Hailed the new ‘rockstar’ pregnancy nutrient in the US and recently labeled the ‘superstar’ pregnancy nutrient by Cosmopolitan Pregnancy magazine, choline (a lessen known member of the B vitamin family) is receiving significant and much warranted, media attention in both the scientific and general community for its role in early brain development.
New studies into maternal choline supplementation show positive effects in the prevention of schizophrenia and dementia as well as a reduction in Down Syndrome dysfunction and improved cognitive function.
“The importance of choline cannot be overstated as we continue to unravel the role it plays in human health and development.” said Gerald Weissmann, M.D., Editor-in-Chief of The FASEB Journal. [i]
A study published in January 2013 in the American Journal of Psychiatry, concluded that maternal choline supplementation in the second and third trimester improved early markers of schizophrenia and other brain disorders even in the presence of gene mutations, which would otherwise be risk factors. “The study breaks new ground both in its potentially therapeutic findings and in its strategy to target markers of schizophrenia long before the illness itself actually appears.” [ii]
Robert Freedman, MD, who is the professor and chairman of the Department of Psychiatry, University of Colorado School of Medicine as well as being one of the study’s authors and Editor of The American Journal of Psychiatry says “Basic research indicates that choline supplementation during pregnancy facilitates cognitive functioning in offspring. Our finding that it ameliorates some of the pathophysiology associated with risk for schizophrenia now requires longer-term follow-up to assess whether it decreases risk for the later development of illness as well.” 1
Previous studies on mouse models have shown dramatic improvements in markers of Down syndrome. “We found that supplementing the maternal diet with additional choline resulted in dramatic improvements in attention and some normalization of emotion regulation in a mouse model of Down syndrome,” said lead author Barbara
Strupp, Professor of nutritional sciences and of psychology.[iii] Ted Boscia, Director of Communications, College of Human Ecology said “More choline during pregnancy and nursing could provide lasting cognitive and emotional benefits to individuals with Down syndrome and protect against neurodegenerative conditions such as Alzheimer’s disease”. [iv]
Maternal choline levels have also been found to be preventative against neural tube defects. A study conducted at the Stanford University School of Medicine showed that high levels of choline in the mother significantly reduced the risk of neural tube defects. 180,000 pregnant women were screened and, blood samples of those pregnancies affected by neural tube defects were compared to a randomly selected sample of those who’s baby’s had no structural birth defects.
“As choline levels went up, risk went down,” said Dr Gary Shaw, professor of neonatology and primary study author. The risk of neural tube defects was found to be 2.4 times higher in women with the lowest blood levels of choline compared to those who’s blood levels were average, furthermore those with the highest blood choline levels were found to have the lowest risk.[v]
Although the incidence of neural tube defects has improved dramatically following the introduction of folic acid fortification in 1996, birth defects still affect 4.6 per 10,000 live births in Australia and this figure is over two fold higher when including early terminated pregnancies. [vi] With today’s advancements in prenatal care this is still a staggeringly high figure, to which choline could help provide an answer.
The recommended adequate intake (AI) for choline during pregnancy is 440mg, increasing to 550mg during breastfeeding.
Good dietary sources include lecithin granules, eggs, beef, salmon, chicken, baked beans, kidney beans, lentils, brussel sprouts, broccoli, spinach, cauliflower, wheat germ, oats and milk. However new research shows that up to 90% of women are not consuming enough. “Our preliminary dietary studies clearly show an insufficient choline intake compared to the recommended levels,” said Curtis, an analytical chemist and project leader for ongoing choline research at the University of Alberta.[vii]
Unfortunately, this critical nutrient has not gained the exposure or notoriety of other prenatal nutrients and is yet to be included in many leading prenatal supplements. Patients should be advised to look closely at their chosen supplement so ensure the inclusion of choline. As dietary intake is proving to be greatly lacking, increased choline intake and supplementation, is not only highly recommended but may prove to be vital for the short and long term health outcomes for the developing infant.
Tasha Jennings ND Bch H Sci Nat Med Adv Dip Naturopath Dip Nutrition Dip Herb Med is a qualified naturopath and nutritionist, presenter and author with over 10 years experience. Tasha is a contributor to major media publications including the New Idea, Herald Sun, medical journals and is author of the Vitamins Guide (http://www.wilkinsonpublishing.com.au/ $11.99). Inspired her desire to start a family and the subsequent birth of her son, Tasha now specialises in pre and post-natal nutrition and is Managing Director of Zycia, which means ‘life’ and provides premium nutrition for conception, pregnancy and breastfeeding www.zycia.com.au. You can follow Tasha’s blog at www.tashajenningsnutrition.com.
[i] Federation of American Societies for Experimental Biology. “Sick from stress? Blame your mom…and epigenetics.” ScienceDaily, 31 Jul. 2012
[ii] University of Colorado Denver. “Choline supplementation during pregnancy presents a new approach to schizophrenia prevention.” ScienceDaily, 15 Jan. 2013. Web
[iii] Cornell University. “More choline for pregnant, nursing women could reduce Down syndrome dysfunction, guard against dementia.” ScienceDaily, 4 Jun. 2010.
[iv] T. Boscia. “More choline for pregnant, nursing women could reduce Down syndrome dysfunction, guard against dementia.” Cornell University Chronicle 2 June 2010
[v] Stanford University School of Medicine. “Low Choline Levels In Pregnant Women Raise Babies’ Risk For Brain And Spinal-cord Defects, Study Shows.” ScienceDaily, 17 Aug. 2009
[vi] Abeywardana S & Sullivan EA 2008. Neural tube defects in Australia. Cat. no. PER 45. Canberra: AIHW
[vii] Andrea Hill. U of A researchers strive to increase awareness of forgotten essential nutrient. University of Alberta News August 5, 2011