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Could we be overlooking a potential choline crisis in the United Kingdom?
  1. Emma Derbyshire
  1. Nutritional Insight, Surrey, UK
  1. Correspondence to Dr Emma Derbyshire; emma{at}nutritional-insight.co.uk

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Introduction

Choline can be likened to omega-3 fatty acids in that it is an ‘essential’ nutrient that cannot be produced by the body in amounts needed for human requirements. The United States (US) Institute of Medicine (IOM)1 and European Food Safety Authority (EFSA)2 recognise that choline plays an important role in the human body and have established dietary reference values. The American Medical Association3 in 2017 published new advice stating that prenatal vitamin supplements should contain "evidenced-based" amounts of choline. Similarly the American Academy of Paediatrics4 5 (from 2018) called on paediatricians to move beyond simply recommending a “good diet” and to make sure that pregnant women and young children have access to food that provides adequate amounts of “brain-building” nutrients with choline being listed as one of these. Unfortunately, in the UK choline is not yet included in food composition databases, main nutrition surveys nor official recommendations. The present article discusses the current choline situation and explains why more needs to be done to include and monitor this essential nutrient in the UK.

About choline

Choline is an ‘essential’ nutrient for humans; and similar to omega-3 fatty acids, as the amount produced endogenously (in the liver) is not sufficient to meet human requirements,6 it therefore needs to be obtained from dietary and supplement sources. Physiologically, choline is critical for a number of functions across the life cycle which include wide-ranging roles in human metabolism from neurotransmitter synthesis to cell structure and methylation, with choline deficiency being linked to liver disease, offspring cognitive function and potential neurological disorders.7 8

Functionally choline in its oxidised form (the metabolite glycine betaine) contributes to S-adenosylmethionine synthesis – a chief methyl donor involved in DNA and histone methylation which play a central role in regulating gene expression and potentially modulating brain …

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