Association between total dietary choline intake and lumbar spine bone mineral density in postmenopausal women based on NHANES 2007–2018

Abstract Postmenopausal estrogen deficiency accelerates bone mineral density (BMD) decline, significantly elevating the risk of osteoporotic fractures. Choline, a vital nutrient involved in lipid homeostasis and inflammatory pathways, has been associated with skeletal health. Yet its role in preserv...

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Main Authors: Jincheng Bai, Penghui Lv, Lu Li, Sichao Cheng, Jianjun Chang
Format: Article
Language:English
Published: Nature Portfolio 2025-07-01
Series:Scientific Reports
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Online Access:https://doi.org/10.1038/s41598-025-08891-6
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author Jincheng Bai
Penghui Lv
Lu Li
Sichao Cheng
Jianjun Chang
author_facet Jincheng Bai
Penghui Lv
Lu Li
Sichao Cheng
Jianjun Chang
author_sort Jincheng Bai
collection DOAJ
description Abstract Postmenopausal estrogen deficiency accelerates bone mineral density (BMD) decline, significantly elevating the risk of osteoporotic fractures. Choline, a vital nutrient involved in lipid homeostasis and inflammatory pathways, has been associated with skeletal health. Yet its role in preserving bone density among postmenopausal populations, a group at high risk of osteoporosis, requires further investigation. This study also examined the modifying effects of socioeconomic factors, including income and race, on the relationship between dietary choline intake and BMD. Using data from 4,160 postmenopausal women aged 50 years and older from the National Health and Nutrition Examination Survey (NHANES) 2007–2018, we employed weighted linear regression models to characterize the dose-response relationship between total dietary choline intake and lumbar spine BMD. In fully adjusted models, each 1 g/day increment in choline intake corresponded to a 0.082 g/cm² increase in lumbar spine BMD (β: 0.082, 95% CI: 0.025–0.139). Participants in the highest choline intake quartile (Q4) exhibited a 0.025 g/cm² higher BMD compared to the lowest quartile (Q1) (β: 0.025, 95% CI: (0.007, 0.042)). Stratified analyses revealed significant effect modifications by obesity (P interaction = 0.015), income (P interaction = 0.003), and race (P interaction = 0.039), with amplified protective effects observed in obese individuals (β: 0.146, 95% CI: 0.067–0.22), high-income subgroups (PIR > 4)(β: 0.121, 95% CI: 0.013–0.228), and non-Hispanic Whites (β: 0.110, 95% CI: 0.034–0.185). This study demonstrates for the first time the positive association of dietary choline with BMD in postmenopausal women, supporting the potential of choline-targeted nutrition strategies for osteoporosis prevention and emphasizing the role of socioeconomic factors in influencing bone health outcomes.
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spelling doaj-art-afa693f0844e49ef9bcf946d150f5e342025-08-20T03:03:25ZengNature PortfolioScientific Reports2045-23222025-07-011511910.1038/s41598-025-08891-6Association between total dietary choline intake and lumbar spine bone mineral density in postmenopausal women based on NHANES 2007–2018Jincheng Bai0Penghui Lv1Lu Li2Sichao Cheng3Jianjun Chang4Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical UniversityShanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical UniversityShanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical UniversityShanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical UniversityShanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical UniversityAbstract Postmenopausal estrogen deficiency accelerates bone mineral density (BMD) decline, significantly elevating the risk of osteoporotic fractures. Choline, a vital nutrient involved in lipid homeostasis and inflammatory pathways, has been associated with skeletal health. Yet its role in preserving bone density among postmenopausal populations, a group at high risk of osteoporosis, requires further investigation. This study also examined the modifying effects of socioeconomic factors, including income and race, on the relationship between dietary choline intake and BMD. Using data from 4,160 postmenopausal women aged 50 years and older from the National Health and Nutrition Examination Survey (NHANES) 2007–2018, we employed weighted linear regression models to characterize the dose-response relationship between total dietary choline intake and lumbar spine BMD. In fully adjusted models, each 1 g/day increment in choline intake corresponded to a 0.082 g/cm² increase in lumbar spine BMD (β: 0.082, 95% CI: 0.025–0.139). Participants in the highest choline intake quartile (Q4) exhibited a 0.025 g/cm² higher BMD compared to the lowest quartile (Q1) (β: 0.025, 95% CI: (0.007, 0.042)). Stratified analyses revealed significant effect modifications by obesity (P interaction = 0.015), income (P interaction = 0.003), and race (P interaction = 0.039), with amplified protective effects observed in obese individuals (β: 0.146, 95% CI: 0.067–0.22), high-income subgroups (PIR > 4)(β: 0.121, 95% CI: 0.013–0.228), and non-Hispanic Whites (β: 0.110, 95% CI: 0.034–0.185). This study demonstrates for the first time the positive association of dietary choline with BMD in postmenopausal women, supporting the potential of choline-targeted nutrition strategies for osteoporosis prevention and emphasizing the role of socioeconomic factors in influencing bone health outcomes.https://doi.org/10.1038/s41598-025-08891-6Dietary cholineBone mineral densityPostmenopausal womenNHANESNutritional intervention
spellingShingle Jincheng Bai
Penghui Lv
Lu Li
Sichao Cheng
Jianjun Chang
Association between total dietary choline intake and lumbar spine bone mineral density in postmenopausal women based on NHANES 2007–2018
Scientific Reports
Dietary choline
Bone mineral density
Postmenopausal women
NHANES
Nutritional intervention
title Association between total dietary choline intake and lumbar spine bone mineral density in postmenopausal women based on NHANES 2007–2018
title_full Association between total dietary choline intake and lumbar spine bone mineral density in postmenopausal women based on NHANES 2007–2018
title_fullStr Association between total dietary choline intake and lumbar spine bone mineral density in postmenopausal women based on NHANES 2007–2018
title_full_unstemmed Association between total dietary choline intake and lumbar spine bone mineral density in postmenopausal women based on NHANES 2007–2018
title_short Association between total dietary choline intake and lumbar spine bone mineral density in postmenopausal women based on NHANES 2007–2018
title_sort association between total dietary choline intake and lumbar spine bone mineral density in postmenopausal women based on nhanes 2007 2018
topic Dietary choline
Bone mineral density
Postmenopausal women
NHANES
Nutritional intervention
url https://doi.org/10.1038/s41598-025-08891-6
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