Journal
EUROPEAN JOURNAL OF NUTRITION
Volume 57, Issue 1, Pages 51-60Publisher
SPRINGER HEIDELBERG
DOI: 10.1007/s00394-016-1296-8
Keywords
Diet; Choline; Betaine; Subclinical measures of cardiovascular disease; Incident coronary heart disease; The Jackson Heart Study
Categories
Funding
- Jackson State University [N01-HC-95170]
- University of Mississippi Medical Center [N01-HC-95171]
- Tougaloo College NIH contracts from the National Heart, Lung, and Blood Institute (NHLBI) [N01-HC-95172]
- National Center on Minority Health and Health Disparities (NCMHD)
- NHLBI [HL076784]
- National Institute of Aging [AG028321]
- NATIONAL HEART, LUNG, AND BLOOD INSTITUTE [R41HL095172, R01HL076784] Funding Source: NIH RePORTER
- NATIONAL INSTITUTE ON AGING [R01AG028321] Funding Source: NIH RePORTER
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Purpose Several mechanisms have been described through which dietary intake of choline and its derivative betaine may be associated in both directions with subclinical atherosclerosis. We assessed the association of dietary intake of choline and betaine with cardiovascular risk and markers of subclinical cardiovascular disease. Methods Data from 3924 Jackson Heart Study (JHS) African-American participants with complete food frequency questionnaire at baseline and follow-up measurements of heart disease measures were used. Multivariable linear regression models were employed to assess associations between choline and betaine intake with carotid intima-media thickness, coronary artery calcium, abdominal aortic calcium and left ventricular mass. Cox proportional hazards regression models were used to estimate associations with time to incident coronary heart disease (CHD), ischemic stroke and cardiovascular disease (CVD). Results During an average nine years of follow-up, 124 incident CHD events, 75 incident stroke events and 153 incident CVD events were documented. In women, greater choline intake was associated with lower left ventricular mass (p = 0.0006 for trend across choline quartiles) and with abdominal aortic calcium score. Among all JHS participants, there was a statistically significant inverse association between dietary choline intake and incident stroke, beta = -0.33 (p = 0.04). Betaine intake was associated with greater risk of incident CHD when comparing the third quartile of intake with the lowest quartile of intake (HR 1.89, 95 % CI 1.14, 3.15). Conclusions Among our African-American participants, higher dietary choline intake was associated with a lower risk of incident ischemic stroke, and thus putative dietary benefits. Higher dietary betaine intake was associated with a nonlinear higher risk of incident CHD.
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