Wallace Taylor C, Blusztajn Jan Krzysztof, Caudill Marie A, Klatt Kevin C, Natker Elana, Zeisel Steven H, Zelman Kathleen M
is the principal and CEO at the Think Healthy Group, Inc, and is a adjunct professor in the Department of Nutrition and Food Studies at George Mason University.
is a professor in the Department of Pathology and Laboratory Medicine at Boston University School of Medicine.
Nutr Today. 2018 Nov-Dec;53(6):240-253. doi: 10.1097/NT.0000000000000302. Epub 2018 Nov 13.
Choline has been recognized as an essential nutrient by the Food and Nutrition Board of the National Academies of Medicine since 1998. Its metabolites have structural, metabolic, and regulatory roles within the body. Humans can endogenously produce small amounts of choline via the hepatic phosphatidylethanolamine -methyltransferase pathway. However, the nutrient must be consumed exogenously to prevent signs of deficiency. The Adequate Intake (AI) for choline was calculated at a time when dietary intakes across the population were unknown for the nutrient. Unlike the traditional National Academy of Medicine approach of calculating an AI based on observed or experimentally determined approximations or estimates of intake by a group (or groups) of healthy individuals, calculation of the AI for choline was informed in part by a depletion-repletion study in adult men who, upon becoming deficient, developed signs of liver damage. The AI for other gender and life-stage groups was calculated based on standard reference weights, except for infants 0 to 6 months, whose AI reflects the observed mean intake from consuming human breast milk. Recent analyses indicate that large portions of the population (ie, approximately 90% of Americans), including most pregnant and lactating women, are well below the AI for choline. Moreover, the food patterns recommended by the 2015-2020 Dietary Guidelines for Americans are currently insufficient to meet the AI for choline in most age-sex groups. An individual's requirement for choline is dependent on common genetic variants in genes required for choline, folate, and 1-carbon metabolism, potentially increasing more than one-third of the population's susceptibly to organ dysfunction. The American Medical Association and American Academy of Pediatrics have both recently reaffirmed the importance of choline during pregnancy and lactation. New and emerging evidence suggests that maternal choline intake during pregnancy, and possibly lactation, has lasting beneficial neurocognitive effects on the offspring. Because choline is found predominantly in animal-derived foods, vegetarians and vegans may have a greater risk for inadequacy. With the 2020-2025 Dietary Guidelines for Americans recommending expansion of dietary information for pregnant women, and the inclusion of recommendations for infants and toddlers 0 to 2 years, better communication of the role that choline plays, particularly in the area of neurocognitive development, is critical. This narrative review summarizes the peer-reviewed literature and discussions from the 2018 Choline Science Summit, held in Washington, DC, in February 2018.
自1998年以来，胆碱一直被美国国家医学院食品与营养委员会认定为一种必需营养素。其代谢产物在人体内具有结构、代谢和调节作用。人类可通过肝脏磷脂酰乙醇胺-甲基转移酶途径内源性地产生少量胆碱。然而，必须从外部摄入这种营养素以预防缺乏症状。胆碱的适宜摄入量（AI）是在人群对该营养素的膳食摄入量未知时计算得出的。与美国国家医学院基于一组（或多组）健康个体的观察或实验确定的摄入量近似值或估计值来计算AI的传统方法不同，胆碱AI的计算部分依据了一项针对成年男性的耗竭-补充研究，这些男性在出现缺乏症状后，出现了肝脏损伤迹象。除0至6个月的婴儿外，其他性别和生命阶段组的AI是根据标准参考体重计算的，0至6个月婴儿的AI反映了食用母乳的观察平均摄入量。最近的分析表明，很大一部分人群（即约90%的美国人），包括大多数孕妇和哺乳期妇女，胆碱摄入量远低于AI。此外，《2015 - 2020年美国人膳食指南》推荐的食物模式目前不足以满足大多数年龄-性别组的胆碱AI。个体对胆碱的需求取决于胆碱、叶酸和一碳代谢所需基因中的常见基因变异，这可能使超过三分之一的人群更容易出现器官功能障碍。美国医学协会和美国儿科学会最近都重申了胆碱在孕期和哺乳期的重要性。新出现的证据表明，孕期以及可能哺乳期的母体胆碱摄入量对后代具有持久有益的神经认知影响。由于胆碱主要存在于动物性食物中，素食者和纯素食者摄入不足的风险可能更高。鉴于《2020 - 2025年美国人膳食指南》建议扩大针对孕妇的膳食信息，并纳入针对0至2岁婴幼儿的建议，更好地宣传胆碱所起的作用，尤其是在神经认知发育领域的作用至关重要。这篇叙述性综述总结了2018年2月在华盛顿特区举行的2018年胆碱科学峰会的同行评议文献及讨论内容。
