Don’t Forget the Choline!

What Does Choline Do?

Choline is a B-complex vitamin involved in metabolism and is necessary for optimal fertility and pregnancy. A deficiency of choline is associated with fatty liver, which affects 15% to 55% of women with PCOS.

One major role of choline is donating a methyl group which can affect gene function, and synthesize hormones and neurotransmitters.

By working with folate to metabolize the amino acid homocysteine, increased choline amounts is associated with a reduced risk for heart disease.

Choline plays a fundamental role in human health and development, in particular, during pregnancy and breastfeeding.

Choline helps protect the structure of cells and cell development, setting the stage for optimal health throughout life span.

Here are just some of choline’s major roles:

  • Promote liver health and prevents fatty liver
  • Supplies energy
  • Reduces the risk of heart disease
  • Protects cell functioning
  • Helps improve memory and attention in children
  • Supports fetal growth and development
  • Prevents neural tube defects
  • Reduces the risk for preeclampsia

Recommended Amounts of Choline

Women age 19+    425 mg/day

Pregnancy             450 mg/day

Breastfeeding        550 mg/day

Despite the benefits of choline, most people aren’t getting sufficient amounts of it. This is due to low intake (vegans are especially at risk) and because most prenatal vitamins don’t contain choline. Does yours?

Choline and Pregnancy

Large amounts of choline are needed in pregnancy. This is due to the rapid cell division and fetal growth that occurs, and choline is needed to support fetal brain development (learning, memory and attention). Despite the increased need, only around 10% of pregnant women in the United States meet the required amounts of choline.

Like folate or folic acid, choline helps to prevent neural tube defects. Mothers who consumed more than 498 mg/day of choline had a decreased risk of their babies being born with neural tube defects compared to those with lower levels, independent of folic acid intake.

Another big benefit of choline: It can reduce the risk for pre-eclampsia, which women with PCOS may be at a higher risk for.

Babies born to moms with optimal choline levels also had lower levels of the stress hormone cortisol.

Choline in pregnancy has been shown to increase infant processing speed and in young children superior cognitive function (better memory, attention, and problem solving).

Adequate amounts of choline may increase amounts of the essential fatty acid DHA which is also involved in baby’s brain development.

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Breastfeeding

Choline needs are much higher in breastfeeding moms. This is to meet the needs of the mother as well as her new baby. Breastmilk is a good source of choline, but only if a nursing mom has adequate choline. Infant formula contains choline.

Food Sources of Choline

Good sources of choline include:

egg yolk, 1                            147 mg

beef, 3 ounces                      85 mg

pork, 3 ounces                      83 mg

chicken, 3 ounces                 65mg

soybeans, ¼ cup roasted     53 mg

salmon, 3 ounces                 77 mg

broccoli, 1 cup                      51 mg

quinoa, 1 cup cooked           43 mg

chickpeas, ½ cup cooked    35 mg

For more food sources of choline, click here

Most prenatal vitamins or multivitamins, contain no choline, so women need to make sure to include foods that are rich in choline.

We recommend our PCOS PRENATAL™, a prenatal vitamin and mineral supplement specifically formulated to meet the needs of women with PCOS who are trying to conceive or who are pregnant or breastfeeding which contains 100 mg of choline in just one tablet.

PCOS prenatal

NEW! The first and only prenatal supplement specifically formulated to meet the needs of women with PCOS

 

Bottom line: Most people aren’t getting in sufficient choline. Choline is necessary to prevent neural tube defects and to promote optimal brain development in utero and throughout childhood. Choline is also important to prevent fatty liver disease. Most prenatal vitamins or multivitamins don’t contain choline.

 

pcos dietitian angela grassiAngela Grassi, MS, RDN, LDN is the founder of The PCOS Nutrition Center where she provides evidence-based nutrition information and coaching to women with PCOS. Angela is the author of several books on PCOS including PCOS: The Dietitian’s Guide, The PCOS Workbook: Your Guide to Complete Physical and Emotional Health, and The PCOS Nutrition Center Cookbook Recognized by Today’s Dietitian as one of the Top 10 Incredible Dietitian’s making a difference in 2014, Angela is the past recipient for The Outstanding Nutrition Entrepreneur Award, The Award in Excellence in Practice in Women’s Health and The Award for Excellence in Graduate Research, from the Academy of Nutrition and Dietetics. Having PCOS herself, Angela has been dedicated to advocacy, education, and research of the syndrome.

Sources

Wallace TC, Fulgoni VL.Assessment of Total Choline Intakes in the United States. J Am Coll Nutr. 2016;35(2):108-12.

Corbin KD, Zeisel SH.The nutrigenetics and nutrigenomics of the dietary requirement for choline. Prog Mol Biol Transl Sci. 2012;108:159-77

Kwan STC, King JH, Grenier JKMaternal Choline Supplementation during Normal Murine Pregnancy Alters the Placental Epigenome: Results of an Exploratory Study. Nutrients. 2018 Mar 28;10(4).

Lavine JE, Torbenson MS, Scheimann AO.Choline intake in a large cohort of patients with nonalcoholic fatty liver disease. Am J Clin Nutr. 2012 Apr;95(4):892-900

Jiang X1, Bar HY, Yan JA higher maternal choline intake among third-trimester pregnant women lowers placental and circulating concentrations of the antiangiogenic factor fms-like tyrosine kinase-1 (sFLT1). FASEB J. 2013 Mar;27(3):1245-53.

Yan J, Jiang X, West AA. Maternal choline intake modulates maternal and fetal biomarkers of choline metabolism in humans. Am J Clin Nutr. 2012 May;95(5):1060-71.

Wu BT, Dyer RA, King D.Early second trimester maternal plasma choline and betaine are related to measures of early cognitive development in term infants. PLoS One. 2012;7(8):e43448

Poly C, Massaro JM, Seshadri S, Wolf PA, Cho E, Krall E, et al. The relation of dietary choline to cognitive performance and white-matter hyperintensity in the Framingham Offspring Cohort. Am J Clin Nutr 2011;94:1584-91.

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