New Guidelines Recommend Choline for Pregnancy and Beyond
For many years, choline slipped under the nutritional radar. It wasn’t until 1998 that the Institute of Medicine recognized it as an essential nutrient.(1) And it wasn’t until 2017 that the American Medical Association emphasized the importance of choline for pregnancy and recommended prenatal vitamins with choline.(2) It was another year after that when the American Academy of Pediatrics acknowledged choline is a “brain-building” nutrient and urged pediatricians to make sure pregnant women are getting enough choline during pregnancy and that children are also nourished with this nutrient.(2)
Both of these organizations have recognized that choline deficiency during the first 1,000 days after birth may lead to lifelong problems with brain function.(3) These problems may continue even if choline supplements are started or a choline-rich diet is eaten after the 1,000 days have passed.(3) This is why a choline supplement in pregnancy such as choline bitartrate can support a healthy brain.
Choline Deficiency Is Widespread
Many people are not getting enough choline in the diet. Pregnant women and women in their childbearing years are often deficient. Because meat, eggs, fish, and dairy are rich sources of choline, vegans and vegetarians are often not getting enough.(4) Menopausal women may also need more choline.(4) In menopause, estrogen levels drop, and estrogen increases the activity of the gene involved in the body’s production of choline.(4)
Choline is known as a methyl donor. Your body exchanges methyl groups between molecules. This is known as methylation, a process that plays a critical role in many areas of health including central nervous system development in early childhood, healthy immunity, and the production of brain chemicals that support mood. Folate is another important methyl donor. In a folate-deficient diet or when a person isn’t able to absorb enough folate, the need for choline increases since it replaces folate as the main methyl donor.(4) Therefore, choline deficiency in folate-deficient people is especially worrisome.
A lot of people have a common gene mutation that interferes with folate absorption. This gene mutation affects the methylenetetrahydrofolate reductase (MTHFR) enzyme, which breaks down folate. If you have this mutation, you’re not absorbing enough folate. In these people, getting enough choline can reduce some of the negative effects of low folate.(5) The fact a lot of pregnant women don’t know they have this mutation makes a strong case for a choline supplement along with folate.
Choline Benefits During Pregnancy and Throughout Life
Choline certainly has earned its new reputation as an essential nutrient during pregnancy and childhood, as well as in male and female adults. The American Academy of Pediatrics officially recommended adequate intake during pregnancy. Studies have shown it’s essential for brain development in the womb and cognitive function in early childhood.(3,6) For example, seven-year-old children of mothers who had the highest choline intakes during the second trimester of pregnancy had better visual memory compared to the children of mothers with the lowest intakes of choline.(7) Animal research shows that choline deficiency during pregnancy is associated with lower brain weight and volume and less white and gray matter in offspring 30 days after birth.(8,9)
Choline also is important for healthy brain function in the elderly thanks to its role in making the neurotransmitter acetylcholine, which is involved in memory, mood, muscle function, and other brain and nervous system activities.(4) In addition, it plays a critical role in liver health.(3) Furthermore, it helps the body repair cell membranes by producing phosphatidylcholine and sphingomyelin, two building blocks of cell membranes.(4) That’s why every plant and animal cell requires choline to maintain its structure.
Supplementation with Choline Bitartrate
The consensus is that most pregnant women in the U.S. and women of reproductive age are not getting enough choline through diet alone. The recommended amount during pregnancy is at least 450 mg, with 550 mg recommended during lactation. Vital Nutrients offers a 550 mg Choline Bitartrate Supplement in vegetarian capsules, which is a great option for people in search of a choline supplement to boost their dietary intake. It is a healthful addition to a prenatal vitamin supplement regimen, to ensure optimal health for both mother and baby.