How much Choline do you need during pregnancy to support your baby’s brain development and cognitive health? The current recommendation is 450 mg per day for pregnant women, but a recent study from Cornell University raises the possibility that this amount may not be enough. Let’s take a look at the study’s findings and see if pregnant women should aim for double the current recommended amount of Choline.
Key findings
- The study is a 7-year follow-up to a randomized controlled feeding trial in the third trimester, and suggested that a higher Choline intake during pregnancy may improve the child’s cognitive functions long after birth.
- In the third trimester, moms were assigned to two groups. In the control group, the moms consumed 480 mg/day of Choline, just above the current recommended daily intake. In the other group, the moms consumed 930 mg/day of Choline, about twice the current recommendation for pregnant women.
- Study authors tested the cognitive functions of the children from the two groups at 7 years of age. The children in the higher Choline group outperformed the children from in the lower Choline group. When the scientists gave children increasingly difficult tasks, the children from the 930 mg group were better able to sustain attention, compared to those from the 480 mg group.
Choline’s role during pregnancy
Choline is an essential nutrient for all cells to function normally, but particularly key to our brain and cognitive health. It helps maintain the structural integrity of cell membranes, facilitates cellular signaling, acts as a methyl donor in the methionine cycle (that reduces harmful homocysteine), regulates DNA expression and more.
During pregnancy, the baby relies on the mom’s Choline intake to develop the central nervous system, including the brain and the spine. This is why Choline is considered just as important during pregnancy as folate (folic acid) in helping prevent neural tube defects and support healthy brain development.
During pregnancy, as the baby’s brain grows, the need for Choline increases. By the time the baby is born, the baby has up to 7 times more Choline circulating in the body than the mom. This increasing demand means the mom’s body can get depleted of Choline as the pregnancy progresses.
Choline’s role after birth
Women who breastfeed exclusively continue to supply all the Choline the baby needs after birth through breast milk. The baby needs Choline mainly for two reasons: For the physical development of the brain and cognitive functions like attention and memory.
To support this, the daily recommendation for the mom’s Choline intake actually goes up – to 550 mg/day, according to the current recommendation.
Do the study results support a higher Choline intake during pregnancy?
Do the results mean that pregnant women should aim for more than double the current recommended amount of choline? In other words - should you be getting 930 mg/day of choline, rather than 450 mg/day, to better support your baby’s cognitive development many years down the road?
With what we know from published studies, this is a tough question to answer.
Choline study's strengths
On one hand, aside from being a randomized, double-blind, controlled trial (considered pretty much the highest level of evidence), the study has several rare strengths:
- In the original trial, everything that the pregnant women consumed was controlled, so we know exactly how much Choline each woman consumed in the third trimester; that’s rare.
- It’s also rare, in that it’s a long-term follow-up study that looked at the children 7 years after birth.
- The scientists also used the same type of test that had been used in animal Choline studies, and found the same patterns, which strengthens the findings.
Interestingly, three other studies reported on these same groups of 7-year-olds. These studies found that the potential benefits of additional Choline during the third trimester include better working memory and problem solving.
Choline study's limitations
However, the study has some limitations. The biggest limitation is the size; although the researchers used statistical methods that let them preserve the statistical power, the fact that only 20 children were included in the 7-year follow-up does reduce the reliability of the results.
How much choline should you aim for during pregnancy?
The study’s authors call for larger clinical trials to verify the findings, rather than immediately increasing the recommended daily Choline intake for pregnant moms. However, the authors do raise the concern that 450 mg/day of Choline during pregnancy may be too low to fully support the baby’s cognitive development years into the future.
So, what should you do?
Given that pregnant women only get about 70% of the current recommended daily amount of Choline, your first step might be to try to meet the current recommendation of 450 mg/day. This applies to over 90% of pregnant women in the US who aren’t meeting the daily requirement.
- Incorporate Choline-rich foods into your diet: With about 150 mg of Choline in each, eggs are a great source of Choline. Animal-derived protein, including beef, chicken and fish; dairy products like milk and yogurt; some plant-based protein like soybeans (100 mg per half cup) and kidney beans (45 mg in half a cup) are good sources of Choline as well.
- Take prenatal vitamins with Choline: It’s difficult to get even the current recommended amount of Choline from food alone. That’s why your prenatal vitamins are important. Many prenatal vitamins either don’t have Choline at all, or have a token amount under 100-150 mg/day. To make a real difference, look for prenatal vitamins with Choline amount that can bridge the gap in your intake from food.
- Get enough B vitamins and Folate: The amounts of B vitamins and Folate in your body affect your Choline levels. Make sure your intake of B vitamins and Folate are up to par.
Please reach out if you have any questions about Choline during pregnancy or when breastfeeding. We are with you.
Study vitals
- Title: Prenatal choline supplementation improves child sustained attention: A 7-year follow-up of a randomized controlled feeding trial
- Authors: Charlotte L. Bahnfleth, Barbara J. Strupp, Marie A. Caudill and Richard L Canfield
- Publication date: December 28, 2021 (online)
- Journal: The FASEB Journal (Journal of the Federation of American Societies for Experimental Biology)
- Study type: Randomized, double-blind controlled trial
