"attachmentType":"pdf","work_url":"https://www.academia.edu/27492462/Choline_concentrations_in_human_maternal_and_cord_blood_and_intelligence_at_5_y_of_age","alternativeTracking":true}"><span class="material-symbols-outlined" style="font-size: 18px" translate="no">download</span><span class="ds2-5-text-link__content">Download free PDF</span></button><a class="ds2-5-text-link ds2-5-text-link--inline js-wsj-grid-card-view-pdf" href="https://www.academia.edu/27492462/Choline_concentrations_in_human_maternal_and_cord_blood_and_intelligence_at_5_y_of_age"><span class="ds2-5-text-link__content">View PDF</span><span class="material-symbols-outlined" style="font-size: 18px" translate="no">chevron_right</span></a></div></div><div class="ds-related-work--container js-wsj-grid-card" data-collection-position="9" data-entity-id="84151330" data-sort-order="default"><a class="ds-related-work--title js-wsj-grid-card-title ds2-5-body-md ds2-5-body-link" href="https://www.academia.edu/84151330/Measurement_of_concentrations_of_whole_blood_levels_of_choline_betaine_and_dimethylglycine_and_their_relations_to_plasma_levels">Measurement of concentrations of whole blood levels of choline, betaine, and dimethylglycine and their relations to plasma levels</a><div class="ds-related-work--metadata"><a class="js-wsj-grid-card-author ds2-5-body-sm ds2-5-body-link" data-author-id="117161978" href="https://independent.academia.edu/hussainawwad">hussain awwad</a></div><p class="ds-related-work--metadata ds2-5-body-xs">Journal of Chromatography B, 2014</p><p class="ds-related-work--abstract ds2-5-body-sm">We aimed at developing a method for the measurement of choline and its metabolites in whole blood (WB). After an extraction step, quantification of choline, betaine, and dimethylglycine (DMG) was performed using ultra performance liquid chromatography tandem mass spectrometry (UPLC-MS/MS). Plasma and WB metabolites were evaluated in a group of 61 elderly people. The calibration curves were linear (r 2 > 0.997) for all compounds. The inter-and intra-assay coefficients of variation for all analytes were <10%. The recoveries were >90% and the relative matrix effect were ≤4.0%. The median concentrations of choline, betaine, and DMG were 11.3, 27.8, and 5.9 mol/L in plasma and 66.6, 165, and 13.7 mol/L in WB, respectively. There were positive correlations between WB and plasma markers; for choline (r = 0.42), betaine (r = 0.61), and DMG (r = 0.56) (all p ≤ 0.001). The concentrations of betaine in WB and plasma were significantly higher in men than in women. The concentrations of WB choline and DMG did not differ significantly according to sex. In conclusion, we have established a reliable method for measuring choline metabolites in WB. The concentrations of WB choline, betaine, and DMG seem to reflect intracellular concentrations of these metabolites.</p><div class="ds-related-work--ctas"><button class="ds2-5-text-link ds2-5-text-link--inline js-swp-download-button" data-signup-modal="{"location":"wsj-grid-card-download-pdf-modal","work_title":"Measurement of concentrations of whole blood levels of choline, betaine, and dimethylglycine and their relations to plasma levels","attachmentId":89273530,"attachmentType":"pdf","work_url":"https://www.academia.edu/84151330/Measurement_of_concentrations_of_whole_blood_levels_of_choline_betaine_and_dimethylglycine_and_their_relations_to_plasma_levels","alternativeTracking":true}"><span class="material-symbols-outlined" style="font-size: 18px" translate="no">download</span><span class="ds2-5-text-link__content">Download free PDF</span></button><a class="ds2-5-text-link ds2-5-text-link--inline js-wsj-grid-card-view-pdf" href="https://www.academia.edu/84151330/Measurement_of_concentrations_of_whole_blood_levels_of_choline_betaine_and_dimethylglycine_and_their_relations_to_plasma_levels"><span class="ds2-5-text-link__content">View PDF</span><span class="material-symbols-outlined" style="font-size: 18px" translate="no">chevron_right</span></a></div></div></div></div><div class="ds-sticky-ctas--wrapper js-loswp-sticky-ctas hidden"><div class="ds-sticky-ctas--grid-container"><div class="ds-sticky-ctas--container"><button class="ds2-5-button js-swp-download-button" data-signup-modal="{"location":"continue-reading-button--sticky-ctas","attachmentId":43844826,"attachmentType":"pdf","workUrl":null}">See full PDF</button><button class="ds2-5-button ds2-5-button--secondary js-swp-download-button" data-signup-modal="{"location":"download-pdf-button--sticky-ctas","attachmentId":43844826,"attachmentType":"pdf","workUrl":null}"><span class="material-symbols-outlined" style="font-size: 20px" translate="no">download</span>Download PDF</button></div></div></div><div class="ds-below-fold--grid-container"><div class="ds-work--container js-loswp-embedded-document"><div class="attachment_preview" data-attachment="Attachment_43844826" style="display: none"><div class="js-scribd-document-container"><div class="scribd--document-loading js-scribd-document-loader" style="display: block;"><img alt="Loading..." src="//a.academia-assets.com/images/loaders/paper-load.gif" /><p>Loading Preview</p></div></div><div style="text-align: center;"><div class="scribd--no-preview-alert js-preview-unavailable"><p>Sorry, preview is currently unavailable. You can download the paper by clicking the button above.</p></div></div></div></div><div class="ds-sidebar--container js-work-sidebar"><div class="ds-related-content--container"><h2 class="ds-related-content--heading">Related papers</h2><div class="ds-related-work--container js-related-work-sidebar-card" data-collection-position="0" data-entity-id="27492453" data-sort-order="default"><a class="ds-related-work--title js-related-work-grid-card-title ds2-5-body-md ds2-5-body-link" href="https://www.academia.edu/27492453/The_association_of_betaine_homocysteine_and_related_metabolites_with_cognitive_function_in_Dutch_elderly_people">The association of betaine, homocysteine and related metabolites with cognitive function in Dutch elderly people</a><div class="ds-related-work--metadata"><a class="js-related-work-grid-card-author ds2-5-body-sm ds2-5-body-link" data-author-id="33009349" href="https://independent.academia.edu/PerUeland">Per Magne Ueland</a></div><p class="ds-related-work--metadata ds2-5-body-xs">British Journal of Nutrition, 2007</p><div class="ds-related-work--ctas"><button class="ds2-5-text-link ds2-5-text-link--inline js-swp-download-button" data-signup-modal="{"location":"wsj-grid-card-download-pdf-modal","work_title":"The association of betaine, homocysteine and related metabolites with cognitive function in Dutch elderly people","attachmentId":47749189,"attachmentType":"pdf","work_url":"https://www.academia.edu/27492453/The_association_of_betaine_homocysteine_and_related_metabolites_with_cognitive_function_in_Dutch_elderly_people","alternativeTracking":true}"><span class="material-symbols-outlined" style="font-size: 18px" translate="no">download</span><span class="ds2-5-text-link__content">Download free PDF</span></button><a class="ds2-5-text-link ds2-5-text-link--inline js-related-work-grid-card-view-pdf" href="https://www.academia.edu/27492453/The_association_of_betaine_homocysteine_and_related_metabolites_with_cognitive_function_in_Dutch_elderly_people"><span class="ds2-5-text-link__content">View PDF</span><span class="material-symbols-outlined" style="font-size: 18px" translate="no">chevron_right</span></a></div></div><div class="ds-related-work--container js-related-work-sidebar-card" data-collection-position="1" data-entity-id="65371316" data-sort-order="default"><a class="ds-related-work--title js-related-work-grid-card-title ds2-5-body-md ds2-5-body-link" href="https://www.academia.edu/65371316/Are_dietary_choline_and_betaine_intakes_determinants_of_total_homocysteine_concentration">Are dietary choline and betaine intakes determinants of total homocysteine concentration?</a><div class="ds-related-work--metadata"><a class="js-related-work-grid-card-author ds2-5-body-sm ds2-5-body-link" data-author-id="32884040" href="https://independent.academia.edu/PaulJacques4">Paul Jacques</a></div><p class="ds-related-work--metadata ds2-5-body-xs">American Journal of Clinical Nutrition, 2010</p><div class="ds-related-work--ctas"><button class="ds2-5-text-link ds2-5-text-link--inline js-swp-download-button" data-signup-modal="{"location":"wsj-grid-card-download-pdf-modal","work_title":"Are dietary choline and betaine intakes determinants of total homocysteine concentration?","attachmentId":76997423,"attachmentType":"pdf","work_url":"https://www.academia.edu/65371316/Are_dietary_choline_and_betaine_intakes_determinants_of_total_homocysteine_concentration","alternativeTracking":true}"><span class="material-symbols-outlined" style="font-size: 18px" translate="no">download</span><span class="ds2-5-text-link__content">Download free PDF</span></button><a class="ds2-5-text-link ds2-5-text-link--inline js-related-work-grid-card-view-pdf" href="https://www.academia.edu/65371316/Are_dietary_choline_and_betaine_intakes_determinants_of_total_homocysteine_concentration"><span class="ds2-5-text-link__content">View PDF</span><span class="material-symbols-outlined" style="font-size: 18px" translate="no">chevron_right</span></a></div></div><div class="ds-related-work--container js-related-work-sidebar-card" data-collection-position="2" data-entity-id="18469257" data-sort-order="default"><a class="ds-related-work--title js-related-work-grid-card-title ds2-5-body-md ds2-5-body-link" href="https://www.academia.edu/18469257/Biochemical_indicators_of_vitamin_B12_and_folate_insufficiency_and_cognitive_decline">Biochemical indicators of vitamin B12 and folate insufficiency and cognitive decline</a><div class="ds-related-work--metadata"><a class="js-related-work-grid-card-author ds2-5-body-sm ds2-5-body-link" data-author-id="38479501" href="https://independent.academia.edu/MarthaMorris">Martha Morris</a><span>, </span><a class="js-related-work-grid-card-author ds2-5-body-sm ds2-5-body-link" data-author-id="38649416" href="https://independent.academia.edu/ChristineTangney">Christine Tangney</a></div><p class="ds-related-work--metadata ds2-5-body-xs">Neurology, 2009</p><div class="ds-related-work--ctas"><button class="ds2-5-text-link ds2-5-text-link--inline js-swp-download-button" data-signup-modal="{"location":"wsj-grid-card-download-pdf-modal","work_title":"Biochemical indicators of vitamin B12 and folate insufficiency and cognitive decline","attachmentId":42243721,"attachmentType":"pdf","work_url":"https://www.academia.edu/18469257/Biochemical_indicators_of_vitamin_B12_and_folate_insufficiency_and_cognitive_decline","alternativeTracking":true}"><span class="material-symbols-outlined" style="font-size: 18px" translate="no">download</span><span class="ds2-5-text-link__content">Download free PDF</span></button><a class="ds2-5-text-link ds2-5-text-link--inline js-related-work-grid-card-view-pdf" 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