http://orcid.org/0000-0002-9201-4666

Emma Derbyshire

http://dx.doi.org/10.1136/bmjnph-2019-000037

Summary and perspective

The mounting evidence of choline’s importance makes it essential that it does not continue to be overlooked in the UK. This is now more important than ever, given that accelerated food trends towards plant-based diets/veganism could have further ramifications on choline intake/status. Government bodies and organizations should look to extended datasets to include this essential nutrient. So far, looking at the evidence base, we know that:

Choline is a critical nutrient needed for neurocognition, lipid metabolism, liver function, and homocysteine regulation.

The majority of Europeans, Americans, Canadians, and Australians are not meeting choline AI recommendations.

Eggs, milk, and meat appear to be major dietary providers, and further reductions in their consumption could have unintended consequences for choline intake/status.

Ongoing nutrition research must study ‘long-term’ intakes of choline, e.g., using food frequency questionnaires rather than 24-hour recalls, to provide a more reliable picture of choline intake.

More needs to be done to educate healthcare professionals and consumers about the importance of a choline-rich diet and how to achieve this.

Suppose choline is not obtained at levels needed from dietary sources. In that case, supplementation strategies will be required, especially during key life-cycle stages, such as pregnancy, when choline intake is critical for infant development.