Prenatal supplement linked to improved child cognition and social behavior

A nutritional supplement taken during pregnancy may support fetal brain development and improve children’s cognitive performance and social behavior, according to new research from the University of Colorado Anschutz.

The randomized clinical trial, published this week in the American Journal of Obstetrics & Gynecology, found that children whose mothers took phosphatidylcholine, a form of choline found naturally in foods, had fewer social withdrawal problems and scored higher on cognitive tests than children whose mothers received a placebo.

“This is the largest randomized clinical trial of prenatal choline supplementation ever conducted,” said the study’s senior author Robert Freedman, MD, professor of psychiatry at CU Anschutz. “What this study showed that we have not observed before was an increase in the overall IQ of about eight points when measured at age 4. That put significantly more children into the higher IQ percentile on the test we used.”

The study, Freedman said, showed that children of mothers who received phosphatidylcholine supplements had fewer problems with language development and social skills, compared to women who had received placebos. All women in the study were encouraged to take standard prenatal vitamins and eat a diet that contained eggs, meat and other natural sources of phosphatidylcholine.

“This study provides additional evidence that choline supplements during pregnancy can have lasting effects on children’s brain development,” said Freedman.

Choline is an essential nutrient that helps support brain development. The researchers investigated whether increasing maternal intake during pregnancy could improve children’s early development, building on previous research suggesting that choline plays a critical role in the formation of connections between brain cells.

Researchers enrolled 206 pregnant women, randomly assigning them at 16 weeks of pregnancy to receive either 9,000 milligrams of phosphatidylcholine daily or a placebo until delivery. Researchers assessed children’s behavior from 18 months to 4 years of age and measured cognitive performance at ages 3 and 4.

Among children whose parents completed behavioral assessments, 4% in the supplement group had elevated social withdrawal problems, compared with 24% in the placebo group. These behaviors can include limited interest in other people, withdrawing from social activities and reduced eye contact.

Children in the supplement group also scored an average of nearly eight points higher on standardized cognitive tests than children in the placebo group. The assessments measured overall intellectual performance, including working memory and visual-spatial skills.

Researchers also observed significantly fewer children with behavioral profiles and language difficulties commonly associated with autism spectrum disorder in the supplement group.

The supplement did not significantly reduce attention problems, another primary outcome of the study.

Freedman said choline works because it activates a receptor made by the CHRNA 7 gene in developing nerve cells that helps them develop the machinery to receive signals from other nerve cells before birth.

“Choline in the baby’s circulation comes from the choline eaten by the mother which activates this receptor,” he said. “But many mothers don’t get enough choline in their diets to fully give the baby all that it needs to complete the activation of its neurons. Unfortunately, once the opportunity to do so before birth passes there is no way to go back and correct the problem in brain development.”

Freedman said it was nearly impossible to get enough choline in a normal diet to fully activate the CHRNA7 receptor – eating 10 eggs a day for example – so supplements are necessary.

“We think the dose we recommended in this trial was a bit higher than needed so we are recommending 7200 mg of phosphatidylcholine or 900 mg of choline itself,” he said. “Both are available in drug and grocery stores.”

The researchers reported no significant supplement-related safety problems among mothers or children. But they cautioned that the findings require careful interpretation: about one-third of participants did not complete the study through the four-year assessments, and parents reported their children’s behavioral symptoms.

The findings add to evidence that choline is important for fetal brain development and could help inform future research into prenatal nutrition. The researchers said larger studies with longer follow-up are needed to determine whether the observed differences persist as children grow.

Diverse and sustained social activities may boost cognition in older age

 

3+ activities, volunteering and sports club membership seem particularly effective

Reports and Proceedings

BMJ Group

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Diverse and sustained social activities may boost cognitive performance and slow the decline in brain health associated with ageing, suggest the findings of a large international study, published online in the Journal of Epidemiology & Community Health.

 

Regularly engaging in 3 or more of these activities, and including volunteering and sports club membership among them, seem to be particularly effective at helping to keep minds sharp, the findings indicate.

 

The global prevalence of dementia, which is preceded by cognitive impairment, is estimated to affect nearly 153 million people by 2050, point out the researchers. While several studies have looked at the association between social activities and both cognitive function and dementia, the findings have been inconsistent, they add.

 

This might be down to small sample sizes, limited geographic diversity, and differences in the definitions and measurements used for social activity and cognitive outcomes, they suggest.

 

In a bid to overcome some of these issues, the researchers drew on pooled long term data from 5 nationally representative surveys spanning 24 countries.

 

These surveys were: the US Health and Retirement Study (HRS, waves 10-15, 2010-21); the English Longitudinal Study of Ageing (ELSA, waves 4-9, 2008-19); the China Health and Retirement Longitudinal Study (CHARLS, waves 1-4, 2011-18); the Mexican Health and Ageing Study (MHAS, waves 3-5, 2012-18); and the Survey of Health, Ageing, and Retirement in Europe (SHARE, waves 4-8, 2011-20).

 

Participants in each wave were asked about the type and number of social activities they engaged in, and their cognitive performance was assessed at each wave using tests of memory and executive function.

 

The test results produced a z score of global cognitive function, with higher z scores indicative of better cognitive performance.

 

In all, 57,793 participants were included in the study. Their average age ranged from 57 to 73, and they were tracked for an average of 6 years.

 

Analysis of the pooled cognitive z-scores showed that those who engaged in social activities had significantly higher scores than those who didn’t, with scores rising in tandem with the number of social activities.

 

Engaging in at least 3 of these seemed to afford the greatest level of protection against impairments in memory and executive function: those who did this had higher yearly  cognitive z-scores during the tracking period than those who engaged in none.

 

Volunteering and sports club membership were associated with a lower risk of cognitive decline across all 5 groups, while attending training courses and taking care of children were significantly associated with higher cognitive z-scores year on year.

 

But active involvement in political, community, church, and religious groups wasn’t consistently associated with cognitive enhancement.

 

Further analysis indicated that the positive associations between social activities and cognitive function were stronger among women, those aged 60+, those with higher levels of education, those who weren’t depressed, those who lived alone, those of normal weight, those living in rural areas, and those who smoked and/or drank alcohol.

 

This is an observational study, so can’t establish cause and effect. And the researchers acknowledge various limitations to their findings. These include the lack of standardisation across the 5 surveys, only partial adjustment for potentially influential factors, and the focus on the quantity of social activities, to the exclusion of quality, motivation, and experience, all of which may be equally important, they suggest.

 

It’s not entirely clear how social activities might protect against cognitive decline, but there are several plausible explanations, say the researchers.

 

These include the ‘use it or lose it’ hypothesis, which proposes that sustained engagement in cognitively stimulating activities may enhance neural plasticity and strengthen synaptic connections.

 

 A higher level of education is also thought to enhance neural efficiency and compensatory capacity, increasing resilience to the neuropathological changes associated with ageing, while participation in meaningful social activities may promote psychological wellbeing. This in turn may modulate neuroendocrine function and lessen the detrimental effects of chronic stress on hippocampal structure and function, say the researchers.

 

“Collectively, these findings suggest that social activities may operate as a multidimensional protective factor against cognitive deterioration in older adults,” they write.

 

“These results underscore the importance of developing and implementing targeted interventions aimed at promoting diverse and sustained social engagement among older adults as a viable strategy to mitigate the risk of age-related cognitive decline,” they conclude.

Children's caffeine habits linked to shorter sleep and brain differences

 

• Young people aged 9 to 11 who consumed more caffeine had slightly lower surface area across the brain's outer layer 

• Children who had more caffeine also slept less, and this shorter sleep was linked to brain differences, and ultimately mental health 

• Children with higher caffeine intake reported more mental health problems six months later 

• Associations between caffeine consumption and brain structure emerged as low as 1 cup per week 

Young people who consume more caffeine, mostly from soft drinks, sleep less and show small differences in how their brains are developing, according to a study led by researchers at the Institute of Psychiatry, Psychology & Neuroscience (IoPPN) at King's College London. 

The researchers drew on data from 9,632 children aged nine to eleven taking part in the Adolescent Brain Cognitive Development (ABCD) Study, which follows the brain development and health of young people across the US. Each child said how many caffeinated drinks they usually had in a week, whether coffee, tea or soft drinks, with parents reporting how long the children usually sleep on average. MRI scans then measured thickness and surface area of the cortex, the brain's folded outer layer, which plays a part in cognitive processing, decision making, attention and emotions, among other important functions. 

The children were then asked to report back on their mental health 6 and 18 months later with the results showing that greater caffeine consumption is associated with lower surface area across the cortex, even after we adjust for household socioeconomic circumstances like parental educational attainment and income. The pattern showed up in 22 separate regions, spanning all four lobes of the brain. These effects were largely driven by the consumption of soft drinks, which were the biggest source of caffeine in the study. Differences in overall surface area showed up from as little as one caffeinated drink a week, compared with none.  

Dr Divyangana Rakesh, senior author of the study from the IoPPN at King’s College London, said:  

“Caffeine is such a normal part of daily life that it's easy to forget young people are consuming it too. Studies have found that two-thirds of adolescents consume caffeine at least once a week. Despite it being a psychoactive substance, it is completely unregulated. 

“We found that even fairly low levels of intake were linked to small differences in brain structure and later mental health, and lower sleep duration seems to be an important underlying link. Although we cannot comment on causality, our results do suggest that both caffeine intake, including from soft drinks, and sleep are worth paying attention to when we think about young people's mental health."  

The researchers then looked at what might connect caffeine to differences in brain structure. Young people who consumed more caffeine slept less, which was in turn linked to lower surface area. Together, shorter sleep and lower surface area partly explained the link between higher caffeine intake and more mental health problems six months later, including problems with attention, mood and behaviour. At 18 months, only the link through overall surface area was still there. 

Jiayi Zheng, first author of the study from the IoPPN at King’s College London, said:  
 
"Soft drinks contain a lot of sugar and often go hand in hand with less healthy lifestyle habits and more risk-taking behaviours, so we can't yet separate the role of caffeine from everything else that comes with them. That's the next question we want to answer, ideally with more precise measures of what young people drink, when they drink it and how well they sleep."  

---

Journal

Biological Psychiatry Cognitive Neuroscience and Neuroimaging

DOI

10.1016/j.bpsc.2026.09.011 

Exercise should be prescribed as a core component of cardiovascular care

 

Exercise should be prescribed as a foundational component of cardiovascular disease (CVD) prevention and treatment, according to a new American College of Cardiology Scientific Statement published today in JACC, its flagship journal. The statement emphasizes that the greatest reduction in cardiovascular risk occurs when sedentary individuals become even modestly more active, and the best exercise prescription is one that is safe, individualized, achievable and sustainable over time.

Low cardiorespiratory fitness is a predictor of future CVD that is on par with traditional cardiovascular risk factors such as smoking, hypertension, high cholesterol and diabetes; however, exercise prescription is inconsistently integrated into routine cardiovascular care. The scientific statement highlights extensive evidence showing that regular physical activity, structured exercise and cardiorespiratory fitness improve exercise capacity, reduce hospitalization and enhance quality of life.

“The most important message is that some activity is better than none,” Jonathan N. Myers, PhD, a health research scientist with the Palo Alto VA Healthcare system and chair of the statement’s writing committee, said. “Patients do not need to become athletes to improve their cardiovascular health. Small increases in physical activity can produce meaningful benefits, particularly for those who are currently inactive.”

For example, the statement highlights growing evidence that meaningful cardiovascular benefits can be achieved with fewer than 10,000 daily steps. Data suggest that approximately 5,000 to 7,000 steps/day are associated with clinically important improvements and substantial reductions in cardiovascular and all-cause mortality for many adults.

Key recommendations and considerations in the statement include:

• Exercise prescriptions should be individualized based on a patient's cardiovascular condition, functional capacity, symptoms, treatment goals and preferences.
• Resistance training should complement aerobic exercise for most adults.
• Wearable devices and virtual or home-based rehabilitation programs may help support exercise participation and long-term adherence, particularly when combined with structured programs such as cardiac rehabilitation.
• Routine exercise testing is not required before starting exercise for most asymptomatic or clinically stable individuals but can provide valuable information for individualized exercise prescription when clinically appropriate.
• Cardiac rehabilitation remains first-line treatment for many patients with CVD and access should be expanded. While insurance reimbursement remains a barrier to entry for many, individualized exercise prescriptions should be provided to those with known CVD who are unable to participate in formal cardiac rehabilitation.

The authors also call for greater integration of exercise counseling into routine cardiovascular care, expanded access to cardiac rehabilitation and additional research on strategies that improve long-term adherence to physical activity.

“Exercise is one of the most effective therapies available for preventing and managing CVD, yet it remains underutilized in routine care,” Myers said. “This statement provides clinicians with practical tools to help patients safely incorporate exercise into their treatment plans and improve long-term cardiovascular health.”

Ultra-processed food intake linked to silent strokes in healthy middle-aged adults

  Healthy adults who eat high amounts of ultra-processed food, like packaged snack foods, sugary breakfast cereals, soft drinks, instant noodles, and ready-to-eat frozen meals, are more likely to have signs of damage to the brain that may increase the chances of clinical stroke and future memory problems.

Researchers used magnetic resonance imaging (MRI) to scan the brains of nearly 9,000 people and detected tiny areas of damage more frequently in participants who ate the most ultra-processed food compared to those who ate the least. Participants with the highest intake were 40 per cent more likely to show these changes, which produce no obvious symptoms but are considered early warning signs that can appear years before a stroke or memory problems begins.

"I would not have expected this finding, frankly. We studied middle-aged Canadians who had no heart problems and reported no other health concerns,” said Russell J. de Souza, first author of the study and an associate scientist at the Population Health Research Institute (PHRI) of McMaster University and Hamilton Health Sciences, and associate professor in Health Research Methods, Evidence, and Impact and the Heersink School of Global Health and Social Medicine at McMaster University.

“Usually, this kind of damage is associated with conditions we hear about and treat at a much older age."

Published in JAMA Network Open on Oct. 15, 2026, the PHRI led study enrolled Canadians between the ages of 35 and 69 with no history of heart disease from communities across Canada.

Participants who ate the most ultra-processed food also carried more body fat and more deep belly fat than those who ate the least. This type of abdominal fat is linked to inflammation and blood vessel damage that can also reach the brain.

The association between ultra-processed food and brain damage appeared stronger among women. Those in the highest consumption group were nearly twice as likely to show signs of brain damage compared with those in the lowest group.

"Our findings suggest that the link between diet and brain health may be detectable before people experience noticeable problems with memory or thinking," said Sonia Anand, senior author of the study and senior scientist at PHRI. “This adds to the growing evidence that what Canadians eat in their 30s, 40s, 50s and 60s shapes their brain health later in life.”

Researchers classified foods according to the extent and purpose of industrial processing used in their production. Ultra-processed foods are often high in sodium, added sugars, and saturated fats, while providing relatively low amounts of fibre, vitamins, and minerals. Their convenience, widespread availability, and intensive marketing may contribute to higher consumption, particularly among time-constrained and lower-income households, potentially widening existing health inequalities.

"For many Canadians, ultra-processed food is often a convenient and affordable option. But our findings suggest that diets high in these foods may be linked to brain changes that may lead to memory loss and stroke as Canadians grow older," said Anand.

In this study, ultra-processed foods made up an average of about 25 per cent of participants' daily food servings. For the heaviest consumers, that increased to 45 per cent of everything on their plates, compared with just 16 per cent for those who ate the least.

Researchers found that as the consumption of ultra-processed food increased, that of whole food decreased. Fruits, vegetables, grains and other minimally processed foods made up 41 per cent of daily servings among participants with the highest consumption of ultra-processed food, compared with 68 per cent among those with the lowest consumption.

“People who ate more ultra-processed foods weren’t simply eating more on top of their usual diet. These foods appeared to crowd out healthier whole foods,” added de Souza.

Researchers analyzed data from participants enrolled in two PHRI studies: the Canadian Alliance for Healthy Hearts and Minds and the Prospective Urban and Rural Epidemiology-MIND study. They completed detailed dietary questionnaires and underwent MRI brain scans reviewed by neurologists who were unaware of the participants’ dietary patterns.

The findings suggest a link between ultra-processed food consumption and signs of brain changes. However, because participants were only assessed once and weren’t followed over time, researchers couldn’t determine whether ultra-processed foods directly caused these changes.

“We need longer-term studies that track people over time with repeated MRI scans to find out whether reducing ultra-processed food intake can slow or prevent these brain changes,” said de Souza. “Such follow-up is ongoing.”

Physical activity may improve mood and quality of life during menopause

 

Published in Menopause Journal, the review of more than 1,000 women studied the effects of physical activity on psychological wellbeing and quality of life during perimenopause and early post menopause.  

Menopause is when a woman’s periods stop due to lower hormone levels. This usually happens between the ages of 45 and 55. It is estimated that there are currently around 13 million perimenopausal or menopausal women in the UK. 

Many women experience psychological symptoms during menopause, including depression, low mood, anxiety, stress, and difficulties with thinking and memory. These can have a significant impact on their quality of life, with an estimated one in ten women leaving work due to menopause symptoms. 

The study found physical activity, such as walking, dance and yoga, may help improve some of these psychological symptoms and overall quality of life during this period.  

As part of a systematic review and meta-analysis, researchers assessed 12 randomised controlled trials involving more than 1,000 women to determine how different types of physical activity impacted psychological symptoms during menopause. 

Types of physical activity were broken into two categories: aerobic-based exercise (ABIs), which included walking, Zumba, aerobic exercise, dance and Taekwondo, and mind-body activities (MBAs), which were made up of yoga, tai chi, Pilates and stretching. 

ABIs showed the strongest effects for reducing depressive symptoms and improving overall quality of life, with increased endorphin release linked to mood enhancement. This may be particularly relevant during perimenopause, when oestrogen fluctuations increase vulnerability to mood instability. 

ABIs also tended to involve fewer sessions, suggesting they may be easier to fit into for midlife women facing time and energy constraints. In one trial, women were instructed to walk three times per week for 30 minutes, and in another they attended three one-hour long Zumba classes per week. Across the 12 randomised trials, participants were required to attend multiple sessions per week, depending on the kind of physical exercise.  

In contrast, those who participated in MBAs saw strong improvements in psychological quality of life. These kinds of exercises incorporate mindfulness, breathwork and body awareness, which may enhance emotional regulation. In one trial, women attended two weekly 75 minute yoga sessions, while another trial saw participants attend daily one hour yoga classes. 

The researchers hope their findings will highlight how physical activity offers a low-cost and widely available intervention option for women experiencing psychological symptoms during menopause, compared to other intervention methods such as hormone therapy and cognitive behavioural therapy.  

The team also believe that the social aspect of physical activity, such as participating in group fitness classes, may have added to improved mood and quality of life. 

Senior author and Director of the UCL Menopause Mind Lab Professor Aimee Spector (UCL Division of Psychology and Language Sciences) said: “Physical activity is an effective, accessible, non-pharmacological strategy to support psychological well-being and quality of life during midlife menopause. 

“The majority of the interventions also used group-based formats, likely to foster social connection and peer support, both being factors associated with improved quality of life during menopause.” 

Improvements in depression, mood and quality of life were particularly evident among women in early post menopause (the stage of life that begins 12 consecutive months after a woman's final menstrual period), while physical activity was also associated with improvements in depressive symptoms during perimenopause. 

Lead author and NHS Clinical Psychologist Simone Saidel, who was a researcher at UCL when this review was conducted, said: “Treatment options for menopause are limited, with many women being unable to or choosing not to take hormone therapy. There are also significant health inequalities in terms of HRT access, and ethnic variations in attitudes towards it.  

“This study plays an important role in expanding the options available for symptom management, whereby clinicians may recommend it as an early intervention or an adjunct to medical or psychological treatments.” 

Further research is needed to establish which forms of physical activity are most beneficial and how they can best be incorporated into support and care for women experiencing menopause. 

Data was included from seven countries (Brazil, China, Tunisia, India, Iran, Korea and USA) to complete this review.  

Study limitations 

The researchers note that the evidence base remains limited, with substantial variation between studies and many of the studies judged to be at high risk of bias, highlighting the need for further high-quality trials. 

Frequent and unintentional daytime napping linked to higher dementia risk in older adults

 

Study of nearly 1,000 older Americans finds napping habits, not just nighttime sleep, may signal or contribute to dementia risk

Peer-Reviewed Publication

Johns Hopkins Bloomberg School of Public Health

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Daytime napping is common among older adults. New research from the Johns Hopkins Bloomberg School of Public Health suggests that how often, how intentionally, and how long older people nap may be linked to their risk of developing dementia.

The study, published online October 5 in The Journal of Gerontology: Medical Sciences, followed 995 U.S. Medicare beneficiaries age 65 and older who were free of dementia at the start of the study in 2013 and tracked them for up to 10 years using data from the National Health and Aging Trends Study, a nationally representative survey of older adults.

The researchers found that participants who napped frequently—defined as most days or every day—had a 48% higher risk of developing dementia compared to those who rarely or never napped, even after accounting for demographic factors, health conditions, and nighttime sleep characteristics such as sleep duration, daytime sleepiness, and a measure of obstructive sleep apnea risk. 

Unintentional napping—defined as falling asleep without meaning to rather than planning a nap—was associated with a 39% higher risk of dementia. Napping for 30 minutes or less was also linked to a 40% higher risk, an association that held up after accounting for a range of potential confounders, while the association for naps longer than 30 minutes weakened once nighttime sleep factors were considered.

“More frequent napping could be a marker of changes in the brain, rather than a cause of brain changes that lead to dementia,” says Adam Spira, PhD, MA, senior author of the paper and professor in the Bloomberg School’s Department of Mental Health.

The researchers point to the likely two-way relationship between napping and dementia. Napping is a potential risk factor for dementia at the same time that degenerating brain regions that help to regulate wakefulness—which can occur early during dementia—may also lead to more frequent napping.

To help address this possibility, the team excluded dementia cases diagnosed within the first five years of follow-up and found that the associations for frequent and unintentional napping remained similar, lending support to the idea that napping patterns may meaningfully precede a dementia diagnosis rather than simply reflect it.

“Monitoring napping behaviors could serve as an early and accessible marker to help identify older adults at higher risk for dementia and guide targeted interventions for dementia prevention,” says Kening Jiang, PhD, a postdoctoral fellow in the Bloomberg School’s Department of Mental Health and first author of the paper. 

Past research investigating the relationship between napping and cognitive decline has yielded mixed results, with some studies linking longer or more frequent naps to greater dementia risk and others finding no association or even potential benefits from short naps. The researchers note that differences in study design—including whether napping was self-reported or measured with wearable devices—and cultural attitudes toward napping across regions may help explain these inconsistent findings.

The researchers caution that the findings are observational and cannot establish that napping causes dementia. The study relied on self-reported napping habits, which can be subject to recall bias, and dementia status was determined using a validated algorithmic classification rather than clinical diagnosis. 

The researchers say that longer-term studies that combine detailed, objective measures of both daytime napping and nighttime sleep are needed to clarify how napping patterns relate to dementia risk and to determine whether changing napping habits could help delay or prevent dementia onset.

“Napping Characteristics and Incident Dementia: Results From the National Health and Aging Trends Study” was written by Kening Jiang, Alden L. Gross, Catriona Tingsea Wu, Junxin Li, Halima Amjad, Emerson M. Wickwire, Jennifer S. Albrecht, Atul Malhotra, Chien-Yu (Irene) Tseng, Marc Kaizi-Lutu, Chunyu Liu, Christopher N. Kaufmann, and Adam P. Spira.