Tier 2
Angela Matthews et al. · British journal of clinical pharmacology · 2002
Pharmacokinetic-pharmacodynamic modelling. The model predicted limited additional homocysteine benefit beyond twice-daily dosing or about 150 mg/kg/day in this setting.
Original sources: DOI · PubMed · Full text
Tier 4
Steven H Zeisel et al. · The Journal of nutrition · 2003
Food-composition analysis. Wheat bran, wheat germ and spinach were among the richest measured betaine sources. Food concentrations varied widely.
Original sources: DOI · PubMed
Tier 4
Akiko Sakamoto et al. · Pediatrics international : official journal of the Japan Pediatric Society · 2002
Food-composition analysis. Wheat-based foods contained substantial betaine, but food amounts were far below specialist therapeutic doses used for homocystinuria.
Original sources: DOI · PubMed
Tier 4
A Sakamoto et al. · Pediatrics international : official journal of the Japan Pediatric Society · 2001
Milk and formula composition study. Betaine was detected in breast milk and standard formula but not at amounts equivalent to homocystinuria therapy.
Original sources: DOI · PubMed
Tier 2
Edel M Keaveney et al. · The British journal of nutrition · 2015
Randomized crossover controlled trial. All betaine-rich wheat fractions raised plasma betaine; minimally processed aleurone produced an earlier peak than aleurone bread.
Original sources: DOI · PubMed
Tier 2
Ruth K Price et al. · The Journal of nutrition · 2010
Randomized food intervention. Blood betaine increased and homocysteine fell modestly; LDL cholesterol also decreased.
Original sources: DOI · PubMed
Tier 2
Alastair B Ross et al. · The British journal of nutrition · 2011
Crossover food intervention. Whole grains increased blood betaine. Total and LDL cholesterol showed nonsignificant trends, and homocysteine did not change.
Original sources: DOI · PubMed
Tier 4
Witold Streb et al. · Nutrients · 2025
Dietary-questionnaire validation. The questionnaire identified dietary patterns potentially useful for assessing TMAO-related food exposure.
Original sources: DOI · PubMed · Full text
Tier 4
Vanessa L Mygind et al. · Asia Pacific journal of clinical nutrition · 2013
Dietary survey. Average estimated betaine intake was about 178 mg/day, largely from cereal products and selected root vegetables.
Original sources: DOI · PubMed
Tier 4
Da-Ming Chu et al. · Asia Pacific journal of clinical nutrition · 2012
Population dietary survey. Estimated betaine intake and leading food sources differed from Western populations, with leafy vegetables and wheat products contributing substantially.
Original sources: PubMed
Tier 4
Kim M Yonemori et al. · The Journal of nutrition · 2013
Dietary database and cohort intake analysis. Estimated choline and betaine intakes varied by sex and ethnic group; database matching made population-level intake analysis feasible.
Original sources: DOI · PubMed · Full text
Tier 4
Svetlana V Konstantinova et al. · The American journal of clinical nutrition · 2008
Cross-sectional cohort analysis. High-fiber bread and several related nutrients predicted higher circulating betaine, whereas a Western dietary pattern predicted lower concentrations.
Original sources: DOI · PubMed
Tier 4
Peiyan Chen et al. · The British journal of nutrition · 2025
Longitudinal dietary survey. Choline intake increased over time, while betaine intake remained relatively stable. Major food sources changed with dietary patterns.
Original sources: DOI · PubMed
Tier 4
Eunyoung Cho et al. · The American journal of clinical nutrition · 2006
Cross-sectional cohort analysis. Higher combined intake was associated with lower homocysteine, particularly when folate intake was low.
Original sources: DOI · PubMed · Full text
Tier 4
Jung Eun Lee et al. · The American journal of clinical nutrition · 2010
Cross-sectional cohort analysis. Higher intake was associated with lower homocysteine mainly at lower folate/B12 status; the association was absent after fortification.
Original sources: DOI · PubMed · Full text
Tier 2
Aurelian Bidulescu et al. · Nutrition journal · 2009
Dietary reliability study. Dietary measurement reliability was moderate and error was substantial, including for combined choline-plus-betaine intake.
Original sources: DOI · PubMed · Full text
Tier 2
Julie M W Wallace et al. · The British journal of nutrition · 2012
Randomized controlled trial. Choline supplementation increased circulating choline and betaine without changing lipids. The homocysteine comparison was only a nonsignificant trend.
Original sources: DOI · PubMed
Tier 2
Margreet R Olthof et al. · The American journal of clinical nutrition · 2005
Randomized crossover controlled trial. Fasting and methionine-load homocysteine were lower during high-dose phosphatidylcholine supplementation.
Original sources: DOI · PubMed
Tier 2
Katrin A Böckmann et al. · European journal of nutrition · 2022
Randomized crossover controlled trial. All forms raised betaine; absorption timing differed. Water-soluble choline forms increased TMAO more rapidly than egg phosphatidylcholine.
Original sources: DOI · PubMed · Full text
Tier 2
Katrin A Böckmann et al. · European journal of nutrition · 2023
Randomized isotope-labelled crossover trial. Choline forms produced different timing and metabolite patterns; phosphatidylcholine generated little labelled TMAO in this experiment.
Original sources: DOI · PubMed · Full text
Tier 2
A Q Zhang et al. · Food and chemical toxicology : an international journal published for the British Industrial Biological Research Association · 1999
Human precursor-challenge pilot. Choline, carnitine and TMAO increased urinary trimethylamine-related products, while betaine did not produce a significant increase in this experiment.
Original sources: DOI · PubMed
Tier 2
Michaela Minarski et al. · Nutrients · 2023
Secondary analysis of an infant nutrition RCT. Blood choline and betaine tracked enteral choline intake; supplied choline did not reproduce fetal-like concentrations.
Original sources: DOI · PubMed · Full text
Tier 2
Chenghao Zhu et al. · Nutrition research (New York, N.Y.) · 2020
Randomized crossover controlled trial. Whole eggs increased plasma choline and betaine without a significant TMAO or overall microbiome change.
Original sources: DOI · PubMed
Tier 2
Giuseppina Costabile et al. · Nutrition, metabolism, and cardiovascular diseases : NMCD · 2022
Randomized crossover controlled trial. The aleurone diet raised plasma betaine and lowered an oxidative-stress marker but did not improve glucose, insulin, triglycerides or homocysteine.
Original sources: DOI · PubMed
Tier 2
Francesca Fava et al. · European journal of nutrition · 2022
Randomized controlled trial. Some microbiome and metabolite measures changed, but homocysteine and conventional cardiovascular biomarkers did not improve.
Original sources: DOI · PubMed · Full text
Tier 3
Lucia Trapanese et al. · Food science of animal resources · 2026
Systematic bibliometric review. The analysis mapped research on ruminant metabolism, infant nutrition and proposed adult-health applications.
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Tier 2
Wendy Atkinson et al. · European journal of nutrition · 2007
Randomized crossover controlled trial. Proline betaine exposure increased its blood and urine concentrations but had little effect on homocysteine.
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Tier 2
J B Leiper et al. · Scandinavian journal of gastroenterology · 1989
Randomized intestinal perfusion experiment. Betaine was absorbed, but adding it did not improve water or solute absorption.
Original sources: DOI · PubMed
Tier 2
K J Storch et al. · The American journal of clinical nutrition · 1991
Controlled metabolic feeding study. Oral tracer estimates suggested changes in methionine methylation and oxidation, while intravenous tracer estimates did not show the same effect.
Original sources: DOI · PubMed
Tier 2
Wu-Ping Sun et al. · Clinical nutrition (Edinburgh, Scotland) · 2017
Randomized acute challenge. Nicotinamide produced larger homocysteine and methylated-metabolite increases and a larger betaine decrease than nicotinic acid.
Original sources: DOI · PubMed
Tier 2
Megan N Hall et al. · The Journal of nutrition · 2016
RCT secondary analysis. Folic acid raised betaine and reduced dimethylglycine; creatine did not produce the same changes.
Original sources: DOI · PubMed · Full text
Tier 2
Anne K Bozack et al. · European journal of nutrition · 2021
RCT secondary analysis. Lower baseline betaine was associated with a larger arsenic-methylation response to folic acid.
Original sources: DOI · PubMed · Full text
Tier 4
Stephen J Bruce et al. · Journal of agricultural and food chemistry · 2010
Analytical validation and food-composition study. The method quantified betaine in foods and plasma; whole-grain wheat and rye products were notable food sources.
Original sources: DOI · PubMed