(PTFS09-02-24) Human Milk Choline Concentration in Relation to Infant Intake Recommendations: Findings From the JiVitA-3 Study

Sunday, June 30, 2024

2:04 PM – 2:08 PM CT

Location: Hall F1 (The Hub) - Poster Theater

Presenting Author(s)

Sulagna Bandyopadhyay, PhD

Postdoctoral Fellow
Center for Human Nutrition, Department of International Health, Johns Hopkins University Bloomberg School of Public Health
Baltimore, Maryland, United States

Disclosure(s): No relevant financial relationship(s) with ineligible companies to disclose.

Co-Author(s)

Kerry J. Schulze, PhD (she/her/hers)

Senior Scientist
Johns Hopkins Bloomberg School of Public Health
Baltimore, Maryland, United States
Daniela Hampel, PhD (she/her/hers)

Project Scientist
University of California, USDA
Davis, California, United States
LW

Lee S. Wu, MHS

Johns Hopkins Bloomberg School of Public Health
Baltimore, Maryland, United States
SB

Sarah Baker

Johns Hopkins Bloomberg School of Public Health
KS

Katherine K. Stephenson

Johns Hopkins University
HA

Hasmot Ali, MBBS, MPH

Senior Research Physician
The JiVitA Project, Gaibandha Bangladesh
Gaibandha, Rajshahi, Bangladesh
SS

Saijuddin Shaik

JiVitA Maternal & Child Nutrition and Health Research Project, Rangpur, Bangladesh
SS

Setarah Shehab-Ferdows, PhD

Nutritionist
USDA, ARS Western Human Nutrition Research Center
Davis, California, United States
Lindsay H. Allen, PhD

Research Scientist
USDA, ARS Western Human Nutrition Research Center and University of California, Davis
Davis, California, United States
KW

Keith P. West Jr

Johns Hopkins Bloomberg School of Public Health
Baltimore, Maryland, United States
PC

Parul Christian, PhD, MSc

Professor
Johns Hopkins Bloomberg School of Public Health
Baltimore, Maryland, United States

Objectives: Choline is an essential nutrient for growth and neurodevelopment in infants and has been found to be sensitive to maternal dietary intakes. We measured the human milk water soluble choline compounds. compared milk total choline concentrations to the infant Adequate Intake (AI) recommendations, and explored maternal intakes of choline rich food groups at 3 months postpartum in rural Bangladesh women.

Methods: In a trial (JiVitA-3) of antenatal multiple micronutrient (without choline) or iron-folic acid (IFA, standard of care) supplementation, a casual human milk sample and dietary intake as servings of food items consumed in the last week were collected from mothers at 3 months postpartum. Milk phosphocholine (PCho), glycerophosphocholine (GPCho), free choline, and choline metabolites betaine and dimethylglycine (DMG) were assessed using ultra-high performance liquid chromatography-tandem mass spectrometry (UHPLC-MS/MS) in 204 samples. Total choline concentration was calculated as [free choline + (PCHo×0.566) + (GPCho×0.405)]. Milk choline was compared to the mean concentration used to set infant AI recommendations (160 mg/L) and with the concentration (90 mg/L) associated with symptoms of choline deficiency in infants.

Results: The concentrations (mean ± SD) of PCho, GPCho, free and total choline were 116.3±38.0, 129.0±35.4, 13.6±8.3, and 131.6±28.9 mg/L, respectively. The concentration (median, IQR) of betaine was 0.59 (0.42) mg/L and DMG was 0.13 (0.11) mg/L. The proportion of milk samples that did not meet the infant AI of choline was 85.0%, and 6.4% were deficient. The prevalence of women consuming ≥3 servings of choline-rich foods in the last week was: for fish, 60.3%; meat, 11.8%; milk, 13.2%; and egg, 8.3%.

Conclusions: Choline in human milk of Bangladeshi mothers met the AI for only 15% of infants and the concentrations were similar to those reported elsewhere and will be explored more thoroughly. Women’s consumption of choline-rich foods was limited except for fish, which is habitually consumed in this setting. The results contribute to our knowledge of global variability in human milk composition and warrant further analysis to explore associations of milk choline with maternal diet and infant developmental outcomes.

Funding Sources: BMGF and USDA, ARS