Assessment of Dietary Choline Intake, Contributing Food Items, and Associations with One-Carbon and Lipid Metabolites in Middle-Aged and Elderly Adults: The Hordaland Health Study

Abstract

Background Choline is an essential nutrient for humans and is involved in various physiological functions. Through its metabolite betaine, it is closely connected to the one-carbon metabolism and the fat-soluble choline form phosphatidylcholine is essential for very-low-density-lipoprotein synthesis and secretion in the liver connecting choline to the lipid metabolism. Dietary recommendations for choline are not available in the Nordic countries primarily due to data scarcity. Objective The aim of this study was to investigate the dietary intake of total choline and individual choline forms, dietary sources, and the association of total choline intake with circulating one-carbon metabolites and lipids. Methods We included 5746 participants in the Hordaland Health Study (HUSK), a survey including community-dwelling adults born in 1925–1927 (mean age 72 years, 55% women) and 1950–1951 (mean age 48 years, 57% women). Dietary data was obtained using a 169-item food frequency questionnaire and choline content was calculated using the USDA Database for Choline Content of Common Foods, release 2. Metabolites of the one-carbon and lipid metabolism were measured in a non-fasting blood sample obtained at baseline and association with total choline intake were assessed using polynomial splines. Results The geometric mean (95% prediction interval) energy-adjusted total choline intake was 260 (170, 389) mg/d with phosphatidylcholine being the main form (44%). The major food items providing dietary choline were eggs, low-fat milk, potatoes, and leafy vegetables. Dietary total choline was inversely associated with circulating concentrations of total homocysteine, glycine and serine and positively associated with choline, methionine, cystathionine, cysteine, trimethyllysine, trimethylamine-N-oxide and dimethylglycine. A weak association was observed between choline intake and serum lipids. Conclusion Phosphatidylcholine was the most consumed choline form in community-dwelling adults in Norway. Our findings suggest that choline intake is associated with the concentration of most metabolites involved in the one-carbon and lipid metabolism.

Changes in Choline Metabolites and Ceramides in Response to a DASH-Style Diet in Older Adults

“…At baseline, males had higher plasma DMG (p = 0.001) and methionine (p = 0.003) compared to females and at week 12 the higher plasma DMG (p < 0.001) in males remained (Table 3). A community-based study conducted by Van Parys et al in western Norway found that both middle-aged and elderly males had higher plasma methionine compared to females with a choline intake of 260 mg per day assessed by FFQs [72]. Unlike the present study, there were no changes in plasma DMG reported between males and females.…”

Dietary choline intake in European and non-european populations: current status and future trends—a narrative review

“…It should be noticed that the great majority of the identified studies released after 2015 are based on data obtained in previous decades (1992–2015), and cannot be relied on in discussing current trends in choline intake. The studies were conducted in nine European countries only: Poland [ 18 , 24 , 26 , 34 ], Norway [ 17 , 28 ], Germany [ 13 ], Spain [ 27 ], Sweden [ 54 ] Romania [ 31 ], Belgium [ 33 ], Italy [ 66 ] and the United Kingdom [ 35 ]. Eight studies have reported choline intake in adults [ 17 , 18 , 24 , 27 , 28 , 54 , 66 ], one study measured choline intake in children [ 31 ], and four studies have recorded choline intake in pregnant women [ 13 , 33 – 35 ].…”

“…The studies were conducted in nine European countries only: Poland [ 18 , 24 , 26 , 34 ], Norway [ 17 , 28 ], Germany [ 13 ], Spain [ 27 ], Sweden [ 54 ] Romania [ 31 ], Belgium [ 33 ], Italy [ 66 ] and the United Kingdom [ 35 ]. Eight studies have reported choline intake in adults [ 17 , 18 , 24 , 27 , 28 , 54 , 66 ], one study measured choline intake in children [ 31 ], and four studies have recorded choline intake in pregnant women [ 13 , 33 – 35 ]. Among the twenty-one studies measuring choline intake in non-European countries, the majority (52%) were conducted in the USA [ 19 , 20 , 25 , 32 , 55 – 57 , 62 – 65 ], while the others were carried out in Palestine [ 58 ], South Africa [ 59 ], Australia [ 36 , 60 ], Mexico [ 23 ], Taiwan [ 16 ], Iran [ 22 , 29 ], Canada [ 21 , 61 ].…”

Relationship between different forms of dietary choline and ovarian cancer survival: findings from the ovarian cancer follow-up study, a prospective cohort study

“…[10][11][12][13] Choline, as an essential nutrient, 14 can be divided into fat-soluble choline ( phosphatidylcholine and sphingomyelin) and water-soluble choline (free choline, phosphocholine, and glycerophosphocholine). 15,16 Choline has important and diverse functions in both cellular maintenance and growth 15,17 that are related to diverse diseases, including neurological disorders, 18 liver diseases, 19 and tumor progression. 20 Deficiency of choline is proposed to have carcinogenic effects, and poten-tial mechanisms include enhanced apoptosis, 14 decreased cell proliferation, 21 increased DNA damage, 22 and altered gene expression.…”