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Choline, Neurological Development and Brain Function: A Systematic Review Focusing on the First 1000 Days

Derbyshire E, Obeid R (2020) Nutrients 12(6) 1731. doi: 10.3390/nu12061731. 

Web URL: View this and related research articles via PubMed here. Free full text is available online

Abstract:

The foundations of neurodevelopment across an individual's lifespan are established in the first 1000 days of life (2 years). During this period an adequate supply of nutrients are essential for proper neurodevelopment and lifelong brain function.

Of these, evidence for choline has been building but has not been widely collated using systematic approaches. Therefore, a systematic review was performed to identify the animal and human studies looking at inter-relationships between choline, neurological development, and brain function during the first 1000 days of life.

The database PubMed was used, and reference lists were searched. In total, 813 publications were subject to the title/abstract review, and 38 animal and 16 human studies were included after evaluation.

Findings suggest that supplementing the maternal or child's diet with choline over the first 1000 days of life could subsequently: (1) support normal brain development (animal and human evidence), (2) protect against neural and metabolic insults, particularly when the fetus is exposed to alcohol (animal and human evidence), and (3) improve neural and cognitive functioning (animal evidence).

Overall, most offspring would benefit from increased choline supply during the first 1000 days of life, particularly in relation to helping facilitate normal brain development.

Health policies and guidelines should consider re-evaluation to help communicate and impart potential choline benefits through diet and/or supplementation approaches across this critical life stage.

 

FAB RESEARCH COMMENT:

Choline is still not classed as an 'essential nutrient' (as vitamins are), because we can make some choline for ourselves - but in vivo synthesis is insufficient to meet the need for this nutrient.

Choline is an essential component of all cell membranes, and plays key roles in lipid metabolism, liver function, and gene expression and regulation. It is also needed to make the neurotransmitter acetylcholine - the primary signalling chemical for the parasympathetic branch of the autonomic nervous system, and important in regulating arousal, mood and cognition as well as movement and blood flow. 


Adequate supplies of dietary choline are particularly crucial in early life to support normal brain development, and yet most women fail to meet the adequate intake (AI) of 450mg/day.  Futhermore, preliminary evidence from human clinical trials suggests that this AI is itself set too low (having been based on small studies of the minimum needed to prevention overt liver dysfunction in healthy men).

This systematic review of the evidence from both pre-clinical and human studies summarises the evidence to date in this area, and makes a compelling case for public health authorities to do more to raise awareness of the benefits of choline and promote increased intakes amng women of childbearing age.

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