Sex and menopausal status influence human dietary requirements for the nutrient choline.
Level 2 - randomized trial
Controlled feeding depletion-repletion trial with randomized supplementation arm
PubMed 17490963 · doi:10.1093/ajcn/85.5.1275
What was done
In a controlled feeding study, 57 healthy adults (26 men, 16 premenopausal women, and 15 postmenopausal women) consumed a baseline diet providing 550 mg choline per 70 kg body weight daily for 10 days, followed by a choline-depletion diet (<50 mg choline per 70 kg daily) for up to 42 days. Participants were randomized during depletion to receive either a folic acid supplement (400 mcg/day) or no supplement. Organ dysfunction was monitored via blood and urine biomarkers and liver fat was assessed using magnetic resonance imaging. Choline was incrementally re-added to restore normal organ function in affected subjects.
What was found
During choline deprivation, 77% of men and 80% of postmenopausal women developed fatty liver or muscle damage, compared with 44% of premenopausal women. Six men developed signs of organ dysfunction while consuming the baseline Adequate Intake (AI) level of 550 mg/70 kg/day; overall, the AI intake was insufficient to prevent organ dysfunction in 19 subjects. Folic acid supplementation did not alter the response to choline depletion.
Why it matters
This study demonstrates that dietary choline requirements differ significantly by sex and menopausal status, likely driven by estrogen-dependent de novo synthesis, and indicates that current Adequate Intake levels are inadequate for a substantial portion of healthy individuals.
Limits
The total sample size was small (n=57, with subgroups of 15 to 26 individuals). The abstract does not report exact p-values, confidence intervals, or the specific time-to-onset of organ dysfunction across subgroups.
Cited by
- context The recommended dietary intake target for choline is approximately 550 mg per day for adults.