Choline supports fetal brain development and healthy neural tube development and contributes to the overall health of both mother and child. Although often overlooked, choline is a very important nutrient, especially during pregnancy and lactation. Choline supports fetal development and the general health of both mother and child. Despite its importance, many people are not aware of choline or its benefits, and it is frequently under-consumed. This article shares the essential functions of choline, benefits of choline consumption during pregnancy and lactation, current dietary recommendations, and ways to ensure adequate intake. What is Choline? Choline is an essential nutrient that is required for many bodily functions (1). While choline is not technically a vitamin, it is often grouped with the B vitamins. Choline is essential for its role in liver function, brain development, muscle movement, nervous system function, and metabolism (1). The body can produce some choline, but not enough to meet daily needs (1), particularly during pregnancy and lactation, making it essential to obtain this nutrient through diet or supplements. The Role of Choline in Pregnancy During pregnancy, choline is critical for fetal brain development and the prevention of neural tube defects (2). The neural tube is the precursor to the central nervous system, which includes the brain and spinal cord (2). Adequate choline intake helps in the formation and closure of the neural tube, reducing the risk of birth defects, such as spina bifida and anencephaly (2). In addition to supporting neural tube development, choline plays a role in gene expression regulation, cell membrane formation, and the production of neurotransmitters (2). These functions are essential for the development of the fetal brain and spinal cord, and they help lay the foundation for lifelong cognitive function. Studies have shown that higher maternal choline intake is associated with improved cognitive outcomes in their children (3). You may also like this article: Key Supplements For Infant & Child Brain Development Choline During Lactation The increased demand for choline continues during lactation, and choline is an important component of breastmilk (4). Research shows that maternal choline intake impacts total choline amounts in breastmilk (5). Choline is also required by law to be added to infant formula in the US, with the minimum being 7 mg of choline per 100 calories (6). Research has indicated that higher choline intake during lactation can enhance cognitive function in infants (7). Choline supports the production of acetylcholine, a neurotransmitter that plays a role in learning, memory, and muscle control (8). Current Recommendations for Choline Intake The National Institutes of Health (NIH) provides guidelines for choline intake, which vary by age, sex, and life stage. For pregnant women, the recommended daily intake is 450 mg, while lactating women should aim for 550 mg per day (1). Unfortunately, surveys show that up to 95% of women do not meet these recommendations (9), with average intakes falling below the required amounts. Here’s how choline needs vary across different life stages: Pregnant Women: 450 mg/day Lactating Women: 550 mg/day Adult Women (non-pregnant, non-lactating): 425 mg/day Study: Benefits of Consuming 930 mg of Choline Per Day During Pregnancy While government recommendations for minimum daily intake during pregnancy are currently at 450 mg per day during pregnancy and 550 mg per day during lactation, these are minimum daily intake amounts, and not necessarily optimal amounts. Current research is highlighting the significant benefits of consuming 930 mg of choline per day during pregnancy (10). In a controlled feeding study, pregnant women who consumed 930 mg of choline daily during the third trimester had infants with faster information processing speeds at four and seven months of age compared to those who consumed only 450 mg (10). At age seven, these children also performed better on tasks involving color-location memory, suggesting long term enhanced cognitive development (10). I wrote an article on this study specifically; to learn more, see: New Study: Prenatal Choline Benefits Attention Span In Children Food Sources of Choline Choline is found in a variety of foods, with animal products containing the most. Eggs and beef liver are some of the most concentrated sources of choline, and choline can also be found in cruciferous vegetables, like broccoli and Brussels sprouts, although in smaller amounts. Here are some examples of choline-rich foods (11): Eggs (1 large): ~147 mg Beef liver (3 oz): ~356 mg Chicken breast (3 oz): ~72 mg Salmon (3 oz): ~62 mg Broccoli (1 cup, cooked): ~63 mg Soybeans (1 cup, cooked): ~57 mg Given the difficulty in meeting choline needs through diet alone, especially when needs are increased during pregnancy and lactation, many healthcare providers recommend considering choline supplements. It is noteworthy that more than half of pre/postnatal supplements do not contain choline (12), and many that do contain very small amounts (12). How Can I Support Choline Absorption? Beyond simply ensuring our intake, we should also be aware of our bodies ability to effectively absorb nutrients. Here are some ways to enhance choline absorption: Adequate Intake of Vitamin B12 and Folate: Vitamin B12 and folate play important roles in the methylation cycle (13), which is interconnected with choline metabolism (13). Ensuring adequate intake of these vitamins can support efficient use and absorption of choline in the body. Maintaining a Healthy Gut: A healthy gut microbiome supports the optimal absorption of nutrients (14), including choline. Consuming probiotics (found in yogurt, kefir, and fermented foods) and prebiotics (found in fiber-rich foods like bananas, onions, and garlic) can help maintain a healthy gut (15), which in turn may improve nutrient absorption. To learn more about when to take your vitamins, read: When To Take Vitamins For Maximum Benefit. To learn more about the benefits of probiotics, see: The Vast Health Benefits of Probiotics. Choline Deficiency During Pregnancy & Lactation Inadequate choline intake during pregnancy can lead to several complications. A deficiency in choline has been linked to an increased risk of neural tube defects, preeclampsia, and fetal growth restrictions (16). Long-term cognitive deficits in children, including impaired memory and learning abilities (16), have also been associated with low choline intake during pregnancy. For lactating mothers, insufficient choline intake can result in lower choline concentrations in breast milk (5), which may affect the infant’s cognitive development and overall health. Choline Supplementation During Pregnancy & Lactation Choline supplementation can be a helpful way to ensure sufficient choline intake, particularly during pregnancy and lactation. Prenatal vitamins don’t always include choline, and if they do, it is often not enough to meet the recommended daily intake (12), much less the higher intake of 930 mg per day that has been studied to benefit cognitive function (10). Research supports the safety and efficacy of choline supplementation during pregnancy and lactation (16). That said, it is important to do your due diligence when choosing a prenatal vitamin because there can be a lot of variation in both nutrient quality and quantity between different brands. To learn more about choosing the right supplements for your needs, see: What To Look For In A Prenatal Vitamin, Choosing A Supplement Delivery Method For Your Family and How To Create A Daily Supplement Protocol For Your Family See Product Can I Take Too Much Choline? The tolerable upper intake level (UL) for choline is 3,500 mg per day for adults (1). This threshold is based on the potential adverse effects associated with high choline intake, which can include (1): Hypotension (Low Blood Pressure): Excessive choline can lead to a drop in blood pressure, which might cause dizziness, fainting, and other related symptoms. Fishy Body Odor: One of the more well-known side effects of too much choline is the development of a fishy body odor. This is due to the buildup of trimethylamine, a byproduct of choline metabolism. Gastrointestinal Distress: Overconsumption of choline can lead to nausea, vomiting, and diarrhea. Liver Toxicity: Extremely high levels of choline may contribute to liver toxicity, although this is more likely at doses far exceeding the UL. Because the tolerable upper intake level of choline is so high, and amounts found in food are not very high, it is almost impossible to overdo it with choline from dietary intake alone. It is important to read supplement labels and be aware of dosages, especially if you are taking multiple different supplements each day. Summary Choline is a crucial, but often under-consumed, nutrient, especially during pregnancy and lactation. Choline supports fetal brain development and healthy neural tube development and contributes to the overall health of both mother and child. While the recommended daily intake is 450 mg during pregnancy and 550 mg during lactation, research shows significant benefits from consuming up to 930 mg per day during pregnancy, including improved cognitive outcomes in children and reduced risk of pregnancy complications, like preeclampsia. Choline is found in foods like eggs and beef liver, but many women find that they need supplements to meet their daily requirement for this nutrient. References: Office of Dietary Supplements - Choline. (2022). Www.ods.od.nih.gov. https://ods.od.nih.gov/factsheets/Choline-Consumer/ Zeisel S. H. (2006). Choline: critical role during fetal development and dietary requirements in adults. Annual review of nutrition, 26, 229–250. https://doi.org/10.1146/annurev.nutr.26.061505.111156 Korsmo, H. W., Jiang, X., & Caudill, M. A. (2019). Choline: Exploring the Growing Science on Its Benefits for Moms and Babies. Nutrients, 11(8), 1823. https://doi.org/10.3390/nu11081823 Heras-Sola J, Gallo-Vallejo JL. Importancia de la colina durante el embarazo y lactancia. Una revisión sistemática [Importance of choline during pregnancy and lactation: A systematic review]. Semergen. 2024 Jan-Feb;50(1):102089. Spanish. doi: 10.1016/j.semerg.2023.102089. Epub 2023 Oct 18. PMID: 37862810. Lewis, E. D., Richard, C., Goruk, S., Wadge, E., Curtis, J. M., Jacobs, R. L., & Field, C. J. (2017). Feeding a Mixture of Choline Forms during Lactation Improves Offspring Growth and Maternal Lymphocyte Response to Ex Vivo Immune Challenges. Nutrients, 9(7), 713. https://doi.org/10.3390/nu9070713 CFR - Code of Federal Regulations Title 21. (n.d.). Www.accessdata.fda.gov. https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfcfr/CFRSearch.cfm?fr=107.100 Cheatham CL, Sheppard KW. Synergistic Effects of Human Milk Nutrients in the Support of Infant Recognition Memory: An Observational Study. Nutrients. 2015 Nov 3;7(11):9079-95. doi: 10.3390/nu7115452. PMID: 26540073; PMCID: PMC4663580. Scientists discover how an essential nutrient enters the brain. (2024, May). National Institutes of Health (NIH). https://www.nih.gov/news-events/news-releases/scientists-discover-how-essential-nutrient-enters-brain Brunst, K. J., Wright, R. O., DiGioia, K., Enlow, M. B., Fernandez, H., Wright, R. J., & Kannan, S. (2013). Racial/ethnic and sociodemographic factors associated with micronutrient intakes and inadequacies among pregnant women in an urban US population. Public Health Nutrition, 17(9), 1960–1970. https://doi.org/10.1017/s1368980013003224 Caudill, M. A., Strupp, B. J., Muscalu, L., Nevins, J. E. H., & Canfield, R. L. (2018). Maternal choline supplementation during the third trimester of pregnancy improves infant information processing speed: a randomized, double-blind, controlled feeding study. FASEB journal : official publication of the Federation of American Societies for Experimental Biology, 32(4), 2172–2180. https://doi.org/10.1096/fj.201700692RR Patterson, K., Bhagwat, S., Williams, J., Howe, J., Holden, J., Zeisel, S., Dacosta, K., & Mar, M.-H. (2008). USDA Database for the Choline Content of Common Foods. https://www.ars.usda.gov/ARSUserFiles/80400525/Data/Choline/Choln02.pdf Cai, F., Young, B. K., & Mccoy, J. A. (2023). Commercially Available Prenatal Vitamins Do Not Meet American College of Obstetricians and Gynecologists Nutritional Guidelines. American Journal of Perinatology, 41(S 01), e2547–e2554. https://doi.org/10.1055/a-2125-1148 Zeisel S. (2017). Choline, Other Methyl-Donors and Epigenetics. Nutrients, 9(5), 445. https://doi.org/10.3390/nu9050445 Barone, M., D'Amico, F., Brigidi, P., & Turroni, S. (2022). Gut microbiome-micronutrient interaction: The key to controlling the bioavailability of minerals and vitamins?. BioFactors (Oxford, England), 48(2), 307–314. https://doi.org/10.1002/biof.1835 Vyas, U., & Ranganathan, N. (2012). Probiotics, Prebiotics, and Synbiotics: Gut and Beyond. Gastroenterology Research and Practice, 2012, 1–16. https://doi.org/10.1155/2012/872716 Jaiswal, A., Dewani, D., Reddy, L. S., & Patel, A. (2023). Choline Supplementation in Pregnancy: Current Evidence and Implications. Cureus, 15(11), e48538. https://doi.org/10.7759/cureus.48538 Facebook Pinterest X Email SHOP & EARN REWARDS. JOIN TODAY! Nutrient Depletion & The Birth Control Pill Read more New Study: Prenatal Choline Benefits Attention Span In Children Read more Preconception Supplements For A Healthy Pregnancy Read more