Nobody is getting enough choline from food alone–and pregnant women are especially easy customers in the supplement aisle.

Todd Runestad, Content Director, NaturalProductsInsider.com, Sr. Supplements Editor

January 9, 2020

4 Min Read
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Pregnant mom Jessie Shafer is taking the Nature Made Prenatal Multi + DHA “because it was one of the most well-rounded ones I could find that included DHA but didn’t require me to take more than one pill per day.”

Pregnant mothers are easy customers in the supplements aisle because even mainstream doctors will recommend a prenatal supplement for pregnant moms.

Folic acid, a B vitamin, is recommended to help prevent neural tube defects. This condition affects some 3,000 infants in America a year according to the March of Dimes. Spina bifida, which affects the spine, is the most common neural tube defect.

The US Preventive Services Task Force recommends taking 400-800 mcg per day of folic acid. So pretty much all prenatal multis contain the requisite amount of folic acid (plus all the other vitamins and minerals required to support both mother and child).

Individual nutrients have recently risen to the fore, starting with the omega-3 fatty acid DHA and probiotics.

DHA is known to promote the growth and development of infant brain and eye health (the brain and eye have high DHA contents compared to other organs), and can help lengthen the time of gestation. Lower DHA content is linked to poorer neonatal cognitive development and visual function.

Visual acuity benefits up to 12 months old have been seen with higher intakes of DHA. DHA is also shown to improve neuronal signaling—you know, thoughts.

It remains a bit of an unknown what the optimal dose of DHA should be for pregnant and nursing women. The March of Dimes and the United Nations recommend that pregnant and lactating women should have a minimal intake of 200-300 mg/day of DHA.

The Nature Made Prenatal that Shafer is taking contains 200 mg DHA.

A 2017 study found only 9% of American women took DHA supplements during pregnancy, and that the average intake was only 66 mg per day. 

Probiotics have been used to help with preemies, especially around the wee infant’s ability to fight infections (sepsis) and in preventing antibiotic-associated diarrhea.

But even in normal-term infants, probiotics can help establish and maintain the fledgling musocal barrier and getting the little tyke’s microbiome off to a healthy start. Colonizing the gut right off the bat is important in building a healthy immune system, which is seen as key to preventing atopic conditions like eczema and asthma. One of the best-studied probiotic strains, LGG, has been shown to do just that.

The new neonatal ingredient

Choline is a cousin to the B vitamins and the precursor to phosphatidylcholine (PC), which is a primary brick-and-mortar of cell walls. It’s also a key building block of the neurotransmitter acetylcholine, which helps the brain communicate everywhere in the body.

Choline was only recognized by the Institute of Medicine in 1998, so there is still much to learn. But that’s what makes it such a compelling story to consumers looking to get the most out of their bun in the oven.

The National Institutes of Health put out a choline fact sheet that says the biggest dietary source of choline is beef liver—one serving provides 356 mg, or 65% of the daily value. But who eats liver? Yuck.

No. 2 on the dietary source list is hard-boiled eggs, which provide about one-quarter the daily value of choline.

Face it, nobody is getting the proper amount of choline from food sources–and that leaves us with supplements.

The NIH fact sheet recommends 450 mg per day for pregnant mothers and 550 mg per day for lactating moms.

There are five areas of neonatal health that can benefit from choline supplements.

  • Neural tube defects—even with appropriate levels of folic acid.

  • Neonate stress and preeclampsia (which, you will recall, killed that girl in Downton Abbey). 

  • Brain development after a mom’s sickness. (Mother’s infections have been linked to ADHD.)

  • Memory. The big memory study one is a 2018 study from Cornell University that showed pregnant women who supplemented 930 mg per day of choline during the third trimester gave birth to infants with greater information processing and visuospatial memory (i.e., keeping track of the location of moving objects) than mothers taking only 480mg per day. The study also showed that greater and longer intake of choline by the mothers was associated with greater cognitive ability in the babies up to age 13 months. The Cornell researchers are currently following up that 2018 study, and have reported findings that suggest the benefits accrue to age 7, with better attention, memory and learning. Of note, in this follow-up, all the mothers received 480mg per day choline.

Dosage matters. And the form matters. The type of choline used in the Cornell research was VitaCholine, which is a branded ingredient sold by Balchem Inc.

Talk with your customers about the value of choline. Remember, pregnant moms are buying supplements for two.

For a deeper dive into all things choline, download this free choline guide from Natural Products INSIDER

About the Author(s)

Todd Runestad

Content Director, NaturalProductsInsider.com, Sr. Supplements Editor, Natural Products Insider

I've been writing on nutrition science news since 1997. I'm The content director for NaturalProductsInsidercom and digital magazines. Other incarnations: supplements editor for newhope.com, Delicious Living and Natural Foods Merchandiser. Former editor-in-chief of Functional Ingredients magazine and still cover raw material innovations and ingredient science.

Connect with me here https://www.linkedin.com/in/toddrunestad/

My daily vitamin regime includes a morning smoothie with a range of powders including protein, collagen and spirulina; a quality multi, B complex, C with bioflavonoids, >2,000IU vitamin D, E, magnesium, high-selenium yeast, PQQ, choline, alpha-lipoic acid with carnitine, coQ10, fish oil concentrate, probiotics and some adaptogenic herbs. 

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