Brief answer: Choline is a nutrient essential for fetal brain and nerve development, and the need appears to increase during pregnancy. EFSA recommends an adequate intake of 480 mg per day for pregnant women. The evidence suggests that many women consume less than this. Eggs, liver, meat, fish, and legumes are good sources. Feel free to discuss your intake with your midwife or healthcare provider.
What is choline and what does it do in the body?
Choline is a vitamin-like nutrient that the body both produces itself to some extent and obtains through food. It is needed, among other things, for building cell membranes, for liver fat metabolism, and for forming the neurotransmitter acetylcholine, which is important for the nervous system. Choline is also linked to the metabolism of the amino acid homocysteine, a system in which folate and vitamin B12 also participate. Since the body's own production rarely covers the entire need, choline is considered a nutrient we need to consume regularly.
Why might the need increase during pregnancy?
During pregnancy, choline is actively transported across the placenta to the fetus, and research suggests that the substance plays a role in the development of the brain and nervous system. Observational studies have found a correlation between the mother's choline status early in pregnancy and measures of the child's early cognitive development. A systematic review of both randomized and observational studies describes promising but not yet conclusive results – the evidence is limited, and more research is needed before definitive conclusions can be drawn about the magnitude of the effect.
How much choline is recommended – and do we get enough?
The European Food Safety Authority (EFSA) has set an adequate intake of 400 mg of choline per day for adults, 480 mg per day for pregnant women, and 520 mg per day for breastfeeding women. It is worth noting that an adequate intake is not the same as an exact requirement, but rather a benchmark based on available data. Several surveys in different countries suggest that a large proportion of women of childbearing age and pregnant women fall below these levels, but how it looks for you specifically depends on your diet.
Good sources of choline in food
The most concentrated sources of choline are egg yolk and liver. Other meats, fish, dairy products, legumes (such as soybeans and chickpeas), nuts, and some vegetables like broccoli also contribute. A varied diet including these foods makes it easier to achieve a reasonable intake. For those who eat a vegetarian or vegan diet, it may be worth paying extra attention, as several choline-rich foods are animal-based – here, legumes, soy products, and nuts can play an important role.
Choline and supplements – what applies?
For those who find it difficult to achieve an adequate intake through food, choline may be present in some pregnancy supplements, often in the form of choline bitartrate. However, the evidence for generally recommending choline supplements to all pregnant women is limited, and the need varies from person to person. A supplement does not replace a varied diet and should not be seen as a treatment. If you are considering supplements, it is wise to consult with a midwife or doctor, who can provide advice based on your situation and other supplements you may be taking.
Frequently asked questions
Can I get enough choline solely through food?
For many, it is entirely possible with a varied diet that includes eggs, meat, fish, and legumes. At the same time, surveys suggest that some still fall below the recommended levels, especially with a monotonous diet. It is individual, and healthcare can help you assess your intake.
Is choline supplementation safe during pregnancy?
Choline in doses close to recommendations is generally considered well-tolerated, but very high doses are not desirable. Since needs and appropriate dosage vary, you should consult with a midwife or doctor before starting a supplement.
Are choline and folate related?
Yes, partly. Both choline and folate are involved in the body's metabolism of homocysteine and in so-called methylation processes. They can support each other to some extent, but they do not replace each other – folate has its own well-established role before and early in pregnancy.
This article provides general information and is not medical advice. It does not replace contact with a midwife, doctor, or other healthcare professional. Always consult with healthcare providers about your diet, supplements, and pregnancy, especially if you have a medical condition or are taking medications.