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Obeid R, Karlsson T. Choline - a scoping review for Nordic Nutrition Recommendations 2023. Food Nutr Res 2023; 67:10359. [PMID: 38187796 PMCID: PMC10770654 DOI: 10.29219/fnr.v67.10359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Revised: 03/15/2022] [Accepted: 11/10/2023] [Indexed: 01/09/2024] Open
Abstract
Choline is an essential nutrient with metabolic roles as a methyl donor in one carbon metabolism and as a precursor for membrane phospholipids and the neurotransmitter acetylcholine. Choline content is particularly high in liver, eggs, and wheat germ, although it is present in a variety of foods. The main dietary sources of choline in the Nordic and Baltic countries are meat, dairy, eggs, and grain. A diet that is devoid of choline causes liver and muscle dysfunction within 3 weeks. Choline requirements are higher during pregnancy and lactation than in non-pregnant women. Although no randomized controlled trials are available, observational studies in human, supported by coherence from interventional studies with neurodevelopmental outcomes and experimental studies in animals, strongly suggest that sufficient intake of choline during pregnancy is necessary for normal brain development and function in the child. Observational studies suggested that adequate intake of choline could have positive effects on cognitive function in older people. However, prospective data are lacking, and no intervention studies are available in the elderly.
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Affiliation(s)
- Rima Obeid
- Department of Clinical Chemistry and Laboratory Medicine, University Hospital of the Saarland, Homburg, Germany
| | - Therese Karlsson
- Department of Internal Medicine and Clinical Nutrition, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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Petersen JM, Smith-Webb RS, Shaw GM, Carmichael SL, Desrosiers TA, Nestoridi E, Darling AM, Parker SE, Politis MD, Yazdy MM, Werler MM. Periconceptional intakes of methyl donors and other micronutrients involved in one-carbon metabolism may further reduce the risk of neural tube defects in offspring: a United States population-based case-control study of women meeting the folic acid recommendations. Am J Clin Nutr 2023; 118:720-728. [PMID: 37661108 PMCID: PMC10624769 DOI: 10.1016/j.ajcnut.2023.05.034] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 05/23/2023] [Accepted: 05/31/2023] [Indexed: 09/05/2023] Open
Abstract
BACKGROUND Neural tube defects (NTDs) still occur among some women who consume 400 μg of folic acid for prevention. It has been hypothesized that intakes of methyl donors and other micronutrients involved in one-carbon metabolism may further protect against NTDs. OBJECTIVES To investigate whether intakes of vitamin B6, vitamin B12, choline, betaine, methionine, thiamine, riboflavin, and zinc, individually or in combination, were associated with NTD risk reduction in offspring of women meeting the folic acid recommendations. METHODS Data were from the National Birth Defects Prevention Study (United States population-based, case-control). We restricted deliveries between 1999 and 2011 with daily periconceptional folic acid supplementation or estimated dietary folate equivalents ≥400 μg. NTD cases were live births, stillbirths, or terminations affected by spina bifida, anencephaly, or encephalocele (n = 1227). Controls were live births without a major birth defect (n = 7095). We categorized intake of each micronutrient as higher or lower based on a combination of diet (estimated from a food frequency questionnaire) and periconceptional vitamin supplementation. We estimated NTD associations for higher compared with lower intake of each micronutrient, individually and in combination, expressed as odds ratios (ORs) and 95% confidence intervals (CIs), adjusted for age, race/ethnicity, education, and study center. RESULTS NTD associations with each micronutrient were weak to modest. Greater NTD reductions were observed with concurrent higher-amount intakes of multiple micronutrients. For instance, NTD odds were ∼50% lower among participants with ≥4 micronutrients with higher-amount intakes than among participants with ≤1 micronutrient with higher-amount intake (adjusted OR: 0.53; 95% CI: 0.33, 0.86). The strongest reduction occurred with concurrent higher-amount intakes of vitamin B6, vitamin B12, choline, betaine, and methionine (adjusted OR: 0.26; 95% CI: 0.09, 0.77) compared with ≤1 micronutrient with higher-amount intake. CONCLUSIONS Our findings support that NTD prevention, in the context of folic acid fortification, could be augmented with intakes of methyl donors and other micronutrients involved in folate metabolism.
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Affiliation(s)
- Julie M Petersen
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, United States; Massachusetts Center for Birth Defects Research and Prevention, Massachusetts Department of Public Health, Boston, MA, United States.
| | - Rashida S Smith-Webb
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, United States
| | - Gary M Shaw
- Division of Neonatal and Developmental Medicine, Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, United States
| | - Suzan L Carmichael
- Division of Neonatal and Developmental Medicine, Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, United States; Center for Population Health Sciences, Stanford University School of Medicine, Stanford, CA, United States
| | - Tania A Desrosiers
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Eirini Nestoridi
- Massachusetts Center for Birth Defects Research and Prevention, Massachusetts Department of Public Health, Boston, MA, United States
| | - Anne Marie Darling
- Massachusetts Center for Birth Defects Research and Prevention, Massachusetts Department of Public Health, Boston, MA, United States
| | - Samantha E Parker
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, United States
| | - Maria D Politis
- Arkansas Center for Birth Defects Research and Prevention, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, AR, United States
| | - Mahsa M Yazdy
- Massachusetts Center for Birth Defects Research and Prevention, Massachusetts Department of Public Health, Boston, MA, United States
| | - Martha M Werler
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, United States
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Obeid R, Derbyshire E, Schön C. Association between Maternal Choline, Fetal Brain Development, and Child Neurocognition: Systematic Review and Meta-Analysis of Human Studies. Adv Nutr 2022; 13:2445-2457. [PMID: 36041182 PMCID: PMC9776654 DOI: 10.1093/advances/nmac082] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Revised: 10/01/2021] [Accepted: 07/25/2022] [Indexed: 01/29/2023] Open
Abstract
We studied associations between prenatal and early postnatal choline intake, brain development, and neurocognitive function of children. We conducted a systematic review followed by a meta-analysis and critical appraisal of human studies published from 1997 to 2021. Thirty publications were identified. The meta-analysis included 5 of 7 case-control studies studying neural tube defects (NTDs) in relation to maternal choline intakes/circulating concentrations. Low maternal choline intake/circulating concentrations were associated with a higher OR for NTDs among 1131 mothers of newborns with NTDs and 4439 control mothers (pooled estimate = 1.36; 95% CI: 1.11, 1.67). The 95% prediction intervals were 0.78, 2.36. Findings and critical evaluation of 10 publications with interventional designs showed that higher maternal choline intakes during the second half of pregnancy and early postnatal period (550 mg up to 1 g/d on top of the diet) or a child intake of 513 to 625 mg/d from supplements were safe and likely to demonstrate favorable effects on several domains of child neurocognition, such as memory, attention, and visuospatial learning versus the comparators. Findings from observational studies (n = 13) partly supported the association between maternal choline intake/serum concentrations and child neurocognition, but there was low confidence in the use of plasma choline concentrations as a choline intake marker. In conclusion, low maternal choline intakes were associated with a higher OR for NTDs. The risk could be up to 2.36-fold in some populations. Despite limitations of available trials and observational studies, higher maternal choline intake was likely to be associated with better child neurocognition/neurodevelopment. The results should be used to guide choline intake recommendations in pregnancy and lactation, especially because most young women are not achieving the reference intake of choline. This meta-analysis is registered at PROSPERO as CRD42021233790.
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Andrews C, Shrestha R, Ghosh S, Appel K, Gurung S, Ausman LM, Marino Costello E, Webb P. Consumption of animal source foods, especially fish, is associated with better nutritional status among women of reproductive age in rural Bangladesh. MATERNAL & CHILD NUTRITION 2022; 18:e13287. [PMID: 34816603 PMCID: PMC8710098 DOI: 10.1111/mcn.13287] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Revised: 10/05/2021] [Accepted: 10/06/2021] [Indexed: 04/11/2023]
Abstract
In rural Bangladesh, intake of nutrient-rich foods, such as animal source foods (ASFs), is generally suboptimal. Diets low in nutrients and lacking in diversity put women of reproductive age (WRA) at risk of malnutrition as well as adverse birth outcomes. The objective of this study was to assess the relationship between maternal dietary diversity, consumption of specific food groups and markers of nutritional status, including underweight [body mass index (BMI) < 18.5 kg/m2 ], overweight (BMI ≥ 23 kg/m2 ) and anaemia (haemoglobin < 120 g/dl) among WRA in Bangladesh. This analysis used data from the third round of a longitudinal observational study, collected from February through May of 2017. Dietary data were collected with a questionnaire, and Women's Dietary Diversity Score (WDDS) was calculated. Associations between WDDS, food group consumption and markers of nutritional status were assessed with separate adjusted logistic regression models. Among WRA, the prevalence of underweight, overweight and anaemia was 13.38%, 40.94% and 39.99%, respectively. Women who consumed dark green leafy vegetables (DGLV) or eggs were less likely to be anaemic or underweight, respectively, and women who consumed ASFs, particularly fish, were less likely to be underweight compared with women who did not consume these foods. WDDS did not show any consistent relationship with WRA outcomes. Interventions that focus on promoting optimal nutritional status among WRA in Bangladesh should emphasise increasing consumption of specific nutrient-rich foods, including ASFs, DGLV and eggs, rather than solely focusing on improving diet diversity in general.
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Affiliation(s)
- Chloe Andrews
- Friedman School of Nutrition Science and PolicyTufts UniversityBostonMassachusettsUSA
| | - Robin Shrestha
- Friedman School of Nutrition Science and PolicyTufts UniversityBostonMassachusettsUSA
| | - Shibani Ghosh
- Friedman School of Nutrition Science and PolicyTufts UniversityBostonMassachusettsUSA
| | - Katherine Appel
- Friedman School of Nutrition Science and PolicyTufts UniversityBostonMassachusettsUSA
| | - Sabi Gurung
- Helen Keller International BangladeshGulshanDhakaBangladesh
| | - Lynne M. Ausman
- Friedman School of Nutrition Science and PolicyTufts UniversityBostonMassachusettsUSA
| | | | - Patrick Webb
- Friedman School of Nutrition Science and PolicyTufts UniversityBostonMassachusettsUSA
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Li J, Xin Y, Li J, Chen H, Li H. Phosphatidylethanolamine N-methyltransferase: from Functions to Diseases. Aging Dis 2022; 14:879-891. [PMID: 37191416 DOI: 10.14336/ad.2022.1025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Accepted: 10/25/2022] [Indexed: 11/18/2022] Open
Abstract
Locating on endoplasmic reticulum and mitochondria associated membrane, Phosphatidylethanolamine N-methyltransferase (PEMT), catalyzes phosphatidylethanolamine methylation to phosphatidylcholine. As the only endogenous pathway for choline biosynthesis in mammals, the dysregulation of PEMT can lead to imbalance of phospholipid metabolism. Dysregulation of phospholipid metabolism in the liver or heart can lead to deposition of toxic lipid species that adversely result in dysfunction of hepatocyte/cardiomyocyte. Studies have shown that PEMT-/- mice increased susceptibility of diet-induced fatty liver and steatohepatitis. However, knockout of PEMT protects against diet-induced atherosclerosis, diet-induced obesity, and insulin resistance. Thus, novel insights to the function of PEMT in various organs should be summarized. Here, we reviewed the structural and functional properties of PEMT, highlighting its role in the pathogenesis of obesity, liver diseases, cardiovascular diseases, and other conditions.
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Johns B, Ficken M, Engberg M, Wecker L, Philpot R. Increasing dietary choline attenuates spatial memory deficits resulting from exposure to the chemotherapeutic agents cyclophosphamide and doxorubicin. J Psychopharmacol 2021; 35:1300-1309. [PMID: 34225528 PMCID: PMC9152698 DOI: 10.1177/02698811211029752] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Choline supplementation (+Ch) improves cognitive function in impaired animals and humans. Chemotherapy-related cognitive deficits (CRCDs) occur in cancer patients, and these deficits persist following treatment, adversely impacting quality of life. To date, there are no approved treatments for this condition. AIM Because +Ch improves impaired memory, it was of interest to determine whether +Ch can attenuate spatial memory deficits induced by the chemotherapeutic agents doxorubicin (DOX) and cyclophosphamide (CYP). METHODS Female BALB/C mice, 64 days of age, were trained in the Morris water maze and baseline performance determined on day 15. Following baseline assessment, mice were placed on +Ch diet (2.0% Ch) or remained on standard diet (0.12% Ch). Mice received intravenous injections of DOX (2.5 mg/kg) and CYP (25 mg/kg), or equivalent volumes of saline (0.9% NaCl), on days 16, 23, 30, and 37, and spatial memory was assessed weekly from day 22 to 71. RESULTS DOX and CYP produced a prolonged impairment in spatial memory as indicated by an increased latency to the correct zone (p < 0.05), and a decrease in time in the correct zone (p < 0.05), % of total swim distance in the correct zone (p < 0.05) and % entries to the correct zone (p < 0.05). These effects were attenuated by +Ch. CONCLUSION Although it remains to be determined whether this effect extends to other cognitive domains and whether +Ch is prophylactic or therapeutic, these findings suggest that +Ch may be an effective intervention for CRCDs.
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Affiliation(s)
| | | | | | | | - R.M. Philpot
- Corresponding Author: Rex M. Philpot, Ph.D., Assistant Professor, Department of Psychiatry and Behavioral Neurosciences, Morsani College of Medicine, University of South Florida, Tampa, 3515 E Fletcher Ave., Tampa, FL 33612,
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Zhu J, Liu YH, He XL, Kohlmeier M, Zhou LL, Shen LW, Yi XX, Tang QY, Cai W, Wang B. Dietary Choline Intake during Pregnancy and PEMT rs7946 Polymorphism on Risk of Preterm Birth: A Case-Control Study. ANNALS OF NUTRITION AND METABOLISM 2021; 76:431-440. [PMID: 33503637 DOI: 10.1159/000507472] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Accepted: 03/24/2020] [Indexed: 11/19/2022]
Abstract
INTRODUCTION AND AIMS Choline-metabolizing genetic variation may interact with choline intake on fetal programming and pregnancy outcome. This case-control study aims to explore the association of maternal choline consumption and phosphatidylethanolamine N-methyltransferase (PEMT) gene polymorphism rs7946 with preterm birth risk. METHODS 145 Han Chinese women with preterm delivery and 157 Han Chinese women with term delivery were recruited in Shanghai. Dietary choline intake during pregnancy was assessed using a validated food frequency questionnaire. Additionally, DNA samples were genotyped for PEMT rs7946 (G5465A) with plasma homocysteine (Hcy) levels measured. RESULTS Compared with the lowest quartile of choline intake, women within the highest consumption quartile had adjusted odds ratio (aOR) for preterm birth of 0.48 (95% confidence interval, CI [0.24, 0.95]). There was a significant interaction between maternal choline intake and PEMT rs7946 (p for interaction = 0.04), where the AA genotype carriers who consumed the energy-adjusted choline <255.01 mg/day had aOR for preterm birth of 3.75 (95% CI [1.24, 11.35]), compared to those with GG genotype and choline intake >255.01 mg/day during pregnancy. Additionally, the greatest elevated plasma Hcy was found in the cases with AA genotype and choline consumption <255.01 mg/day (p < 0.001). CONCLUSION The AA genotype of PEMT rs7946 may be associated with increased preterm birth in these Han Chinese women with low choline intake during pregnancy.
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Affiliation(s)
- Jie Zhu
- Department of Obstetrics, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Nutrition and Foods Program, School of Family and Consumer Sciences, Texas State University, San Marcos, Texas, USA.,Department of Clinical Nutrition, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Department of Nutrition, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yu-Hong Liu
- Department of Gynaecology and Obstetrics, Shanghai Seventh People's Hospital, Shanghai, China
| | - Xiang-Long He
- Department of Nutrition, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Martin Kohlmeier
- Human Research Core and Nutrigenetics Laboratory, UNC Nutrition Research Institute, University of North Carolina at Chapel Hill, Kannapolis, North Carolina, USA
| | - Li-Li Zhou
- Department of Obstetrics, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Li-Wei Shen
- Department of Obstetrics, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xin-Xuan Yi
- Department of Nutrition, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Qing-Ya Tang
- Department of Obstetrics, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Wei Cai
- Department of Clinical Nutrition, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Department of Nutrition, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Shanghai Key Laboratory of Pediatric Gastroenterology and Nutrition, Shanghai, China
| | - Bei Wang
- Department of Obstetrics, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China,
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Beluska-Turkan K, Korczak R, Hartell B, Moskal K, Maukonen J, Alexander DE, Salem N, Harkness L, Ayad W, Szaro J, Zhang K, Siriwardhana N. Nutritional Gaps and Supplementation in the First 1000 Days. Nutrients 2019; 11:E2891. [PMID: 31783636 PMCID: PMC6949907 DOI: 10.3390/nu11122891] [Citation(s) in RCA: 62] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2019] [Revised: 11/13/2019] [Accepted: 11/19/2019] [Indexed: 12/23/2022] Open
Abstract
Optimized nutrition during the first 1000 days (from conception through the 2nd birthday) is critical for healthy development and a healthy life for the newborn. Pregnancy and the postpartum period are accompanied by physiological changes, increased energy needs, and changing requirements in the nutrients critical for optimal growth and development. Infants and toddlers also experience physiological changes and have specific nutritional needs. Food and nutrition experts can provide women of childbearing age with adequate dietary advice to optimize nutrition, as well as guidance on selecting appropriate dietary supplements. Considering the approaching 2020-2025 Dietary Guidelines for Americans (DGA) will be making specific recommendations for children, it is important to provide accurate scientific information to support health influencers in the field of nutrition. The purpose of this review is to summarize the nutrition and supplementation literature for the first 1000 days; to highlight nutritional and knowledge gaps; and to educate nutrition influencers to provide thoughtful guidance to mothers and families. Optimal nutrition during pregnancy through early childhood is critical for supporting a healthy life. Nutrition influencers, such as dietitians, obstetricians/gynecologists, and other relevant health professionals, should continue guiding supplement and food intake and work closely with expectant families and nutrition gatekeepers.
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Affiliation(s)
- Katrina Beluska-Turkan
- Church & Dwight, Co., Inc., Product Development Nutritional Sciences, Princeton, NJ 08540, USA; (K.B.-T.); (K.M.); (L.H.); (W.A.); (J.S.); (K.Z.)
| | - Renee Korczak
- Premier Nutrition, LLC, Bernardsville, NJ 07924, USA;
| | - Beth Hartell
- PearTree Nutrition, LLC, Seattle, WA 98115, USA;
| | - Kristin Moskal
- Church & Dwight, Co., Inc., Product Development Nutritional Sciences, Princeton, NJ 08540, USA; (K.B.-T.); (K.M.); (L.H.); (W.A.); (J.S.); (K.Z.)
| | | | | | - Norman Salem
- DSM Nutritional Products, Columbia, MD 21045, USA;
| | - Laura Harkness
- Church & Dwight, Co., Inc., Product Development Nutritional Sciences, Princeton, NJ 08540, USA; (K.B.-T.); (K.M.); (L.H.); (W.A.); (J.S.); (K.Z.)
| | - Wafaa Ayad
- Church & Dwight, Co., Inc., Product Development Nutritional Sciences, Princeton, NJ 08540, USA; (K.B.-T.); (K.M.); (L.H.); (W.A.); (J.S.); (K.Z.)
| | - Jacalyn Szaro
- Church & Dwight, Co., Inc., Product Development Nutritional Sciences, Princeton, NJ 08540, USA; (K.B.-T.); (K.M.); (L.H.); (W.A.); (J.S.); (K.Z.)
| | - Kelly Zhang
- Church & Dwight, Co., Inc., Product Development Nutritional Sciences, Princeton, NJ 08540, USA; (K.B.-T.); (K.M.); (L.H.); (W.A.); (J.S.); (K.Z.)
| | - Nalin Siriwardhana
- Church & Dwight, Co., Inc., Product Development Nutritional Sciences, Princeton, NJ 08540, USA; (K.B.-T.); (K.M.); (L.H.); (W.A.); (J.S.); (K.Z.)
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Wallace TC, Blusztajn JK, Caudill MA, Klatt KC, Zeisel SH. Choline: The Neurocognitive Essential Nutrient of Interest to Obstetricians and Gynecologists. J Diet Suppl 2019; 17:733-752. [DOI: 10.1080/19390211.2019.1639875] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Taylor C. Wallace
- Department of Nutrition and Food Studies, George Mason University, Fairfax, VA, USA
- Think Healthy Group, Inc, Washington, DC, USA
| | - Jan Krzysztof Blusztajn
- Department of Pathology and Laboratory Medicine, Boston University School of Medicine, Boston, MA, USA
| | - Marie A. Caudill
- Division of Nutritional Sciences, Cornell University, Ithaca, NY, USA
| | - Kevin C. Klatt
- USDA/ARS Children's Nutrition Research Center, Baylor College of Medicine, Houston, TX, USA
| | - Steven H. Zeisel
- Research Institute, University of North Carolina, Kannapolis, NC, USA
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King JH, Kwan STC, Bae S, Klatt KC, Yan J, Malysheva OV, Jiang X, Roberson MS, Caudill MA. Maternal choline supplementation alters vitamin B-12 status in human and murine pregnancy. J Nutr Biochem 2019; 72:108210. [PMID: 31473512 DOI: 10.1016/j.jnutbio.2019.07.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2018] [Revised: 05/26/2019] [Accepted: 07/02/2019] [Indexed: 12/28/2022]
Abstract
Despite participation in overlapping metabolic pathways, the relationship between choline and vitamin B-12 has not been well characterized especially during pregnancy. We sought to determine the effects of maternal choline supplementation on vitamin B-12 status biomarkers in human and mouse pregnancy, hypothesizing that increased choline intake would improve vitamin B-12 status. Associations between common genetic variants in choline-metabolizing genes and vitamin B-12 status biomarkers were also explored in humans. Healthy third-trimester pregnant women (n=26) consumed either 480 or 930 mg choline/day as part of a 12-week controlled feeding study. Wild-type NSA and Dlx3 heterozygous (Dlx3+/-) mice, which display placental insufficiency, consumed a 1×, 2× or 4× choline diet and were sacrificed at gestational days 15.5 and 18.5. Serum vitamin B-12, methylmalonic acid (MMA) and homocysteine were measured in all samples; holotranscobalamin (in humans) and hepatic vitamin B-12 (in mice) were also measured. The 2× choline supplementation for 12 weeks in pregnant women yielded higher serum concentrations of holotranscobalamin, the bioactive form of vitamin B-12 (~24%, P=.01). Women with genetic variants in choline dehydrogenase (CHDH) and betaine-homocysteine S-methyltransferase (BHMT) had higher serum MMA concentrations (~31%, P=.03) and lower serum holotranscobalamin concentrations (~34%, P=.03), respectively. The 4× choline dose decreased serum homocysteine concentrations in both NSA and Dlx3+/- mice (~36% and~43% respectively, P≤.015). In conclusion, differences in choline supply due to supplementation or genetic variation modulate vitamin B-12 status during pregnancy, supporting a functional relationship between these nutrients.
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Affiliation(s)
- Julia H King
- Division of Nutritional Sciences, Cornell University, Ithaca, NY
| | | | - Sajin Bae
- Division of Nutritional Sciences, Cornell University, Ithaca, NY
| | - Kevin C Klatt
- Division of Nutritional Sciences, Cornell University, Ithaca, NY
| | - Jian Yan
- Division of Nutritional Sciences, Cornell University, Ithaca, NY
| | - Olga V Malysheva
- Division of Nutritional Sciences, Cornell University, Ithaca, NY
| | - Xinyin Jiang
- Division of Nutritional Sciences, Cornell University, Ithaca, NY; Department of Health and Nutrition Sciences, Brooklyn College, Brooklyn, NY
| | - Mark S Roberson
- Department of Biomedical Sciences, Cornell University, Ithaca, NY.
| | - Marie A Caudill
- Division of Nutritional Sciences, Cornell University, Ithaca, NY.
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Petersen JM, Parker SE, Crider KS, Tinker SC, Mitchell AA, Werler MM. One-Carbon Cofactor Intake and Risk of Neural Tube Defects Among Women Who Meet Folic Acid Recommendations: A Multicenter Case-Control Study. Am J Epidemiol 2019; 188:1136-1143. [PMID: 30976786 DOI: 10.1093/aje/kwz040] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2018] [Revised: 02/08/2019] [Accepted: 02/11/2019] [Indexed: 11/12/2022] Open
Abstract
We aimed to investigate associations between individual and concurrent (≥2) intakes of one-carbon cofactors vitamins B6 and B12, choline, betaine, and methionine and neural tube defect (NTD) outcomes among mothers meeting the folic acid recommendations. In the Slone Birth Defects Study (case-control design; North America, 1998-2015), mothers of 164 NTD cases and 2,831 nonmalformed controls completed food frequency questionnaires and structured interviews. Estimated intakes of one-carbon cofactors were dichotomized (high vs. low) for all except betaine (low or middle vs. high). We used logistic regression models to estimate odds ratios and 95% confidence intervals adjusted for center, age, and race. The analysis was restricted to mothers with estimated daily total folate intake of ≥400 μg during periconception. Fewer cases, compared with controls, had high intakes for each one-carbon cofactor except betaine, where the starkest contrast occurred in the middle group. Women with concurrent high intakes of B6, B12, choline, and methionine and moderate intake of betaine had approximately half the risk of an NTD-affected pregnancy (odds ratio = 0.49, 95% confidence interval: 0.23, 1.08). These findings suggest that, in the presence of folic acid, one-carbon cofactors-notably when consumed together-might reduce NTD risk. Additional research should inform any changes to clinical recommendations.
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Affiliation(s)
- Julie M Petersen
- Department of Epidemiology, Boston University School of Public Health, Boston, Massachusetts
| | - Samantha E Parker
- Department of Epidemiology, Boston University School of Public Health, Boston, Massachusetts
| | - Krista S Crider
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Sarah C Tinker
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Allen A Mitchell
- the Slone Epidemiology Center at Boston University, Boston, Massachusetts
| | - Martha M Werler
- Department of Epidemiology, Boston University School of Public Health, Boston, Massachusetts
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Renard E, Chéry C, Oussalah A, Josse T, Perrin P, Tramoy D, Voirin J, Klein O, Leheup B, Feillet F, Guéant-Rodriguez RM, Guéant JL. Exome sequencing of cases with neural tube defects identifies candidate genes involved in one-carbon/vitamin B12 metabolisms and Sonic Hedgehog pathway. Hum Genet 2019; 138:703-713. [DOI: 10.1007/s00439-019-02015-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2018] [Accepted: 04/13/2019] [Indexed: 12/13/2022]
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Shipkowski KA, Sanders JM, McDonald JD, Garner CE, Doyle-Eisele M, Wegerski CJ, Waidyanatha S. Comparative disposition of dimethylaminoethanol and choline in rats and mice following oral or intravenous administration. Toxicol Appl Pharmacol 2019; 378:114592. [PMID: 31100288 DOI: 10.1016/j.taap.2019.05.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2019] [Revised: 04/15/2019] [Accepted: 05/10/2019] [Indexed: 12/13/2022]
Abstract
Dimethylaminoethanol (DMAE) and its salts have been used to treat numerous disorders in humans and hence safety of its use is a concern. DMAE is a close structural analog of choline, an essential nutrient. Exposure to DMAE may affect choline uptake and synthesis. The current investigation characterizes: 1) the absorption, distribution, metabolism, and excretion (ADME) of DMAE in Wistar Han rats and B6C3F1 mice following a single gavage or intravenous (IV) administration of 10, 100 or 500 mg/kg [14C]DMAE, and 2) the ADME of [14C]choline (160 mg/kg) and the effect on its disposition following pre-treatment with DMAE (100 or 500 mg/kg). In both rats and mice, following gavage administration, DMAE was excreted in urine (16-69%) and as exhaled CO2 (3-22%). The tissue retention was moderate (21-44%); however, the brain concentrations were low and there was no accumulation. Serum choline levels were not elevated following administration of DMAE. The DMAE metabolites in urine were DMAE N-oxide and N,N-dimethylglycine; the carcinogen, N-N-dimethylnitrosamine, was not detected. The pattern of disposition of [14C]choline following gavage administration was similar to that of [14C]DMAE. Prior treatment with DMAE had minimal effects on choline disposition. The pattern of disposition of [14C]DMAE and [14C]choline following IV administration was similar to gavage administration. There were minimal dose-, sex- or species-related effects following gavage or IV administration of [14C]DMAE or [14C]choline. Data from the current study did not support previous reports that: 1) DMAE alters choline uptake and distribution, or 2) that DMAE is converted into choline in vivo.
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Affiliation(s)
- K A Shipkowski
- Division of the National Toxicology Program, National Institute of Environmental Health Sciences, Research Triangle Park, NC, United States of America
| | - J M Sanders
- Division of the National Toxicology Program, National Institute of Environmental Health Sciences, Research Triangle Park, NC, United States of America
| | - J D McDonald
- Lovelace Biomedical and Environmental Research Institute, Albuquerque, NM, United States of America
| | - C E Garner
- Lovelace Biomedical and Environmental Research Institute, Albuquerque, NM, United States of America
| | - M Doyle-Eisele
- Lovelace Biomedical and Environmental Research Institute, Albuquerque, NM, United States of America
| | - C J Wegerski
- Lovelace Biomedical and Environmental Research Institute, Albuquerque, NM, United States of America
| | - S Waidyanatha
- Division of the National Toxicology Program, National Institute of Environmental Health Sciences, Research Triangle Park, NC, United States of America.
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Wallace TC, Blusztajn JK, Caudill MA, Klatt KC, Natker E, Zeisel SH, Zelman KM. Choline: The Underconsumed and Underappreciated Essential Nutrient. NUTRITION TODAY 2018; 53:240-253. [PMID: 30853718 PMCID: PMC6259877 DOI: 10.1097/nt.0000000000000302] [Citation(s) in RCA: 80] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
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 N-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.
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Affiliation(s)
- Taylor C Wallace
- 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
- is a professor in the Division of Nutritional Sciences at Cornell University
- is a PhD candidate in the Division of Nutritional Sciences at Cornell University
- is the principal at Sage Leaf Communications
- is the director of the University of North Carolina Nutrition Research Institute, the director of the University of North Carolina Obesity Research Center, and aprofessor in the Department of Nutrition at the University of North Carolina
- is the principal of Nonsense Nutrition and has served as the Director of Nutrition for WebMD
| | - Jan Krzysztof Blusztajn
- 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
- is a professor in the Division of Nutritional Sciences at Cornell University
- is a PhD candidate in the Division of Nutritional Sciences at Cornell University
- is the principal at Sage Leaf Communications
- is the director of the University of North Carolina Nutrition Research Institute, the director of the University of North Carolina Obesity Research Center, and aprofessor in the Department of Nutrition at the University of North Carolina
- is the principal of Nonsense Nutrition and has served as the Director of Nutrition for WebMD
| | - Marie A Caudill
- 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
- is a professor in the Division of Nutritional Sciences at Cornell University
- is a PhD candidate in the Division of Nutritional Sciences at Cornell University
- is the principal at Sage Leaf Communications
- is the director of the University of North Carolina Nutrition Research Institute, the director of the University of North Carolina Obesity Research Center, and aprofessor in the Department of Nutrition at the University of North Carolina
- is the principal of Nonsense Nutrition and has served as the Director of Nutrition for WebMD
| | - Kevin C Klatt
- 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
- is a professor in the Division of Nutritional Sciences at Cornell University
- is a PhD candidate in the Division of Nutritional Sciences at Cornell University
- is the principal at Sage Leaf Communications
- is the director of the University of North Carolina Nutrition Research Institute, the director of the University of North Carolina Obesity Research Center, and aprofessor in the Department of Nutrition at the University of North Carolina
- is the principal of Nonsense Nutrition and has served as the Director of Nutrition for WebMD
| | - Elana Natker
- 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
- is a professor in the Division of Nutritional Sciences at Cornell University
- is a PhD candidate in the Division of Nutritional Sciences at Cornell University
- is the principal at Sage Leaf Communications
- is the director of the University of North Carolina Nutrition Research Institute, the director of the University of North Carolina Obesity Research Center, and aprofessor in the Department of Nutrition at the University of North Carolina
- is the principal of Nonsense Nutrition and has served as the Director of Nutrition for WebMD
| | - Steven H Zeisel
- 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
- is a professor in the Division of Nutritional Sciences at Cornell University
- is a PhD candidate in the Division of Nutritional Sciences at Cornell University
- is the principal at Sage Leaf Communications
- is the director of the University of North Carolina Nutrition Research Institute, the director of the University of North Carolina Obesity Research Center, and aprofessor in the Department of Nutrition at the University of North Carolina
- is the principal of Nonsense Nutrition and has served as the Director of Nutrition for WebMD
| | - Kathleen M Zelman
- 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
- is a professor in the Division of Nutritional Sciences at Cornell University
- is a PhD candidate in the Division of Nutritional Sciences at Cornell University
- is the principal at Sage Leaf Communications
- is the director of the University of North Carolina Nutrition Research Institute, the director of the University of North Carolina Obesity Research Center, and aprofessor in the Department of Nutrition at the University of North Carolina
- is the principal of Nonsense Nutrition and has served as the Director of Nutrition for WebMD
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15
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Leung KY, Pai YJ, Chen Q, Santos C, Calvani E, Sudiwala S, Savery D, Ralser M, Gross SS, Copp AJ, Greene NDE. Partitioning of One-Carbon Units in Folate and Methionine Metabolism Is Essential for Neural Tube Closure. Cell Rep 2018; 21:1795-1808. [PMID: 29141214 PMCID: PMC5699646 DOI: 10.1016/j.celrep.2017.10.072] [Citation(s) in RCA: 58] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2017] [Revised: 09/27/2017] [Accepted: 10/18/2017] [Indexed: 11/18/2022] Open
Abstract
Abnormal folate one-carbon metabolism (FOCM) is implicated in neural tube defects (NTDs), severe malformations of the nervous system. MTHFR mediates unidirectional transfer of methyl groups from the folate cycle to the methionine cycle and, therefore, represents a key nexus in partitioning one-carbon units between FOCM functional outputs. Methionine cycle inhibitors prevent neural tube closure in mouse embryos. Similarly, the inability to use glycine as a one-carbon donor to the folate cycle causes NTDs in glycine decarboxylase (Gldc)-deficient embryos. However, analysis of Mthfr-null mouse embryos shows that neither S-adenosylmethionine abundance nor neural tube closure depend on one-carbon units derived from embryonic or maternal folate cycles. Mthfr deletion or methionine treatment prevents NTDs in Gldc-null embryos by retention of one-carbon units within the folate cycle. Overall, neural tube closure depends on the activity of both the methionine and folate cycles, but transfer of one-carbon units between the cycles is not necessary. Inhibition of methionine cycle activity prevents neural tube closure, causing NTDs Loss of embryonic and maternal MTHFR activity does not prevent neural tube closure Glycine is a 1C donor to the folate cycle via the glycine cleavage system in the embryo Ablation of glycine cleavage causes NTDs, preventable by MTHFR inactivity or methionine
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Affiliation(s)
- Kit-Yi Leung
- Developmental Biology & Cancer Programme, UCL Great Ormond Street Institute of Child Health, University College London, London WC1N 1EH, UK
| | - Yun Jin Pai
- Developmental Biology & Cancer Programme, UCL Great Ormond Street Institute of Child Health, University College London, London WC1N 1EH, UK
| | - Qiuying Chen
- Department of Pharmacology, Weill Cornell Medical College of Cornell University, 1300 York Avenue, New York, NY 10021, USA
| | - Chloe Santos
- Developmental Biology & Cancer Programme, UCL Great Ormond Street Institute of Child Health, University College London, London WC1N 1EH, UK
| | - Enrica Calvani
- The Francis Crick Institute, 1 Midland Road, London NW1 1AT, UK
| | - Sonia Sudiwala
- Developmental Biology & Cancer Programme, UCL Great Ormond Street Institute of Child Health, University College London, London WC1N 1EH, UK
| | - Dawn Savery
- Developmental Biology & Cancer Programme, UCL Great Ormond Street Institute of Child Health, University College London, London WC1N 1EH, UK
| | - Markus Ralser
- The Francis Crick Institute, 1 Midland Road, London NW1 1AT, UK
| | - Steven S Gross
- Department of Pharmacology, Weill Cornell Medical College of Cornell University, 1300 York Avenue, New York, NY 10021, USA
| | - Andrew J Copp
- Developmental Biology & Cancer Programme, UCL Great Ormond Street Institute of Child Health, University College London, London WC1N 1EH, UK
| | - Nicholas D E Greene
- Developmental Biology & Cancer Programme, UCL Great Ormond Street Institute of Child Health, University College London, London WC1N 1EH, UK.
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Chittiboyina S, Chen Z, Chiorean EG, Kamendulis LM, Hocevar BA. The role of the folate pathway in pancreatic cancer risk. PLoS One 2018; 13:e0193298. [PMID: 29474406 PMCID: PMC5825090 DOI: 10.1371/journal.pone.0193298] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2017] [Accepted: 02/08/2018] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Pancreatic cancer is the third leading cause of cancer related deaths in the United States. Several dietary factors have been identified that modify pancreatic cancer risk, including low folate levels. In addition to nutrition and lifestyle determinants, folate status may be influenced by genetic factors such as single nucleotide polymorphisms (SNPs). In the present study, we investigated the association between folate levels, genetic polymorphisms in genes of the folate pathway, and pancreatic cancer. METHODS Serum and red blood cell (RBC) folate levels were measured in pancreatic cancer and control subjects. Genotypes were determined utilizing Taqman probes and SNP frequencies between cases and controls were assessed using Fisher's exact test. Logistic regression was used to estimate the odds ratio (OR) and corresponding 95% confidence intervals (CIs) to measure the association between genotypes and pancreatic cancer risk. The association between folate levels and SNP expression was calculated using one-way ANOVA. RESULTS Mean RBC folate levels were significantly lower in pancreatic cancer cases compared to unrelated controls (508.4 ± 215.9 ng/mL vs 588.3 ± 229.2 ng/mL, respectively) whereas serum folate levels were similar. Irrespective of cancer status, several SNPs were found to be associated with altered serum folate concentrations, including the D919G SNP in methionine synthase (MTR), the L474F SNP in serine hydroxymethyl transferase 1 (SHMT1) and the V175M SNP in phosphatidyl ethanolamine methyltransferase (PEMT). Further, the V allele of the A222V SNP and the E allele of the E429A SNP in methylene tetrahydrofolate reductase (MTHFR) were associated with low RBC folate levels. Pancreatic cancer risk was found to be significantly lower for the LL allele of the L78R SNP in choline dehydrogenase (CHDH; OR = 0.29; 95% CI 0.12-0.76); however, it was not associated with altered serum or RBC folate levels.
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Affiliation(s)
- Shirisha Chittiboyina
- Department of Environmental Health, School of Public Health, Indiana University, Bloomington, Indiana, United States of America
| | - Zhongxue Chen
- Department of Epidemiology and Biostatistics, School of Public Health, Indiana University, Bloomington, Indiana, United States of America
| | - E. Gabriela Chiorean
- University of Washington, Fred Hutchinson Cancer Research Center, Seattle, Washington, United States of America
- Indiana University Melvin and Bren Simon Cancer Center, Indianapolis, Indiana, United States of America
| | - Lisa M. Kamendulis
- Department of Environmental Health, School of Public Health, Indiana University, Bloomington, Indiana, United States of America
| | - Barbara A. Hocevar
- Department of Environmental Health, School of Public Health, Indiana University, Bloomington, Indiana, United States of America
- * E-mail:
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17
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Wallace TC. A Comprehensive Review of Eggs, Choline, and Lutein on Cognition Across the Life-span. J Am Coll Nutr 2018; 37:269-285. [DOI: 10.1080/07315724.2017.1423248] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Taylor C. Wallace
- Department of Nutrition and Food Studies, George Mason University, Fairfax, Virginia; Think Healthy Group, Inc., Washington, DC
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18
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Dietary choline and betaine intake, choline-metabolising genetic polymorphisms and breast cancer risk: a case-control study in China. Br J Nutr 2016; 116:961-8. [PMID: 27488260 DOI: 10.1017/s0007114516002956] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Choline and betaine are essential nutrients involved in one-carbon metabolism and have been hypothesised to affect breast cancer risk. Functional polymorphisms in genes encoding choline-related one-carbon metabolism enzymes, including phosphatidylethanolamine N-methyltransferase (PEMT), choline dehydrogenase (CHDH) and betaine-homocysteine methyltransferase (BHMT), have important roles in choline metabolism and may thus interact with dietary choline and betaine intake to modify breast cancer risk. This study aimed to investigate the interactive effect of polymorphisms in PEMT, BHMT and CHDH genes with choline/betaine intake on breast cancer risk among Chinese women. This hospital-based case-control study consecutively recruited 570 cases with histologically confirmed breast cancer and 576 age-matched (5-year interval) controls. Choline and betaine intakes were assessed by a validated FFQ, and genotyping was conducted for PEMT rs7946, CHDH rs9001 and BHMT rs3733890. OR and 95 % CI were estimated using unconditional logistic regression. Compared with the highest quartile of choline intake, the lowest intake quartile showed a significant increased risk of breast cancer. The SNP PEMT rs7946, CHDH rs9001 and BHMT rs3733890 had no overall association with breast cancer, but a significant risk reduction was observed among postmenopausal women with AA genotype of BHMT rs3733890 (OR 0·49; 95 % CI 0·25, 0·98). Significant interactions were observed between choline intake and SNP PEMT rs7946 (P interaction=0·029) and BHMT rs3733890 (P interaction=0·006) in relation to breast cancer risk. Our results suggest that SNP PEMT rs7946 and BHMT rs3733890 may interact with choline intake on breast cancer risk.
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Abstract
PURPOSE OF REVIEW The review highlights recent advances in our understanding of the interactions between genetic polymorphisms in genes that metabolize choline and the dietary requirements of choline and how these interactions relate to human health and disease. RECENT FINDINGS The importance of choline as an essential nutrient has been well established, but our appreciation of the interaction between our underlying genetic architecture and dietary choline requirements is only beginning. It has been shown in both human and animal studies that choline deficiencies contribute to diseases such as nonalcoholic fatty liver disease and various neurodegenerative diseases. An adequate supply of dietary choline is important for optimum development, highlighted by the increased maternal requirements during fetal development and in breast-fed infants. We discuss recent studies investigating variants in PEMT and MTHFR1 that are associated with a variety of birth defects. In addition to genetic interactions, we discuss several recent studies that uncover changes in fetal global methylation patterns in response to maternal dietary choline intake that result in changes in gene expression in the offspring. In contrast to the developmental role of adequate choline, there is now an appreciation of the role choline has in cardiovascular disease through the gut microbiota-mediated metabolite trimethylamine N-oxide. This pathway highlights some of our understanding of how the microbiome affects nutrient processing and bioavailability. Finally, to better characterize the genetic architecture regulating choline requirements, we discuss recent results focused on identifying polymorphisms that regulate choline and its derivative products. SUMMARY Here we discuss recent studies that have advanced our understanding of how specific alleles in key choline metabolism genes are related to dietary choline requirements and human disease.
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Affiliation(s)
- Tangi Smallwood
- Department of Genetics, University of North Carolina Chapel Hill, North Carolina 27599
| | - Hooman Allayee
- Department of Preventive Medicine and Institute for Genetic Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033
| | - Brian J. Bennett
- Department of Genetics, University of North Carolina Chapel Hill, North Carolina 27599
- Nutrition Research Institute, University of North Carolina Kannapolis, North Carolina 28081
- Department of Nutrition, University of North Carolina Chapel Hill, North Carolina 27599
- Corresponding author: Brian J. Bennett, 500 Laureate Way, Suite 2303, Kannapolis NC 28081, Phone: 704-250-5044, Fax: 704-250-5000,
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Leermakers ETM, Moreira EM, Kiefte-de Jong JC, Darweesh SKL, Visser T, Voortman T, Bautista PK, Chowdhury R, Gorman D, Bramer WM, Felix JF, Franco OH. Effects of choline on health across the life course: a systematic review. Nutr Rev 2015; 73:500-22. [PMID: 26108618 DOI: 10.1093/nutrit/nuv010] [Citation(s) in RCA: 68] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
CONTEXT Choline is a precursor of both betaine and acetylcholine and might, therefore, influence cardiovascular and cognitive outcomes. There has been concern, however, that it may influence blood lipid levels because it is an essential component of very-low-density lipoproteins. OBJECTIVE The aim was to systematically review, using PRISMA guidelines, the literature pertaining to the effects of choline on body composition and on metabolic, cardiovascular, respiratory, and neurological outcomes in different life stages. DATA SOURCES The MEDLINE, Embase, Cochrane Central, Web of Science, PubMed, and Google Scholar databases were searched up to July 2014. DATA EXTRACTION Fifty relevant articles were identified. These comprised trials and cohort, case-control, and cross-sectional studies that assessed blood levels of choline, dietary intake of choline, and supplementation with choline in a population free of diseases at baseline. DATA SYNTHESIS There is some observational evidence that choline during pregnancy may be beneficial for the neurological health of the child. In adults, choline may have beneficial effects on cognition, but high-quality (intervention) studies are lacking. Results on the effects of choline on body composition, blood lipids, and cardiovascular health were inconsistent. CONCLUSIONS Evidence to confirm the suggested effects of choline on health in different stages of life is scarce. Potential effects of choline need to be confirmed by intervention studies. Possible harmful effects on cardiometabolic health need careful evaluation.
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Affiliation(s)
- Elisabeth T M Leermakers
- E.T.M. Leermakers, E.M. Moreira, J.C. Kiefte-de Jong, S.K.L. Darweesh, T. Visser, T. Voortman, P.K. Bautista, J.F. Felix, and O.H. Franco are with the Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, the Netherlands. R. Chowdhury and D. Gorman are with the Department of Public Health & Primary Care, Cardiovascular Epidemiology Unit, University of Cambridge, Cambridge, CB1 8RN, United Kingdom. W.M. Bramer is with the Medical Library, Erasmus MC, University Medical Center Rotterdam, the Netherlands
| | - Eduardo M Moreira
- E.T.M. Leermakers, E.M. Moreira, J.C. Kiefte-de Jong, S.K.L. Darweesh, T. Visser, T. Voortman, P.K. Bautista, J.F. Felix, and O.H. Franco are with the Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, the Netherlands. R. Chowdhury and D. Gorman are with the Department of Public Health & Primary Care, Cardiovascular Epidemiology Unit, University of Cambridge, Cambridge, CB1 8RN, United Kingdom. W.M. Bramer is with the Medical Library, Erasmus MC, University Medical Center Rotterdam, the Netherlands
| | - Jessica C Kiefte-de Jong
- E.T.M. Leermakers, E.M. Moreira, J.C. Kiefte-de Jong, S.K.L. Darweesh, T. Visser, T. Voortman, P.K. Bautista, J.F. Felix, and O.H. Franco are with the Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, the Netherlands. R. Chowdhury and D. Gorman are with the Department of Public Health & Primary Care, Cardiovascular Epidemiology Unit, University of Cambridge, Cambridge, CB1 8RN, United Kingdom. W.M. Bramer is with the Medical Library, Erasmus MC, University Medical Center Rotterdam, the Netherlands
| | - Sirwan K L Darweesh
- E.T.M. Leermakers, E.M. Moreira, J.C. Kiefte-de Jong, S.K.L. Darweesh, T. Visser, T. Voortman, P.K. Bautista, J.F. Felix, and O.H. Franco are with the Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, the Netherlands. R. Chowdhury and D. Gorman are with the Department of Public Health & Primary Care, Cardiovascular Epidemiology Unit, University of Cambridge, Cambridge, CB1 8RN, United Kingdom. W.M. Bramer is with the Medical Library, Erasmus MC, University Medical Center Rotterdam, the Netherlands
| | - Thirsa Visser
- E.T.M. Leermakers, E.M. Moreira, J.C. Kiefte-de Jong, S.K.L. Darweesh, T. Visser, T. Voortman, P.K. Bautista, J.F. Felix, and O.H. Franco are with the Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, the Netherlands. R. Chowdhury and D. Gorman are with the Department of Public Health & Primary Care, Cardiovascular Epidemiology Unit, University of Cambridge, Cambridge, CB1 8RN, United Kingdom. W.M. Bramer is with the Medical Library, Erasmus MC, University Medical Center Rotterdam, the Netherlands
| | - Trudy Voortman
- E.T.M. Leermakers, E.M. Moreira, J.C. Kiefte-de Jong, S.K.L. Darweesh, T. Visser, T. Voortman, P.K. Bautista, J.F. Felix, and O.H. Franco are with the Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, the Netherlands. R. Chowdhury and D. Gorman are with the Department of Public Health & Primary Care, Cardiovascular Epidemiology Unit, University of Cambridge, Cambridge, CB1 8RN, United Kingdom. W.M. Bramer is with the Medical Library, Erasmus MC, University Medical Center Rotterdam, the Netherlands
| | - Paula K Bautista
- E.T.M. Leermakers, E.M. Moreira, J.C. Kiefte-de Jong, S.K.L. Darweesh, T. Visser, T. Voortman, P.K. Bautista, J.F. Felix, and O.H. Franco are with the Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, the Netherlands. R. Chowdhury and D. Gorman are with the Department of Public Health & Primary Care, Cardiovascular Epidemiology Unit, University of Cambridge, Cambridge, CB1 8RN, United Kingdom. W.M. Bramer is with the Medical Library, Erasmus MC, University Medical Center Rotterdam, the Netherlands
| | - Rajiv Chowdhury
- E.T.M. Leermakers, E.M. Moreira, J.C. Kiefte-de Jong, S.K.L. Darweesh, T. Visser, T. Voortman, P.K. Bautista, J.F. Felix, and O.H. Franco are with the Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, the Netherlands. R. Chowdhury and D. Gorman are with the Department of Public Health & Primary Care, Cardiovascular Epidemiology Unit, University of Cambridge, Cambridge, CB1 8RN, United Kingdom. W.M. Bramer is with the Medical Library, Erasmus MC, University Medical Center Rotterdam, the Netherlands
| | - Donal Gorman
- E.T.M. Leermakers, E.M. Moreira, J.C. Kiefte-de Jong, S.K.L. Darweesh, T. Visser, T. Voortman, P.K. Bautista, J.F. Felix, and O.H. Franco are with the Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, the Netherlands. R. Chowdhury and D. Gorman are with the Department of Public Health & Primary Care, Cardiovascular Epidemiology Unit, University of Cambridge, Cambridge, CB1 8RN, United Kingdom. W.M. Bramer is with the Medical Library, Erasmus MC, University Medical Center Rotterdam, the Netherlands
| | - Wichor M Bramer
- E.T.M. Leermakers, E.M. Moreira, J.C. Kiefte-de Jong, S.K.L. Darweesh, T. Visser, T. Voortman, P.K. Bautista, J.F. Felix, and O.H. Franco are with the Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, the Netherlands. R. Chowdhury and D. Gorman are with the Department of Public Health & Primary Care, Cardiovascular Epidemiology Unit, University of Cambridge, Cambridge, CB1 8RN, United Kingdom. W.M. Bramer is with the Medical Library, Erasmus MC, University Medical Center Rotterdam, the Netherlands
| | - Janine F Felix
- E.T.M. Leermakers, E.M. Moreira, J.C. Kiefte-de Jong, S.K.L. Darweesh, T. Visser, T. Voortman, P.K. Bautista, J.F. Felix, and O.H. Franco are with the Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, the Netherlands. R. Chowdhury and D. Gorman are with the Department of Public Health & Primary Care, Cardiovascular Epidemiology Unit, University of Cambridge, Cambridge, CB1 8RN, United Kingdom. W.M. Bramer is with the Medical Library, Erasmus MC, University Medical Center Rotterdam, the Netherlands
| | - Oscar H Franco
- E.T.M. Leermakers, E.M. Moreira, J.C. Kiefte-de Jong, S.K.L. Darweesh, T. Visser, T. Voortman, P.K. Bautista, J.F. Felix, and O.H. Franco are with the Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, the Netherlands. R. Chowdhury and D. Gorman are with the Department of Public Health & Primary Care, Cardiovascular Epidemiology Unit, University of Cambridge, Cambridge, CB1 8RN, United Kingdom. W.M. Bramer is with the Medical Library, Erasmus MC, University Medical Center Rotterdam, the Netherlands
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