Data from the study, published in the FASEB Journal, indicated that infants of mothers receiving 930 mg of choline per day, over twice the current 450 mg per day recommendations, experienced greater cognitive benefits than children of women consuming 480 mg per day.
“In animal models using rodents, there’s widespread agreement that supplementing the maternal diet with additional amounts of this single nutrient has lifelong benefits on offspring cognitive function,” said Marie Caudill, professor of nutritional sciences and the study’s first author. “Our study provides some evidence that a similar result is found in humans.”
Widespread inadequacies
Choline does have an RDI, which is set at 550 mg per day for adult males. The Institute of Medicine (IOM) recognized choline - found naturally in beef and chicken liver, egg yolk, salmon, milk, and soybeans among other things - as an essential nutrient in 1998. The adequate intake for women was set at 425 mg/day (rising to 450 mg for pregnant women and 550 mg for breastfeeding women).
Yet according to National Health and Nutrition Examination Survey (NHANES) data, 90% of children, adults and pregnant women are not getting enough. On average, pregnant women actually consume 319 mg of choline per day, which is just 70% of the AI and less than two-thirds of the control group’s 480mg daily intake in the Cornell FASEB study.
Study details
Prof Caudill and her co-workers included 26 women entering their third trimester of pregnancy in their clinical trial. All the women consumed exactly the same diet and provided with supplemental choline at doses of 480 mg or 930 mg per day. The supplemental choline provided by Balchem. Intake of choline and other nutrients were tightly controlled, which was important since the metabolism of choline and its functions can overlap with such nutrients as vitamin B12, folic acid and vitamin B6.
“By ensuring that all the nutrients were provided in equal amounts, we could be confident that the differences in the infants resulted from their choline intake,” Caudill said. In this study, half the women received 480 mg/day of choline, slightly more than the adequate intake level, and the other half received 930 mg/day.
Using well-established cognitive tests to evaluate the newborns’ memory, information processing speed, and visual attention span at four, seven, 10 and 13 months of age, the researchers found that the infants whose mothers consumed the 930mg choline dose experienced higher information processing speeds at all ages, significantly faster than the control group. Interestingly, the control group also showed a linear effect of exposure duration, which suggests that even moderate increases in consistent choline intake may support improved cognitive development.
These findings are consistent with other research that supports the important role choline plays for pregnant women and newborns. In fact, the American Medical Association (AMA) recently recommended that choline be included in all prenatal multivitamins as a result of the clear science and demonstrated benefits.
Implications for choline recommendations
Study funding
The study was funded by the Egg Nutrition Center, the Beef Checkoff, the U.S. Department of Agriculture, the Institute for the Social Sciences, the Bronfenbrenner Life Course Center, and the National Institute of Food and Agriculture.
Despite being a relatively small study, the findings suggest that current recommendations for daily choline intake may not be enough to produce optimal cognitive abilities in offspring, said Richard Canfield, a developmental psychologist in the Division of Nutritional Sciences and the senior author of the study. Current choline intake recommendations are based on amounts required to prevent liver dysfunction, and were extrapolated from studies done in men in part because no studies had investigated requirements during pregnancy.
“A prudent approach would be to increase dietary choline intake by consuming more animal source foods during pregnancy – egg yolks, lean red meats, fish and poultry,” said Caudill. “For women who restrict animal-sourced foods, consuming a choline supplement that provides choline at a level comparable to 450 mg/day may be needed.”
“Access to choline for pregnant women is a priority”
The study’s findings were welcomed by Tom Druke, Director of VitaCholine Brand Development, Balchem Human Nutrition and Pharma, which provided the choline used in the study.
“The growing body of science, along with the newly established Reference Daily Intake (RDI) of 550mg and the recent AMA endorsement, make it clear that increasing awareness of and access to choline for pregnant women is a priority,” said Druke.
“We are proud to have provided VitaCholine as the supplemental choline source for this important study and we continue to invest in clinical research showing how important choline is to good health, particularly during the first 1000 days of life when the demand is so high and the benefits so substantial.”
Source: FASEB Journal
Published online ahead of print, doi: 10.1096/fj.201700692RRf
“Maternal choline supplementation during the third trimester of pregnancy improves infant information processing speed: a randomized, double-blind, controlled feeding study”
Authors: M.A. Caudill, et al.