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Choline: An Update on a Vital Fertility and Pregnancy Nutrient

By Margaret Eich, MS, RDN

Choline is little talked about essential nutrient for fertility and pregnancy. It is not technically considered a vitamin, as our bodies can synthesize choline though not enough to meet our daily needs.  Choline is a major component of all cell membranes and is a precursor to the neurotransmitter acetylcholine, which is involved in muscle control and memory. Choline is also converted to betaine, which prevents homocysteine levels from becoming elevated. Elevated homocysteine has been associated with increased risk for cardiovascular disease and miscarriage. Choline deficiency may also play a role in the development of fatty liver, as choline is necessary to transport fat from the liver to other tissues in the body.

Choline also has important functions during pregnancy. Choline is essential for baby’s brain development and for DNA methylation, meaning that choline deficiency can have epigenetic effects on the developing baby. There is also evidence that adequate choline intake helps prevent neural tube defects like spinal bifida, which most people associate only with folate/folic acid intake. 

Several studies have compared intakes of 480 mg choline daily to 930 mg choline daily at varying times during pregnancy and found a variety of outcomes. For example, supplementation with 930 mg choline compared to 480 mg throughout the 3rd trimester resulted in faster information processing in 4-13 month old infants. In a similar study, children whose mothers took in 930 mg choline daily performed better with a color location memory task compared to children whose mothers who had only taken in 480 mg choline daily. Another study reported reduced attention and behavior problems and social withdrawal in children at 40 months of age in the group of mothers supplemented with 900 mg choline from the 2nd trimester through delivery in addition to baby being supplemented with 100 mg choline daily through 3 months of age compared to controls.

The daily requirement for choline for non-pregnant women of childbearing age is 425 mg. This goes up 450 mg during pregnancy and further increases to 550 mg during breastfeeding. Less than 10% of pregnant women are meeting their daily requirement for choline, underscoring the importance of focusing on this nutrient.

The impact of choline during pregnancy is an emerging area of research, and currently it seems that 450 mg choline at a minimum is needed to support a healthy pregnancy, but up 900-930 mg is safe and may have long-term benefits to the baby. Animal products are better sources of choline than plant foods–with liver and egg yolks being the best sources–followed by meat and fish and cruciferous vegetables.

Because so few women are meeting even basic daily choline needs during pregnancy, taking a prenatal vitamin that contains choline is a good idea, especially if you are a vegetarian or vegan. Pulling Down the Moon carries two prenatal vitamins, both of which contain choline. TheraNatal OvaVite contains 100 mg choline, and PlusOne contains 450 mg choline. Do you have more questions about optimal choline intake prior to and during a pregnancy? Book a nutrition appointment today!

 

  

 

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