Choline intake in pregnancy linked to lower inflammation

 

 A new Cornell University study suggests that choline, a nutrient many pregnant people consume too little of, may play an underappreciated role in keeping inflammation in check during pregnancy.

Researchers analyzed data from more than 1,300 pregnant participants enrolled in the Alberta Pregnancy Outcomes and Nutrition (APrON) cohort, one of the most detailed long-running pregnancy nutrition studies in North America. They found that higher recent dietary choline intake was associated with lower levels of inflammation in the third trimester.

“We all have these signaling proteins that can be inflammatory in our blood, but when they go beyond outside their normal range, we get worried,” said first author Elisabeth Larson, a doctoral student in nutritional sciences. “Inflammation can be caused by anything from viral infection to chronic disease, such as obesity or cardiovascular disease, and even things like psychological stress.” 

Most strikingly, Larson found that participants with the highest choline intakes had dramatically lower odds of having clinically elevated inflammation than those with the lowest intakes.

Choline is an essential nutrient involved in many biological processes, including cell membrane structure, neurotransmitter production, methylation, immune cell receptor agonism, and fetal brain development, and some of these biochemical processes play a role in the regulation of inflammation. It is found primarily in eggs, meat, fish, dairy and some legumes and cruciferous vegetables.

“It’s most abundant in animal-source foods,” Larson said. “If you’re vegetarian or vegan and not taking supplements, I would be concerned that you aren’t consuming enough choline.”

Despite its importance, choline remains something of a nutritional afterthought. It is not always emphasized in prenatal counseling, and many prenatal vitamins contain little or none of it. Surveys suggest that most pregnant people fall short of recommended intake levels.

The study found inflammation dropped most steeply as intake rose from very low levels into moderate and higher ranges, suggesting potential thresholds rather than a simple “more is better” effect.

“We had fewer data points at the lower or higher intake ends, so we need to do more research about a potential threshold relationship,” Larson cautioned. 

The current recommendation for choline during pregnancy is 450 mg, but there’s some evidence that that may not be enough, Larson said. 

The findings also raise questions about whether current dietary guidelines adequately reflect choline’s role during pregnancy, and whether clinicians should pay closer attention to it alongside better-known nutrients like folate and iron.

“There really isn’t enough work on these under-appreciated nutrients that might be predictive of health for mother and child,” Larson said. “It’s important because Mom’s health is very predictive of Baby’s future health.”

Among the best sources of chol;ine:

1. Whole Eggs

Eggs are one of the most convenient and versatile choline sources. A single large egg contains approximately 169 mg of choline, meaning just two eggs provide 61% of the daily value.

Nearly all the choline in eggs is concentrated in the yolk—about 680 mg per 100 grams of yolk compared to just 1 mg per 100 grams of egg white. This makes it essential to eat whole eggs rather than just egg whites to maximize choline intake. Research suggests that the choline in eggs may be better absorbed than synthetic forms found in supplements, as it’s bound to phospholipids that are readily absorbed by the digestive system.

2. Fish and Seafood

Various types of fish provide substantial amounts of choline. A 3-ounce (85-gram) serving of salmon contains approximately 187 mg, or 34% of daily needs. Tuna, cod, and other fish also offer good amounts.

Studies have linked low fish consumption with reduced blood choline levels. Research involving 222 pregnant women found that those consuming 75 grams or less of fish weekly had lower choline, DHA, and vitamin D intake compared to women eating 150 grams or more per week.