Dietary Recommendations

The Institute of Medicine, USA National Academy of Sciences, recommended an adequate intake (I) of 550mg/70kg body weight for choline in the diet. This amount may be influenced by gender, and it may be influenced by pregnancy, lactation, and stage of development (Table 1).

Amino acid-glucose solutions used in total parent-eral nutrition of humans lack choline. The lipid emulsions that deliver extra calories and essential fatty acids during parenteral nutrition contain cho-line in the form of lecithin (20% emulsion contains 13.2mmoll_1). Humans treated with parenteral nutrition require 1-1.7 mmol of choline-containing phospholipid per day during the first week of par-enteral nutrition therapy to maintain plasma choline levels.

Human milk, which contains approximately 200 mgl-1 choline and choline esters, is an especially good source of choline. An infant consuming 500 ml breast milk in a day ingests 50 mg choline. Human milk is not a static food; its choline composition changes over time postnatally. The choline composition of infant formulas can differ greatly from that present in human milk. It is essential that variations in the bioavailability and utilization of choline, phosphocholine, glycerophosphocholine, and lecithin in milk be considered when milk substitutes are developed.

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