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Ironjustic
Thu, Jul-13-06, 06:20
Increased choline intake could cut CVD risk, suggests study

By Stephen Daniells

22/06/2006 - Increased intake of choline, a nutrient found in
meat, milk and eggs, can reduce circulating levels of
homocysteine, an amino acid linked to increased risk of
heart disease, says a study.

"Our study adds further evidence that intakes of less than one
gram choline or betaine per day can reduce homocysteine
concentrations in a free-living population," wrote lead author
Eunyoung Cho from Harvard Medical School. Few studies have
investigated the effects of the nutrient in terms of disease
prevention because food composition databases were not
available until only recently.

The new study has taken advantage of these databases and
reports that people with increased intake of choline, and its
oxidation product betaine (found naturally in vegetables such
as spinach), have lower levels of homocysteine.

The amino acid homocysteine has been linked by epidemiological
studies to an increased risk of cardiovascular disease. A
meta-analysis in the British Medical Journal (Vol. 325, pp.
1202-1208) of genetic and prospective studies reported that a
3 micromole per litre decrease in homocysteine levels was
associated with a decrease in the risk of ischemic heart
disease of 16 percent.

The Harvard study, published in the American Journal of
Clinical Nutrition (Vol. 83, pp. 905-911), analysed the
dietary intake of 1960 volunteers (1040 women) with an average
age of 54 using a validated 130-item food frequency
questionnaire.

Choline and betaine intake was calculated using the Harvard
University Food Composition Database, the US Department of
Agriculture's choline database, and values published in 2003
in the Journal of Nutrition (Vol. 133, pp. 1302-1307).

The researchers found that the highest choline intake (401
milligrams per day) was associated with a nine per cent lower
plasma concentration of homocysteine, compared to the lowest
intake group (234 milligrams per day).

When betaine was counted along with choline, a similar
reduction in homocysteine level was observed (9.2 per cent)
when comparing the highest intake groups (689 milligrams per
day) with the lowest intake group (383 milligrams per day).

The results took into account possible complicating factors
such as age, sex, smoking, alcohol, hypertension, and intakes
of B-vitamins.

Increased intake of B-vitamins, and particularly folate/folic
acid, has been reported to reduce homocysteine levels, and
protect against heart disease.

"Intakes of choline and betaine predicted plasma homocysteine
concentrations independent predictors, including intakes of
folate and B vitamins," said the researchers.

The mechanism behind the benefits is proposed to be the
oxidation of choline to betaine, which then donates a methyl
group to homocysteine to form methionine. This mechanism, say
the researchers, is confined to the kidney and livers.

This also suggests, said Cho, that even if folate intake is
low, homocysteine levels can be reduced by having an adequate
intake of choline and betaine.

Recommended daily intakes of choline were set in 1998 at
values of 550 milligrams per day for men and 425 milligrams a
day for women. The mean intake of the entire study population
was found to be 313 milligrams a day, indicating this study
population were not consuming adequate amounts of the
micronutrient.

The results appear to be in line with intervention studies
using high dose betaine or choline supplementation, which have
reported homocysteine reductions of up to 20 per cent
(betaine, 1.5 to 6 grams per day).

Red meat was reported to be the richest source of choline,
giving about 14 per cent of the daily intake. Spinach was
reported to be the participants' richest source of betaine,
accounting for over 25 per cent of the daily intake.

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<<snip>> Lecithin may therefore be the method of choice for
accelerating acetylcholine synthesis by increasing the
availability of choline, its precursor in the blood.

<<snip>>

Lancet. 1977 Jul 9;2(8028):68-9. Related Articles, Links

Lecithin consumption raises serum-free-choline levels.

Wurtman RJ, Hirsch MJ, Growdon JH.

Consumption of choline by rats sequentially increases
serum-choline, brain-choline, and brain-acetylcholine
concentrations. In man consumption of choline increases in
levels in the serum and cerebrospinal fluid; its
administration is an effective way of treating

tardive dyskinesia. We found that oral lecithin is
considerably more effective in raising human serum-choline
levels than an equivalent quantity of choline chloride. 30
minutes after ingestion of choline chloride (2-3 g free base),
serum-choline levels rose by 86% and returned to normal values
within 4 hours; 1 hour after lecithin ingestion, these levels
rose by 265% and remained significantly raised for 12 hours.
Lecithin may therefore be the method of choice for
accelerating acetylcholine synthesis by increasing the
availability of choline, its precursor in the blood.

PMID: 69151 [PubMed - indexed for MEDLINE]

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