The association between betaine and choline intakes and the plasma concentrations of homocysteine in women

Am J Clin Nutr. 2007 Oct;86(4):1073-81. doi: 10.1093/ajcn/86.4.1073.


Background: Elevated total homocysteine (tHcy), a risk factor for many chronic diseases, can be remethylated to methionine by folate. Alternatively, tHcy can be metabolized by other 1-carbon nutrients, ie, betaine and its precursor, choline.

Objective: We aimed to assess the association between the dietary intakes of betaine and choline and the concentration of tHcy.

Design: We conducted a cross-sectional analysis in 1477 women by using linear regression models to predict mean fasting tHcy by intakes of of betaine and choline.

Results: tHcy was 8% lower in the highest quintile of total betaine + choline intake than in the lowest quintile, even after control for folate intake (P for trend = 0.07). Neither choline nor betaine intake individually was significantly associated with tHcy. Choline from 2 choline-containing compounds, glycerophosphocholine and phosphocholine, was inversely associated with tHcy. These inverse associations were more pronounced in women with folate intake < 400 mug/d than in those with intakes >or=400 microg/d (P for interaction = 0.03 for phosphocholine) and in moderate alcohol drinkers (>or=15 g/d) than in nondrinkers or light drinkers (<15 g/d) (P for interaction = 0.02 for glycerophosphocholine and 0.04 for phosphocholine). The strongest dose response was seen in women with a low-methyl diet (high alcohol and low folate intake) (P for interaction = 0.002 for glycerophosphocholine and 0.001 for phosphocholine).

Conclusions: Total choline + betaine intake was inversely associated with tHcy, as was choline from 2 water-soluble choline-containing compounds. Remethylation of tHcy may be more dependent on the betaine pathway when methyl sources are low as a result of either inadequate folate intake or heavier alcohol consumption.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Alcohol Drinking*
  • Betaine / administration & dosage*
  • Betaine / metabolism
  • Biomarkers / blood
  • Choline / administration & dosage*
  • Choline / metabolism
  • Cross-Sectional Studies
  • Diet Records
  • Female
  • Folic Acid / administration & dosage
  • Folic Acid / metabolism
  • Homocysteine / blood*
  • Humans
  • Linear Models
  • Lipotropic Agents / administration & dosage*
  • Lipotropic Agents / metabolism
  • Methylation
  • Middle Aged
  • Predictive Value of Tests
  • Surveys and Questionnaires
  • Vitamin B Complex / administration & dosage
  • Vitamin B Complex / metabolism


  • Biomarkers
  • Lipotropic Agents
  • Homocysteine
  • Vitamin B Complex
  • Betaine
  • Folic Acid
  • Choline