Most pregnant women understand the crucial role that certain vitamins and minerals play in prenatal health. It is generally recommended for women who are pregnant or who are trying to conceive to consume foods that are high in iron, calcium, folate, and iodine in order to optimize neonatal outcomes and lower their risk of forming health issues like anemia or thyroid disorders.
While folate is the most widely recommended nutrient for prenatal nutrition, there is another nutrient that is rarely discussed but is equally as important in neurodevelopment and other vital functions during pregnancy – choline.
While choline is not always given the credit it deserves, years of research suggest it is an essential prenatal nutrient that pregnant women should not forego. Here, we will discuss its major health benefits, forms, and recommended dosages to help you promote the best maternal and neonatal outcomes possible.
Choline In Pregnancy
Choline is a nutrient that’s naturally produced in the liver and regulates various benefits to the body. It has piqued the interest of researchers in recent years because of its similarities to the nutrient folate, or Vitamin B9, which, according to medical experts is the most important prenatal nutrient for the development of a newborn child.
You can consider choline as folate’s long-lost cousin. They’re not the exact same but share some key traits and functions.
Folate is metabolically related to choline due to its structural derivation from choline. Like folate, choline helps support an infant’s brain health, neural tube, and spinal cord development. It’s also known to help support brain functions like learning and memory.
Choline has not received as much attention as folate because it was a relatively new nutrient with insufficient evidence after its discovery. Choline was only recommended for intake in 1998, nearly 70 years after folate was discovered. However, as research progresses, researchers have continued to discover promising data on choline, particularly in the field of prenatal nutrition.
What’s unique about choline is that it has several different forms, namely alpha-GPC, citicoline, choline bitartrate, and sunflower lecithin. Each form provides various benefits to the body, but choosing what form of choline to take matters since some are absorbed and used by the body slower than others. Although there are no precise percentage absorption measurements for each choline form, the most efficient forms are alpha-GPC, choline bitartrate, and citicoline
While the liver produces choline naturally, it cannot maintain the body’s choline levels on its own. That is why pregnant women should consume choline-rich foods or take choline supplements.
Choline Benefits For Pregnancy
Neural Tube Defects
Neural tube defects (NTD) are severe abnormalities in a developing fetus’s brain and spinal cord. They commonly happen in the early stages of pregnancy, often before a woman knows she’s pregnant.
NTD occurs when the embryo’s nervous system or neural tube fails to close properly, exposing the developing brain or spinal cord to amniotic fluid. The most common NTDs are spina bifida, in which nerve damage causes partial paralysis of the legs, and anencephaly, in which most of the brain and skull do not develop.
The exact cause of neural tube defects is unknown, but several factors, including genetics and a lack of nutrition, are thought to play a role. There are some cases where surgery can correct neural tube defects, but it is expensive, and there is a risk of losing your child’s life. That is why it is preferable to take choline to reduce the risk of neural tube defects before they occur.
Researchers investigated the relationship between choline and the risk of neural tube defects in a folate-fortified population in a prospective study. It included information from more than 180,000 pregnant women in California between 2003 and 2005. The researchers identified 80 NTD pregnancy cases and randomly selected 409 pregnancy controls.
The results showed that low choline levels are associated with a higher risk of NTD, whereas higher choline levels reduce the risk. The study provides a foundation for associating NTD with choline levels, allowing for a clear understanding of how NTD can be avoided during pregnancy.
Another study linked the effects of choline and betaine on the risk of neural tube defects. According to the researchers, NTD is caused by deficiencies in methylation which revolves around folate and choline. Addressing methylation with choline lowers the risk of neural tube defects, allowing for the healthy development of the newborn.
In line with this, supporting evidence suggests that maternal periconceptional diets containing choline and betaine reduce NTD risks. The researchers believe that choline and other dietary factors may alleviate the burden of NTD even in the absence of folic acid.
Sufficient prenatal nutrition ensures a newborn’s total physical and cognitive ability development. Failure to develop early puts the child at a disadvantage, limiting his ability to cope with the environment as he or she grows older. Taking choline during pregnancy has been an effective way to address a child’s development.
A study published in the Journal of Pediatrics looked at the importance of high gestational choline levels in preventing maternal infection and its impact on child development. Researchers hypothesized that babies born to mothers with high choline levels would perform better in two areas of the brain than babies born to mothers with low choline levels.
Results showed that babies born to mothers with high choline levels during pregnancy perform better in the inhibition test than babies born to mothers with low choline levels. Three months after childbirth, the children are observed in a behavioral regulation feature as part of the evaluation. The children of mothers with high choline levels outperformed their peers in every way. Moreover, the outcome of child development continues until the newborn babies reach adulthood, allowing them to outperform the rest.
Best Form Of Choline For Pregnancy
Alpha-GPC is the most recommended choline form for prenatal nutrition and pregnancy. It carries 40% choline by weight compared to other forms, ensuring the body receives the amount of choline needed. Taking 100 grams of alpha-GPC already contains 40 grams of pure choline.
Alpha-GPC can also cross the blood-brain barrier to improve cognitive function by improving memory and lowering stress and anxiety associated with pregnancy.
Although not as effective as alpha-GPC, other forms of choline, like choline bitartrate, can be an effective supplement to risks during pregnancy. However, they do not contain a high percentage of choline by weight, and some cannot cross the blood-brain barrier. As a result, alpha-GPC is the most effective form of choline for pregnant women.
How Much Choline Is Generally Recommended For Pregnancy?
The Institute of Medicine advises pregnant women to take at least 450 mg of choline per day. Choline may be present in many foods, although most have low quantities.
To ensure high choline levels throughout your pregnancy, you can derive it from animal-based foods, choline supplements, or a combination of the two.
For breastfeeding mothers, it’s recommended to take at least 550mg of choline per day to maintain the body’s choline levels. Breastfeeding may necessitate a lot of choline, so taking more during your pregnancy period is ideal to ensure your child’s nutrition.
Studies You Can Read About Choline
- Choline: the underconsumed and underappreciated essential nutrient (Nutrition today, 2018)
- Choline and Risk of Neural Tube Defects in a Folate-fortified Population (Epidemiology, 2009)
- Higher Gestational Choline Levels in Maternal Infection Are Protective for Infant Brain Development (The Journal of pediatrics, 2019)
Also read our article on the best choline supplements.
Editor’s note: we are regularly updating this review. If you see any problems, weird interpretations of the data, or just want to say hi, please reach out to firstname.lastname@example.org.