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Paules EM, Silva-Gomez JA, Friday WB, Zeisel SH, Trujillo-Gonzalez I. Choline Regulates SOX4 through miR-129-5p and Modifies H3K27me3 in the Developing Cortex. Nutrients 2023; 15:2774. [PMID: 37375678 PMCID: PMC10304412 DOI: 10.3390/nu15122774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Revised: 06/09/2023] [Accepted: 06/14/2023] [Indexed: 06/29/2023] Open
Abstract
Choline availability regulates neural progenitor cell proliferation and differentiation in the developing cerebral cortex. Here, we investigated the molecular mechanism underlying this process and demonstrated that choline regulates the transcription factor SOX4 in neural progenitor cells. Specifically, we found that low choline intake during neurogenesis reduces SOX4 protein levels, causing the downregulation of EZH2, a histone methyltransferase. Importantly, we demonstrate that low choline is not involved in SOX4 protein degradation rate and established that protein reduction is caused by aberrant expression of a microRNA (miR-129-5p). To confirm the role of miR-129-5p, we conducted gain-of-function and loss-of-function assays in neural progenitor cells and demonstrated that directly altering miR-129-5p levels could affect SOX4 protein levels. We also observed that the reduction in SOX4 and EZH2 led to decreased global levels of H3K27me3 in the developing cortex, contributing to reduced proliferation and precocious differentiation. For the first time, to our knowledge, we demonstrate that a nutrient, choline, regulates a master transcription factor and its downstream targets, providing a novel insight into the role of choline in brain development.
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Affiliation(s)
- Evan M. Paules
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC 27514, USA; (E.M.P.); (J.A.S.-G.); (W.B.F.); (S.H.Z.)
| | - Jorge A. Silva-Gomez
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC 27514, USA; (E.M.P.); (J.A.S.-G.); (W.B.F.); (S.H.Z.)
| | - Walter B. Friday
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC 27514, USA; (E.M.P.); (J.A.S.-G.); (W.B.F.); (S.H.Z.)
| | - Steve H. Zeisel
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC 27514, USA; (E.M.P.); (J.A.S.-G.); (W.B.F.); (S.H.Z.)
- Nutrition Research Institute, University of North Carolina at Chapel Hill, Kannapolis, NC 28081, USA
| | - Isis Trujillo-Gonzalez
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC 27514, USA; (E.M.P.); (J.A.S.-G.); (W.B.F.); (S.H.Z.)
- Nutrition Research Institute, University of North Carolina at Chapel Hill, Kannapolis, NC 28081, USA
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Bragg MG, Prado EL, Caswell BL, Arnold CD, George M, Oakes LM, Beckner AG, DeBolt MC, Bennett BJ, Maleta KM, Stewart CP. The association between plasma choline, growth and neurodevelopment among Malawian children aged 6-15 months enroled in an egg intervention trial. MATERNAL & CHILD NUTRITION 2023; 19:e13471. [PMID: 36567549 PMCID: PMC10019050 DOI: 10.1111/mcn.13471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 11/23/2022] [Accepted: 12/01/2022] [Indexed: 12/27/2022]
Abstract
Choline is an essential micronutrient that may influence growth and development; however, few studies have examined postnatal choline status and children's growth and development in low- and middle-income countries. The aim of this observational analysis was to examine associations of plasma choline with growth and development among Malawian children aged 6-15 months enrolled in an egg intervention trial. Plasma choline and related metabolites (betaine, dimethylglycine and trimethylamine N-oxide) were measured at baseline and 6-month follow-up, along with anthropometric (length, weight, head circumference) and developmental assessments (the Malawi Developmental Assessment Tool [MDAT], the Infant Orienting with Attention task [IOWA], a visual paired comparison [VPC] task and an elicited imitation [EI] task). In cross-sectional covariate-adjusted models, each 1 SD higher plasma choline was associated with lower length-for-age z-score (-0.09 SD [95% confidence interval, CI -0.17 to -0.01]), slower IOWA response time (8.84 ms [1.66-16.03]) and faster processing speed on the VPC task (-203.5 ms [-366.2 to -40.7]). In predictive models, baseline plasma choline was negatively associated with MDAT fine motor z-score at 6-month follow-up (-0.13 SD [-0.22 to -0.04]). There were no other significant associations of plasma choline with child measures. Similarly, associations of choline metabolites with growth and development were null except higher trimethylamine N-oxide was associated with slower information processing on the VPC task and higher memory scores on the EI task. In this cohort of children with low dietary choline intake, we conclude that there were no strong or consistent associations between plasma choline and growth and development.
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Affiliation(s)
- Megan G. Bragg
- Department of NutritionUniversity of California DavisDavisCaliforniaUSA
- AJ Drexel Autism InstituteDrexel UniversityPhiladelphiaPennsylvaniaUSA
| | | | - Bess L. Caswell
- USDA Western Human Nutrition Research CenterDavisCaliforniaUSA
| | - Charles D. Arnold
- Department of NutritionUniversity of California DavisDavisCaliforniaUSA
| | - Matthews George
- School of Public Health and Family MedicineKamuzu University of Health SciencesBlantyreMalawi
| | - Lisa M. Oakes
- Center for Mind and BrainUniversity of California DavisDavisCaliforniaUSA
| | - Aaron G. Beckner
- Center for Mind and BrainUniversity of California DavisDavisCaliforniaUSA
| | - Michaela C. DeBolt
- Center for Mind and BrainUniversity of California DavisDavisCaliforniaUSA
| | | | - Kenneth M. Maleta
- School of Public Health and Family MedicineKamuzu University of Health SciencesBlantyreMalawi
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Bragg MG, Prado EL, Arnold CD, Zyba SJ, Maleta KM, Caswell BL, Bennett BJ, Iannotti LL, Lutter CK, Stewart CP. Plasma Choline Concentration Was Not Increased After a 6-Month Egg Intervention in 6-9-Month-Old Malawian Children: Results from a Randomized Controlled Trial. Curr Dev Nutr 2022; 6:nzab150. [PMID: 35233478 PMCID: PMC8881212 DOI: 10.1093/cdn/nzab150] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Revised: 12/12/2021] [Accepted: 12/14/2021] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Eggs are a rich source of choline, an essential nutrient important for child growth and development. In a randomized trial of 1 egg/d in young children in Ecuador, an egg intervention led to significant improvements in growth, which were partially mediated by increased plasma choline concentration. A similar trial in Malawi (clinicaltrials.gov: NCT03385252) found little improvement in child growth or development. OBJECTIVES We aimed to evaluate the effect of 1 egg/d for 6 mo on plasma choline concentrations in Malawian children enrolled in a randomized trial. METHODS Infants aged 6-9 mo in rural Malawi were randomly assigned to receive 1 egg/d (n = 331) or serve as a nonintervention control (n = 329) for 6 mo. Anthropometric, developmental, and dietary data were collected at baseline and 6-mo follow-up, along with a blood draw. Plasma choline, betaine, dimethylglycine, trimethylamine N-oxide (TMAO), and DHA were measured at both time points using ultrahigh performance liquid chromatography-tandem MS (n = 200 per group). Linear regression analysis was used to determine the difference in plasma choline and related metabolites between groups after 6 mo of intervention. RESULTS Plasma choline, betaine, dimethylglycine, and DHA concentrations did not differ between groups at 6-mo follow-up. Plasma TMAO was significantly (26%; 95% CI: 7%, 48%) higher in the egg intervention group in a fully adjusted model. CONCLUSIONS Provision of 1 egg/d for 6 mo did not result in increases in plasma choline or related metabolites, except TMAO. This could partially explain the lack of effect on growth and development. Additional interventions are needed to improve choline status, growth, and development in this population.
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Affiliation(s)
- Megan G Bragg
- Institute for Global Nutrition, Department of Nutrition, University of California Davis, Davis, CA, USA
| | - Elizabeth L Prado
- Institute for Global Nutrition, Department of Nutrition, University of California Davis, Davis, CA, USA
| | - Charles D Arnold
- Institute for Global Nutrition, Department of Nutrition, University of California Davis, Davis, CA, USA
| | - Sarah J Zyba
- Institute for Global Nutrition, Department of Nutrition, University of California Davis, Davis, CA, USA
| | - Kenneth M Maleta
- School of Public Health and Family Medicine, Kamuzu University of Health Sciences, Blantyre, Malawi
| | - Bess L Caswell
- USDA Western Human Nutrition Research Center, Davis, CA, USA
| | - Brian J Bennett
- USDA Western Human Nutrition Research Center, Davis, CA, USA
| | - Lora L Iannotti
- Brown School, Institute for Public Health, Washington University in St Louis, St Louis, MO, USA
| | | | - Christine P Stewart
- Institute for Global Nutrition, Department of Nutrition, University of California Davis, Davis, CA, USA
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Smith SM, Virdee MS, Eckerle JK, Sandness KE, Georgieff MK, Boys CJ, Zeisel SH, Wozniak JR. Polymorphisms in SLC44A1 are associated with cognitive improvement in children diagnosed with fetal alcohol spectrum disorder: an exploratory study of oral choline supplementation. Am J Clin Nutr 2021; 114:617-627. [PMID: 33876196 PMCID: PMC8326038 DOI: 10.1093/ajcn/nqab081] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Accepted: 03/01/2021] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND The essential nutrient choline provides one-carbon units for metabolite synthesis and epigenetic regulation in tissues including brain. Dietary choline intake is often inadequate, and higher intakes are associated with improved cognitive function. OBJECTIVE Choline supplements confer cognitive improvement for those diagnosed with fetal alcohol spectrum disorder (FASD), a common set of neurodevelopmental impairments; however, the effect sizes have been modest. In this retrospective analysis, we report that genetic polymorphisms affecting choline utilization are associated with cognitive improvement following choline intervention. METHODS Fifty-two children from the upper midwestern United States and diagnosed with FASD, ages 2-5 y, were randomly assigned to receive choline (500 mg/d; n = 26) or placebo (n = 26) for 9 mo, and were genotyped for 384 choline-related single nucleotide polymorphisms (SNPs). Memory and cognition were assessed at enrollment, study terminus, and at 4-y follow-up for a subset. RESULTS When stratified by intervention (choline vs. placebo), 14-16 SNPs within the cellular choline transporter gene solute carrier family 44 member 1 (SLC44A1) were significantly associated with performance in an elicited imitation sequential memory task, wherein the effect alleles were associated with the greatest pre-/postintervention improvement. Of these, rs3199966 is a structural variant (S644A) and rs2771040 is a single-nucleotide variant within the 3' untranslated region of the plasma membrane isoform. An additive genetic model best explained the genotype associations. Lesser associations were observed for cognitive outcome and polymorphisms in flavin monooxygenase-3 (FMO3), methylenetetrahydrofolate dehydrogenase-1 (MTHFD1), fatty acid desaturase-2 (FADS2), and adiponectin receptor 1 (ADIPOR1). CONCLUSIONS These SLC44A1 variants were previously associated with greater vulnerability to choline deficiency. Our data potentially support the use of choline supplements to improve cognitive function in individuals diagnosed with FASD who carry these effect alleles. Although these findings require replication in both retrospective and prospective confirmatory trials, they emphasize the need to incorporate similar genetic analyses of choline-related polymorphisms in other FASD-choline trials, and to test for similar associations within the general FASD population. This trial was registered at www.clinicaltrials.gov as NCT01149538.
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Affiliation(s)
| | - Manjot S Virdee
- Nutrition Research Institute, University of North Carolina at Chapel Hill, Kannapolis, NC, USA
| | - Judith K Eckerle
- Department of Pediatrics, University of Minnesota Twin Cities, Minneapolis, MN, USA
| | - Kristin E Sandness
- Department of Pediatrics, University of Minnesota Twin Cities, Minneapolis, MN, USA
| | - Michael K Georgieff
- Department of Pediatrics, University of Minnesota Twin Cities, Minneapolis, MN, USA
| | - Christopher J Boys
- Department of Pediatrics, University of Minnesota Twin Cities, Minneapolis, MN, USA
| | - Steven H Zeisel
- Nutrition Research Institute, University of North Carolina at Chapel Hill, Kannapolis, NC, USA,Department of Nutrition, University of North Carolina at Chapel Hill, Kannapolis, NC, USA
| | - Jeffrey R Wozniak
- Department of Psychiatry and Behavioral Sciences, University of Minnesota Twin Cities, Minneapolis, MN, USA
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Zeisel SH. Precision (Personalized) Nutrition: Understanding Metabolic Heterogeneity. Annu Rev Food Sci Technol 2020; 11:71-92. [DOI: 10.1146/annurev-food-032519-051736] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
People differ in their requirements for and responses to nutrients and bioactive molecules in the diet. Many inputs contribute to metabolic heterogeneity (including variations in genetics, epigenetics, microbiome, lifestyle, diet intake, and environmental exposure). Precision nutrition is not about developing unique prescriptions for individual people but rather about stratifying people into different subgroups of the population on the basis of biomarkers of the above-listed sources of metabolic variation and then using this stratification to better estimate the different subgroups’ dietary requirements, thereby enabling better dietary recommendations and interventions. The hope is that we will be able to subcategorize people into ever-smaller groups that can be targeted in terms of recommendations, but we will never achieve this at the individual level, thus, the choice of precision nutrition rather than personalized nutrition to designate this new field. This review focuses mainly on genetically related sources of metabolic heterogeneity and identifies challenges that need to be overcome to achieve a full understanding of the complex interactions between the many sources of metabolic heterogeneity that make people differ from one another in their requirements for and responses to foods. It also discusses the commercial applications of precision nutrition.
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Affiliation(s)
- Steven H. Zeisel
- Nutrition Research Institute, Department of Nutrition, University of North Carolina, Kannapolis, North Carolina 28081, USA
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Zeisel SH. A Conceptual Framework for Studying and Investing in Precision Nutrition. Front Genet 2019; 10:200. [PMID: 30936893 PMCID: PMC6431609 DOI: 10.3389/fgene.2019.00200] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2018] [Accepted: 02/25/2019] [Indexed: 12/15/2022] Open
Abstract
Nutrients and food-derived bioactive molecules must transit complex metabolic pathways, and these pathways vary between people. Metabolic heterogeneity is caused by genetic variation, epigenetic variation, differences in microbiome composition and function, lifestyle differences and by variation in environmental exposures. This review discusses a number of these sources of metabolic heterogeneity and presents some of the research investments that will be needed to make applications of precision nutrition practical.
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Affiliation(s)
- Steven H Zeisel
- Nutrition Research Institute, The University of North Carolina at Chapel Hill, Kannapolis, NC, United States
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Chmurzynska A, Seremak-Mrozikiewicz A, Malinowska AM, Różycka A, Radziejewska A, Szwengiel A, Kurzawińska G, Barlik M, Jagodziński PP, Drews K. PEMT rs12325817 and PCYT1A rs7639752 polymorphisms are associated with betaine but not choline concentrations in pregnant women. Nutr Res 2018; 56:61-70. [PMID: 30055775 DOI: 10.1016/j.nutres.2018.04.018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2017] [Revised: 04/27/2018] [Accepted: 04/27/2018] [Indexed: 02/04/2023]
Abstract
Maternal metabolism during gestation may depend on nutrient intake but also on polymorphism of genes encoding enzymes involved in metabolism of different nutrients. Data on choline or carnitine metabolism in pregnant women are scarce. We hypothesized that (1) choline intake in Polish pregnant women is inadequate and (2) choline and carnitine metabolism would differ by genotype and nutritional status of pregnant women. One hundred three healthy Polish women aged 18 to 44 years in the third trimester of pregnancy were enrolled in the study. The average choline, folate, and carnitine intakes were 365 ± 14 mg/d, 1089 ± 859 μg, and 132 ± 8 mg/d, respectively. Most women did not achieve an adequate intake of choline. Average choline, betaine, trimethylamine oxide, l-carnitine, and acetylcarnitine concentrations were 10.64 ± 3.30 μmol/L, 14.43 ± 4.01 μmol/L, 2.01 ± 1.24 μmol/L, 12.73 ± 5.41 μmol/L, and 6.79 ± 3.82 μmol/L, respectively. Approximately 15% lower betaine concentrations were observed in the GG homozygotes of PEMT rs12325817 and in the GG homozygotes of PCYT1A rs7639752 than in the respective minor allele carriers. Birth weight was higher in the G allele homozygotes of the CHDH rs2289205 than in the minor allele carriers: GG: 3398 ± 64 g; GA+AA: 3193 ± 76 g. Our study shows that choline intake in Polish pregnant women is inadequate and that polymorphisms of PEMT rs12325817 and PCYT1A rs7639752 are associated with betaine but not choline concentrations.
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Affiliation(s)
- Agata Chmurzynska
- Institute of Human Nutrition and Dietetics, Poznań University of Life Sciences.
| | - Agnieszka Seremak-Mrozikiewicz
- Division of Perinatology and Women's Diseases, Poznań University of Medical Sciences, Poznań, Poland; Laboratory of Molecular Biology, Division of Perinatology and Women's Diseases, Poznań University of Medical Sciences, Poznań, Poland
| | - Anna M Malinowska
- Institute of Human Nutrition and Dietetics, Poznań University of Life Sciences
| | - Agata Różycka
- Department of Biochemistry and Molecular Biology, Poznań University of Medical Sciences
| | - Anna Radziejewska
- Institute of Human Nutrition and Dietetics, Poznań University of Life Sciences
| | - Artur Szwengiel
- Institute of Food Technology of Plant Origin, Poznań University of Life Sciences
| | - Grażyna Kurzawińska
- Division of Perinatology and Women's Diseases, Poznań University of Medical Sciences, Poznań, Poland; Laboratory of Molecular Biology, Division of Perinatology and Women's Diseases, Poznań University of Medical Sciences, Poznań, Poland
| | - Magdalena Barlik
- Division of Perinatology and Women's Diseases, Poznań University of Medical Sciences, Poznań, Poland; Laboratory of Molecular Biology, Division of Perinatology and Women's Diseases, Poznań University of Medical Sciences, Poznań, Poland
| | - Paweł P Jagodziński
- Department of Biochemistry and Molecular Biology, Poznań University of Medical Sciences
| | - Krzysztof Drews
- Division of Perinatology and Women's Diseases, Poznań University of Medical Sciences, Poznań, Poland; Laboratory of Molecular Biology, Division of Perinatology and Women's Diseases, Poznań University of Medical Sciences, Poznań, Poland
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Stover PJ, James WPT, Krook A, Garza C. Emerging concepts on the role of epigenetics in the relationships between nutrition and health. J Intern Med 2018; 284:37-49. [PMID: 29706028 DOI: 10.1111/joim.12768] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Understanding the physiological and metabolic underpinnings that confer individual differences in responses to diet and diet-related chronic disease is essential to advance the field of nutrition. This includes elucidating the differences in gene expression that are mediated through programming of the genome through epigenetic chromatin modifications. Epigenetic landscapes are influenced by age, genetics, toxins and other environmental factors, including dietary exposures and nutritional status. Epigenetic modifications influence transcription and genome stability are established during development with life-long consequences. They can be inherited from one generation to the next. The covalent modifications of chromatin, which include methylation and acetylation, on DNA nucleotide bases, histone proteins and RNA are derived from intermediates of one-carbon metabolism and central metabolism. They influence key physiological processes throughout life, and together with inherited DNA primary sequence, contribute to responsiveness to environmental stresses, diet and risk for age-related chronic disease. Revealing diet-epigenetic relationships has the potential to transform nutrition science by increasing our fundamental understanding of: (i) the role of nutrients in biological systems, (ii) the resilience of living organisms in responding to environmental perturbations, and (iii) the development of dietary patterns that programme physiology for life-long health. Epigenetics may also enable the classification of individuals with chronic disease for specific dietary management and/or for efficacious diet-pharmaceutical combination therapies. These new emerging concepts at the interface of nutrition and epigenetics were discussed, and future research needs identified by leading experts at the 26th Marabou Symposium entitled 'Nutrition, Epigenetics, Genetics: Impact on Health and Disease'. For a compilation of the general discussion at the marabou symposium, click here http://www.marabousymposium.org/.
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Affiliation(s)
- P J Stover
- Division of Nutritional Sciences, Cornell University, Ithaca, NY, USA
| | - W P T James
- Department of Population Health, Nutrition Group, London School of Hygiene and Tropical Medicine, London, UK
| | - A Krook
- Department of Physiology and Pharmacology, Section for Integrative Physiology, Karolinska Institutet, Stockholm, Sweden
| | - C Garza
- Division of Nutritional Sciences, Cornell University, Ithaca, NY, USA
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Jacobson SW, Carter RC, Molteno CD, Meintjes EM, Senekal M, Lindinger NM, Dodge NC, Zeisel SH, Duggan CP, Jacobson JL. Feasibility and Acceptability of Maternal Choline Supplementation in Heavy Drinking Pregnant Women: A Randomized, Double-Blind, Placebo-Controlled Clinical Trial. Alcohol Clin Exp Res 2018; 42:1315-1326. [PMID: 29750366 PMCID: PMC6028314 DOI: 10.1111/acer.13768] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2018] [Accepted: 04/16/2018] [Indexed: 12/18/2022]
Abstract
BACKGROUND Choline, an essential nutrient, serves as a methyl-group donor for DNA methylation and is a constituent of the neurotransmitter acetylcholine and a precursor to major components of cell membranes. Findings from animal studies suggest that choline supplementation during pregnancy can mitigate adverse effects of prenatal alcohol exposure on growth and neurocognitive function. We conducted a randomized, double-blind exploratory trial to examine feasibility and acceptability of a choline supplementation intervention during pregnancy. METHODS Seventy heavy drinkers, recruited in mid-pregnancy, were randomly assigned to receive a daily oral dose of 2 g of choline or a placebo from time of enrollment until delivery. Each dose consisted of an individually wrapped packet of powder that, when mixed with water, produced a sweet tasting grape-flavored drink. Adherence was assessed by collecting used and unused drink packets on a monthly basis and tabulating the number used. Side effects were assessed in monthly interviews. Blood samples obtained at enrollment and at 4 and 12 weeks after randomization were assayed for plasma choline concentration. RESULTS Adherence was good-to-excellent (median doses taken = 74.0%; interquartile range = 53.9 to 88.7%) and was not related to a range of sociodemographic characteristics or to alcohol consumption ascertained using a timeline follow-back interview. By 4 weeks, plasma choline concentrations were significantly higher in the choline supplementation than the placebo arm, and this group difference continued to be evident at 12 weeks. The only side effect was a small increase in nausea/dyspepsia. No effects were seen for diarrhea, vomiting, muscle stiffness, blood pressure, or body odor changes. CONCLUSIONS This study demonstrated that a choline supplementation program with very heavy drinkers during pregnancy is feasible even among highly disadvantaged, poorly educated women. The broad acceptability of this intervention is indicated by our finding that adherence was not related to maternal education, intellectual function, depression, nutritional status, or alcohol use.
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Affiliation(s)
- Sandra W. Jacobson
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, Michigan, USA
- Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
- Department of Psychiatry and Mental Health, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - R. Colin Carter
- Division of Pediatric Emergency Medicine, Morgan Stanley Children’s Hospital of New York, and Institute for Human Nutrition, Columbia University Medical Center, New York, New York, USA
| | - Christopher D. Molteno
- Department of Psychiatry and Mental Health, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Ernesta M. Meintjes
- Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
- MRC/UCT Medical Imaging Research Unit, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Marjanne Senekal
- Division of Nutrition, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Nadine M. Lindinger
- Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Neil C. Dodge
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, Michigan, USA
| | - Steven H. Zeisel
- Nutrition Research Institute, University of North Carolina at Chapel Hill, Kannapolis, NC 28081, USA
| | - Christopher P. Duggan
- Center for Nutrition, Division of Gastroenterology, Hepatology and Nutrition, Boston Children’s Hospital/Harvard Medical School, Boston, Massachusetts, USA
| | - Joseph L. Jacobson
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, Michigan, USA
- Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
- Department of Psychiatry and Mental Health, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
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Freedman R, Hunter SK, Hoffman MC. Prenatal Primary Prevention of Mental Illness by Micronutrient Supplements in Pregnancy. Am J Psychiatry 2018; 175:607-619. [PMID: 29558816 PMCID: PMC6984656 DOI: 10.1176/appi.ajp.2018.17070836] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
Genes, infection, malnutrition, and other factors affecting fetal brain development are a major component of risk for a child's emotional development and later mental illnesses, including schizophrenia, bipolar disorder, and autism. Prenatal interventions to ameliorate that risk have yet to be established for clinical use. A systematic review of prenatal nutrients and childhood emotional development and later mental illness was performed. Randomized trials of folic acid, phosphatidylcholine, and omega-3 fatty acid supplements assess effects of doses beyond those adequate to remedy deficiencies to promote normal fetal development despite genetic and environmental risks. Folic acid to prevent neural tube defects is an example. Vitamins A and D are currently recommended at maximum levels, but women's incomplete compliance permits observational studies of their effects. Folic acid and phosphatidylcholine supplements have shown evidence for improving childhood emotional development associated with later mental illnesses. Vitamins A and D decreased the risk for schizophrenia and autism in retrospective observations. Omega-3 fatty acid supplementation during early pregnancy increased the risk for schizophrenia and increased symptoms of attention deficit hyperactivity disorder, but in later pregnancy it decreased childhood wheezing and premature birth. Studies are complicated by the length of time between birth and the emergence of mental illnesses like schizophrenia, compared with anomalies like facial clefts identified at birth. As part of comprehensive maternal and fetal care, prenatal nutrient interventions should be further considered as uniquely effective first steps in decreasing risk for future psychiatric and other illnesses in newborn children. [AJP at 175: Remembering Our Past As We Envision Our Future July 1959: Longitudinal Observations of Biological Deviations in a Schizophrenic Infant Barbara Fish described the course of an infant born with fluctuating motor problems who developed schizophrenia. (Am J Psychiatry 1959; 116:25-31 )].
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Affiliation(s)
- Robert Freedman
- From the Institute for Children’s Mental Disorders and the Departments of Psychiatry and of Obstetrics and Gynecology, University of Colorado School of Medicine, Aurora
| | - Sharon K. Hunter
- From the Institute for Children’s Mental Disorders and the Departments of Psychiatry and of Obstetrics and Gynecology, University of Colorado School of Medicine, Aurora
| | - M. Camille Hoffman
- From the Institute for Children’s Mental Disorders and the Departments of Psychiatry and of Obstetrics and Gynecology, University of Colorado School of Medicine, Aurora
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11
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Semba RD, Zhang P, Gonzalez-Freire M, Moaddel R, Trehan I, Maleta KM, Ordiz MI, Ferrucci L, Manary MJ. The association of serum choline with linear growth failure in young children from rural Malawi. Am J Clin Nutr 2016; 104:191-7. [PMID: 27281303 PMCID: PMC4919529 DOI: 10.3945/ajcn.115.129684] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2015] [Accepted: 05/04/2016] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Choline is an essential nutrient for cell structure, cell signaling, neurotransmission, lipid transport, and bone formation. Choline can be irreversibly converted to betaine, a major source of methyl groups. Trimethylene N-oxide (TMAO), a proatherogenic molecule, is produced from the metabolism of dietary choline by the gut microbiome. The relation between serum choline and its closely related metabolites with linear growth in children is unknown. OBJECTIVE The aim was to characterize the relation between serum choline and its closely related metabolites, betaine and TMAO, with linear growth and stunting in young children. DESIGN We measured serum choline, betaine, and TMAO concentrations by using liquid chromatography isotopic dilution tandem mass spectrometry in a cross-sectional study in 325 Malawian children, aged 12-59 mo, of whom 62% were stunted. RESULTS Median (25th, 75th percentile) serum choline, betaine, and TMAO concentrations were 6.4 (4.8, 8.3), 12.4 (9.1, 16.3), and 1.2 (0.7, 1.8) μmol/L, respectively. Spearman correlation coefficients of age with serum choline, betaine, and TMAO were -0.57 (P < 0.0001), -0.26 (P < 0.0001), and -0.10 (P = 0.07), respectively. Correlation coefficients of height-for-age z score with serum choline, betaine-to-choline ratio, and TMAO-to-choline ratio were 0.31 (P < 0.0001), -0.24 (P < 0.0001), and -0.29 (P < 0.0001), respectively. Serum choline concentrations were strongly and significantly associated with stunting. Children with and without stunting had median (25th, 75th percentile) serum choline concentrations of 5.6 (4.4, 7.4) and 7.3 (5.9, 9.1) μmol/L (P < 0.0001). CONCLUSIONS Linear growth failure in young children is associated with low serum choline and elevated betaine-to-choline and TMAO-to-choline ratios. Further work is needed to understand whether low dietary choline intake explains low circulating choline among stunted children living in low-income countries and whether increasing choline intake may correct choline deficiency and improve growth and development. This trial was registered in the ISRCTN registry (www.isrctn.com) as ISRCTN14597012.
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Affiliation(s)
- Richard D Semba
- Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD;
| | - Pingbo Zhang
- Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD
| | | | | | - Indi Trehan
- Department of Pediatrics, Washington University in St. Louis, St. Louis, MO; and Departments of Community Health and Pediatrics and Child Health, University of Malawi College of Medicine, Blantyre, Malawi
| | - Kenneth M Maleta
- Community Health and Pediatrics and Child Health, University of Malawi College of Medicine, Blantyre, Malawi
| | - M Isabel Ordiz
- Department of Pediatrics, Washington University in St. Louis, St. Louis, MO; and Departments of
| | | | - Mark J Manary
- Department of Pediatrics, Washington University in St. Louis, St. Louis, MO; and Departments of Community Health and Pediatrics and Child Health, University of Malawi College of Medicine, Blantyre, Malawi
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Ganz AB, Shields K, Fomin VG, Lopez YS, Mohan S, Lovesky J, Chuang JC, Ganti A, Carrier B, Yan J, Taeswuan S, Cohen VV, Swersky CC, Stover JA, Vitiello GA, Malysheva OV, Mudrak E, Caudill MA. Genetic impairments in folate enzymes increase dependence on dietary choline for phosphatidylcholine production at the expense of betaine synthesis. FASEB J 2016; 30:3321-3333. [PMID: 27342765 DOI: 10.1096/fj.201500138rr] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2016] [Accepted: 06/14/2016] [Indexed: 01/15/2023]
Abstract
Although single nucleotide polymorphisms (SNPs) in folate-mediated pathways predict susceptibility to choline deficiency during severe choline deprivation, it is unknown if effects persist at recommended intakes. Thus, we used stable isotope liquid chromatography-mass spectrometry (LC-MS) methodology to examine the impact of candidate SNPs on choline metabolism in a long-term, randomized, controlled feeding trial among pregnant, lactating, and nonpregnant (NP) women consuming 480 or 930 mg/d choline (22% as choline-d9, with d9 indicating a deuterated trimethyl amine group) and meeting folate-intake recommendations. Variants impairing folate metabolism, methylenetetrahydrofolate reductase (MTHFR) rs1801133, methionine synthase (MTR) rs1805087 [wild-type (WT)], MTR reductase (MTRR) rs1801394, and methylenetetrahydrofolate dehydrogenase-methenyltetrahydrofolate cyclohydrolase-formyltetrahydrofolate synthetase (MTHFD1) rs2236225, influenced choline dynamics, frequently through interactions with reproductive state and choline intake, with fewer genotypic alterations observed among pregnant women. Women with these variants partitioned more dietary choline toward phosphatidylcholine (PC) biosynthesis via the cytidine diphosphate (CDP)-choline pathway at the expense of betaine synthesis even when use of betaine as a methyl donor was increased. Choline intakes of 930 mg/d restored partitioning of dietary choline between betaine and CDP-PC among NP (MTHFR rs1801133 and MTR rs1805087 WT) and lactating (MTHFD1 rs2236225) women with risk genotypes. Overall, our findings indicate that loss-of-function variants in folate-metabolizing enzymes strain cellular PC production, possibly via impaired folate-dependent phosphatidylethanolamine-N-methyltransferase (PEMT)-PC synthesis, and suggest that women with these risk genotypes may benefit from choline intakes exceeding current recommendations.-Ganz, A. B., Shields, K., Fomin, V. G., Lopez, Y. S., Mohan, S., Lovesky, J., Chuang, J. C., Ganti, A., Carrier, B., Yan, J., Taeswuan, S., Cohen, V. V., Swersky, C. C., Stover, J. A., Vitiello, G. A., Malysheva, O. V., Mudrak, E., Caudill, M. A. Genetic impairments in folate enzymes increase dependence on dietary choline for phosphatidylcholine production at the expense of betaine synthesis.
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Affiliation(s)
- Ariel B Ganz
- Division of Nutritional Sciences, Cornell University, Ithaca, New York, USA; and
| | - Kelsey Shields
- Division of Nutritional Sciences, Cornell University, Ithaca, New York, USA; and
| | - Vlad G Fomin
- Division of Nutritional Sciences, Cornell University, Ithaca, New York, USA; and
| | - Yusnier S Lopez
- Division of Nutritional Sciences, Cornell University, Ithaca, New York, USA; and
| | - Sanjay Mohan
- Division of Nutritional Sciences, Cornell University, Ithaca, New York, USA; and
| | - Jessica Lovesky
- Division of Nutritional Sciences, Cornell University, Ithaca, New York, USA; and
| | - Jasmine C Chuang
- Division of Nutritional Sciences, Cornell University, Ithaca, New York, USA; and
| | - Anita Ganti
- Division of Nutritional Sciences, Cornell University, Ithaca, New York, USA; and
| | - Bradley Carrier
- Division of Nutritional Sciences, Cornell University, Ithaca, New York, USA; and
| | - Jian Yan
- Division of Nutritional Sciences, Cornell University, Ithaca, New York, USA; and
| | - Siraphat Taeswuan
- Division of Nutritional Sciences, Cornell University, Ithaca, New York, USA; and
| | - Vanessa V Cohen
- Division of Nutritional Sciences, Cornell University, Ithaca, New York, USA; and
| | - Camille C Swersky
- Division of Nutritional Sciences, Cornell University, Ithaca, New York, USA; and
| | - Julie A Stover
- Division of Nutritional Sciences, Cornell University, Ithaca, New York, USA; and
| | - Gerardo A Vitiello
- Division of Nutritional Sciences, Cornell University, Ithaca, New York, USA; and
| | - Olga V Malysheva
- Division of Nutritional Sciences, Cornell University, Ithaca, New York, USA; and
| | - Erika Mudrak
- Statistical Consulting Unit, Cornell University, Ithaca, New York, USA
| | - Marie A Caudill
- Division of Nutritional Sciences, Cornell University, Ithaca, New York, USA; and
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13
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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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May PA, Hamrick KJ, Corbin KD, Hasken JM, Marais AS, Blankenship J, Hoyme HE, Gossage JP. Maternal nutritional status as a contributing factor for the risk of fetal alcohol spectrum disorders. Reprod Toxicol 2016; 59:101-8. [PMID: 26656914 PMCID: PMC4783250 DOI: 10.1016/j.reprotox.2015.11.006] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2015] [Accepted: 11/17/2015] [Indexed: 02/08/2023]
Abstract
OBJECTIVE Compare nutritional status of 57 South African mothers of children with fetal alcohol spectrum disorders (FASD) with 148 mothers of controls. METHODS Dietary data were analyzed for macronutrients, micronutrients, and fats via estimated average requirements (EAR) and adequate intakes (AI) for pregnant women. RESULTS Virtually all mothers were likely deficient on most micronutrients by either EAR (<50%) or AI values. Mothers of FASD children consumed more of 13 of 25 micronutrients. For percentage below EAR, only vitamin D was significantly higher for FASD mothers. Despite no difference in total food intake, control mothers had a higher mean body mass index (BMI) than FASD mothers. Maternal BMI is more significant for positive child outcomes than any individual nutrient. CONCLUSIONS Most mothers have inadequate dietary intake. Minor advantages in nutrient intake are overpowered by teratogenic effects of alcohol. Further study is needed of the interaction of alcohol, maternal nutrition, and metabolism.
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Affiliation(s)
- Philip A May
- University of North Carolina at Chapel Hill, Nutrition Research Institute, Gillings School of Global Public Health, USA; The University of New Mexico Center on Alcoholism, Substance Abuse, and Addictions (CASAA), Albuquerque, USA.
| | | | - Karen D Corbin
- Florida Hospital, Translational Research Institute for Metabolism and Diabetes, USA
| | - Julie M Hasken
- University of North Carolina at Chapel Hill, Nutrition Research Institute, Gillings School of Global Public Health, USA
| | - Anna-Susan Marais
- Stellenbosch University, Faculty of Medicine and Health Sciences, Tygerberg, South Africa; University of Cape Town, Foundation for Alcohol Related Research (FARR), Cape Town, South Africa
| | - Jason Blankenship
- The University of New Mexico Center on Alcoholism, Substance Abuse, and Addictions (CASAA), Albuquerque, USA
| | - H Eugene Hoyme
- Sanford School of Medicine, The University of South Dakota, Sioux Falls, USA
| | - J Phillip Gossage
- The University of New Mexico Center on Alcoholism, Substance Abuse, and Addictions (CASAA), Albuquerque, USA
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