In 1998 choline was officially recognized as an essential nutrient by the Institute of Medicine, and Adequate Intake levels established based on sex, age, and pregnancy and lactation status. Subsequent nutrigenetic studies suggested, however, that genotype information could be used to further refine choline dietary recommendations. Controlled studies identified clinical manifestations of choline deficiency, as well as individuals at higher deficiency risk based on their genetic background. Both controlled animal, as well as observational studies in humans, also suggested that the roles of choline, as well as the risks derived from a choline deficient status, may be specific to certain development stages, and that transgenerational effects could be attributed to maternal choline deficiency. The aims of the ISNN 2019 inaugural working group meeting is to initiate the process of establishing the nutrigenetic bases for choline requirements, and identify the evidence-based scientific facts that can be used to further tailor current choline recommendations to the needs of each individual. The group will identify which genetic variants can be used to guide clinical practice; the levels of evidence for their association with specific choline requirements, and how such specific requirements can be met while identifying safety criteria. In addition, we will discuss the role of population science to describe distributional differences in choline consumption and relevant genetic variants to identify high-risk groups and inform an understanding of public health impact. Recognizing that establishing nutrigenetic-based choline dietary requirements is an ongoing process, this initiative will continue with the establishment of a scientific committee, under ISNN auspices, which will work further toward accomplishing these aims. If successful, this effort will result in creating guidelines on choline intakes, based on a nutrigenetic framework, and which can be used for nutritional management in health and disease.
