Choline and pregnancy: the importance of this essential nutrient

The adequate intake of choline is 400 mg/day for women and 480 mg/day for pregnant women [2].
In France, women consume an average of 291 mg of choline per day, which is well below the adequate intake [3]!

The transport of choline from mother to foetus depletes choline from the maternal plasma in humans. 
The body's own production of choline is low, but it increases in the presence of oestrogens. During pregnancy, oestrogen concentrations rise dramatically towards term. However, despite the potentially enhanced capacity of the body to synthesise choline due to rising oestrogen levels, the data suggest that the demand from the foetus and infant is so high that maternal reserves are depleted during pregnancy and breastfeeding [4].

Furthermore, the latest data suggest that choline intake during pregnancy may need to be nearly TWICE the current recommendations (930 mg versus 480 mg) [5]! It is a pregnancy-compatible vitamin but above all, essential.

After ingestion, choline is converted into various metabolites, such as betaine. Betaine participates in folate-dependent metabolism. As a result, choline and folate levels are closely linked, and deficiencies in either of these compounds can worsen the nutritional status of the other [13].

For example, a study in rats showed that a choline-deficient diet reduced folate content in the liver by 31%, compared to rats with a controlled choline intake [14].
Similarly, in women, a study showed that a deficient folate intake led to a 25% reduction in choline levels [15].

Furthermore, a mutation in the 677T MTHFR gene (which enables the conversion of folates into their active form) can affect choline status [16]. It is estimated that at least 10% of the population carry a mutation in this gene [17]! 

Choline and pregnancy is therefore just as essential asfolic acid and pregnancy !

To boost your vitamin B9 intake, our pregnancy gummies or our pregnancy snack are ideal. 

Study findings highlight potential interactions between the two nutrients and their effects on metabolism. For example, DHA supplementation significantly increases cellular choline uptake compared to cells cultured without a DHA supplement, demonstrating that DHA can have an impact on choline status [18].

In a study on choline supplementation, with a DHA supplement or in saline solution of pregnant rat mothers, the offspring of groups supplemented with choline or DHA showed a significantly higher number of neurons compared to the offspring of untreated control groups. Combined choline and DHA supplementation during pregnancy further improved neurodevelopment in rats compared to the control group, with these effects being greater than choline or DHA supplementation alone [19].

Their combined effect was demonstrated in a study in which DHA supplementation in rats significantly increased DHA levels in plasma and red blood cells compared to the control, and choline supplementation alone significantly increased free plasma choline but did not affect DHA levels. However, combined DHA and choline supplementation increased DHA to significantly higher levels than DHA supplementation alone, indicating that the impact of combined choline and DHA supplementation on circulating DHA levels is greater than an additive effect [20].

The duo: our omega 3 pregnancy Omega Mama + our choline pregnancy Choline mama. 

Baby Bump, Bump essentials and Bump powder, our range of pregnancy food supplement, contains choline!

Eggs are the best source of choline!

A 50 g egg contains 125 mg of choline [21], whilst a hard-boiled egg contains 115 mg of choline [21], as cooking reduces the nutrient content of eggs.

You can safely eat cooked eggs, but avoid raw eggs, which carry a higher risk of contamination. You can eat them runny, provided you choose organic, extra-fresh eggs and consume them promptly after purchase, as close to the laying date as possible.

The main risk of contamination from eggs is from the Salmonella bacterium. However, it is estimated that in the United States, for example, 1 egg in every 10,000 to 30,000 is contaminated [22]. And the risk is 7 times lower for organic, free-range eggs [23].

Bonus: Compared with eggs from caged hens, eggs from pasture-raised hens contain 2.5 times more total omega-3 fatty acids [24]!
Studies show that more than 50% of egg consumers have satisfactory choline intakes, compared with only 2% of those who do not eat them, and they have almost twice the choline status [25]. It appears difficult to achieve satisfactory choline intakes without consuming eggs.

Other sources of choline

Good quantities of choline are also found in liver, but consumption of certain types is not recommended during pregnancy due to their retinol content (even though poultry liver contains the least retinol).

Choline is found in a variety of foods other than eggs and liver, but in much smaller quantities, for example:
100 g of roast chicken provides 85.3 mg of choline
100 g of sunflower seeds contains 55.1 mg of choline  
100 g of almonds contains 52.1 mg of choline  
100 g of cauliflower contains 45.2 mg of choline  
100 g of shiitake mushrooms contains 36.8 mg of choline
100 g of beans contains 30.5 mg of choline
100 g of Brussels sprouts contains 19.1 mg of choline

Choline is particularly essential during pregnancy, and the estimated requirements may in fact be twice the recommended amounts!

Choline reduces, amongst other things, the risk of neural tube defects and pre-eclampsia, and adequate intake helps to maintain folate and DHA status.

Eggs are the best source of choline; some vegetables contain it too, but to a lesser extent — which is why it is all the more important to monitor your intake when following a vegan diet.