And UK failing to recommend or
monitor dietary levels of choline, warns nutritionist
August 29, 2019
BMJ
The momentum behind a move to
plant-based and vegan diets for the good of the planet is commendable, but
risks worsening an already low intake of an essential nutrient involved in
brain health, warns a nutritionist.
The momentum behind a move to
plant-based and vegan diets for the good of the planet is commendable, but
risks worsening an already low intake of an essential nutrient involved in
brain health, warns a nutritionist in the online journal BMJ Nutrition,
Prevention & Health.
To make matters worse, the UK
government has failed to recommend or monitor dietary levels of this nutrient
-- choline -- found predominantly in animal foods, says Dr Emma Derbyshire, of
Nutritional Insight, a consultancy specialising in nutrition and biomedical
science.
Choline is an essential
dietary nutrient, but the amount produced by the liver is not enough to meet
the requirements of the human body.
Choline is critical to brain
health, particularly during fetal development. It also influences liver function,
with shortfalls linked to irregularities in blood fat metabolism as well as
excess free radical cellular damage, writes Dr Derbyshire.
The primary sources of dietary
choline are found in beef, eggs, dairy products, fish, and chicken, with much
lower levels found in nuts, beans, and cruciferous vegetables, such as
broccoli.
In 1998, recognising the
importance of choline, the US Institute of Medicine recommended minimum daily
intakes. These range from 425 mg/day for women to 550 mg/day for men, and 450
mg/day and 550 mg/day for pregnant and breastfeeding women, respectively,
because of the critical role the nutrient has in fetal development.
In 2016, the European Food
Safety Authority published similar daily requirements. Yet national dietary
surveys in North America, Australia, and Europe show that habitual choline
intake, on average, falls short of these recommendations.
"This is....concerning
given that current trends appear to be towards meat reduction and plant-based
diets," says Dr Derbyshire.
She commends the first report
(EAT-Lancet) to compile a healthy food plan based on promoting environmental
sustainability, but suggests that the restricted intakes of whole milk, eggs
and animal protein it recommends could affect choline intake.
And she is at a loss to
understand why choline does not feature in UK dietary guidance or national
population monitoring data.
"Given the important
physiological roles of choline and authorisation of certain health claims, it
is questionable why choline has been overlooked for so long in the UK,"
she writes. "Choline is presently excluded from UK food composition
databases, major dietary surveys, and dietary guidelines," she adds.
It may be time for the UK
government's independent Scientific Advisory Committee on Nutrition to reverse
this, she suggests, particularly given the mounting evidence on the importance
of choline to human health and growing concerns about the sustainability of the
planet's food production.
"More needs to be done to
educate healthcare professionals and consumers about the importance of a
choline-rich diet, and how to achieve this," she writes.
"If choline is not
obtained in the levels needed from dietary sources per se then supplementation
strategies will be required, especially in relation to key stages of the life
cycle, such as pregnancy, when choline intakes are critical to infant development,"
she concludes.
Story Source:
Journal Reference:
Emma Derbyshire. Could we
be overlooking a potential choline crisis in the United Kingdom? BMJ
Nutrition, Prevention & Health, 2019; bmjnph-2019-000037 DOI: 10.1136/bmjnph-2019-000037
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