Although an Adequate Intake (AI) level for choline was established in 1998, ~90% of pregnant women in the US and Europe consume less than this recommended amount. Moreover, recent evidence suggests that the AI level may not meet the demands of pregnancy and fetal neurodevelopment, with possible lifelong consequences for the child.
Based on strong animal data and limited, but suggestive, human data, we hypothesize that insufficient maternal choline intake produces subclinical, but functionally important reductions in offspring neurobehavioral functioning, with potential lifelong consequences. Similar to the case of early-life low-level lead exposure, where blood lead levels that did not result in clinically-observable symptoms caused subtle and enduring neurobehavioral deficits in children, insufficient maternal choline intake could be an unrecognized threat to lifelong brain and cognitive health and place offspring at an increased risk of subtle neurocognitive impairments. Therefore, optimal dietary intake of choline is vital during the critical period of gestation to support the mother’s health and the lifelong health of the child.
The only way to ensure optimal choline intake for pregnant women is for the research results we seek to generate to provide definitive evidence that can be combined with preclinical findings. This will support population-wide efforts to increase maternal choline intake during pregnancy. Accordingly, the primary goal of the proposed study is to determine the effects of maternal choline supplementation (MCS) on offspring cognition.
To achieve this goal, we are conducting a randomized, double-blind clinical trial. Pregnant women are randomized to 550 or 25 mg/day supplemental choline from gestation week 16 until delivery, followed by assessments of memory and attention at postnatal ages 5, 7, and 10 months. Our study has the following specific aims
To test the hypothesis that the infants of women supplemented with 550 mg/day choline (vs 25 mg/day) will show superior attention and information processing speed.
To test the hypothesis that the infants of women supplemented with 550 mg/day choline (vs 25 mg/day) will show superior memory function.