Pregnancy and lactation require specific nutritional needs to support the development of the baby. Choline is an essential nutrient for fetal development and nervous system formation. It has gained attention as a crucial component of a mother's nutrition during pregnancy. Adequate intake of choline is necessary to ensure the health of both the mother and the fetus. It is important for pregnant women to be mindful of their diet and ensure they are getting the necessary nutrients to support a healthy pregnancy and breastfeeding journey.
What is choline?
Choline is a nutrient that can be found naturally in some foods and is available as a food supplement. Choline contributes to the building process of our body's cell membranes. In addition, this nutrient is needed to produce acetylcholine, which is responsible for mood, memory, muscle control, and other functions of the nervous system. Choline also is involved in the early brain development of the baby. You can produce choline in the liver, but the amount that the body naturally makes may not be sufficient to meet your needs, especially when you are pregnant or breastfeeding.
Why is choline important during pregnancy?
As mentioned before, choline plays a role in metabolism, is involved in the cell structure-building process, and ensures the development of a healthy baby's nervous system.
Five recent nutrition guidelines from the United States, Australia, Canada, and the International Federation of Obstetrics and Gynecology have discussed the importance of choline intake for pregnant women. Meta-analysis of 12 studies revealed a prevalence of only 11.24% of pregnant women that followed adequate choline intake recommendations. A meta-analysis of six studies indicated a significant association between adequate maternal choline levels and a reduced risk of developing adverse pregnancy outcomes.
If you are pregnant, it is recommended to consume 450 mg of choline daily. It is known that pregnant and lactating women have higher choline requirements; however, some women do not get enough choline from their diet. Women need to seek guidance from their healthcare providers or nutritionists when considering choline supplementation to avoid toxicity and negative effects.
Forms of choline supplements
In many cases, prenatal and postpartum supplements typically have small amounts of choline or do not contain it at all. The forms of choline in supplements include choline bitartrate, phosphatidylcholine, or lecithin. Choline supplements can contain choline only, the combination of choline and vitamin B, or multivitamin products. Typical amounts of choline in supplements range from 10 mg to 250 mg per tablet. The daily amount of choline depends on your age and current situation, whether you are pregnant or breastfeeding.
The most common sources of choline are the water-soluble compounds glycerophosphocholine, phosphocholine, fat-soluble phospholipids sphingomyelin, phosphatidylcholine, and free choline. Choline is stored in the liver, used in your body when needed, or flows in the lymphatic circulation and travels to tissues and other organs, including the brain and placenta. You should choose supplements that contain an adequate amount of choline.
Benefits of choline during pregnancy
During pregnancy, the need for choline increases. The supplement requirements of pregnant women can vary from factors such as age, dietary
habits, and underlying medical conditions. Choline is involved in the development of:
- Baby's brain and nervous system (choline helps to develop brain cells and junctions between neurons)
- Neural tube formation (potentially helps to prevent spina bifida — a condition in which the baby's spine and spinal cord do not develop properly, resulting in a gap in the spine; however, the evidence is inconsistent)
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Cognitive function and behavior (may improve memory, potentially has a role in age-related cognitive function improvement)
- Liver function (it plays a role in the metabolism of fats and cholesterol)
It is also essential for a mother's cell formation, lipid metabolism, and liver function.
Breastfeeding women are recommended to consume 550 mg of choline daily throughout the first year postpartum. It is 100 mg more than what is recommended during pregnancy. You need extra choline not only for yourself but also for your growing baby, as it is responsible for overall health and development. Choline levels in breast milk have an impact on a baby's circulating choline levels.
What is the recommended choline intake?
You need more choline during pregnancy and while breastfeeding as your baby relies on you for nutrients. Adequate intakes of choline for women are the following:
| Age | Intake | Pregnancy | Lactation |
|---|---|---|---|
| Birth to 6 months | 125 mg/day | NA | NA |
| 7–12 months | 150 mg/day | NA | NA |
| 1–3 years | 200 mg/day | NA | NA |
| 4–8 years | 250 mg/day | NA | NA |
| 9–13 years | 375 mg/day | NA | NA |
| 14–18 years | 400 mg/day | 450 mg/day | 550 mg/day |
| 19+ years | 425 mg/day | 450 mg/day | 550 mg/day |
How to increase choline intake?
Many scientists suggest you eat a healthy diet first and use choline supplements if inadequate intake is suspected. Always check the ingredients of the vitamins you use. Currently, there are no known interactions between choline and any foods or medicines.
Sources of choline
Many daily foods contain choline. Animal-based products — meat, poultry, fish, eggs, and dairy products are the main nutritional sources of choline. Certain vegetables and beans are also rich in choline. Other sources include nuts, seeds, and whole grains. Many foods also contain lecithin, a substance rich in phosphatidylcholine, that is used as an emulsifying agent in processed foods (gravies, salad dressings, margarine). Choline is also added to most baby formulas.
| Eggs | Egg yolks consist of approximately 147 milligrams of choline per large egg. They are one of the richest sources of choline. |
| Poultry and meat | Chicken, beef, and pork are excellent sources of choline. For example, three ounces of roasted chicken breast has 72 mg of choline. |
| Fish | Salmon and cod are known for their choline-rich content. Three ounces of Atlantic cod, cooked in dry heat, contains 71 mg of choline per serving. |
| Dairy products | Milk, yogurt, and cheese are commonly used and provide essential nutrients and choline. For example, a 1% fat cup of milk contains 43 mg of choline. |
| Cruciferous vegetables | Half a cup of broccoli or Brussels sprouts contain 31 and 32 mg of choline. |
| Legumes and nuts | One-fourth cup of dry roasted peanuts contains 24 mg of choline. Legumes and nuts also contribute health benefits such as healthy fats, protein, and fiber. |
| Whole grains | Certain whole grains, such as quinoa, contain moderate amounts of choline. One ounce of toasted wheat germ consists of 51 mg of choline. |
Choline deficiency risks
You need to increase your choline intake daily while pregnant or breastfeeding. It is known that choline deficiency may include:
- Brain and neural function development disorders
- Liver damage
- Muscle damage
Choline deficiency may also be associated with anxiety.
Studies have shown choline's role in fetal neural tube formation, brain development, and, possibly, the cognitive boosting potential of choline. However, challenges in methodology and variations in study findings exist. Increased awareness, continued research, and development of guidelines are necessary to optimize the benefits of choline in maternal nutrition. Always consult with a specialist before using choline. Choline supplementation shows promise in enhancing maternal and fetal health, but further research and awareness efforts are needed to fully realize its benefits.
FAQ
How much choline is in eggs?
About 25% of your day's choline is in one egg. Eggs are one of the highest food sources of choline, with an impressive 147 mg per large egg. If you eat 2–3 eggs at a meal, it means you can get 50–75% of your daily choline needs.
Can too much choline be harmful to a baby?
No reports containing this information were found. Choline is essential during pregnancy and the lactation period. Yet, it's important to note that if one takes more choline than recommended, it may pose direct risks to the mother's health, potentially affecting the baby as well.
What trimester is choline most important?
Even though adequate choline intake is important throughout the whole pregnancy, it should be emphasized that the impact of choline begins very early in pregnancy, in the first trimester. Choline plays a role in the development of the neural tube and contributes to the formation of the fetal brain.
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Choline is an essential nutrient in pregnancy and lactation.
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Eggs and chicken breast are one of the best choline food sources.
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The daily dose for pregnant women is 450 mg per day, and breastfeeding women need 550 mg per day.
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Always check the supplement labels to know the exact amounts of nutrients you're taking.
6 resources
- National Institutes of Health. Choline.
- Cureus. Choline supplementation in pregnancy: current evidence and implications.
- Oxford academic. Choline in pregnant women: a systematic review and meta-analysis.
- Clinical Nutrition. Longitudinal changes in choline concentration and associated factors in human breast milk.
- The American Journal of Clinical Nutrition. Choline in anxiety and depression: the Hordaland Health study.
- ACOG. Nutrition during pregnancy.
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