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de novo may decrease after menopause (Lindblad and Schersten, 1976), because estrogens increase hepatic phosphatidylethanolamine-N-methyltransferase activity in rats (Drouva et al., 1986; Young, 1971).

Exercise

Strenuous physical activity in trained athletes reduced the plasma choline concentration by approximately 40 percent, from 14.1 to 8.4 µmol/L (Conlay et al., 1986). A choline supplement given to marathon runners modestly enhanced performance (Sandage et al., 1992). In 10 top-level triathletes who were given either a placebo or lecithin at 0.2 g/kg body mass 1 hour before each type of exercise, plasma choline concentrations in all the triathletes decreased on average by 16.9 percent after the bicycle exercise when placebo was taken before the race but did not do so when lecithin was given (Von Allworden et al., 1993).

Bioavailability

No estimates are available for percentage absorption of the various forms of choline in humans. The water-soluble choline-derived compounds (choline, phosphocholine, and glycerophosphocholine) are absorbed via the portal circulation whereas the lipid-soluble compounds (phosphatidylcholine and sphingomyelin) present in foods are absorbed into lymph as chylomicrons via the thoracic duct. This results in differential delivery and kinetics of distribution to tissues (Cheng et al., 1996; Zeisel et al., 1980b).

FINDINGS BY LIFE STAGE AND GENDER GROUP

Data are not sufficient for deriving an Estimated Average Requirement (EAR) for choline. The two published studies in healthy humans used male subjects only and tested a single level of choline intake. For these reasons only an Adequate Intake (AI) can be estimated. This amount will be influenced by the availability of methionine and folate in the diet. It may be influenced by gender, pregnancy, lactation, and stage of development. Although AIs are set for choline, it may be that the choline requirement can be met by endogenous synthesis at some of these stages.

To date, all studies have used choline-free diets and compared them with choline-containing diets; no intermediate levels of defi-



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