Written by Jessica Patella, ND. Based on a169-item food frequency questionnaire, completed by 2649 American women and 1983 American men, this study demonstrated a positive correlation between dietary choline intake and bone density.

bone healthCholine is an important nutrient found in meat, milk, grains, egg and fish 1,2. Previous research as shown blood levels of choline are related to bone mineral density, but the following is the first study to look at dietary choline in relation to bone mineral density 1.

Adequate intake of choline in the United States is 425 mg/day for women and 550 mg/day for men; however research suggests dietary intake of choline may be inadequate 1,3. Low intake of choline has been associated with liver fat accumulation, liver and muscle damage and impaired mental functioning 1,4,5.

Participants in the study included 2649 women and 1983 men (aged 46-49 and 71-74 respectively). All participants completed a 169-item food frequency questionnaire to determine their dietary intake of choline. Bone mineral density was measured by dual-energy X-ray (absorptiometry), more commonly known as a DXA or DEXA scan 1.

Results of the study showed average intakes of choline were far below the recommended adequate intake levels:

WomenMen
Middle-aged group (46-49 years)255 mg/day259 mg/day
Elderly-aged group (71-74)265 mg/day258 mg/day
Adequate Intake recommended425 mg/day550 mg/day

Dietary choline was positively correlated with intakes of meat, fish, eggs, milk, fiber, calcium and protein, but negatively associated with the intake of carbohydrates and fat 1.

Participants in the lowest tertile of dietary total choline (about 250 mg/day or less) were more likely to have low bone mineral density than those in the highest tertile (about 350 mg/day or more) 1. The strongest association was observed for intakes of free choline (OR: 1.83; 95% CI:1.24, 2.69; P=0.002) (1). Dietary intake of choline was also associated with blood levels of choline among middle-aged and elderly men (p:0.08 and 0.06 respectively; P<0.05), but not among women 1.

In conclusion, dietary intake of choline was positively associated with bone mineral density and blood levels of choline among middle-aged and elderly participants 1. These results indicate dietary choline has an effect on choline blood levels and dietary intervention should be considered for bone density 1.

Source: Øyen, Jannike, Clara Gram Gjesdal, Therese Karlsson, Gard FT Svingen, Grethe S. Tell, Elin Strand, Christian A. Drevon et al. “Dietary Choline Intake Is Directly Associated with Bone Mineral Density in the Hordaland Health Study.” The Journal of Nutrition 147, no. 4 (2017): 572-578.

© 2017 American Society for Nutrition

Posted August 3, 2017.

Jessica Patella, ND, is a naturopathic physician specializing in nutrition and homeopathic medicine and offers a holistic approach to health.  She earned her ND from Southwest College of Naturopathic Medicine in Tempe, AZ, and is a member of the North Carolina Association of Naturopathic Physicians.  Visit her website at www.awarenesswellness.com.

References:

  1. Øyen J, Gjesdal CG, Karlsson T, et al. Dietary Choline Intake Is Directly Associated with Bone Mineral Density in the Hordaland Health Study. The Journal of Nutrition. 2017;147(4):572-578.
  2. Vennemann FB, Ioannidou S, Valsta LM, et al. Dietary intake and food sources of choline in European populations. British journal of nutrition. 2015;114(12):2046-2055.
  3. Wallace TC, Fulgoni III VL. Assessment of total choline intakes in the United States. Journal of the American College of Nutrition. 2016;35(2):108-112.
  4. Fischer LM, da Costa K-A, Kwock L, Galanko J, Zeisel SH. Dietary choline requirements of women: effects of estrogen and genetic variation. The American journal of clinical nutrition. 2010;92(5):1113-1119.
  5. Poly C, Massaro JM, Seshadri S, et al. The relation of dietary choline to cognitive performance and white-matter hyperintensity in the Framingham Offspring Cohort. The American journal of clinical nutrition. 2011;94(6):1584-1591.