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Choline is a precursor for numerous substances that influence fetal and child growth, particularly brain development. It is required for normal cell division, and it contributes to the protective covering on nerve fibers that helps transmit impulses along the nerves. Choline also helps maintain healthy cell membranes, and is involved with fatty acid synthesis. By aiding in the transport of cholesterol, it helps preserve healthy maternal liver function.
While it’s not clear whether a pregnant woman’s blood levels of choline can directly affect fetal and newborn blood levels, most of the research supports a link between them. For instance, low choline intake in mothers is associated with a doubled risk of neural tube defects (like spina bifida) and feeding pregnant animals a choline-rich diet results in offspring that have long-lasting improvements in attention, learning, and memory. The diet of lactating animals also influences the choline concentrations in their milk, suggesting that the mother’s diet plays a role in the amount of choline available in her breast milk.
Human breast milk differs in the amount and proportions of choline and choline-derivatives than cow’s milk and soy-based formulas, and breast-fed infants have choline levels that are two times higher than that of formula-fed babies. It remains to be seen what effects this choline shortage might lead to in formula-fed babies, and if supplementing formula with choline could correct for the difference.
The Institute of Medicine has set an Adequate Intake level of 425 mg per day for non-pregnant women. For pregnant women, the AI level increases to 450 mg per day and for lactating women it’s 550 mg per day.
Choline is found in soybeans, egg yolks, butter, beef, salmon, chicken, peanuts, potatoes, cauliflower, lentils, oats, sesame seeds, tomatoes, bananas, milk, oranges, and corn.
Some dietary supplement manufacturers have added choline to their prenatal formulas. Since surveys estimate that 90% of pregnant women don’t get enough of this nutrient, it might be worth looking for a prenatal vitamin that includes it.
(J Am Diet Assoc 2010;110:1198–206)
Kimberly Beauchamp, ND, earned her bachelor’s degree from the University of Rhode Island and her Doctorate of Naturopathic Medicine from Bastyr University in Kenmore, WA. She cofounded South County Naturopaths in Wakefield, RI, and now sees patients in East Greenwich and Wakefield. Inspired by her passion for healthful eating and her own young daughters, Dr. Beauchamp is currently writing a book about optimizing children’s health through better nutrition.