Choline during pregnancy: new study shows lasting cognitive benefit for children

Getting enough choline is important throughout the lifespan, but it is especially critical during pregnancy and lactation to support the baby’s brain development.^1,2  Previous research demonstrated that choline supplementation during the third trimester of pregnancy can improve an infant’s cognitive function,³ and a recently published follow-up study with this same group of children found a lasting impact into school-age years.⁴  While larger studies will need to confirm these human data, the current evidence demonstrates higher maternal choline intake during pregnancy can have a lasting beneficial impact on children’s brain health and development.

Previously, a randomized, double-blind, controlled feeding study found that higher maternal choline supplementation during the third trimester of pregnancy (930 vs. 480 mg/day) improved infant information processing speed (a measure of cognitive function).  Importantly, a benefit was also seen at the lower level of intake for infants born to mothers who were enrolled in the study for a greater duration of pregnancy.  The authors concluded, “even modest increases in maternal choline intake during pregnancy may produce cognitive benefits for offspring.”³

As a follow-up, the same children from this initial study were assessed at seven years old.  Children born to women who were in the 930 mg supplementation group demonstrated superior performance in sustained attention (a measure of cognitive function), compared to children in the 480 mg supplementation group.⁴  The long-term benefits of choline supplementation during pregnancy are hypothesized to be at least partly due to lasting changes during brain development, which would be consistent with animal studies.  While these results strongly support a beneficial impact of higher choline intake during pregnancy, the authors recommend larger studies in more diverse populations to confirm the observations.  Further, more research is needed to determine the optimal level of choline intake during pregnancy.

Most Americans, including pregnant women (average choline intake of 350 mg/day), do not meet the Adequate Intake for choline.^2,4,5  With these new human data supporting the critical role of higher choline intake during early life, consuming choline-rich foods (along with a supplement if indicated), are encouraged as part of healthy dietary patterns.^5,6  Importantly, one large egg provides several nutrients essential for brain growth, including 150 mg choline.^7,8  A large egg also provides 252 mcg of lutein + zeaxanthin, carotenoids with emerging evidence linking to brain development and health.⁹  Other nutrient-rich foods that can help provide choline to the diet include meat, soybeans, poultry, fish, dairy products, potatoes with skin, wheat germ, quinoa, cruciferous vegetables, nuts, and seeds.¹⁰

“Meeting nutrient needs through foods and beverages is preferred, but women who are concerned about meeting recommendations should speak with their healthcare provider to determine whether choline supplementation is appropriate.”¹¹  For more information about choline, see the National Institutes of Health Choline Fact Sheet for Health Professionals and Choline Throughout the Lifespan article. For recipe inspiration, check out IncredibleEgg.org.