Doubling prenatal choline intake improves cognitive performance in childhood, say scientists

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There are “population-wide benefits of adding choline to a standard prenatal vitamin regimen,” according to a nutrition expert.

Cornell University’s Barbara Strupp headed up a team that compared the attention performance of children whose mothers consumed the (approximate) recommended amount of choline to mothers taking double the recommended dose.

The study provides more evidence to support significant increases in daily prenatal intake with results suggesting increased performance with higher choline intake.

Professor Strupp said: "By demonstrating that maternal choline supplementation in humans produces offspring attentional benefits that are similar to those seen in animals, our findings suggest that the full range of cognitive and neuroprotective benefits demonstrated in rodents may also be seen in humans."

Current recommendations for daily choline intake (450 milligrams (mg)), including those for pregnant women are based on levels needed to prevent liver dysfunction in men, the scientists explain.

Study design

The cohort study comprised a seven-year follow-up of 20 children born to women who took part in a randomised, double-blind choline feeding study during the third trimester of pregnancy and involved 4,315 trials to evaluate the effects of choline intake on child cognition.

Children were predominantly non-Hispanic white and male, and most had completed first grade at the time of testing.

Most of the pregnant women were highly educated, and the majority had earned a bachelor's degree or higher.

A non-significant trend indicated slightly higher educational attainment for mothers in the 480 mg choline/d group versus the 930mg choline/d group (Fisher's Exact test); treatment groups were otherwise similar in demographic and birth characteristics.

The pregnant women were randomised to consume 480mg choline/d (the approximate Adequate Intake [AI] recommended) or 930mg choline/d during the third trimester.

Sustained attention was assessed in the children at seven years using a signal detection task (visual cues) that showed benefits of maternal choline supplementation.

Results

On average, the children correctly identified the presence of signals in 78% of all signal trials and correctly noted the absence of a signal on 78% of non-signal trials.

Those with mothers who consumed 930mg choline/d more accurately identified signals, while also correctly rejecting non-signals, as compared to children whose mothers consumed 480mg choline/d.

The researchers noted that children in the higher maternal choline group showed superior performance on the Sustained Attention Task (SAT score) and a superior ability to maintain correct signal detections (hits) across the 12-min session, indicative of improved sustained attention.

The team concluded that findings are consistent with those from a mouse model and suggest that many other benefits of maternal choline supplementation documented for rodents may also translate into humans.

Benefits of Choline

Little is known about the functional effects of maternal choline intake on childhood cognition in humans or the maternal intake level needed to fully support foetal neurodevelopment, although researchers have established that physiological demands for choline increase markedly during pregnancy due to choline's numerous roles in foetal development.

The report explained: “Maternal choline supplementation is broadly neuroprotective for the offspring in conditions as diverse as foetal or early postnatal alcohol exposure, prenatal stress exposure, autism, down syndrome, epilepsy, Rett syndrome, cognitive ageing, and Alzheimer's disease.”

Choline also helps regulate early brain development, including ‘attentional function’, but maternal deprivation can produce lasting cognitive impairment.

Source: The FASEB Journal

Published: https://doi.org/10.1096/fj.202101217R

Prenatal choline supplementation improves child sustained attention: A 7-year follow-up of a randomized controlled feeding trial’

Authors: Charlotte L. Bahnfleth, Barbara J. Strupp, Marie A. Caudill, Richard L. Canfield