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One-year longitudinal association between changes in dietary choline or betaine intake and cardiometabolic variables in the PREvención con DIeta MEDiterránea-Plus (PREDIMED-Plus) trial.

Nutritional Control of the Epigenome Group, Precision Nutrition and Obesity Program, IMDEA Food, CEI UAM + CSIC, Madrid, Spain. Cardiometabolic Health Group, Precision Nutrition and Cardiometabolic Health Program, IMDEA Food, CEI UAM + CSIC, Madrid, Spain. Primary Care Center Ibiza, SERMAS, Madrid, Spain. Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain. Department of Preventive Medicine and Public Health, Navarra Institute of Health Research (IdISNA), University of Navarra, Pamplona, Spain. Department of Nutrition, Harvard TH Chan School of Public Health, Boston, MA, USA. Department of Preventive Medicine, University of Valencia, Valencia, Spain. Universitat Rovira i Virgili, Departament of Biochemistry and Biotechnology, Human Nutrition Unit, Reus, Spain. Institut d'Investigació Sanitària Pere Virgili (IISPV), Reus, Spain. Nutrition Unit, University Hospital of Sant Joan de Reus, Reus, Spain. Unit of Preventive Medicine & Public Health, Faculty of Medicine & Health Sciences, Universitat Rovira i Virgili, Reus, Spain. Unit of Cardiovascular Risk and Nutrition, Institut Hospital del Mar d`Investigació Médica (IMIM), Barcelona, Spain. Department of Medicine, Universitat Autonoma de Barcelona, Barcelona, Spain. Center for Nutrition Research, Department of Nutrition, Food Sciences, and Physiology, University of Navarra, Pamplona, Spain. Cardiovascular, Respiratory and Metabolic Area, Bioaraba Health Research Institute; Araba University Hospital, Osakidetza Basque Health Service; University of the Basque Country UPV/EHU, Vitoria-Gasteiz, Spain. Department of Nursing, University of Málaga, Institute of Biomedical Research in Malaga (IBIMA), Málaga, Spain. CIBER de Epidemiología y Salud Pública (CIBERESP), Carlos III Institute of Health (ISCIII), Madrid, Spain. Institute of Health and Biomedical Research of Alicante, Miguel Hernández University (ISABIAL-UMH), Alicante, Spain. Research Group on Nutritional Epidemiology & Cardiovascular Physiopathology, Health Research Institute of the Balearic Islands (IdISBa), Palma de Mallorca, Spain. Department of Internal Medicine, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofia University Hospital, University of Cordoba, Cordoba, Spain. Department of Internal Medicine, Institut d'Investigacions Biomèdiques August Pi Sunyer (IDIBAPS), Hospital Clinic, University of Barcelona, Barcelona, Spain. Department of Endocrinology, Virgen de la Victoria Hospital, Málaga Biomedical Research Institute (IBIMA), University of Málaga, Málaga, Spain. Research Unit, Department of Family Medicine, Sevilla Primary Care Health District, Sevilla, Spain. Research Institute of Biomedical and Health Sciences (IUIBS), University of Las Palmas de Gran Canaria and Maternal and Child Insular University Hospital Center (CHUIMI), Canarian Health Service, Las Palmas de Gran Canaria, Spain. Department of Preventive Medicine and Public Health, University of Granada, Granada, Spain. Research Group on Community Nutrition & Oxidative Stress, University of the Balearic Islands, Palma de Mallorca, Spain. Institute of Biomedicine (IBIOMED), University of León, León, Spain. Lipids and Vascular Risk Unit, Internal Medicine, Bellvitge University Hospital, Barcelona, Spain. Department of Health Sciences, University Institute for Research on Olives and Olive Oils, University of Jaén, Jaén, Spain. Department of Endocrinology and Nutrition, San Carlos Clinical Hospital Institute of Health Research (IdISSC), Madrid, Spain. CIBER Diabetes y Enfermedades Metabólicas (CIBERDEM), Carlos III Institute of Health (ISCIII), Madrid, Spain. Department of Endocrinology, Institut d` Investigacions Biomédiques August Pi Sunyer (IDIBAPS), Hospital Clinic, University of Barcelona, Barcelona, Spain. Department of Endocrinology and Nutrition, Jimenez Díaz Foundation Hospital Biomedical Research Institute (IISFJD), Autonomous University of Madrid, Madrid, Spain. Lipid Clinic, Department of Endocrinology and Nutrition, Institut d'Investigacions Biomèdiques August Pi Sunyer (IDIBAPS), Hospital Clínic, Barcelona, Spain. Endocrinology Service, Navarra Hospital Complex, Osasunbidea, Navarro Health Service, Pamplona, Spain. Internal Medicine Department, HM Sanchinarro Hospital, HM Hospitals, Madrid, Spain. Division of Preventive Medicine and Public Health, University of Malaga, Institute of Biomedical Research in Málaga (IBIMA-University of Malaga), Málaga, Spain. San Vicent del Raspeig Health Center, Alicante, Spain. Nutritional Genomics and Epigenomics Group, Precision Nutrition and Obesity Program, IMDEA Food, CEI UAM + CSIC, Madrid, Spain. Nutrition and Genomics Laboratory, Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA, USA.

The American journal of clinical nutrition. 2022;(6):1565-1579
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Abstract

BACKGROUND Choline and betaine intakes have been related to cardiovascular health. OBJECTIVES We aimed to explore the relation between 1-y changes in dietary intake of choline or betaine and 1-y changes in cardiometabolic and renal function traits within the frame of the PREDIMED (PREvención con DIeta MEDiterránea)-Plus trial. METHODS We used baseline and 1-y follow-up data from 5613 participants (48.2% female and 51.8% male; mean ± SD age: 65.01 ± 4.91 y) to assess cardiometabolic traits, and 3367 participants to assess renal function, of the Spanish PREDIMED-Plus trial. Participants met ≥3 criteria of metabolic syndrome and had overweight or obesity [BMI (in kg/m2) ≥27 and ≤40]. These criteria were similar to those of the PREDIMED parent study. Dietary intakes of choline and betaine were estimated from the FFQ. RESULTS The greatest 1-y increase in dietary choline or betaine intake (quartile 4) was associated with improved serum glucose concentrations (-3.39 and -2.72 mg/dL for choline and betaine, respectively) and HbA1c levels (-0.10% for quartile 4 of either choline or betaine intake increase). Other significant changes associated with the greatest increase in choline or betaine intake were reduced body weight (-2.93 and -2.78 kg, respectively), BMI (-1.05 and -0.99, respectively), waist circumference (-3.37 and -3.26 cm, respectively), total cholesterol (-4.74 and -4.52 mg/dL, respectively), and LDL cholesterol (-4.30 and -4.16 mg/dL, respectively). Urine creatinine was reduced in quartile 4 of 1-y increase in choline or betaine intake (-5.42 and -5.74 mg/dL, respectively). CONCLUSIONS Increases in dietary choline or betaine intakes were longitudinally related to improvements in cardiometabolic parameters. Markers of renal function were also slightly improved, and they require further investigation.This trial was registered at https://www.isrctn.com/ as ISRCTN89898870.

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Publication Type : Clinical Trial

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