Dietary intake of choline and plasma choline concentrations in pregnant women in Jamaica

Abstract

Choline is an essential nutrient for humans and its availability during pregnancy is important for optimal fetal development. The Food and Nutrition Board of the Institute of Medicine in the United States of America has set the adequate choline intake during pregnancy at 450 mg/day. There is limited data available on normal plasma choline concentrations in pregnancy. Moreover, there are neither documented studies of choline intake among pregnant women in the Jamaican population nor of free plasma choline concentrations during pregnancy. Sixteen women presenting to the antenatal clinic of the University Hospital of the West Indies (UHWI) at 10-15 weeks of gestation were selected for this pilot study. A food frequency questionnaire was administered to estimate frequency of consumption of foods rich in choline. Fasting blood samples were collected by venepuncture and plasma assayed for choline using liquid chromatography electrospray ionization isotopic dilution mass spectrometry. Most of the women reported consumption of diets that delivered less than the recommended choline intake (mean +/- SEM, 278.5 +/- 28.9 mg). Mean plasma choline concentration was 8.4 +/- 0.4 micromol/L. This falls below the normal concentration (10 micromol/L) reported for individuals that are not pregnant and pregnant (14.5 micromol/L). The results of this study may be an indication that the choline included in the diet of pregnant women in Jamaica may not be adequate to meet both the needs of the mother and fetus and that further studies are warranted to determine clinical implications.

Choline, Other Methyl-Donors and Epigenetics

“…Similar ranges of intake were reported in the Framingham Offspring Study [89], the Atherosclerosis Risk in Communities study [90,91] and the Nurse’s Health Study [92]. Intake of choline is even lower in low-income countries such as Jamaica and The Gambia [93,94]. …”

Nutrition in pregnancy: the argument for including a source of choline

“…Prenatal vitamin supplements do not contain an adequate source of choline, yet in high income countries almost a quarter of women consume diets low in choline content, and several small studies suggest that in low income countries most women eat low choline foods 4–9…”

Metabolic crosstalk between choline/1-carbon metabolism and energy homeostasis

“…In several human cohorts choline intake has been estimated to vary by as much as three-fold – the lowest quartile (or quintile) and the highest quartile of intake were approximately 150 mg and 500 mg/d choline equivalents, respectively, in the Framingham Offspring Study [5], the Atherosclerosis Risk In Communities study [6, 7] and the Nurse’s Health Study [8]. Intake of choline is likely lower in low income countries [9]. Normal dietary intake of betaine is 100 mg/d in the USA [7].…”