Conclusion
breast milk
All water-soluble D9-choline supplements increased plasma levels of D9-choline and D9-betaine. Highest levels were detected after the intake of D9-choline chloride and D9-GPC, with D9-GPC showing lower D9-betaine formation. Since GPC is a natural component of breast milk, we suggest this as the most suitable water-soluble choline supplement for preterm infants. Absence of plasma D9-choline after D9-POPC may be due to delayed absorption and different metabolism, as it increased plasma D9-PC at the expense of D9-betaine compared to water-soluble components. De- and re-acylation of administered PC as a choline source has the potential to shuttle arachidonic and docosahexaenoic acid into the PC-fraction of chylomicrons, with PC as their major transport form in plasma. (PO)PC also leads to lowest levels of betaine, which is strongly increased in response to water-soluble choline supplements. We therefore conclude that a combination of GPC and PC may be the most suitable choline supplement for preterm infants.
