Choline: A Key Nutrient During Pregnancy and Breastfeeding

Kathryn Adel December 10, 2019 Eat Well, Health, Pregnancy, Women

Recent analyses in Canada and the United States indicate that about 82% to 92% of pregnant women have an inadequate choline intake. Indeed, an analysis of 593 American pregnant women in the 2005-2014 National Health and Nutrition Examination Survey (NHANES) found that 92% of pregnant women did not achieve adequate choline intake. Their average choline intake was 320 mg daily, which is 130 mg less than the recommended daily intake of 450 mg. A new study of 274 pregnant women living in southern Ontario compared their choline intake through foods and supplements to the current recommendations and found similar results, with only 18% of pregnant women reaching sufficient choline intake.

Food sources of choline

Choline is an essential nutrient, that is, our body is not able to synthesize enough to meet our needs. Thus, it is important to consume enough of it through our foods. The following table presents the main dietary sources of choline.

Table 1: Food Sources of Choline

Roles of choline in pregnant women

Choline is necessary for the development of the placenta, the workload demands of the mother’s organs and the growth of the fetal organs. Inadequate consumption of choline has been associated with pre-eclampsia, cholestasis gravidarum (a liver condition that may be dangerous for the baby) and fatty liver during pregnancy. In addition, low choline levels in the blood have been associated with the risk of neural tube defects. Finally, a sufficient intake of choline during pregnancy could be important for the development of memory in children. According to one study, children of mothers with adequate choline intake during pregnancy had a better memory at age seven as compared to children of mothers whose choline intake was only 50% of the adequate intake.

Choline needs during pregnancy and breastfeeding

An adequate choline intake is 450 mg daily during pregnancy and 550 mg daily while breastfeeding. Breastfeeding mothers need extra choline to meet the demands of their bodies and those of their growing baby. It is important to know that many prenatal multivitamin supplements usually contain little or no choline.

The SOSCuisine pregnancy meal plan provides the amount of choline that is required to meet the daily needs of pregnant women. It might be helpful for women who do not consume eggs on a regular basis to take a choline supplement during pregnancy. During breastfeeding, it might be useful to take a supplement.

References

• Wallace and Fulgoni (2017) Usual Choline Intakes Are Associated with Egg and Protein Food Consumption in the United States. Nutrients; 9(8): 839.
• Moore et al. (2019) Diet in Early Pregnancy: Focus on Folate, Vitamin B12, Vitamin D, and Choline. Can J Diet Pract Res; 1-8. 
• National Institutes of Health (NIH). Choline Fact Sheet for Health Professionals, Last updated in July 2019. https://ods.od.nih.gov/factsheets/Choline-HealthProfessional/
• Bailey et al. (2019) Estimation of Total Usual Dietary Intakes of Pregnant Women in the United States. AMA Network Open; 2(6):e195967.
• Government of Canada. Canadian Nutrient File (CNF) – Search by food – https://food-nutrition.canada.ca/cnf-fce/index-eng.jsp
• Boeke et al. (2013) Choline intake during pregnancy and child cognition at age 7 years. Am J Epidemiol;177(12):1338-47.

Author

Kathryn Adel

Kathryn holds a Bachelor Degree in Nutrition as well as a Bachelor and a Master Degree in Kinesiology, all from Laval University. She is a Registered Dietitian and active member of the Ordre professionnel des Diététistes Nutritionnistes du Québec (ODNQ) and of the American Academy of Nutrition and Dietetics. She holds the Monash University's certification for the FODMAP diet and IBS, and has considerable clinical experience in that area. She is also an accomplished athlete, having ran track and cross-country at a national level. Kathryn specializes in sports nutrition, weight loss, diabetes, as well as heart and gastrointestinal health.