Abstract
Choline is an essential nutrient for brain growth and other processes in the developing neonate. The impact of a maternal plant-based diet on the choline composition of breast milk is unknown. We assessed the water-soluble choline content of milk from lactating women in the United States following 3 dietary patterns: vegan, vegetarian, and nonvegetarian. We conducted a cross-sectional study of 74 healthy lactating women who provided a single breast-milk sample using a standardized collection protocol. Participants completed a food-frequency screener and were classified as follows: nonvegetarians (NONVEG) consumed meat; vegetarians (VEGT) consumed milk, dairy, and/or fish; and vegans (VEGAN) consumed animal products less than monthly. Primary outcomes measured were the concentration (in milligrams per liter) and distribution (percentage) of choline from the following water-soluble forms: free choline, phosphocholine (PCho), and glycerophosphocholine (GPC). Differences between diet groups were evaluated with ANOVA. There was a wide range in breast-milk total water-soluble choline (4-301mg/L), with no significant difference (P>0.05) by maternal diet pattern. There were differences in choline forms, with VEGAN having a greater mean±SD concentration and distribution of choline derived from GPC (62.7±25.3mg/L) than VEGT (47.7±21.2mg/L) and NONVEG (42.4±14.9mg/L) (P=0.0052). There was a lower mean±SD percentage of choline from PCho (P=0.0106) in VEGAN (32.5%±18.3%) than in VEGT (46.1%±18.3%) and NONVEG (44.8%±15.7%). Lactation stage and maternal BMI were significantly associated with some choline forms. There was a wide range of water-soluble choline concentrations in the milk of healthy lactating women following vegan, vegetarian, and nonvegetarian diets, with no observed difference in total water-soluble choline concentration by maternal diet. This suggests that maternal plant-based diet by itself is not a risk factor for low breast-milk choline.
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