Choline Found to Help Pregnancy Health

October 2009, an article by Jacqui Simcock, naturopath and medical herbalist, abstracted from “Choline and risk of neural tube defects in a folate-fortified population” in the September 2009 issue of Epidemiology

A healthy diet before and throughout pregnancy is important for a healthy pregnancy and a healthy baby. Research has shown that supplementing the diet with various nutrients helps to maintain a healthy pregnancy. These nutrients go far beyond folic acid (healthy babies are not made of folic acid alone). Some of the key supplement recommendations include vitamin C(1), vitamin E(2), vitamin B3(3), calcium(4,6) and probiotics(5). Because the modern diet is particularly low in omega-3 fatty acids, appropriate supplementation of DHA, GLA and AA is also extremely important for eye and brain health(7), helping maintain a healthy blood pressure(8), supporting the development of eye-hand coordination(9) and even helping with long-term lung health(10).

Folic acid supplementation of the food supply helped reduced neural tube defects, such as spina bifida, in US children by 23% in the 1990’s(11). Now a new study(12) has found that choline, a little known relative of the B vitamin family, may also play a role in a healthy pregnancy by helping protect against neural tube defects.

The study, analyzed data on more than 180,000 pregnant women in California from 2003 through 2005. They compared the blood samples of 80 women who delivered a baby with neural tube defects to 409 samples from women with babies without neural tube defects.

Choline is a nutrient similar to the B-vitamins. Although it is not (yet) an "official" B-vitamin it is often categorised with them. Although choline’s entire mechanism of action, particularly how it interacts with other nutrients, is not completely understood, it seems to often work in concert with folate and an amino acid called methionine. Although the human body can make some choline it is generally recognised that it is important to get dietary choline as well.

When suggesting why choline deficiency may promote neural tube defects, the researchers pointed to choline’s role in forming cell membranes, its interaction with folate and its role in the production of an important nerve chemical in the brain called acetylcholine(13). The researchers stated that their findings suggest that, in regards to choline, “low levels were a risk factor and higher levels were a protective factor for neural tube defects.”

During pregnancy and lactation, the health and development of the baby is the body’s priority. This means that if there are not enough of certain nutrients in the diet to supply the growing foetus, then the mother's body stores of those nutrients will be utilised to feed the baby. That is why some women have decreased bone strength, loose their teeth, find their hair and nails loose condition, become depressed or weakened, especially after multiple pregnancies. This is also why it is so important that a healthy wholefood diet is maintained and appropriate nutritional supplements are utilised throughout pregnancy and breast feeding, as it is entirely possible that nutrient deficiencies started or made worse by pregnancy may not only affect the health of the new born baby and the mother's health immediately after the birth, they may also increase the risk of a wide range of conditions not considered to be related to pregnancy or neonatal development at all.

What Does Choline Do in Your Body?

• Helps to produce the bi-lipid layer cell membranes that provide structure to your cells and help maintain their essential functions
• Is a part of acetylcholine, a neurotransmitter needed for the health of your nervous system
• Helps to transport fat and cholesterol to your cells thereby preventing the accumulation of fat and cholesterol in your liver
• Converts to trimethylglycine, which helps to reduce your homocysteine level, lowering your risk of stroke, heart disease, cancer, Parkinson's, Alzheimer's disease and many other degenerative diseases.
• In pregnant women, it provides an essential nutritional element for the healthy growth and development of the baby

To help you ensure your choline levels are up to scratch, here are some healthy, whole food dietary sources of choline:

Supplements that help support optimal nutrition in pregnancy

Multi For Pregnancy A balanced broad spectrum multi vitamin and mineral to support optimal nutrition before, during and after pregnancy	Calcium Complex A balanced broad spectrum mineral supplement to support optimal mineral intake before, during and after pregnancy	Vitamin D3 1000IU natural, bioavailable vitamin D to support optimal vitamin D levels before, during and after pregnancy	Efanatal A proven effective, balanced omega-3 and omega-6  fatty acid supplement to support optimal nutrition before, during and after pregnancy

References:

1. Hoppu, U., M. Rinne, et al. (2005). "Vitamin C in breast milk may reduce the risk of atopy in the infant." Eur J Clin Nutr 59(1): 123-8

2. Beyrouty P. Co-consumption of selenium and vitamin E altered the reproductive and developmental toxicity of methylmercury in rats Neurotoxicity and Teratology. Available online 19 January 2006\

3. Ieraci A. Nicotinamide Protects against Ethanol-Induced Apoptotic Neurodegeneration in the Developing Mouse Brain. Public Library and Science – Medicine 2006; Volume 3 Issue 4 printed online ahead of print

4. Chan G. Effects of Dietary Calcium Intervention on Adolescent Mothers and Newborns: A Randomized Controlled Trial. Obst Gynecol 2006; 108(3, Part 1):565-571

5. Huurre A. Impact of maternal atopy and probiotic supplementation during pregnancy on infant sensitization: a double-blind placebo-controlled study. Clin Exp Allergy 2008; 28(8): 1342-1348. Published Online: May 8 2008. DOI:10.1111/j.1365-2222.2008.03008.x

6. Ettinger AS, Effect of Calcium Supplementation on Blood Lead Levels in Pregnancy: A Randomized Control Trial Environ Health Perspect 2008: doi:10.1289/ehp.11868. [Online 2 September 2008]

7. Jacobson JL. Beneficial Effects of a Polyunsaturated Fatty Acid on Infant Development: Evidence from the Inuit of Arctic Quebec. Jou Ped 2008; 152: 356-364.e1

8. Damsgaard CT. Fish Oil Affects Blood Pressure and the Plasma Lipid Profile in Healthy Danish Infants. J. Nutr. 2006;136 94-99

9. Dunstan JA. Cognitive assessment of children at age 2K years after maternal fish oil supplementation in pregnancy: a randomised controlled trial. Arch Dis Child Fetal Neonatal Ed. doi: 10.1136/adc.2006.099085

10. Olsen SF. Fish oil intake compared with olive oil intake in late pregnancy and asthma in the offspring: 16 y of registry-based follow-up from a randomized controlled trial. Am Jou Clin Nutr 2008; 88(1):167-175

11. Shaw GM. Choline and risk of neural tube defects in a folate-fortified population. Epidemiology. 2009 Sep;20(5):714-9.

12. Honein MA. Impact of folic acid fortification of the US food supply on the occurrence of neural tube defects. JAMA. 2001;285:2981--6.

13. Zeisel SH. Choline: needed for normal development of memory. J Am Coll Nutr. 2000;19:528S–531S