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Mediterranean Diet Reduces Inflammation

People whose diets supplied the highest average intake of choline (found in egg yolk and soybeans), and its metabolite betaine (found naturally in vegetables such as beets and spinach), have levels of inflammatory markers at least 20% lower than subjects with the lowest average intakes, report Greek researchers in the American Journal of Clinical Nutrition (Detopoulou P, Panagiotakos DB, et al.)

Compared to those whose diets contained <250 mg/day of choline, subjects whose diets supplied >310 mg of choline daily had, on average:

  • 22% lower concentrations of C-reactive protein
  • 26% lower concentrations of interleukin-6
  • 6% lower concentrations of tumor necrosis factor alpha

Compared to those consuming <260 mg/day of betaine, subjects whose diets provided >360 mg per day of betaine had, on average:

  • 10% lower concentrations of homocysteine
  • 19% lower concentrations of C-reactive protein
  • 12% lower concentrations of tumor necrosis factor alpha

    Each of these markers of chronic inflammation has been linked to a wide range of conditions including heart disease, osteoporosis, cognitive decline and Alzheimer's, and type-2 diabetes.

    In an accompanying editorial in the American Journal of Clinical Nutrition entitled, "Is there a new component of the Mediterranean diet that reduces inflammation?," Steven Zeisel from the University of North Carolina at Chapel Hill noted that choline and betaine work together in the cellular process of methylation, which is not only responsible for the removal of homocysteine, but is involved in turning off the promoter regions of genes involved in inflammation.

    "Exposure to oxidative stress is a potent trigger for inflammation. Betaine is formed from choline within the mitochondria , and this oxidation contributes to mitochondrial redox status ," Zeisel continued.

    "If the association between choline and betaine and inflammation can be confirmed in studies of other populations, an interesting new dietary approach may be available for reducing chronic diseases associated with inflammation," he concluded.

    Recommended daily intakes of choline were set in 1998 at 550 milligrams per day for men and 425 milligrams a day for women. No RDI has been set for betaine, which, since it is a metabolite of choline, is not considered an essential nutrient.

    Practical Tip: Egg yolks are the richest source of choline, followed by soybeans. Spinach, beets and whole wheat products are primary sources of betaine. (Olthof MR, van Vliet T, et al. J Nutr)

    Detopoulou P, Panagiotakos DB, Antonopoulou S, Pitsavos C, Stefanadis C. Dietary choline and betaine intakes in relation to concentrations of inflammatory markers in healthy adults: the ATTICA study. Am J Clin Nutr. 2008 Feb;87(2):424-30.

    Zeisel SH. Is there a new component of the Mediterranean diet that reduces inflammation? Am J Clin Nutr. 2008 Feb;87(2):277-8.

    Olthof MR, van Vliet T, Boelsma E, Verhoef P. Low dose betaine supplementation leads to immediate and long term lowering of plasma homocysteine in healthy men and women. J Nutr. 2003 Dec;133(12):4135-8.

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