Choline-An Underappreciated Component of a Mother-to-Be's Diet

Abstract

The nutritional status of the mother-to-be has a key impact on the proper development of the fetus. Although all nutrients are important for the developing baby, recent research indicates the importance of adequate choline intake during the periconceptional period, pregnancy, and lactation. Choline plays a key role in the biosynthesis of cell membranes, supporting liver function, neurotransmission, brain development, and DNA and histone methylation. Choline participates in the formation of a child's nervous system, supports its cognitive development, and reduces the risk of neural tube defects. The human body is incapable of producing sufficient choline to meet its needs; therefore, it must be obtained from the diet. Current data indicate that most women in their reproductive years do not achieve the recommended daily intake of choline. The presented narrative review indicates the importance of educating mothers-to-be and thereby increasing their awareness of the effects of choline on maternal and child health, which can lead to a more aware and healthy pregnancy and proper child development.

Keywords: choline; dietary recommendations; fetal growth; infant development; maternal diet; nutrition; pregnancy; women’s health.

Figure 1

Flowchart for selection of methodology.

Figure 2

One carbon metabolism metabolic pathways [16]. Folate cycle metabolites and enzymes: 5,10-CH2-THF, 5,10-methylenetetrahydrofolate; 5mTHF, 5-methyl-tetrahydrofolate; DHF, dihydrofolate; DHFR, dihydrofolate reductase; MTHFR, 5,10-methylenetetrahydrofolate reductase; TYMS, thymidylate synthase. Methionine cycle metabolites and enzymes: DMG, dimethylglycine; Hcy, homocysteine; Met, methionine; SAH, S-adenosylhomocysteine; SAM, S-adenosylmethionine; Sar, sarcosine; Gly, glycine; AHCY, S-adenosyl-L-homocysteine hydrolase; BHMT, betaine-homocysteine S-methyltransferase; CHDH, choline dehydrogenase; GNMT, glycine N-methyltransferase; MATI/III, methionine adenosyltransferase; MTR, methionine synthase; MTRR, methionine synthase reductase; DNMTs, de novo and maintenance DNA methyltransferases; HMT, histone methyltransferase; PRMT, protein arginine methyltransferase. Transsulfuration pathway metabolites and enzymes: Cth, cystathionine; Cys, cysteine; Hse, homoserine; CBS, cystathionine β-synthase; CTH, cystathionine γ-lyase; Ser, serine. Choline metabolites and enzymes: CDP–choline, cytidine diphosphate-choline; PC, phosphatidylcholine; pCholine, phosphocholine; PE, phosphatidylethanolamine; ACh, acetylocholine; CCT, CTP:phosphocholine cytidylyltransferase; ChAT, choline acetyltransferase; CK, choline kinase; CPT, cholinephosphotransferase; PLD, phospholipase D; PEMT, phosphatidylethanolamine N-methyltransferase. Coenzymes: vitamin B2, B6 and B12.