Choline status and related health outcomes in humans: A scoping review

BackgroundCholine is an essential nutrient involved in human health and development across the lifespan. The evidence on choline and its health effects has been growing; yet the findings are inconsistent.AimWe aimed to map the current evidence and identify gaps in knowledge.MethodsWe conducted a scoping review of the studies that examined relationships between choline exposure and any health outcomes. MEDLINE, CINAHL, and the Cochrane Central Register of Controlled Trials were searched for research involving humans and published between January 2000 and May 2025. Screening and data abstraction were performed in duplicate.ResultsA total of 117 primary studies were included. Most of the studies were conducted in North America (54%) and Europe (22%). Cardiometabolic disease accounted for the largest proportion (34%), followed by offspring neurodevelopment (19%) and liver conditions (12%). The studies were predominantly observational (prospective 60%, retrospective 12%, cross-sectional 20%). The evidence regarding potential benefits and harms was reported to be insufficient or equivocal for many health outcomes. Based largely on data from small randomized controlled trials in women with prenatal exposure to alcohol or infants with fetal alcohol syndrome disorder, high maternal choline intake/status was associated with improved neurocognition and neurodevelopmental outcomes in the offspring.ConclusionPotential benefits of high maternal choline intake/status was indicated for neurodevelopment of the offspring; however, the evidence was insufficient or equivocal for most of the outcomes reviewed. A more comprehensive synthesis incorporating preclinical evidence from animal studies will improve the current understanding of choline and its health effects.