Abstract
Choline is an important nutrient during the first 1000 days post conception due to its roles in brain function. An increasing number of studies have measured choline intakes at the population level. We collated the evidence focusing on habitual choline intakes in the preconceptual, pregnancy, and lactation life stages. We conducted a review including studies published from 2004 to 2021. Twenty-six relevant publications were identified. After excluding studies with a high choline intake (>400 mg/day; two studies) or low choline intake (<200 mg/day; one study), average choline intake in the remaining 23 studies ranged from 233 mg/day to 383 mg/day, even with the inclusion of choline from supplements. Intakes were not higher in studies among pregnant and lactating women compared with studies in nonpregnant women. To conclude, during the childbearing years and across the globe, habitual intakes of choline from foods alone and foods and supplements combined appear to be consistently lower than the estimated adequate intakes for this target group. Urgent measures are needed to (1) improve the quality of choline data in global food composition databases, (2) encourage the reporting of choline intakes in dietary surveys, (3) raise awareness about the role(s) of choline in foetal–maternal health, and (4) consider formally advocating the use of choline supplements in women planning a pregnancy, pregnant, or lactating.
Highlights
Choline is an essential nutrient involved in critical physiological functions due to its role as methyl donor and precursor of acetylcholine and phospholipids [1]
The American Medical Association and American Academy of Paediatrics have recognised that a failure to provide choline during the first 1000 days post conception could result in lifelong deficits in brain function regardless of subsequent nutrient repletion [5–7]
A growing body of evidence suggests that choline is an important micronutrient and methyl donor that is required for normal brain growth and development, during sensitive windows of life, including the childbearing years [1,8]
Summary
Choline is an essential nutrient involved in critical physiological functions due to its role as methyl donor and precursor of acetylcholine and phospholipids [1]. Choline requirements in pregnancy and lactation are higher than in nonpregnant women due to the rapid division of foetal cells and active transport to the foetus and infant [2]. Growing evidence implies a role for sufficient maternal choline intake in foetal growth and development [3,4]. A growing body of evidence suggests that choline is an important micronutrient and methyl donor that is required for normal brain growth and development, during sensitive windows of life, including the childbearing years [1,8]. The foetal origins of memory hypothesis proposes that maternal and infant dietary intakes of choline influence brain development which could permanently modulate brain function of the offspring, i.e., resulting in cognitive and memory deficits with mechanisms likely to involve DNA methylation and alterations to gene expression, as well as stem-cell proliferation and differentiation [10]. Underpinning studies in rodents further demonstrate that a higher choline intake during pregnancy facilitates cognitive function and offsets memory decline with advancing age [11]
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