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The purpose of this research is to determine whether extra betaine and choline influence metabolic health in adults with overweight and obesity.
Betaine (N,N,N-trimethylglycine or also glycine betaine) is a derivative of choline that functions as an organic osmolyte and participates in one-carbon metabolism as a methyl donor. Betaine is naturally found in beets, wheat and spinach and sold as a food supplement without prescription. Choline is recognized as an essential nutrient that is found in various foods including eggs, nuts and beef, with the major form of choline in food found as phosphatidylcholine. In addition to being oxidized to the methyl donor betaine, choline is a precursor of several compounds involved in neurotransmitter synthesis, lipid metabolism and transport as well as the structural integrity and signaling of cell membranes. Previous studies have reported alterations in one-carbon metabolites in response to a single meal containing different forms of choline, with interindividual variability dependent on genetics and gut microbiota composition. This study will extend to longer-term impact of different forms of choline (betaine as oxidized choline and choline provided from food) with a focus on overweight and obesity, which comprise a predominant portion of the population in North America. The objective of this study is to determine the effect of betaine supplementation with or without food-form choline (eggs) on metabolic health in adults with overweight and obesity. A randomized crossover study design will be employed, which men and women of age 18-70 years with BMI 25-35 kg/m2 will participate in a 14-week study consisting of three 4-week dietary periods: 1) daily consumption of 3 grams of betaine supplement with no eggs; 2) daily consumption of 3 grams of betaine supplement with 3 whole eggs; and 3) daily consumption of 3 grams of cellulose supplement with no eggs, in a random order, each dietary period separated by a 1-week washout break. Blood, urine and fecal samples as well as anthropometric measurements will be collected at baseline, then at weeks 4, 9 and 14. The collected biological samples will be used to measure glucose and lipid markers, one-carbon metabolites and profiling of gut microbiota and genotype to determine interindividual differences in metabolism.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Daily 3 whole eggs with daily supplement containing 3 g trimethylglycine | Experimental |
| |
| Experimental: No eggs with daily supplement containing 3 g trimethylglycine | Experimental |
| |
| Placebo Comparator: No eggs with daily supplement containing 3 g cellulose | Placebo Comparator |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Trimethylglycine | Dietary Supplement | Betaine anhydrous from sugar beets |
|
| Measure | Description | Time Frame |
|---|---|---|
| Lipid panel | Triglyceride, cholesterol and lipoprotein concentrations | Weeks 0, 4, 9 and 14 |
| Glucose concentrations | Concentrations of glucose as mol units per volume | Weeks 0, 4, 9 and 14 |
| Insulin concentrations | Concentrations of insulin as international units per volume | Weeks 0, 4, 9 and 14 |
| Concentrations of glucose metabolism panel | Concentrations of C-peptide, GLP-1 and GIP as mol units per volume | Weeks 0, 4, 9 and 14 |
| Body mass | Mass on a scale | Weeks 0, 4, 9 and 14 |
| One-carbon metabolism panel | Choline metabolite concentrations | Weeks 0, 4, 9 and 14 |
| Measure | Description | Time Frame |
|---|---|---|
| Gene expression | Global gene expression in isolated immune cells | Weeks 0, 4, 9 and 14 |
| Inflammatory response in immune cells | Expression of cytokines in immune cells as assessed in response to lipopolysaccharide challenge |
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Inclusion Criteria:
Exclusion Criteria:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Human Nutraceutical Research Unit | Guelph | Ontario | N1G 2W1 | Canada |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 19906248 | Background | Zeisel SH, da Costa KA. Choline: an essential nutrient for public health. Nutr Rev. 2009 Nov;67(11):615-23. doi: 10.1111/j.1753-4887.2009.00246.x. | |
| 30853718 | Background | Wallace TC, Blusztajn JK, Caudill MA, Klatt KC, Natker E, Zeisel SH, Zelman KM. Choline: The Underconsumed and Underappreciated Essential Nutrient. Nutr Today. 2018 Nov-Dec;53(6):240-253. doi: 10.1097/NT.0000000000000302. Epub 2018 Nov 13. |
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| ID | Term |
|---|---|
| D009765 | Obesity |
| D050177 | Overweight |
| ID | Term |
|---|---|
| D044343 | Overnutrition |
| D009748 | Nutrition Disorders |
| D009750 | Nutritional and Metabolic Diseases |
| D001835 | Body Weight |
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| ID | Term |
|---|---|
| D001622 | Betaine |
| D004531 | Eggs |
| D002482 | Cellulose |
| ID | Term |
|---|---|
| D050337 | Trimethyl Ammonium Compounds |
| D000644 | Quaternary Ammonium Compounds |
| D000588 | Amines |
| D009930 | Organic Chemicals |
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Supplements will be double-blinded, which the order of dietary periods will not be revealed to participants until after the study is completed. Care provider, investigator and outcomes assessor who will be involved in collecting study data will not know the supplement assignment.
| Eggs | Other | 3 whole eggs |
|
| Cellulose | Dietary Supplement | Cellulose |
|
| Weeks 0, 4, 9 and 14 |
| Composition of the gut microbiota | Gut microbiota profiles as assessed by sequencing technologies | Weeks 0, 4, 9 and 14 |
| Characterization of single nucleotide polymoprhisms | Allelic discrimination of variants in enzymes that influence choline metabolites | Week 0 |
| Liver health panel | ALT, AST, GGT, ALP and bilirubin concentrations | Weeks 0, 4, 9 and 14 |
| Blood cell counts | Complete counts of white blood cell, red blood cell, hemoglobin, hematocrit and platelet | Weeks 0, 4, 9 and 14 |
| Blood pressure | Systolic and diastolic blood pressure | Weeks 0, 4, 9 and 14 |
| Dietary intake | 24-hour prior day food record | Weeks 0, 4, 9 and 14 |
| 20346934 | Background | Lever M, Slow S. The clinical significance of betaine, an osmolyte with a key role in methyl group metabolism. Clin Biochem. 2010 Jun;43(9):732-44. doi: 10.1016/j.clinbiochem.2010.03.009. Epub 2010 Mar 25. |
| 15321791 | Background | Craig SA. Betaine in human nutrition. Am J Clin Nutr. 2004 Sep;80(3):539-49. doi: 10.1093/ajcn/80.3.539. |
| 27377678 | Background | Cho CE, Taesuwan S, Malysheva OV, Bender E, Tulchinsky NF, Yan J, Sutter JL, Caudill MA. Trimethylamine-N-oxide (TMAO) response to animal source foods varies among healthy young men and is influenced by their gut microbiota composition: A randomized controlled trial. Mol Nutr Food Res. 2017 Jan;61(1). doi: 10.1002/mnfr.201600324. Epub 2016 Aug 3. |
| 32722424 | Background | Cho CE, Aardema NDJ, Bunnell ML, Larson DP, Aguilar SS, Bergeson JR, Malysheva OV, Caudill MA, Lefevre M. Effect of Choline Forms and Gut Microbiota Composition on Trimethylamine-N-Oxide Response in Healthy Men. Nutrients. 2020 Jul 25;12(8):2220. doi: 10.3390/nu12082220. |
| D012816 |
| Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D009861 |
| Onium Compounds |
| D005502 | Food |
| D000066888 | Diet, Food, and Nutrition |
| D010829 | Physiological Phenomena |
| D019602 | Food and Beverages |
| D005936 | Glucans |
| D001704 | Biopolymers |
| D011108 | Polymers |
| D046911 | Macromolecular Substances |
| D011134 | Polysaccharides |
| D002241 | Carbohydrates |
| D001697 | Biomedical and Dental Materials |
| D008420 | Manufactured Materials |
| D013676 | Technology, Industry, and Agriculture |