Choline benefits: Food scientist, Dr Taylor Wallace, shares why choline is so important for pregnant and breastfeeding women

The importance of proper nutrition during pregnancy and breastfeeding is well-known. In fact, prenatal vitamins are recommended for all pregnant and breastfeeding women as a way to ensure your baby gets the best possible start in life. And while prenatals contain many of the essential nutrients required for a healthy pregnancy, they aren’t typically a good source of choline. Choline is important for both mom and baby, so what are the best ways to ensure you’re getting enough?

To better understand the importance of choline for pregnant and breastfeeding mothers, we spoke with the choline expert, Dr. Taylor C. Wallace, Ph.D., CFS, FACN, Principal and CEO at the Think Healthy Group, and Professor in the Department of Nutrition and Food Studies at George Mason University.

Dr. Wallace is an advocate for proper nutrition at every stage of life and has extensively researched and published about choline. As an expert food scientist, his academic research focuses on nutritional interventions that promote optimal health and prevent the onset of chronic disease.

What is choline?

Choline is an essential water-soluble nutrient that’s required for a variety of bodily functions. Although not considered a vitamin or mineral, choline is typically included as part of the B-complex group of vitamins—which are crucial for maintaining good health. 

According to Dr. Wallace’s research, choline has structural, metabolic, and regulatory roles throughout the body. It’s involved in many different processes, including liver and muscle function, brain development, memory, mood, and cellular membrane composition and repair.¹

How much choline do I need?

The recommended intake levels, set by the National Academy of Medicine (NAM) in 1998, vary from 125 mg per day to 550 mg per day—based on age and sex. For pregnant and lactating women, the recommendation is 425 mg per day.

A maternal choline study shows cognitive benefits in infants born to mothers who consumed 930 mg of choline each day during the third trimester. Additional research is needed to determine adequate intake amounts for the full benefits of a choline-rich diet.²

Although choline levels play an important role in a variety of internal functions, the body can only produce small amounts on its own. Because of this, it’s critical to prevent choline deficiency by incorporating it into your diet through food or supplementation.

What are the signs of a choline deficiency?

While extreme cases of choline deficiency result in the development of fatty liver disease, the majority of people will experience other signs and symptoms.

Common signs of choline deficiency include:

• Memory loss
• Cognitive impairment
• Tiredness and fatigue
• Muscle aches
• Nerve damage
• Mood changes 

What is choline good for during pregnancy and breastfeeding?

Choline plays a critical role in brain and spinal cord development during gestation. According to the American Medical Association (AMA), choline intake by the mother during pregnancy and breastfeeding has lasting neurocognitive benefits for the child.³

Adequate intake levels may result in increased cognitive function throughout the child’s entire life, while inadequate levels may have lasting negative effects.

Additionally, Dr. Wallace’s professional research states that adequate intake of choline during pregnancy results in a decrease in certain preeclampsia risk factors. It’s also linked to a decrease in infant plasma cortisol levels. This may reduce the child’s risk of developing stress-related diseases as they age.¹

He adds that only 8% of pregnant women and 10% of all Americans are getting adequate amounts of choline in their diets. But the need for choline doesn’t stop when the baby is born.¹

“Choline is equally important during lactation since the body deprives the mother of choline stored for the infant’s development and wellbeing,” explains Dr. Wallace. 

Do prenatal vitamins include choline?

Despite the fact that the National Academy of Medicine recognizes choline as an essential nutrient and the American Medical Association encourages the inclusion of choline in all prenatal vitamin supplements, Dr. Wallace explains that most prenatal vitamins don’t contain choline.

In reality, most multivitamins only contain choline in tiny amounts (25 to 35 mg). This is not enough to meet the daily recommended intake levels.

How can women get enough choline in their diet?

According to Dr. Wallace, whole eggs are a great choline-rich food, with about 150 mg of choline per egg—the majority coming from the yolk. The choline in eggs along with other nutrients provides several health benefits during pregnancy, making it an excellent food to incorporate into your daily diet. 

Other foods high in choline include seafood, dairy, and lean meat, with animal products typically containing more choline than plant foods. Soy protein shakes provide an additional option for vegetarians. 

Examples of great choline sources include:

• Chicken liver (3 oz; 247 mg)
• Salmon (3 oz; 187 mg)
• Shiitake mushrooms (½ cup; 58 mg) 
• Chicken broilers or fryers (3 oz; 56 mg)
• Beef grass-fed strip steak (3 oz; 55mg)
• Wheat germ (1 oz toasted; 51 mg)
• Milk (8 oz; 38 mg)
• Brussel sprouts (½ cup; 32 mg)
• Almond (1 oz; 15 mg)

While it’s possible to get the recommended amount of choline through diet alone, most don’t eat enough choline-rich foods to meet the recommended daily intake. Learning more about the foods that contain choline and incorporating them into your diet is a good way to ensure you’re getting enough of this essential nutrient.

Why is choline important for babies and toddlers?

The part of the brain responsible for learning and memory, known as the hippocampus, continues to develop for years after birth. Choline benefits the development of the hippocampus during these years.

For that reason, the FDA mandates that 7 mg per 100kcal of choline be required in infant formula. While this recommendation is based on the amount of choline naturally found in breastmilk, Dr. Wallace expresses that it’s still not enough. 

Fortunately, babies can begin to eat complementary foods at 6 months old. Dr. Wallace reiterates the fact that “eggs are a great complementary food” and just one egg a day can drastically increase a baby’s choline intake.

So, where does Bobbie baby formula stand when it comes to choline?

Dr. Wallace spoke to us specifically about where Bobbie baby formula stands with regard to choline recommendations for infants, and his answer was reassuring.

“Bobbie has 3.57 times more choline than the FDA minimum mandated amount (7 mg per 100 kcal),” explains Dr. Wallace. 

“The FDA guidelines recommend 7 to 50 mg (so Bobbie formula falls right in the middle). This puts the product at providing about 132.5 mg of choline per day (based on the standard infant intake calculations FDA and NAM use). The Adequate Intake for infants 0 to 6 months is 125 mg per day, so this is a good place to be.”

Should women continue to supplement choline after pregnancy and breastfeeding?

While adequate choline intake during pregnancy and breastfeeding is crucial for healthy fetal development, it’s important to note that most people don’t get enough choline in their diet.

Dr. Wallace advises women who don’t consume many animal-derived foods to continue supplementing choline, even after their pregnancy and breastfeeding journey is over. Don’t concern yourself with finding the best choline supplement. Rather, focus on consuming choline-rich foods every day.

Sources:

1. Choline Research | NCBI
2. Maternal Choline Supplementation | FASB
3. AMA Backs Global Health Experts | AMA