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Socha MW, Flis W, Wartęga M. Epigenetic Genome Modifications during Pregnancy: The Impact of Essential Nutritional Supplements on DNA Methylation. Nutrients 2024; 16:678. [PMID: 38474806 DOI: 10.3390/nu16050678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2024] [Revised: 02/26/2024] [Accepted: 02/27/2024] [Indexed: 03/14/2024] Open
Abstract
Pregnancy is an extremely stressful period in a pregnant woman's life. Currently, women's awareness of the proper course of pregnancy and its possible complications is constantly growing. Therefore, a significant percentage of women increasingly reach for various dietary supplements during gestation. Some of the most popular substances included in multi-ingredient supplements are folic acid and choline. Those substances are associated with positive effects on fetal intrauterine development and fewer possible pregnancy-associated complications. Recently, more and more attention has been paid to the impacts of specific environmental factors, such as diet, stress, physical activity, etc., on epigenetic modifications, understood as changes occurring in gene expression without the direct alteration of DNA sequences. Substances such as folic acid and choline may participate in epigenetic modifications by acting via a one-carbon cycle, leading to the methyl-group donor formation. Those nutrients may indirectly impact genome phenotype by influencing the process of DNA methylation. This review article presents the current state of knowledge on the use of folic acid and choline supplementation during pregnancy, taking into account their impacts on the maternal-fetal unit and possible pregnancy outcomes, and determining possible mechanisms of action, with particular emphasis on their possible impacts on epigenetic modifications.
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Affiliation(s)
- Maciej W Socha
- Department of Perinatology, Gynecology and Gynecologic Oncology, Faculty of Health Sciences, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University, Łukasiewicza 1, 85-821 Bydgoszcz, Poland
- Department of Obstetrics and Gynecology, St. Adalbert's Hospital in Gdańsk, Copernicus Healthcare Entity, Jana Pawła II 50, 80-462 Gdańsk, Poland
| | - Wojciech Flis
- Department of Perinatology, Gynecology and Gynecologic Oncology, Faculty of Health Sciences, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University, Łukasiewicza 1, 85-821 Bydgoszcz, Poland
- Department of Obstetrics and Gynecology, St. Adalbert's Hospital in Gdańsk, Copernicus Healthcare Entity, Jana Pawła II 50, 80-462 Gdańsk, Poland
| | - Mateusz Wartęga
- Department of Pathophysiology, Faculty of Pharmacy, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University, M. Curie-Skłodowskiej 9, 85-094 Bydgoszcz, Poland
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Obeid R, Karlsson T. Choline - a scoping review for Nordic Nutrition Recommendations 2023. Food Nutr Res 2023; 67:10359. [PMID: 38187796 PMCID: PMC10770654 DOI: 10.29219/fnr.v67.10359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Revised: 03/15/2022] [Accepted: 11/10/2023] [Indexed: 01/09/2024] Open
Abstract
Choline is an essential nutrient with metabolic roles as a methyl donor in one carbon metabolism and as a precursor for membrane phospholipids and the neurotransmitter acetylcholine. Choline content is particularly high in liver, eggs, and wheat germ, although it is present in a variety of foods. The main dietary sources of choline in the Nordic and Baltic countries are meat, dairy, eggs, and grain. A diet that is devoid of choline causes liver and muscle dysfunction within 3 weeks. Choline requirements are higher during pregnancy and lactation than in non-pregnant women. Although no randomized controlled trials are available, observational studies in human, supported by coherence from interventional studies with neurodevelopmental outcomes and experimental studies in animals, strongly suggest that sufficient intake of choline during pregnancy is necessary for normal brain development and function in the child. Observational studies suggested that adequate intake of choline could have positive effects on cognitive function in older people. However, prospective data are lacking, and no intervention studies are available in the elderly.
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Affiliation(s)
- Rima Obeid
- Department of Clinical Chemistry and Laboratory Medicine, University Hospital of the Saarland, Homburg, Germany
| | - Therese Karlsson
- Department of Internal Medicine and Clinical Nutrition, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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Kansakar U, Trimarco V, Mone P, Varzideh F, Lombardi A, Santulli G. Choline supplements: An update. Front Endocrinol (Lausanne) 2023; 14:1148166. [PMID: 36950691 PMCID: PMC10025538 DOI: 10.3389/fendo.2023.1148166] [Citation(s) in RCA: 14] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Accepted: 02/07/2023] [Indexed: 03/08/2023] Open
Abstract
In this comprehensive review, we examine the main preclinical and clinical investigations assessing the effects of different forms of choline supplementation currently available, including choline alfoscerate (C8H20NO6P), also known as alpha-glycerophosphocholine (α-GPC, or GPC), choline bitartrate, lecithin, and citicoline, which are cholinergic compounds and precursors of acetylcholine. Extensively used as food supplements, they have been shown to represent an effective strategy for boosting memory and enhancing cognitive function.
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Affiliation(s)
- Urna Kansakar
- Department of Medicine, Division of Cardiology, Einstein Institute for Aging Research, Montefiore Health System, New York, NY, United States
| | | | - Pasquale Mone
- Department of Medicine, Division of Cardiology, Einstein Institute for Aging Research, Montefiore Health System, New York, NY, United States
- ASL Avellino, Montefiore Health System, New York, NY, United States
| | - Fahimeh Varzideh
- Department of Medicine, Division of Cardiology, Einstein Institute for Aging Research, Montefiore Health System, New York, NY, United States
| | - Angela Lombardi
- Department of Microbiology and Immunology, Montefiore Health System, New York, NY, United States
- *Correspondence: Angela Lombardi,
| | - Gaetano Santulli
- Department of Medicine, Division of Cardiology, Einstein Institute for Aging Research, Montefiore Health System, New York, NY, United States
- University of Naples “Federico II”, Naples, Italy
- Department of Molecular Pharmacology, Einstein-Sinai Diabetes Research Center (ES-DRC), Montefiore Health System, New York, NY, United States
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Obeid R, Derbyshire E, Schön C. Association between Maternal Choline, Fetal Brain Development, and Child Neurocognition: Systematic Review and Meta-Analysis of Human Studies. Adv Nutr 2022; 13:2445-2457. [PMID: 36041182 PMCID: PMC9776654 DOI: 10.1093/advances/nmac082] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Revised: 10/01/2021] [Accepted: 07/25/2022] [Indexed: 01/29/2023] Open
Abstract
We studied associations between prenatal and early postnatal choline intake, brain development, and neurocognitive function of children. We conducted a systematic review followed by a meta-analysis and critical appraisal of human studies published from 1997 to 2021. Thirty publications were identified. The meta-analysis included 5 of 7 case-control studies studying neural tube defects (NTDs) in relation to maternal choline intakes/circulating concentrations. Low maternal choline intake/circulating concentrations were associated with a higher OR for NTDs among 1131 mothers of newborns with NTDs and 4439 control mothers (pooled estimate = 1.36; 95% CI: 1.11, 1.67). The 95% prediction intervals were 0.78, 2.36. Findings and critical evaluation of 10 publications with interventional designs showed that higher maternal choline intakes during the second half of pregnancy and early postnatal period (550 mg up to 1 g/d on top of the diet) or a child intake of 513 to 625 mg/d from supplements were safe and likely to demonstrate favorable effects on several domains of child neurocognition, such as memory, attention, and visuospatial learning versus the comparators. Findings from observational studies (n = 13) partly supported the association between maternal choline intake/serum concentrations and child neurocognition, but there was low confidence in the use of plasma choline concentrations as a choline intake marker. In conclusion, low maternal choline intakes were associated with a higher OR for NTDs. The risk could be up to 2.36-fold in some populations. Despite limitations of available trials and observational studies, higher maternal choline intake was likely to be associated with better child neurocognition/neurodevelopment. The results should be used to guide choline intake recommendations in pregnancy and lactation, especially because most young women are not achieving the reference intake of choline. This meta-analysis is registered at PROSPERO as CRD42021233790.
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Díez-Ricote L, San-Cristobal R, Concejo MJ, Martínez-González MÁ, Corella D, Salas-Salvadó J, Goday A, Martínez JA, Alonso-Gómez ÁM, Wärnberg J, Vioque J, Romaguera D, López-Miranda J, Estruch R, Tinahones FJ, Lapetra J, Serra-Majem L, Bueno-Cavanillas A, Tur JA, Martín Sánchez V, Pintó X, Gaforio JJ, Matía-Martín P, Vidal J, Mas Fontao S, Ros E, Vázquez-Ruiz Z, Ortega-Azorín C, García-Gavilán JF, Malcampo M, Martínez-Urbistondo D, Tojal-Sierra L, García Rodríguez A, Gómez-Bellvert N, Chaplin A, García-Ríos A, Bernal-López RM, Santos-Lozano JM, Basterra-Gortari J, Sorlí JV, Murphy M, Gasulla G, Micó V, Salaverria-Lete I, Goñi Ochandorena E, Babio N, Herraiz X, Ordovás JM, Daimiel L. 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. Am J Clin Nutr 2022; 116:1565-1579. [PMID: 36124652 PMCID: PMC9761742 DOI: 10.1093/ajcn/nqac255] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Accepted: 09/09/2022] [Indexed: 02/01/2023] Open
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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Affiliation(s)
- Laura Díez-Ricote
- Nutritional Control of the Epigenome Group, Precision Nutrition and Obesity Program, IMDEA Food, CEI UAM + CSIC, Madrid, Spain
| | - Rodrigo San-Cristobal
- Cardiometabolic Health Group, Precision Nutrition and Cardiometabolic Health Program, IMDEA Food, CEI UAM + CSIC, Madrid, Spain
| | | | - Miguel Á Martínez-González
- 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
| | - Dolores Corella
- 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, University of Valencia, Valencia, Spain
| | - Jordi Salas-Salvadó
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, 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
| | - Albert Goday
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, 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
| | - J Alfredo Martínez
- Cardiometabolic Health Group, Precision Nutrition and Cardiometabolic Health Program, IMDEA Food, CEI UAM + CSIC, Madrid, Spain
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain
- Center for Nutrition Research, Department of Nutrition, Food Sciences, and Physiology, University of Navarra, Pamplona, Spain
| | - Ángel M Alonso-Gómez
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, 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
| | - Julia Wärnberg
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain
- Department of Nursing, University of Málaga, Institute of Biomedical Research in Malaga (IBIMA), Málaga, Spain
| | - Jesús Vioque
- 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
| | - Dora Romaguera
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain
- Research Group on Nutritional Epidemiology & Cardiovascular Physiopathology, Health Research Institute of the Balearic Islands (IdISBa), Palma de Mallorca, Spain
| | - José López-Miranda
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain
- Department of Internal Medicine, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofia University Hospital, University of Cordoba, Cordoba, Spain
| | - Ramon Estruch
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain
- Department of Internal Medicine, Institut d’Investigacions Biomèdiques August Pi Sunyer (IDIBAPS), Hospital Clinic, University of Barcelona, Barcelona, Spain
| | - Francisco J Tinahones
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain
- Department of Endocrinology, Virgen de la Victoria Hospital, Málaga Biomedical Research Institute (IBIMA), University of Málaga, Málaga, Spain
| | - José Lapetra
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain
- Research Unit, Department of Family Medicine, Sevilla Primary Care Health District, Sevilla, Spain
| | - Lluís Serra-Majem
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, 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
| | - Aurora Bueno-Cavanillas
- CIBER de Epidemiología y Salud Pública (CIBERESP), Carlos III Institute of Health (ISCIII), Madrid, Spain
- Department of Preventive Medicine and Public Health, University of Granada, Granada, Spain
| | - Josep A Tur
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain
- Research Group on Community Nutrition & Oxidative Stress, University of the Balearic Islands, Palma de Mallorca, Spain
| | - Vicente Martín Sánchez
- CIBER de Epidemiología y Salud Pública (CIBERESP), Carlos III Institute of Health (ISCIII), Madrid, Spain
- Institute of Biomedicine (IBIOMED), University of León, León, Spain
| | - Xavier Pintó
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain
- Lipids and Vascular Risk Unit, Internal Medicine, Bellvitge University Hospital, Barcelona, Spain
| | - José J Gaforio
- CIBER de Epidemiología y Salud Pública (CIBERESP), Carlos III Institute of Health (ISCIII), Madrid, Spain
- Department of Health Sciences, University Institute for Research on Olives and Olive Oils, University of Jaén, Jaén, Spain
| | - Pilar Matía-Martín
- Department of Endocrinology and Nutrition, San Carlos Clinical Hospital Institute of Health Research (IdISSC), Madrid, Spain
| | - Josep Vidal
- 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
| | - Sebastián Mas Fontao
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain
- Department of Endocrinology and Nutrition, Jimenez Díaz Foundation Hospital Biomedical Research Institute (IISFJD), Autonomous University of Madrid, Madrid, Spain
| | - Emilio Ros
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain
- Lipid Clinic, Department of Endocrinology and Nutrition, Institut d’Investigacions Biomèdiques August Pi Sunyer (IDIBAPS), Hospital Clínic, Barcelona, Spain
| | - Zenaida Vázquez-Ruiz
- 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
- Endocrinology Service, Navarra Hospital Complex, Osasunbidea, Navarro Health Service, Pamplona, Spain
| | - Carolina Ortega-Azorín
- 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, University of Valencia, Valencia, Spain
| | - Jesús F García-Gavilán
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, 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
| | - Mireia Malcampo
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain
- Unit of Cardiovascular Risk and Nutrition, Institut Hospital del Mar d`Investigació Médica (IMIM), Barcelona, Spain
| | | | - Lucas Tojal-Sierra
- 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
| | - Antonio García Rodríguez
- Division of Preventive Medicine and Public Health, University of Malaga, Institute of Biomedical Research in Málaga (IBIMA-University of Malaga), Málaga, Spain
| | | | - Alice Chaplin
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain
- Research Group on Nutritional Epidemiology & Cardiovascular Physiopathology, Health Research Institute of the Balearic Islands (IdISBa), Palma de Mallorca, Spain
| | - Antonio García-Ríos
- Department of Internal Medicine, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofia University Hospital, University of Cordoba, Cordoba, Spain
| | - Rosa M Bernal-López
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain
- Department of Endocrinology, Virgen de la Victoria Hospital, Málaga Biomedical Research Institute (IBIMA), University of Málaga, Málaga, Spain
| | - José M Santos-Lozano
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain
- Research Unit, Department of Family Medicine, Sevilla Primary Care Health District, Sevilla, Spain
| | - Javier Basterra-Gortari
- 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
- Endocrinology Service, Navarra Hospital Complex, Osasunbidea, Navarro Health Service, Pamplona, Spain
| | - José V Sorlí
- 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, University of Valencia, Valencia, Spain
| | - Michelle Murphy
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, 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
| | - Griselda Gasulla
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain
- Unit of Cardiovascular Risk and Nutrition, Institut Hospital del Mar d`Investigació Médica (IMIM), Barcelona, Spain
| | - Víctor Micó
- Cardiometabolic Health Group, Precision Nutrition and Cardiometabolic Health Program, IMDEA Food, CEI UAM + CSIC, Madrid, Spain
| | - Itziar Salaverria-Lete
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, 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
| | - Estibaliz Goñi Ochandorena
- 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
| | - Nancy Babio
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, 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
| | - Xavier Herraiz
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain
- Unit of Cardiovascular Risk and Nutrition, Institut Hospital del Mar d`Investigació Médica (IMIM), Barcelona, Spain
| | - José M Ordovás
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, 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
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Effects of pharmacological treatment on metabolomic alterations in animal models of depression. Transl Psychiatry 2022; 12:175. [PMID: 35487889 PMCID: PMC9055046 DOI: 10.1038/s41398-022-01947-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2021] [Revised: 04/17/2022] [Accepted: 04/21/2022] [Indexed: 12/16/2022] Open
Abstract
Numerous studies have investigated metabolite alterations resulting from pharmacological treatment in depression models although few quantitative studies explored metabolites exhibiting constant alterations. This study aimed to identify consistently dysregulated metabolites across such studies using a knowledgebase-driven approach. This study was based on 157 studies that identified an assembly of 2757 differential metabolites in the brain, blood, urine, liver, and feces samples of depression models with pharmacological medication. The use of a vote-counting approach to identify consistently upregulated and downregulated metabolites showed that serotonin, dopamine, norepinephrine, gamma-aminobutyric acid, anandamide, tryptophan, hypoxanthine, and 3-methoxytyramine were upregulated in the brain, while quinolinic acid, glutamic acid, 5-hydroxyindoleacetic acid, myo-inositol, lactic acid, and the kynurenine/tryptophan ratio were downregulated. Circulating levels of trimethylamine N-oxide, isoleucine, leucine, tryptophan, creatine, serotonin, valine, betaine, and low-density lipoprotein were elevated. In contrast, levels of alpha-D-glucose, lactic acid, N-acetyl glycoprotein, glutamine, beta-D-glucose, corticosterone, alanine, phenylacetylglycine, glycine, high-density lipoprotein, arachidonic acid, myo-inositol, allantoin, and taurine were decreased. Moreover, 12 metabolites in urine and nine metabolites in the liver were dysregulated after treatment. Pharmacological treatment also increased fecal levels of butyric acid, acetic acid, propionic acid, and isovaleric acid. Collectively, metabolite disturbances induced by depression were reversed by pharmacological treatment. Pharmacological medication reversed the reduction of brain neurotransmitters caused by depression, modulated disturbance of the tryptophan-kynurenine pathway and inflammatory activation, and alleviated abnormalities of amino acid metabolism, energy metabolism, lipid metabolism, and gut microbiota-derived metabolites.
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Mah E, Chen O, Liska DJ, Blumberg JB. Dietary Supplements for Weight Management: A Narrative Review of Safety and Metabolic Health Benefits. Nutrients 2022; 14:nu14091787. [PMID: 35565754 PMCID: PMC9099655 DOI: 10.3390/nu14091787] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2022] [Revised: 04/13/2022] [Accepted: 04/19/2022] [Indexed: 12/15/2022] Open
Abstract
Dietary supplements for weight management include myriad ingredients with thermogenic, lipotropic, satiety, and other metabolic effects. Recently, the safety of this product category has been questioned. In this review, we summarize the safety evidence as well as relevant clinical findings on weight management and metabolic effects of six representative dietary supplement ingredients: caffeine, green tea extract (GTE), green coffee bean extract (GCBE), choline, glucomannan, and capsaicinoids and capsinoids. Of these, caffeine, GTE (specifically epigallocatechin gallate [EGCG]), and choline have recommended intake limits, which appear not to be exceeded when used according to manufacturers’ instructions. Serious adverse events from supplements with these ingredients are rare and typically involve unusually high intakes. As with any dietary component, the potential for gastrointestinal intolerance, as well as possible interactions with concomitant medications/supplements exist, and the health status of the consumer should be considered when consuming these components. Most of the ingredients reviewed also improved markers of metabolic health, such as glucose, lipids, and blood pressure, although the data are limited for some. In summary, weight management supplements containing caffeine, GTE, GCBE, choline, glucomannan, and capsaicinoids and capsinoids are generally safe when taken as directed and demonstrate metabolic health benefits for overweight and obese people.
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Affiliation(s)
- Eunice Mah
- Biofortis Research, Addison, IL 60101, USA
- Correspondence:
| | - Oliver Chen
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA 02111, USA; (O.C.); (J.B.B.)
| | | | - Jeffrey B. Blumberg
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA 02111, USA; (O.C.); (J.B.B.)
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8
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Mani MS, Joshi MB, Shetty RR, DSouza VL, Swathi M, Kabekkodu SP, Dsouza HS. Lead exposure induces metabolic reprogramming in rat models. Toxicol Lett 2020; 335:11-27. [PMID: 32949623 DOI: 10.1016/j.toxlet.2020.09.010] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Revised: 08/14/2020] [Accepted: 09/12/2020] [Indexed: 11/17/2022]
Abstract
Lead is a toxin of great public health concern affecting the young and aging population. Several factors such as age, gender, lifestyle, dose, and genetic makeup result in interindividual variations to lead toxicity mainly due to variations in metabolic consequences. Hence, the present study aimed to examine dose-dependent lead-induced systemic changes in metabolism using rat model by administering specific doses of lead such as 10 (low lead; L-Pb), 50 (moderate lead; M-Pb), and 100 mg/kg (high lead; H-Pb) body weight for a period of one month. Biochemical and haematological analysis revealed that H-Pb was associated with low body weight and feed efficiency, low total protein levels (p ≤ 0.05), high blood lead (Pb-B) levels (p ≤ 0.001), low ALAD (δ-aminolevulinate dehydratase) activity (p ≤ 0.0001), high creatinine (p ≤ 0.0001) and blood urea nitrogen (BUN) (p ≤ 0.01) levels, elevated RBC and WBC counts, reduced haemoglobin and blood cell indices compared to control. Spatial learning and memory test revealed that H-Pb exposed animals presented high latency to the target quadrant and escape platform compared to other groups indicating H-Pb alters cognition function in rats. Histopathological changes were observed in liver and kidney as they are the main target organs of lead toxicity. LC-MS analysis further revealed that Butyryl-L-carnitine (p ≤ 0.01) and Ganglioside GD2 (d18:0/20:0) (p ≤ 0.05) levels were significantly reduced in H-Pb group compared to all groups. Further, pathway enrichment analysis revealed abundance and significantly modulated metabolites associated with oxidative stress pathways. The present study is the first in vivo model of dose-dependent lead exposure for serum metabolite profiling.
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Affiliation(s)
- Monica Shirley Mani
- Department of Radiation Biology and Toxicology, Manipal School of Life Sciences, Manipal Academy of Higher Education, Manipal, Karnataka, India.
| | - Manjunath B Joshi
- Department of Ageing, Manipal School of Life Sciences, Manipal Academy of Higher Education, Manipal, Karnataka, India.
| | - Rashmi R Shetty
- Department of Pathology, Melaka Manipal Medical College, Manipal Academy of Higher Education, Manipal, Karnataka, India.
| | - Venzil Lavie DSouza
- Department of Radiation Biology and Toxicology, Manipal School of Life Sciences, Manipal Academy of Higher Education, Manipal, Karnataka, India.
| | - M Swathi
- Department of Radiation Biology and Toxicology, Manipal School of Life Sciences, Manipal Academy of Higher Education, Manipal, Karnataka, India.
| | - Shama Prasada Kabekkodu
- Department of Cellular and Molecular Biology, Manipal School of Life Sciences, Manipal Academy of Higher Education, Manipal, Karnataka, India.
| | - Herman Sunil Dsouza
- Department of Radiation Biology and Toxicology, Manipal School of Life Sciences, Manipal Academy of Higher Education, Manipal, Karnataka, India.
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Rashvand S, Mobasseri M, Tarighat-Esfanjani A. Effects of Choline and Magnesium Concurrent Supplementation on Coagulation and Lipid Profile in Patients with Type 2 Diabetes Mellitus: a Pilot Clinical Trial. Biol Trace Elem Res 2020; 194:328-335. [PMID: 31385202 DOI: 10.1007/s12011-019-01802-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2019] [Accepted: 06/26/2019] [Indexed: 01/29/2023]
Abstract
Metabolic failure is associated with dyslipidemia and coagulation which can result in a higher risk of cardiovascular disease (CVD) in type 2 diabetes mellitus (T2DM). The aim of this study was to assess the effects of choline and magnesium co-supplementation on lipid profile and coagulation parameters in patients with T2DM. In a randomized, double-blind, placebo-controlled trial, supplements of choline bitartrate (1000 mg), magnesium oxide (500 mg), choline plus magnesium, or placebo were administered for 2 months to 96 diabetic participants of both sexes aged 30-60 years. Anthropometric characteristics, dietary intake, physical activity, serum lipids, and coagulation markers were measured in all subjects. Significant differences were observed in plasminogen activator inhibitor-1 (PAI-1) levels in the magnesium and choline-magnesium groups (p < 0.05). Moreover, tissue plasminogen activator (tPA) levels increased in choline-magnesium groups (p < 0.001). When adjusted for potential confounders, a significant decrease in PAI-1 (p = 0.03) and a marginally significant increase in tPA (p = 0.054) were found in the choline-magnesium group compared with the other groups. Compared with baseline values, there were significant differences in serum magnesium, HDL, and triglycerides (TG) following choline-magnesium co-supplementation (p < 0.05); however, there were no significant differences in serum magnesium, HDL, and TG among the groups (p > 0.05). Overall, concurrent supplementation of magnesium and choline is more effective than either magnesium or choline alone to improve coagulation in subjects with T2DM.
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Affiliation(s)
- Samaneh Rashvand
- Nutrition Research Center, Student Research Committee, School of Nutrition and Food Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Majid Mobasseri
- Endocrine Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Ali Tarighat-Esfanjani
- Nutrition Research Center, School of Nutrition and Food Sciences, Tabriz University of Medical Sciences, Attar Nishabouri St., PO Box 14711, Tabriz, 5166614711, Iran.
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Short-term determination and long-term evaluation of the dietary methionine requirement in adult dogs. Br J Nutr 2020; 123:1333-1344. [PMID: 32100649 DOI: 10.1017/s0007114520000690] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Methionine, an essential sulphur-containing amino acid (SAA), plays an integral role in many metabolic processes. Evidence for the methionine requirements of adult dogs is limited, and we employed the indicator amino acid oxidation (IAAO) method to estimate dietary methionine requirements in Labrador retrievers (n 21). Using semi-purified diets, the mean requirement was 0·55 (95 % CI 0·41, 0·71) g/4184 kJ. In a subsequent parallel design study, three groups of adult Labrador retrievers (n 52) were fed semi-purified diets with 0·55 g/4184 kJ (test diet 1), 0·71 g/4184 kJ (test diet 2) or 1·37 g/4184 kJ (control diet) of methionine for 32 weeks to assess the long-term consequences of feeding. The total SAA content (2·68 g/4184 kJ) was maintained through dietary supplementation of cystine. Plasma methionine did not decrease in test group and increased significantly on test diet 1 in weeks 8 and 16 compared with control. Reducing dietary methionine did not have a significant effect on whole blood, plasma or urinary taurine or plasma N-terminal pro B-type natriuretic peptide. Significant effects in both test diets were observed for cholesterol, betaine and dimethylglycine. In conclusion, feeding methionine at the IAAO-estimated mean was sufficient to maintain plasma methionine over 32 weeks when total SAA was maintained. However, choline oxidation may have increased to support plasma methionine and have additional consequences for lipid metabolism. While the IAAO can be employed to assess essential amino acid requirements, such as methionine in the dog using semi-purified diets, further work is required to establish safe levels for commercial diet formats.
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Rashvand S, Mobasseri M, Tarighat-Esfanjani A. The Effects of Choline and Magnesium Co-Supplementation on Metabolic Parameters, Inflammation, and Endothelial Dysfunction in Patients With Type 2 Diabetes Mellitus: A Randomized, Double-Blind, Placebo-Controlled Trial. J Am Coll Nutr 2019; 38:714-721. [PMID: 31012803 DOI: 10.1080/07315724.2019.1599745] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Objective: To our knowledge, no study has investigated the effects of choline and magnesium co-supplementation on metabolic parameters, inflammation, and endothelial dysfunction in patients with type 2 diabetes mellitus (T2DM). The aim of this study was investigation of the effects of the choline and magnesium co-supplementation on metabolic parameters, inflammation, and endothelial dysfunction in patients with T2DM.Methods: A randomized double-blind placebo-controlled parallel clinical trial was carried out among 96 diabetic patients. Ninety-six patients were randomly assigned to either choline, magnesium, choline-magnesium, or placebo for 2 months. Anthropometric measurement; metabolic, inflammatory, and endothelial markers; dietary intake; and physical activity were assessed at baseline and after treatment.Results: There was a significant change in serum magnesium in both magnesium and choline-magnesium groups (p < 0.05). Also, significant changes were observed in interleukin (IL)-6 levels in magnesium and choline-magnesium groups (p < 0.05). Moreover, vascular cell adhesion molecule-1 (VCAM-1) levels decreased in choline and choline-magnesium groups (p < 0.05). When adjusted for potential confounders, inflammation and endothelial factors (IL-6 and VCAM-1) decreased significantly in the choline-magnesium group as compared to other groups (p < 0.05). Compared to baseline values there were no significant differences in all anthropometric measurements and metabolic factors among four groups (p > 0.05).Conclusions: Choline and magnesium co-supplementation was more effective in improving inflammation and endothelial dysfunction than supplementation with choline or magnesium alone.
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Affiliation(s)
- Samaneh Rashvand
- Nutrition Research Center, Student Research Committee, School of Nutrition and Food Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Majid Mobasseri
- Professor, Endocrine Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Ali Tarighat-Esfanjani
- Nutrition Research Center, School of Nutrition and Food Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
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Heo G, Ko KS. Long-Term Feeding of Soy Protein Attenuates Choline Deficient-Induced Adverse Effects in Wild Type Mice and Prohibitin 1 Deficient Mice Response More Sensitively. Prev Nutr Food Sci 2019; 24:32-40. [PMID: 31008094 PMCID: PMC6456240 DOI: 10.3746/pnf.2019.24.1.32] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2018] [Accepted: 01/31/2019] [Indexed: 02/06/2023] Open
Abstract
Non-alcoholic fatty liver disease (NAFLD) is the most common chronic liver disease, however the exact cause of NAFLD remains unknown. Methionine, an essential amino acid, is the first limiting amino acid of soy protein, and its deficiency is suggested to cause hepatocyte damage and NAFLD. The objective of this study is to examine the changes in NAFLD susceptibility with soy protein consumption and deterioration due to prohibitin 1 (PHB1) deficiency, an important protein in hepatic mitochondrial function. In this study, liver-specific phb1 +/- mice and wild-type mice were fed a normal diet, choline-deficient diet (CDD), or soy protein diet without choline (SPD) for 16 weeks. Using hematoxylin and eosin staining, we showed that SPD attenuates symptoms of hepatocyte damage and lipid accumulation induced by CDD in mouse liver. The liver damage in mice fed the SPD was alleviated by decreasing lipogenic markers and by increasing anti-inflammatory markers. Furthermore, mRNA expression of genes involved in hepatic methionine metabolism was significantly lower in liver-specific phb1 +/- mice fed with a SPD compared with wild-type mice fed with a SPD. These data suggest a CDD can cause non-alcohol related liver damage, which can be attenuated by a SPD in wild-type mice. These phenomena were not observed in liver-specific phb1 +/- mice. It may therefore be concluded that SPD attenuates CDD-induced liver damage in wild-type mice, and that PHB1 deficiency blocks the beneficial effects of SPD against CDD-induced liver damage.
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Affiliation(s)
- Gieun Heo
- Department of Nutritional Science and Food Management, Ewha Womans University, Seoul 03760, Korea
| | - Kwang Suk Ko
- Department of Nutritional Science and Food Management, Ewha Womans University, Seoul 03760, Korea
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Plasma metabolite profiles in healthy women differ after intervention with supplemental folic acid v. folate-rich foods. J Nutr Sci 2018; 7:e32. [PMID: 30510697 PMCID: PMC6262689 DOI: 10.1017/jns.2018.22] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2018] [Revised: 10/24/2018] [Accepted: 11/01/2018] [Indexed: 12/31/2022] Open
Abstract
Public health authorities recommend all fertile women to increase their folate intake to 400 µg/d by eating folate-rich foods or by taking a folic acid supplement to protect against neural tube defects. In a previous study it was shown that folate-rich foods improved folate blood status as effectively as folic acid supplementation. The aim of the present study was to investigate, using NMR metabolomics, the effects of an intervention with a synthetic folic acid supplement v. native food folate on the profile of plasma metabolites. Healthy women with normal folate status received, in parallel, 500 µg/d synthetic folic acid from a supplement (n 18), 250 µg/d folate from intervention foods (n 19), or no additional folate (0 µg/d) through a portion of apple juice (n 20). The metabolic profile of plasma was measured using 1H-NMR in fasted blood drawn at baseline and after 12 weeks of intervention. Metabolic differences between the groups at baseline and after intervention were assessed using a univariate statistical approach (P ≤ 0·001, Bonferroni-adjusted significance level). At baseline, the groups showed no significant differences in measured metabolite concentrations. After intervention, eight metabolites, of which six (glycine, choline, betaine, formate, histidine and threonine) are related to one-carbon metabolism, were identified as discriminative metabolites. The present study suggests that different folate forms (synthetic v. natural) may affect related one-carbon metabolites differently.
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14
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Ismaeel A. Effects of Betaine Supplementation on Muscle Strength and Power: A Systematic Review. J Strength Cond Res 2018; 31:2338-2346. [PMID: 28426517 DOI: 10.1519/jsc.0000000000001959] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Ismaeel, A. Effects of betaine supplementation on muscle strength and power: a systematic review. J Strength Cond Res 31(8): 2338-2346, 2017-Betaine (BET) has recently gotten much attention for its potential role as an ergogenic aid and has become a common ingredient in peri-workout dietary supplements. The purpose of this systematic review of the literature was to investigate the effects of BET supplementation on muscular strength and power. A computerized literature search of 3 databases (PubMed, MEDLINE, and Scopus) was performed. Included in the review were randomized controlled trials that measured muscle strength, power, or both measures in healthy participants. Quality was assessed using the PEDro scale. Seven trials were identified, and quality assessment showed that all were of "excellent quality." Only 2 of the studies reported increases in strength or power after supplementation with BET. The remaining 5 studies showed no change in any strength or power outcome measures with BET supplementation. This review highlights the lack of evidence for a clear ergogenic effect of BET supplementation on strength and power performance. However, because 2 studies did identify increases of up to 24.61% on strength and power as a result of BET supplementation, additional studies are necessary to evaluate its effectiveness.
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Affiliation(s)
- Ahmed Ismaeel
- Department of Family and Consumer Sciences, Nutrition Sciences, Baylor University, Waco, Texas
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15
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Guilliams TG. MTHFR, Homocysteine and Nutrient Needs. Integr Med (Encinitas) 2018. [DOI: 10.1016/b978-0-323-35868-2.00038-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Tabassum S, Haider S, Ahmad S, Madiha S, Parveen T. Chronic choline supplementation improves cognitive and motor performance via modulating oxidative and neurochemical status in rats. Pharmacol Biochem Behav 2017. [DOI: 10.1016/j.pbb.2017.05.011] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
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Roe AJ, Zhang S, Bhadelia RA, Johnson EJ, Lichtenstein AH, Rogers GT, Rosenberg IH, Smith CE, Zeisel SH, Scott TM. Choline and its metabolites are differently associated with cardiometabolic risk factors, history of cardiovascular disease, and MRI-documented cerebrovascular disease in older adults. Am J Clin Nutr 2017; 105:1283-1290. [PMID: 28356272 PMCID: PMC5445668 DOI: 10.3945/ajcn.116.137158] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2016] [Accepted: 02/27/2017] [Indexed: 12/25/2022] Open
Abstract
Background: There is a potential role of choline in cardiovascular and cerebrovascular disease through its involvement in lipid and one-carbon metabolism.Objective: We evaluated the associations of plasma choline and choline-related compounds with cardiometabolic risk factors, history of cardiovascular disease, and cerebrovascular pathology.Design: A cross-sectional subset of the Nutrition, Aging, and Memory in Elders cohort who had undergone MRI of the brain (n = 296; mean ± SD age: 73 ± 8.1 y) was assessed. Plasma concentrations of free choline, betaine, and phosphatidylcholine were measured with the use of liquid-chromatography-stable-isotope dilution-multiple-reaction monitoring-mass spectrometry. A volumetric analysis of MRI was used to determine the cerebrovascular pathology (white-matter hyperintensities and small- and large-vessel infarcts). Multiple linear and logistic regression models were used to examine relations of plasma measures with cardiometabolic risk factors, history of cardiovascular disease, and radiologic evidence of cerebrovascular pathology.Results: Higher concentrations of plasma choline were associated with an unfavorable cardiometabolic risk-factor profile [lower high-density lipoprotein (HDL) cholesterol, higher total homocysteine, and higher body mass index (BMI)] and greater odds of large-vessel cerebral vascular disease or history of cardiovascular disease but lower odds of small-vessel cerebral vascular disease. Conversely, higher concentrations of plasma betaine were associated with a favorable cardiometabolic risk-factor profile [lower low-density lipoprotein (LDL) cholesterol and triglycerides] and lower odds of diabetes. Higher concentrations of plasma phosphatidylcholine were associated with characteristics of both a favorable cardiometabolic risk-factor profile (higher HDL cholesterol, lower BMI, lower C-reactive protein, lower waist circumference, and lower odds of hypertension and diabetes) and an unfavorable profile (higher LDL cholesterol and triglycerides).Conclusion: Choline and its metabolites have differential associations with cardiometabolic risk factors and subtypes of vascular disease, thereby suggesting differing roles in the pathogenesis of cardiovascular and cerebral large-vessel disease compared with that of small-vessel disease.
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Affiliation(s)
- Annie J Roe
- Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA
| | - Shucha Zhang
- Nutrition Research Institute at the University of North Carolina Chapel Hill, Kannapolis, NC
| | - Rafeeque A Bhadelia
- Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA; and
| | - Elizabeth J Johnson
- Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA
| | - Alice H Lichtenstein
- Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA
| | - Gail T Rogers
- Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA
| | - Irwin H Rosenberg
- Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA
| | - Caren E Smith
- Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA
| | - Steven H Zeisel
- Nutrition Research Institute at the University of North Carolina Chapel Hill, Kannapolis, NC
| | - Tammy M Scott
- Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA;
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Palisi A, Grimaldi M, Sabatini P, Montoro P, Scrima M, Rodriquez M, D'Ursi AM. A serum nuclear magnetic resonance-based metabolomic signature of antiphospholipid syndrome. J Pharm Biomed Anal 2016; 133:90-95. [PMID: 27829500 DOI: 10.1016/j.jpba.2016.11.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2016] [Revised: 10/24/2016] [Accepted: 11/01/2016] [Indexed: 01/03/2023]
Abstract
Antiphospholipid syndrome (APS) is a rheumatic inflammatory chronic autoimmune disease inducing hypercoagulable state associated with vascular thrombosis and pregnancy loss in women. Cardiac, cerebral and vascular strokes in these patients are responsible for reduction in life expectancy. Timely diagnosis and accurate monitoring of disease are decisive to improve the accuracy of therapy. In the present work, we present a NMR-based metabolomic study of blood sera of APS patients. Our data show that individuals suffering APS have a characteristic metabolomic profile with abnormalities associated to the metabolism of methyl group donors, ketone bodies and amino acids. We have identified for the first time the metabolomic fingerprint characterizing APS disease having potential application to improve APS timely diagnosis and appropriate therapeutic approaches.
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Affiliation(s)
- Angelica Palisi
- Department of Pharmacy, University of Salerno, Via Giovanni Paolo II, 132 - 84084 Fisciano, Salerno, Italy
| | - Manuela Grimaldi
- Department of Pharmacy, University of Salerno, Via Giovanni Paolo II, 132 - 84084 Fisciano, Salerno, Italy
| | - Paola Sabatini
- U.O.C. Clinical Pathology D.E.A. III Umberto I, Nocera Inferiore, Salerno, Italy
| | - Paola Montoro
- Department of Pharmacy, University of Salerno, Via Giovanni Paolo II, 132 - 84084 Fisciano, Salerno, Italy
| | - Mario Scrima
- Department of Pharmacy, University of Salerno, Via Giovanni Paolo II, 132 - 84084 Fisciano, Salerno, Italy
| | - Manuela Rodriquez
- Department of Pharmacy, University of Salerno, Via Giovanni Paolo II, 132 - 84084 Fisciano, Salerno, Italy
| | - Anna Maria D'Ursi
- Department of Pharmacy, University of Salerno, Via Giovanni Paolo II, 132 - 84084 Fisciano, Salerno, Italy.
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Choline Supplementation With a Structured Lipid in Children With Cystic Fibrosis: A Randomized Placebo-Controlled Trial. J Pediatr Gastroenterol Nutr 2016; 62:618-26. [PMID: 26465792 PMCID: PMC4805439 DOI: 10.1097/mpg.0000000000001004] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND Choline depletion is seen in cystic fibrosis (CF) and pancreatic insufficiency in spite of enzyme treatment and may result in liver, fatty acid, and muscle abnormalities. This study evaluated the efficacy and safety of an easily absorbed choline-rich structured lipid (LYM-X-SORB™ [LXS]) to improve choline status. METHODS Children with CF and pancreatic insufficiency were randomized to LXS or placebo in a 12-month double blind trial. Dietary choline intake, plasma cholines, plasma and fecal phospholipids, coefficient of fat absorption, pulmonary function, growth status, body composition, and safety measures were assessed. Magnetic resonance spectroscopy for calf muscle choline and liver fat were assessed in a subgroup and compared with a healthy comparison group matched for age, sex, and body size. RESULTS A total of 110 subjects were enrolled (age 10.4 ± 3.0 years). Baseline dietary choline, 88% recommended, increased 3-fold in the LXS group. Plasma choline, betaine, and dimethylglycine increased in the LXS but not placebo (P = 0.007). Plasma lysophosphatidylcholine and phosphatidylcholine increased, and fecal phosphatidylcholine/phosphatidylethanolamine ratio decreased (P ≤ 0.05) in LXS only, accompanied by a 6% coefficient of fat absorption increase (P = 0.001). Children with CF had higher liver fat than healthy children and depleted calf muscle choline at baseline. Muscle choline concentration increased in LXS and was associated with improvement in plasma choline status. No relevant changes in safety measures were evident. CONCLUSIONS LXS had improved choline intake, plasma choline status, and muscle choline stores compared with placebo group. The choline-rich supplement was safe, accepted by participants, and improved choline status in children with CF.
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Associations of gut-flora-dependent metabolite trimethylamine-N-oxide, betaine and choline with non-alcoholic fatty liver disease in adults. Sci Rep 2016; 6:19076. [PMID: 26743949 PMCID: PMC4705470 DOI: 10.1038/srep19076] [Citation(s) in RCA: 205] [Impact Index Per Article: 25.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2015] [Accepted: 12/02/2015] [Indexed: 02/06/2023] Open
Abstract
Many studies suggest that trimethylamine-N-oxide (TMAO), a gut-flora-dependent metabolite of choline, contributes to the risk of cardiovascular diseases, but little is known for non-alcoholic fatty liver disease (NAFLD). We examined the association of circulating TMAO, choline and betaine with the presence and severity of NAFLD in Chinese adults. We performed a hospital-based case-control study (CCS) and a cross-sectional study (CSS). In the CCS, we recruited 60 biopsy-proven NAFLD cases and 35 controls (18–60 years) and determined serum concentrations of TMAO, choline and betaine by HPLC-MS/MS. For the CSS, 1,628 community-based adults (40-75 years) completed the blood tests and ultrasonographic NAFLD evaluation. In the CCS, analyses of covariance showed adverse associations of ln-transformed serum levels of TMAO, choline and betaine/choline ratio with the scores of steatosis and total NAFLD activity (NAS) (all P-trend <0.05). The CSS revealed that a greater severity of NAFLD was independently correlated with higher TMAO but lower betaine and betaine/choline ratio (all P-trend <0.05). No significant choline-NAFLD association was observed. Our findings showed adverse associations between the circulating TMAO level and the presence and severity of NAFLD in hospital- and community-based Chinese adults, and a favorable betaine-NAFLD relationship in the community-based participants.
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Ruxton CHS, Derbyshire E, Toribio-Mateas M. Role of fatty acids and micronutrients in healthy ageing: a systematic review of randomised controlled trials set in the context of European dietary surveys of older adults. J Hum Nutr Diet 2015; 29:308-24. [DOI: 10.1111/jhn.12335] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
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Leermakers ETM, Moreira EM, Kiefte-de Jong JC, Darweesh SKL, Visser T, Voortman T, Bautista PK, Chowdhury R, Gorman D, Bramer WM, Felix JF, Franco OH. Effects of choline on health across the life course: a systematic review. Nutr Rev 2015; 73:500-22. [PMID: 26108618 DOI: 10.1093/nutrit/nuv010] [Citation(s) in RCA: 68] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
CONTEXT 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. OBJECTIVE 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. DATA SOURCES The MEDLINE, Embase, Cochrane Central, Web of Science, PubMed, and Google Scholar databases were searched up to July 2014. DATA EXTRACTION 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. DATA SYNTHESIS There is some observational evidence that choline during pregnancy may be beneficial for the neurological health of the child. In adults, choline may have beneficial effects on cognition, but high-quality (intervention) studies are lacking. Results on the effects of choline on body composition, blood lipids, and cardiovascular health were inconsistent. CONCLUSIONS Evidence to confirm the suggested effects of choline on health in different stages of life is scarce. Potential effects of choline need to be confirmed by intervention studies. Possible harmful effects on cardiometabolic health need careful evaluation.
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Affiliation(s)
- Elisabeth T M Leermakers
- E.T.M. Leermakers, E.M. Moreira, J.C. Kiefte-de Jong, S.K.L. Darweesh, T. Visser, T. Voortman, P.K. Bautista, J.F. Felix, and O.H. Franco are with the Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, the Netherlands. R. Chowdhury and D. Gorman are with the Department of Public Health & Primary Care, Cardiovascular Epidemiology Unit, University of Cambridge, Cambridge, CB1 8RN, United Kingdom. W.M. Bramer is with the Medical Library, Erasmus MC, University Medical Center Rotterdam, the Netherlands
| | - Eduardo M Moreira
- E.T.M. Leermakers, E.M. Moreira, J.C. Kiefte-de Jong, S.K.L. Darweesh, T. Visser, T. Voortman, P.K. Bautista, J.F. Felix, and O.H. Franco are with the Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, the Netherlands. R. Chowdhury and D. Gorman are with the Department of Public Health & Primary Care, Cardiovascular Epidemiology Unit, University of Cambridge, Cambridge, CB1 8RN, United Kingdom. W.M. Bramer is with the Medical Library, Erasmus MC, University Medical Center Rotterdam, the Netherlands
| | - Jessica C Kiefte-de Jong
- E.T.M. Leermakers, E.M. Moreira, J.C. Kiefte-de Jong, S.K.L. Darweesh, T. Visser, T. Voortman, P.K. Bautista, J.F. Felix, and O.H. Franco are with the Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, the Netherlands. R. Chowdhury and D. Gorman are with the Department of Public Health & Primary Care, Cardiovascular Epidemiology Unit, University of Cambridge, Cambridge, CB1 8RN, United Kingdom. W.M. Bramer is with the Medical Library, Erasmus MC, University Medical Center Rotterdam, the Netherlands
| | - Sirwan K L Darweesh
- E.T.M. Leermakers, E.M. Moreira, J.C. Kiefte-de Jong, S.K.L. Darweesh, T. Visser, T. Voortman, P.K. Bautista, J.F. Felix, and O.H. Franco are with the Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, the Netherlands. R. Chowdhury and D. Gorman are with the Department of Public Health & Primary Care, Cardiovascular Epidemiology Unit, University of Cambridge, Cambridge, CB1 8RN, United Kingdom. W.M. Bramer is with the Medical Library, Erasmus MC, University Medical Center Rotterdam, the Netherlands
| | - Thirsa Visser
- E.T.M. Leermakers, E.M. Moreira, J.C. Kiefte-de Jong, S.K.L. Darweesh, T. Visser, T. Voortman, P.K. Bautista, J.F. Felix, and O.H. Franco are with the Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, the Netherlands. R. Chowdhury and D. Gorman are with the Department of Public Health & Primary Care, Cardiovascular Epidemiology Unit, University of Cambridge, Cambridge, CB1 8RN, United Kingdom. W.M. Bramer is with the Medical Library, Erasmus MC, University Medical Center Rotterdam, the Netherlands
| | - Trudy Voortman
- E.T.M. Leermakers, E.M. Moreira, J.C. Kiefte-de Jong, S.K.L. Darweesh, T. Visser, T. Voortman, P.K. Bautista, J.F. Felix, and O.H. Franco are with the Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, the Netherlands. R. Chowdhury and D. Gorman are with the Department of Public Health & Primary Care, Cardiovascular Epidemiology Unit, University of Cambridge, Cambridge, CB1 8RN, United Kingdom. W.M. Bramer is with the Medical Library, Erasmus MC, University Medical Center Rotterdam, the Netherlands
| | - Paula K Bautista
- E.T.M. Leermakers, E.M. Moreira, J.C. Kiefte-de Jong, S.K.L. Darweesh, T. Visser, T. Voortman, P.K. Bautista, J.F. Felix, and O.H. Franco are with the Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, the Netherlands. R. Chowdhury and D. Gorman are with the Department of Public Health & Primary Care, Cardiovascular Epidemiology Unit, University of Cambridge, Cambridge, CB1 8RN, United Kingdom. W.M. Bramer is with the Medical Library, Erasmus MC, University Medical Center Rotterdam, the Netherlands
| | - Rajiv Chowdhury
- E.T.M. Leermakers, E.M. Moreira, J.C. Kiefte-de Jong, S.K.L. Darweesh, T. Visser, T. Voortman, P.K. Bautista, J.F. Felix, and O.H. Franco are with the Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, the Netherlands. R. Chowdhury and D. Gorman are with the Department of Public Health & Primary Care, Cardiovascular Epidemiology Unit, University of Cambridge, Cambridge, CB1 8RN, United Kingdom. W.M. Bramer is with the Medical Library, Erasmus MC, University Medical Center Rotterdam, the Netherlands
| | - Donal Gorman
- E.T.M. Leermakers, E.M. Moreira, J.C. Kiefte-de Jong, S.K.L. Darweesh, T. Visser, T. Voortman, P.K. Bautista, J.F. Felix, and O.H. Franco are with the Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, the Netherlands. R. Chowdhury and D. Gorman are with the Department of Public Health & Primary Care, Cardiovascular Epidemiology Unit, University of Cambridge, Cambridge, CB1 8RN, United Kingdom. W.M. Bramer is with the Medical Library, Erasmus MC, University Medical Center Rotterdam, the Netherlands
| | - Wichor M Bramer
- E.T.M. Leermakers, E.M. Moreira, J.C. Kiefte-de Jong, S.K.L. Darweesh, T. Visser, T. Voortman, P.K. Bautista, J.F. Felix, and O.H. Franco are with the Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, the Netherlands. R. Chowdhury and D. Gorman are with the Department of Public Health & Primary Care, Cardiovascular Epidemiology Unit, University of Cambridge, Cambridge, CB1 8RN, United Kingdom. W.M. Bramer is with the Medical Library, Erasmus MC, University Medical Center Rotterdam, the Netherlands
| | - Janine F Felix
- E.T.M. Leermakers, E.M. Moreira, J.C. Kiefte-de Jong, S.K.L. Darweesh, T. Visser, T. Voortman, P.K. Bautista, J.F. Felix, and O.H. Franco are with the Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, the Netherlands. R. Chowdhury and D. Gorman are with the Department of Public Health & Primary Care, Cardiovascular Epidemiology Unit, University of Cambridge, Cambridge, CB1 8RN, United Kingdom. W.M. Bramer is with the Medical Library, Erasmus MC, University Medical Center Rotterdam, the Netherlands
| | - Oscar H Franco
- E.T.M. Leermakers, E.M. Moreira, J.C. Kiefte-de Jong, S.K.L. Darweesh, T. Visser, T. Voortman, P.K. Bautista, J.F. Felix, and O.H. Franco are with the Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, the Netherlands. R. Chowdhury and D. Gorman are with the Department of Public Health & Primary Care, Cardiovascular Epidemiology Unit, University of Cambridge, Cambridge, CB1 8RN, United Kingdom. W.M. Bramer is with the Medical Library, Erasmus MC, University Medical Center Rotterdam, the Netherlands
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Obeid R. The metabolic burden of methyl donor deficiency with focus on the betaine homocysteine methyltransferase pathway. Nutrients 2013; 5:3481-95. [PMID: 24022817 PMCID: PMC3798916 DOI: 10.3390/nu5093481] [Citation(s) in RCA: 173] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2013] [Revised: 08/15/2013] [Accepted: 08/15/2013] [Indexed: 12/18/2022] Open
Abstract
Methyl groups are important for numerous cellular functions such as DNA methylation, phosphatidylcholine synthesis, and protein synthesis. The methyl group can directly be delivered by dietary methyl donors, including methionine, folate, betaine, and choline. The liver and the muscles appear to be the major organs for methyl group metabolism. Choline can be synthesized from phosphatidylcholine via the cytidine-diphosphate (CDP) pathway. Low dietary choline loweres methionine formation and causes a marked increase in S-adenosylmethionine utilization in the liver. The link between choline, betaine, and energy metabolism in humans indicates novel functions for these nutrients. This function appears to goes beyond the role of the nutrients in gene methylation and epigenetic control. Studies that simulated methyl-deficient diets reported disturbances in energy metabolism and protein synthesis in the liver, fatty liver, or muscle disorders. Changes in plasma concentrations of total homocysteine (tHcy) reflect one aspect of the metabolic consequences of methyl group deficiency or nutrient supplementations. Folic acid supplementation spares betaine as a methyl donor. Betaine is a significant determinant of plasma tHcy, particularly in case of folate deficiency, methionine load, or alcohol consumption. Betaine supplementation has a lowering effect on post-methionine load tHcy. Hypomethylation and tHcy elevation can be attenuated when choline or betaine is available.
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Affiliation(s)
- Rima Obeid
- Department of Clinical Chemistry, University Hospital of the Saarland, D-66424, Homburg, Germany.
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North–south gradients in plasma concentrations of B-vitamins and other components of one-carbon metabolism in Western Europe: results from the European Prospective Investigation into Cancer and Nutrition (EPIC) Study. Br J Nutr 2012; 110:363-74. [DOI: 10.1017/s0007114512004990] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
Different lifestyle patterns across Europe may influence plasma concentrations of B-vitamins and one-carbon metabolites and their relation to chronic disease. Comparison of published data on one-carbon metabolites in Western European regions is difficult due to differences in sampling procedures and analytical methods between studies. The present study aimed, to compare plasma concentrations of one-carbon metabolites in Western European regions with one laboratory performing all biochemical analyses. We performed the present study in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort among 5446 presumptively healthy individuals. Quantile regression was used to compare sex-specific median concentrations between Northern (Denmark and Sweden), Central (France, Germany, The Netherlands and United Kingdom) and Southern (Greece, Spain and Italy) European regions. The lowest folate concentrations were observed in Northern Europe (men, 10·4 nmol/l; women, 10·7 nmol/l) and highest concentrations in Central Europe. Cobalamin concentrations were slightly higher in Northern Europe (men, 330 pmol/l; women, 352 pmol/l) compared with Central and Southern Europe, but did not show a clear north–south gradient. Vitamin B2 concentrations were highest in Northern Europe (men, 22·2 nmol/l; women, 26·0 nmol/l) and decreased towards Southern Europe (Ptrend< 0·001). Vitamin B6 concentrations were highest in Central Europe in men (77·3 nmol/l) and highest in the North among women (70·4 nmol/l), with decreasing concentrations towards Southern Europe in women (Ptrend< 0·001). In men, concentrations of serine, glycine and sarcosine increased from the north to south. In women, sarcosine increased from Northern to Southern Europe. These findings may provide relevant information for the study of regional differences of chronic disease incidence in association with lifestyle.
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