There are rock-star nutrients in the pregnancy world that tend to receive all the attention. Folic acid, iron, and calcium are covered extensively in pregnancy magazines, and they're easily part of the mom-to-be vernacular. Choline—a water-soluble nutrient in the B vitamin family—on the other hand, remains largely unknown for many pregnant moms. But based on recent research, it deserves to be elevated to rock-star nutrient status.
One reason choline is difficult to study is that it's related to brain development, and linking low choline in pregnancy to a lower IQ or a higher rate of depression later in life is tough to measure. How do you measure IQ potential? How do you know if depression could have been avoided, had the child received more of a particular nutrient during early brain development?
One recent study found that babies whose moms had low choline in their blood during pregnancy scored lower on cognitive tests at 18 months, indicating that their brain development had been compromised. Rodent studies have also demonstrated that choline during pregnancy increases intelligence into adulthood, and also seems to be protective against memory loss later in life. Finally, a recent study found an interesting effect of high choline intake during pregnancy: The nutrient appears to help decrease the baby's levels of cortisol, which is widely known as the "stress hormone." The researchers speculate that this may help reduce the impact of a pregnant mother's stress on the baby's developing brain, nervous system, and metabolism.
The take-home message is best summarized by a review in the Journal of Pediatrics: Choline in the diet of the pregnant mother and the infant is directly related to permanent changes in brain function. Without enough choline during the critical time of brain growth and development, intelligence, memory, and possibly mood regulation will be damaged permanently. We may not be able to measure the exact impact on IQ or other brain functions, but we know enough at this point to start preaching the choline message.
So, how much choline does a pregnant woman need? The current recommendation for pregnancy is 450 milligrams a day, and the number jumps to 550 milligrams a day for breastfeeding moms. Also, remember that brain development is crucial during the first three years of a child's life, which means choline is also critically important in the diets of infants and toddlers. Infants need 125 milligrams a day, while toddlers need closer to 200 milligrams a day.
Prenatal vitamins should contain choline, but check the label. Other foods to add to your diet include eggs (126 mg./egg); tofu (100 mg./3 ounces); lean beef (67 mg./3oz.); Brussels sprouts (62 mg./cup cooked); cauliflower (62 mg./ ¾ cup cooked); navy beans (48 mg./½ cup cooked); peanut butter (20 mg./2 tablespoons); and skim milk (38 mg./cup). Some spices add a small bit of choline, such as dried parsley or chili powder. Another food that contains small amounts of choline: chocolate!
For infants, breast milk is a great source of choline, which may be one of the reasons research shows a link between breastfeeding and optimal brain development. Parents who feed their infants formula should check the label to make sure choline is included.
As with anything in life, too much of a good thing is no longer a good thing—it is possible to get too much choline, mainly from overdoing it with supplements. Choline toxicity can lead to a fishy body odor, vomiting, and decreased blood pressure. Food sources and a modest amount in a prenatal vitamin are the best bets for moms-to-be.
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Melinda Johnson, MS, RD, is Director of the Didactic Program in Dietetics and lecturer for the Nutrition Program at Arizona State University, and a Spokesperson for the Academy of Nutrition and Dietetics. Follow her on Twitter @MelindaRD.