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Background: Cardiovascular disease is the most important cause of human mortality in the world. Higher intakes of choline and betaine are indicated to be associated with lower plasma homocysteine levels. This study aimed to review the evidence of the relationship between dietary intakes of choline and betaine and the traditional/novel CVD risk factors.   Methods: The PubMed was searched from 1990 to 2009, with the use of "dietary choline and betaine, cardiovascular disease, metabolic syndrome, inflammation" as the search engine. The cross-sectional and prospective studies together with clinical trials were recruited in this investigation.   Findings: Dietary intakes of choline/choline and betaine were not significantly associated with CVD risk; but the higher intakes of choline and betaine were associated with higher serum concentrations of CRP, IL-6 and TNF-α. Individuals with a high plasma choline levels were obese and had elevated plasma triglycerides, HDL and non HDL cholesterol levels; whereas high plasma betaine levels were inversely associated with these biochemical markers. Both choline and betaine supplementation resulted in the increased blood lipid profiles.   Conclusion: Although dietary intakes of choline and betaine were not significantly associated with CVD incidence, the long term consumption of these nutrients is shown to prevent CVD mortality by decreasing inflammation and the other risk factors.   Key Words: Choline, Betaine, Cardiovascular Disease, Metabolic Syndrome, Inflammation

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