Specifically, 7-year-old children did better on challenging tasks that demanded sustained attention when their mothers took twice the recommended amount of choline in pregnancy, according to a study in Journal of the Federation of American Societies for Experimental Biology.
The American College of Obstetricians and Gynecologists (ACOG) recommends pregnant women get 450 mg per day and lactating women get 550 mg per day, respectively, according to a spokesperson with ACOG.
Sounds simple, right? But most prenatal vitamins don’t have choline in them at all, or enough of it.
“Choline is bulky [like calcium], and therefore it’s hard to add to a prenatal… the pill would be too gigantic to swallow,” Taylor C. Wallace, PhD, an adjunct professor at George Mason University, tells Motherly.
Research on how critical choline is has only just started “booming” over the last five to seven years, Dr. Wallace adds.
Current recommendations need an update
Authors of the study say that the recommended intake doesn’t meet the needs of babies when they are developing in utero.
“Our findings suggest population-wide benefits of adding choline to a standard prenatal vitamin regimen,” says Barbara Strupp, PhD, a Cornell University professor and co-senior author of the study, in a statement.
ACOG has not been involved in any efforts to promote the inclusion of choline in prenatal vitamins, and does not have an official position on the inclusion of choline in prenatal vitamins, the spokesperson tells Motherly.
Food sources of choline
You can get choline in egg yolks, fish, poultry, lean red meat, legumes, nuts and cruciferous veggies. But it’s not in most prenatal vitamins, and more than 90% of expectant mothers consume less than the recommended amount, the authors say.
Scientists have studied choline for decades and shown that getting ample amounts of it while pregnant produces long-term cognitive benefits for offspring. It can help with attention and memory, and can be protective against cognitive adversities caused by everything from prenatal stress and autism to fetal alcohol exposure and epilepsy, the researchers noted.
Choline in pregnancy boosts cognition in children
As part of the study, women ate a prepared diet with a specified amount of choline throughout their third trimesters. Half consumed 480 mg choline per day, and the other half consumed a total intake of 930 mg choline per day. Their children—20 of them—were tested when they were 7 years old.
Kids of moms who had 480 mg/day showed a decline in accuracy in terms of giving sustained attention from the beginning to end of a task. Those from the 930 mg/day group maintained a high level of accuracy throughout the task.
The findings—the first to follow up on choline results in school-aged children—support a previous study that reported on benefits during infancy, and another report that touted increasing intake among expectant mothers. Wallace noted that more than 40 studies in rodents have shown lasting effects of choline when mothers take it.
“By showing that the beneficial effects of prenatal supplementation endure into childhood, these findings illustrate a role for prenatal choline in programming the course of child cognitive development,” Richard Canfield, PhD, a senior research associate at Cornell who was involved in the research, said in a statement.
“And because the ability to sustain attention in challenging situations is critical to nearly all areas of cognitive performance, the cumulative impact of improving sustained attention is likely to be substantial,” Dr. Canfield adds.
Sharon Palmer, a registered dietitian nutritionist from California, believes more research on choline is needed. While choline is beneficial in many ways, there is some research showing too much could increase our risk for heart disease.
“I recommend getting the recommended amount and not exceeding it until we learn more about this balance in our diets,” Palmer notes.
Take a second peek at your prenatal
The study is a good reminder to take a deep dive into choosing a prenatal. And to talk to your doctor about supplements.
Wallace notes that choline isn’t the only nutrient prenatal vitamins often don’t contain enough of.
Magnesium and calcium are also too bulky for prenatals but “very critical nutrients for both the mother and infant,” Dr. Wallace says.
“Magnesium is involved in over 600 enzymatic reactions in the body and both nutrients are under-consumed relative to recommended amounts by many women,” he adds.
If you’re concerned you’re not getting enough of a specific nutrient from your prenatal vitamin or your diet, talk to your doctor or a dietitian or nutritionist about how to maximize intake safely during pregnancy.
Bell CC, Aujla J (2016) Prenatal Vitamins Deficient in Recommended Choline Intake for Pregnant Women. J Fam Med Dis Prev 2:048. doi:10.23937/2469-5793/1510048
Bahnfleth, CL, Strupp, BJ, Caudill, MA, Canfield, RL. Prenatal choline supplementation improves child sustained attention: A 7-year follow-up of a randomized controlled feeding trial. FASEB J. 2022; 36:e22054. doi:10.1096/fj.202101217R
Caudill MA, Strupp BJ, Muscalu L, Nevins JEH, Canfield RL. Maternal choline supplementation during the third trimester of pregnancy improves infant information processing speed: a randomized, double-blind, controlled feeding study. The FASEB Journal. 2018. 32: 2172-2180. doi:10.1096/fj.201700692RR
Choline: Fact sheet for health professionals. National Institutes for Health Office of Dietary Supplements. March 29, 2021
Korsmo HW, Jiang X, Caudill MA. Choline: Exploring the Growing Science on Its Benefits for Moms and Babies. Nutrients. 2019;11(8):1823. doi:10.3390/nu11081823
Schwarzenberg SJ, Georgieff MK; COMMITTEE ON NUTRITION. Advocacy for Improving Nutrition in the First 1000 Days to Support Childhood Development and Adult Health. Pediatrics. 2018 Feb;141(2):e20173716. doi:10.1542/peds.2017-3716