Total water-soluble choline concentration does not differ in milk from vegan, vegetarian, and nonvegetarian lactating women

Authors: PERRIN, MARYANNE - University Of North Carolina; PAWLAK, ROMAN - East Carolina University; Allen, Lindsay - A; Hampel, Daniela

Submitted to: Journal of Nutrition
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 9/26/2019
Publication Date: 11/15/2019
Citation: Perrin, M.T., Pawlak, R., Allen, L.H., Hampel, D. 2019. Total water-soluble choline concentration does not differ in milk from vegan, vegetarian, and nonvegetarian lactating women. Journal of Nutrition. 150(3):512-517. https://doi.org/10.1093/jn/nxz257.
DOI: https://doi.org/10.1093/jn/nxz257

Interpretive Summary: The micronutrient choline is important for brain growth and other biological processes in the developing neonate. Yet, little is known about how a maternal plant-based diet can affect choline concentration in breast milk. Therefore we measured the water-soluble choline content of breast milk from lactating vegan, vegetarian, and non-vegetarian women living in the United States. 74 mothers of healthy term infants, older than 2 weeks (range 2 – 186 weeks), provided one breast milk sample and completed a food frequency screener to classify them as vegans (n=26), vegetarians (n=22), or non-vegetarians (n=26). Additionally, mothers were categorized by egg consumption (never, n=29; often, n=26). Milk samples were analyzed for free choline, phosphocholine (PCho), and glycerophosphocholine (GPC) using ultra performance liquid chromatography - tandem mass spectrometry. The milk samples contained a wide range of total water-soluble choline concentrations (4 mg/L to 301 mg/L). Vegan mothers had a higher concentration of GPC in their milk than vegetarians and non-vegetarians (62.7 + 25.3, 47.7 + 21.2, 42.4 + 14.9 mg/L, respectively; P = 0.0025), and less choline from PCho (32.5% + 18.3%, 46.1% + 18.3%, 44.8% + 15.7%, respectively; P = 0.0123). Diet and egg consumption did not influence total water-soluble choline content of the milk. However some cholines were related to stage of lactation and maternal BMI. Thus, while total water-soluble choline in milk was not affected by maternal diet, the distribution of the different forms of choline changed with maternal dietary pattern.

Technical Abstract: Background. Choline is an essential nutrient for brain growth and other biological processes in the developing neonate. The impact of a maternal plant-based diet on the choline concentration and composition in breast milk is unknown. Objectives. To assess the water-soluble choline content of breast milk from lactating women in the United States following three different dietary patterns: vegan; vegetarian; and non-vegetarian. Methods. Seventy-four mothers of healthy term infants who were older than 2 weeks (range 2 – 186 weeks) were recruited to provide one breast milk sample using a standardized collection protocol. Participants completed a food frequency screener which was used to classify them as vegans (n=26), vegetarians (n=22), or non-vegetarian (n=26). Participants were also classified by their egg consumption pattern (never =29; often=26). Milk samples were assessed for free choline, phosphocholine (PCho), and glycerophosphocholine (GPC) using ultra performance liquid chromatography - tandem mass spectrometry. Results. There was a wide range in total water-soluble choline (4 mg/L to 301 mg/L). Milk from participants consuming a vegan diet contained a significantly higher concentration of GPC than milk from vegetarians and non-vegetarians (62.7 + 25.3, 47.7 + 21.2, 42.4 + 14.9 mg/L, respectively; P = 0.0025). Milk from vegan participants had a lower percentage of choline from PCho than milk from vegetarians and non-vegetarians (32.5% + 18.3%, 46.1% + 18.3%, 44.8% + 15.7%, respectively; P = 0.0123). There was no difference in the total water-soluble choline content of breast milk by maternal diet pattern or egg consumption. Lactation stage and maternal BMI were significantly associated with some choline metabolites. Conclusions: While total water-soluble concentration of breast milk did not differ by maternal diet pattern, the distribution of choline metabolites did vary significantly, with vegans and non-egg consumers having higher concentrations and percentage from GPC and a lower percentage from PCho.