The majority of offspring may gain benefit from a higher intake of choline during the first 1000 days of life, especially in facilitating normal development of the brain.

This study was conducted to explore relevant human and animal studies exploring the interconnections between choline, the development of the nervous system, and brain function within the initial 1000 days of life (two years).

In this systematic review, the PubMed database was utilized, and reference lists were meticulously examined. The search strategy was constructed based on a PICO model. Out of a total of 813 publications subjected to title/abstract review, 38 animal studies and 16 human studies were incorporated following a thorough assessment.

For determining the quality of animal studies, the Systematic Review Center for Laboratory animal Experimentation (SYRCLE) approach was utilized. For developing quality scores for each human RCT or clinical study, the Jadad scale and criteria were used.

Adding choline to the diet of either the mother or child within the first 1000 days of life has the potential to:

(1) Enhance neural and cognitive functioning (supported by animal evidence)

(2) Foster normal development of the brain (supported by both animal and human evidence)

(3) Yield protection against metabolic and neural insults, specifically in cases of fetal exposure to alcohol (backed by both animal and human evidence)

Choline is an essential ‘neurocognitive nutrient’ that plays a fundamental role in proper neurological and brain development. Considering these insights, there is a call for a re-evaluation of health policies and guidelines. This re-assessment is crucial to effectively communicate and promote the potential benefits of choline via dietary and/or supplementation approaches during this critical life stage.