Is Choline the new Folic Acid?

We’ve got a new flavour of the month in the prenatal nutrition world…. CHOLINE! You may be thinking “hold up, I have never even heard of that nutrient before, surely it can’t be all that important?”

Think again, many people have never heard of choline but new research has put this nutrient on the map for pregnancy planning and pregnant women. Many people haven’t, but I am here to highlight the latest research which will put in on the map when planning a pregnancy or during pregnancy. Some are even heralding it as the new folic acid!

So, I think this flavour is here to stay!

Folic acid is the synthetic form of folate (a B-group vitamin), which we know (through a lot of research), is essential in the first 12 weeks of pregnancy, as your baby develops its neural tube (a structure from which the brain and spinal cord forms). We have shown through rigorous research that folic acid prevents neural tube defects like spina bifida.

Folate is naturally found variety of vegetables (such as asparagus, spinach, broccoli), fruit (such as oranges, bananas and strawberries), and legumes, cereals, nuts and vegemite. The Australian Government has also made it mandatory to fortify (add) folic acid into our bread, if you’re reading from overseas check your national guidelines.

Read more about the difference between folic acid and folate here.

Choline is a critical nutrient but not in the traditional suite of vitamins and minerals, like folate, necessary during the preconception period, as well as pregnancy. This vitamin-like nutrient (yes, not a vitamin, nor a mineral, confusing – huh?!) is naturally found in eggs, meat, salmon, legumes and beans, and mushrooms. It is involved in many bodily processes, such as the structure of our cells, transporting fat around the body, creating our genes and creating messengers for our nervous system to work properly. That’s a lot of responsibility for this vitamin-like nutrient!

Why is Choline so Important?

The reason that choline is in the spotlight, is because it is now being recognised as being equally as important as folate for the prevention of neural tube defects (NTD) – the issue is that most of us don’t know about this nutrient, let alone getting enough of it!

Choline is also one of the building blocks for the baby’s cells when they develop in the womb and necessary for the expression of your baby’s genes and cellular health too (Wallace, et al., 2018).

This amazing nutrient has ALSO been found to be important for the health of your placenta and the transfer of nutrients to the growing foetus across the placenta. One human study by Jiang, Yan et al, 2012 found that a higher maternal choline intake in the 3^rd trimester of pregnancy, could alter the expression of your genes that regulate placenta blood vessels and stress reactivity.

There are also high levels of choline in our breastmilk, and did you know it has now become mandatory for infant formula companies to fortify their formulas with choline! So, choline is definitely getting on the map.

However, you will find that most prenatal supplements don’t have choline at all or not a lot of it, and this is because it is such a large nutrient it is difficult to stuff into a multi-vitamin that is easy to swallow. Staggeringly, only 1% of Australian women of reproductive age are actually meeting their choline requirements, so ladies, we have a lot of work to do!

This just highlights how important it is to have a well-planned diet from early pregnancy and throughout to meet your needs through a combination of diet and supplements for a healthy pregnancy and a healthy baby!

Choline for Baby’s Brain Health

I have never met a woman who doesn’t dream of a brainy baby! Well, pay attention as choline has been studied in the brain and cognitive development of infants, and it all starts in pregnancy!

A trial was done in New York, looking at choline supplementation in pregnancy, and the benefits for the baby. They found that infants born to mothers supplementing with 930mg of choline, as opposed to 480mg, demonstrated a faster information processing speed – i.e. better cognitive and brain development (Caudill et al., 2018).

How much do I need?

Simply, eating a diet rich in choline when trying to conceive AND throughout all three trimesters of pregnancy, can improve the lifelong cognitive ability of your bub!

Keep in mind that our Australian Nutrient Reference Values tell us that pregnant women should consume 450mg of choline per day. The upper limit, however (the amount that may pose a potential risk to your health), is all the way up at 3500 mg per day during pregnancy (NHMRC, 2014). And the studies are showing benefits at almost double the current Australian guidelines. Choline needs may also change according to the individual, so if you need some extra advice, pop into a fertility and pregnancy Dietitian for some input.

Top 3 Tips to Boost your Choline Status

Okay, so now that we’ve got the background knowledge, and we know why choline is so important for us and our growing bub, let’s talk how to get it into your day!

Here are my top 3 foods to help boost the choline in your diet:

• Eggs – Just 2 eggs per day (yes, 2 eggs per day), can help you achieve 50% of your choline needs! Try your eggs scrambled, but have them poached, fried, or even in a frittata. Check out these freezer-friendly frittata muffins on my blog!

• Salmon – I am not sure how many times I have (and will continue) to recommend salmon, but here it is again! This delicious fish is a big contributor to our choline needs and can be enjoyed twice a week. It will also boost our omega-3 intake, so why not!

• Mushrooms – this versatile vegetable comes in all shapes and sizes! They can be added to almost everything, think bolognese sauce, lasagna, salad, you name it! Bonus, chuck your mushies in the sunshine for a couple of hours and they’ll absorb Vitamin D and give you the gift of this critical fat-soluble nutrient too!

Are you trying to fall pregnant, planning to get pregnant (sometime in the next 6 months to 2 years) or just want to know more about how you can boost your choline intake? Book in for a complete evaluation of your pre-conception diet & supplementation inside our 2-hour deep-dive consultation, our Fertility Nutrition Intensive, including a thorough review of your pathology results, diet, lifestyle and a bespoke nutrition & supplementation tailored to YOU! Book in for an intensive today.

This blog was written by Dr Kaylee Slater APD.