When it comes to pregnancy nutrition, folic acid, iron, and omega-3s tend to steal the spotlight. But there’s one essential nutrient that deserves just as much attention—choline. Despite being critical for baby’s brain development, liver function, and lifelong cognitive health, studies show that up to 90% of pregnant women don’t get enough(Roeren et al., 2022). Let’s dive into why choline should be on your radar and on your plate.
Choline: The Unsung Hero of Pregnancy Nutrition
Choline is a multitasking powerhouse, playing a vital role in:
✅ Brain development & memory – It’s a building block for acetylcholine, a neurotransmitter that helps with memory, learning, and attention. Studies suggest babies whose mums had higher choline intake performed better on cognitive tests in childhood (Caudill et al., 2018).
✅ Neural tube formation – Working alongside folate, choline ensures proper cell division and DNA methylation, helping to reduce the risk of birth defects like spina bifida (Chmurzynska et al., 2024).
✅ Liver function & metabolism – Choline helps process fats efficiently, preventing excess fat build-up in the liver—something particularly important during pregnancy (Van Parys et al., 2022).
✅ Cortisol regulation & stress resilience – Higher maternal choline intake has been linked to better stress responses in babies, likely due to its role in regulating cortisol levels (Zuk et al., 2024).
What Happens If You Don’t Get Enough Choline?
A choline shortfall can have real consequences for both mum and baby:
❌ Slower brain development – Choline is essential for neuron formation. Babies born to mums with higher choline intake had faster reaction times and better attention spans (Horita et al., 2021).
❌ Higher risk of pregnancy complications – Choline helps regulate homocysteine levels, and when these levels get too high, they can impact placental function and increase the risk of preeclampsia (Van Parys et al., 2022).
❌ Lower DHA absorption – Choline helps transport DHA (an omega-3 crucial for baby’s brain and eye development) across the placenta. Without enough choline, DHA transport is less efficient (Roeren et al., 2024).
❌ Greater risk of liver issues – Low choline intake increases fat accumulation in the liver, raising the risk of pregnancy-related non-alcoholic fatty liver disease (NAFLD) (Chmurzynska et al., 2024).
Best Dietary Sources of Choline
Many foods contain choline, but some are better sources than others. Here’s where you’ll find the biggest choline boosts:
✔️ Eggs – One of the richest sources, with 250 mg per egg ✔️ Beef liver – A choline powerhouse at 418 mg per 100g ✔️ Chicken & turkey – Around 72 mg per 100g ✔️ Salmon & cod – Fish can provide up to 80 mg per 100g ✔️ Dairy products – Milk, yoghurt, and cheese contain moderate amounts ✔️ Legumes & nuts – Soybeans, peanuts, and almonds offer plant-based choline (Zuk et al., 2024).
However, vegans and vegetarians typically consume 30% less choline, which can make supplementation necessary (Roeren et al., 2024).
Should You Take a Choline Supplement?
Even with a well-balanced diet, hitting the recommended 450 mg per day can be tough (Kansakar et al., 2023). Here’s why supplementation may help:
✔️ Boosts baby’s brainpower – Research shows that babies whose mums supplemented with choline had stronger problem-solving skills and memory (Wallace et al., 2020).
✔️ Supports liver health – Supplementation can help reduce liver fat and lower the risk of pregnancy-related liver conditions (Horita et al., 2021).
✔️ Improves birth outcomes – Adequate choline intake has been linked to better metabolic health and stronger immune responses in newborns (Van Parys et al., 2022).
The best-absorbed forms of choline include choline bitartrate and alpha-GPC (Kansakar et al., 2023).
Final Thoughts
Choline may not be the most talked-about nutrient in pregnancy, but it should be. From brain development to stress regulation and liver health, it’s a key player in ensuring both mum and baby thrive.
So, if you’re expecting—or planning to be—ask yourself: Am I getting enough choline? Your baby’s future brainpower may just depend on it.
References
Derbyshire, E., & Obeid, R. (2020). Choline, neurological development and brain function: A systematic review focusing on the first 1000 days. Nutrients, 12(6), 1731. doi:10.3390/nu12061731.
Kansakar, U., Trimarco, V., Mone, P., Varzideh, F., Lombardi, A., & Santulli, G. (2023). Choline supplements: An update. Frontiers in Endocrinology, 14, 1148166. doi:10.3389/fendo.2023.1148166.
Horita, D. A., Hwang, S., Stegall, J. M., Friday, W. B., Kirchner, D. R., & Zeisel, S. H. (2021). Two methods for assessment of choline status in people: Isotope dilution MS of plasma and MRS of liver. The American Journal of Clinical Nutrition, 113(6), 1670-1678. doi:10.1093/ajcn/nqaa439.
Zuk, E., Nikrandt, G., & Chmurzynska, A. (2024). Dietary choline intake in European and non-European populations: Current status and future trends. Nutrition Journal, 23(68). doi:10.1186/s12937-024-00970-0.
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Derbyshire, E., Obeid, R., & Schön, C. (2021). Habitual choline intakes across the childbearing years. Nutrients, 13(12), 4390. doi:10.3390/nu13124390.
Wallace, J. M., & Caudill, M. A. (2018). Association between maternal choline, fetal brain development, and child neurocognition: Systematic review and meta-analysis. Nutrients, 10(11), 1513. doi:10.3390/nu10111513.
Van Parys, A., Brantsæter, A. L., Karlsson, T., Stormark, K. M., & Wik Markhus, M. (2022). Maternal choline intake and liver function of the fetus and the infant; Implications for research, policy, and practice. Nutrients, 14(3), 513. doi:10.3390/nu14030513.
Roeren, E., Schönenberger, K. A., & Schön, C. (2022). Inadequate choline intake in pregnant women in Germany. Nutrients, 14(7), 1353. doi:10.3390/nu14071353.
Chmurzynska, A., Mlodzik, M. A., & Nikrandt, G. (2023). Dietary choline intake: Current state of knowledge across the life cycle. Nutrients, 15(5), 1235. doi:10.3390/nu15051235.
Wiedeman, A. M., Whitfield, K. C., & March, K. M. (2018). Choline—An underappreciated component of a mother-to-be’s diet. Nutrients, 10(9), 1235. doi:10.3390/nu10091235.
Mygind, V. L., Evans, S. E., Peddie, M. C., Miller, J. C., Houghton, L. A., & Kruger, M. C. (2013). The distribution of dietary choline intake and serum choline levels in Australian women during pregnancy and associated early life factors. Nutrients, 5(10), 4828-4840. doi:10.3390/nu5104828.
Øyen, J., Gjesdal, C. G., Karlsson, T., Svingen, G. F., & Pedersen, E. R. (2023). Assessment of dietary choline intake, contributing food items, and associations with one-carbon and lipid metabolites in middle-aged and elderly adults: The Hordaland Health Study. Nutrients, 15(8), 1923. doi:10.3390/nu15081923.
