title: Dietary Choline Intake Is Directly Associated with Bone Mineral Density in the Hordaland Health Study.
abstract: Background:Choline is an important nutrient either obtained from a variety of foods or synthesized endogenously, and it is the precursor of betaine. We previously reported positive associations between plasma free choline and bone mineral density (BMD). Animal studies suggest an impact of dietary choline on bone metabolism, but the role of dietary intake of choline and betaine for human bone health is unknown.Objectives:The main aims were to examine the associations of dietary choline, choline species, and betaine with BMD and to study the relations between dietary and plasma free choline and betaine.Methods:Study subjects were participants in the Hordaland Health Study, including 2649 women and 1983 men (aged 46-49 or 71-74 y). BMD was measured by dual-energy X-ray absorptiometry, and dietary intake was obtained by using a validated 169-item food-frequency questionnaire. Risk associations were assessed by logistic regression and correlations by ρ (Spearman's bivariate rank order correlation).Results:Subjects in the lowest compared with the highest tertile of dietary total choline, free choline, glycerophosphocholine, phosphocholine, phosphatidylcholine, and sphingomyelin had a higher risk of low-femoral neck BMD, defined as the lowest BMD quintile. Particularly strong associations were found among middle-aged men for intake of free choline (OR: 1.83; 95% CI: 1.24, 2.69;P= 0.002) and glycerophosphocholine (OR: 2.13; 95% CI: 1.43, 3.16;P< 0.001) and among elderly women for total choline (OR: 1.96; 95% CI: 1.33, 2.88;P= 0.001) and phosphatidylcholine (OR: 1.94; 95% CI: 1.33, 2.84:P= 0.001) intake. No significant associations were observed between dietary betaine and BMD. Dietary total choline, free choline, glycerophosphocholine, phosphatidylcholine, and sphingomyelin correlated weakly with plasma free choline (ρ: 0.07, 0.05, 0.07, 0.07, and 0.05, respectively;P< 0.01). Dietary betaine correlated with plasma betaine (ρ: 0.23;P< 0.001).Conclusion:Dietary choline was positively associated with BMD in middle-aged and elderly participants.
authors.affiliation: Departments of Rheumatology and jannike.oyen@nifes.no.|Department of Global Public Health and Primary Care.|National Institute of Nutrition and Seafood Research, Bergen, Norway.
authors.forename: Jannike
authors.identifier: 0000-0002-5590-5136
authors.initials: J
authors.lastname: Øyen
authors.affiliation: Departments of Rheumatology and.|Department of Clinical Science, and.
authors.forename: Clara Gram
authors.initials: CG
authors.lastname: Gjesdal
authors.affiliation: Department of Clinical Science, and.
authors.forename: Therese
authors.initials: T
authors.lastname: Karlsson
authors.affiliation: Heart Disease and.
authors.forename: Gard Ft
authors.initials: GF
authors.lastname: Svingen
authors.affiliation: Department of Global Public Health and Primary Care.
authors.forename: Grethe S
authors.identifier: 0000-0003-1386-1638
authors.initials: GS
authors.lastname: Tell
authors.affiliation: Department of Clinical Science, and.
authors.forename: Elin
authors.initials: E
authors.lastname: Strand
authors.affiliation: Department of Nutrition, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Oslo, Norway; and.
authors.forename: Christian A
authors.identifier: 0000-0002-7216-2784
authors.initials: CA
authors.lastname: Drevon
authors.affiliation: Department of Nutrition, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Oslo, Norway; and.
authors.forename: Kathrine J
authors.initials: KJ
authors.lastname: Vinknes
authors.affiliation: BEVITAL AS, Bergen, Norway.
authors.forename: Klaus
authors.initials: K
authors.lastname: Meyer
authors.affiliation: Department of Clinical Science, and.|Laboratory of Clinical Biochemistry, Haukeland University Hospital, Bergen, Norway.
authors.forename: Per Magne
authors.initials: PM
authors.lastname: Ueland
authors.affiliation: Heart Disease and.|KG Jebsen Centre for Diabetes Research, Department of Clinical Science, University of Bergen, Bergen, Norway.
authors.forename: Ottar
authors.initials: O
authors.lastname: Nygård
mesh_terms: D000368:Aged; D000375:Aging; D015519:Bone Density / Q000502:physiology*; D002794:Choline / Q000008:administration & dosage*; D004032:Diet; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio
chemical_list: D002794:Choline
keywords: bone mineral density; community-dwelling participants; dietary betaine; dietary choline; glycerophosphocholine; phosphatidylcholine; phosphocholine; plasma betaine; plasma choline; sphingomyelin