Choline and docosahexaenoic acid during the first 1000 days and children’s health and development in low- and middle-income countries

Abstract

Choline and DHA are nutrients that, when provided during the first 1000 days from conception to age 2 years, may have beneficial effects on child neurodevelopment as well as related health factors, including birth outcomes and child growth, morbidity, and inflammation. Because these nutrients are found mainly in animal-source foods, they may be lacking in the diets of pregnant and lactating women and young children in low- and middle-income countries, potentially putting children at risk for suboptimal development and health. Prior reviews of these nutrients have mainly focused on studies from high-income countries. Here, a narrative review is presented of studies describing the pre- and postnatal roles of choline, docosahexaenoic acid, and a combination of the 2 nutrients on child neurodevelopment, birth outcomes, growth, morbidity, and inflammation in low- and middle-income countries. More studies are needed to understand the specific, long-term effects of perinatal choline and docosahexaenoic acid intake in various contexts.

Effect of a Child-Owned Poultry Intervention Providing Eggs on Nutrition Status and Motor Skills of Young Children in Southern Ethiopia: A Cluster Randomized and Controlled Community Trial

“…Although all nutrients are important for growth and development, nutrients particularly protein; zinc; iron; choline; folate; iodine; vitamins A, D, and B 12 ; and long-chain polyunsaturated fatty acids including docosahexaenoic acid and arachidonic acid play an indispensable role in neurocognitive development [ 54 , 55 , 56 ]. Early infancy deficiency of these nutrients is associated with long-term neurobehavioral damage that may not be reversible by nutritional therapy [ 57 ].…”

Choline, DHA, and Diarrheal Disease Associated with Growth Faltering in a Case-Control Study

“…Similarly, evidence supports the role of DHA, an ω-3 long-chain PUFA, as an anti-inflammatory mediator of the immune system ( 13 , 14 ). Coinciding with this function, DHA is vital for linear growth and brain and eye development ( 15–18 ). A deeper understanding of how these nutrients influence diarrhea, enteric health, and child growth may be critical in LMIC contexts.…”

The association between plasma choline, growth and neurodevelopment among Malawian children aged 6–15 months enroled in an egg intervention trial

“…Choline is an essential micronutrient that may affect the risk of stunting and poor development (Bragg et al, 2021), perhaps through its role as a precursor for important metabolites including phosphatidylcholine, acetylcholine, trimethylamine N‐oxide (TMAO), betaine and dimethylglycine (DMG). Choline is crucial for brain development, especially for the development of the dentate gyrus region of the hippocampus (Albright et al, 1999; Blusztajn & Mellott, 2012; Zeisel, 2004), which is needed for declarative memory (Bauer et al, 2010).…”

“…Few studies have reported on the relationship between postnatal (<2 years) choline concentration and child growth and neurodevelopment in LMICs (Bragg et al, 2021). Because choline is mainly found in animal source foods, which are relatively expensive (Headey & Alderman, 2019), intake is likely suboptimal in many LMICs (Wiedeman, Barr, et al, 2018).…”