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Updated: Aug 16, 2025
Author Spotlight: Studying the Impact of Maternal Dietary Deficiencies on Long-Term Offspring Health Outcomes
Published on: June 28, 2024
The association between plasma choline, growth and neurodevelopment among Malawian children aged 6-15 months enroled
Megan G Bragg1,2, Elizabeth L Prado1, Bess L Caswell3
1Department of Nutrition, University of California Davis, Davis, California, USA.
Insights
This study found no strong links between choline levels and growth or development in Malawian children. Further research is needed to understand choline
Area of Science:
- Nutritional Science
- Developmental Pediatrics
- Global Health
Background:
- Choline is vital for growth and development, but its impact on children in low- and middle-income countries is understudied.
- Understanding postnatal choline status is crucial for child development interventions.
Purpose of the Study:
- To investigate the association between plasma choline levels and growth and developmental outcomes in Malawian infants and young children.
- To explore relationships between choline metabolites and child development.
Main Methods:
- Observational analysis of children aged 6-15 months in Malawi.
- Measurement of plasma choline and metabolites, anthropometry, and developmental assessments (MDAT, IOWA, VPC, EI tasks).
- Cross-sectional and predictive models were used to analyze associations.
Main Results:
- Higher plasma choline was linked to lower length-for-age z-scores and altered cognitive task performance (slower attention, faster processing speed).
- Baseline plasma choline negatively predicted fine motor skills at follow-up.
- Choline metabolites showed limited associations with developmental outcomes.
Conclusions:
- In this cohort with low dietary choline intake, plasma choline showed no consistent strong associations with overall growth and development.
- Further research may be needed to clarify the role of choline in child development in resource-limited settings.
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.
