April 2012 Archives

April 30, 2012

Choline Helps Mitigate Impact of Stress During Pregnancy - Why thats Important

filed under: Choline Benefits General Baby Health
A lot of people - especially working professional women - may not know the negative impact on the child of stress during pregnancy.  Below is a good interview with an expert on this topic - and why I suspect all working women (and also low income women) would benefit from high levels of choline supplementation during pregnancy:

Stress in pregnancy 'lowers a child's IQ.
Source: Daily Mail, UK
Date: 24/11/2005

Fiona MacRae, in the Daily Mail, reports on research at Imperial College London, which has revealed that pregnant women who are stressed double the risk of their babies having lower than average IQs. Professor Vivette Glover, who conducted the study, followed the progress of almost 70 women and their children. The children of women who were believed to have suffered greater levels of stress during pregnancy scored around 90 in subsequent tests, compared to an average score of 100 for children whose mothers were deemed to have experienced less stress during pregnancy.

In interview with Vivette Glover, perinatal psychobiologist, Imperial College, England

Q: How and why do you think that the stress experienced by mothers during pregnancy can affect the unborn child?

A: We found two possible mechanisms by which maternal stress during pregnancy could affect the development of the baby. One is if the mother is very anxious or stressed while she's pregnant, there's reduced blood flow to the baby through the uterine arteries, the main source of blood and nutrition for the baby, and this could explain why the baby doesn't grow as well and also set up a secondary stress response in the fetus. Second, we have shown that if the mother has high levels of cortisol, the main stress hormone, so does the fetus. It seems that enough cortisol crosses the placenta from the mother to the fetus to actually affect fetal levels. So if the mother is stressed, her cortisol goes up, so does the cortisol level in the fetus. This in turn could well affect the development of the brain and the future stress responses of the baby.

Q: In what ways could a mother's cortisol levels affect the baby?

A: We're realising now that the development of the brain is sensitive to the hormones that are around it, and particularly cortisol, just as it is to alcohol, smoking or other drugs. And that the cortisol level that the fetus experiences will set a number of brain receptors to cortisol and this in turn will set later responses. It's very important that we learn to understand what's the optimal development here because it's much easier to change things while they're being made than to try and change them later. If, for example, it turns out that high levels of maternal stress--or even different methods of delivery, really have adverse affects on the development of the baby's brain, it's important to understand more about this and address it at this period, than have children with behavioral problems more difficult to resolve later.

Q: What effect does different methods of delivery have on a newborn's stress response?

A: The most stressful thing that happens to any baby is being born, compared to anything else that goes on. We're very concerned about the experience of the mother during pregnancy and her pain and a lot's done for the mother but very little attention is paid to the baby. But we now know from looking at cortisol levels in the umbilical cord immediately after birth that birth is very distressful for the baby and different types of delivery induce different levels of stress. We've found that babies born by elective cesarean had the lowest response. Those born by normal vaginal birth had an intermediate response. And those born by assisted delivery, such as with forceps or suction, had the biggest response. We then looked at eight-week-old babies who'd been born by these different methods and looked at their stress responses to a vaccination by measuring saliva cortisol. This showed that, at least for the first eight weeks, delivery method affects the behavior, the stress response of the baby. And it may well have a much more long-term effect, so that's the next thing we need to study.

But we can't assume that the least stressful delivery is the best for the child. I think it's likely that a normal vaginal delivery is actually best. Because we know that babies born by elective caesarean, for example, don't breathe so well just after they're born. It's likely that the amount of stress associated with a normal vaginal delivery does get the baby best adjusted to the outside world. But what I think we can be concerned about is that some assisted deliveries put a very high level of stress on the baby and this may be damaging.

What are you looking at with your current research?

A: Well all the evidence we have so far suggests that the very early period is important for the long-term stress responses. But we need much more evidence to actually pinpoint what is exactly going on; when during pregnancy does stress matter, what degree of stress becomes harmful and so on. Our current research is to try and find out more about the long term affects of stress in pregnancy on the behavior of a child, and we're using about ten thousand women who've been followed through pregnancy to actually determine properly whether pre-natal stress as opposed to post-natal does have an effect on the child. We also intend to follow up children who've been born by different methods up to the age of one or two and see how long the different types of delivery actually affect their stress responses. We know it affects up to eight weeks, but does it carry on for one year, two years or for life?

Q: Many women feel the need to return to work as soon as possible after having a baby, even working at home. What effects might the stress of juggling work and early motherhood have?

A: We don't know enough in terms of our changing lifestyles and their effect on the future generation. But I think we do need to do a lot of research to actually find out what our changing lifestyles are doing to us and particularly to our children. It's clear that from birth, babies are very sensitive to their mother's feelings. If the mother is stressed or depressed, the baby picks up on it, can cry more, [and] you get a bad interaction. We know that if mothers are depressed in the very early weeks or months, this often has an effect on the interaction with the child. And this in turn has long term harmful effects on the development of the child. The children have more behavioral problems, more cognitive problems, the boys may have a lower IQ. So the very early mother-baby interaction is very important for the later development of the child. And a very stressed mother can interfere with this. Alternatively, the good news is that very good mothering early on can actually help to undo some of the possible damage that might have been caused during the fetal period. So that the whole system is very plastic both for benefit and harm in this very early period.

I think that all our research is making us more aware that very early mothering is absolutely crucial. And that perhaps women should take a bit of time off work, certainly in the early months, to make sure that they get a good relationship going with their baby. I think that this has implications for society as a whole and governments, that we need to give women time to establish the relationship with their child, help them to be in as good an emotional state as possible, while they have a new baby. And then go back to work later. I think that politicians maybe have a role to play here, that they ought to be aware that for the sake of the emotional health of future generations, encouraging mothering and parenting is very important.


April 28, 2012

Questions from Blog readers - My Personal Experiences...

filed under: Choline Benefits Choline Risks Personal Experience

I get questions occasionally from blog readers - here is one recent question from someone I've emailed with before.

"Hope all is going well for you, we corresponded last fall and I wanted to possibly ask you some questions about your post in January.  According to your site the pharmacist recommends starting at day 56 during pregnancy with the increased amounts of choline (around 3.5 grams) and then continue at this increased amount, or at least elevated amounts until age four correct?  I am currently supplementing at 1200 mg choline bitartrate once daily, yielding 480 mg of choline by molecular weight. (We aren't planning on trying to conceive till next summer) I plan on starting on day 56 during the gestational period, supplementing at 3600 mg choline bitartrate yielding approximately 1440 mg choline by weight.  Do you think I should adjust this amount and increase it to at least 1500 mg or more?  Also did you see this article? (http://medicalxpress.com/news/2012-04-transgenerational-effect-antibiotics.html) thought you might be interested. 

I had one more question in mind to ask you, which unfortunately will be totally subjective and essentially anecdotal from you, but in giving your children high choline diets, and seeing them perhaps be somewhat fearless, does this concern you to any degree in their future decision making capabilities.  And also specifically when it comes to mood, anxiety, and empathy do you feel as though perhaps the choline has had any effect?

Here is my response:


"The pharmacist that took the class with Steven Zeisel - the top researcher on Choline  - said that Zeisel in his classes (I think about a decade ago) recommended at least 1.5 grams of choline (and by that he meant the actual amount of choline - not a precursor) starting at day 56 (new research is also showing that taking choline prior to and early in pregnancy reduces risk of neural tube defects) .  So - I think somewhere between 1.5 grams/day and the Tolerable upper limit that we did of 3.5 grams is what I would do if I had another child (and given our success with 3.5 grams/day before - I'd probably do it at this level again, if not a little higher).

One thing I would change given my discussions with other parents who have supplemented at higher rates -and their results - is that I would now do the following now:

1.       I would take at least 75% (and as much as 100%) of whatever type of choline you take (or a minimum of 1.5 grams/day)  in Lecithin form (i.e. phosphatidylcholine).  Probably the Triple strength lecithin that some manufacturers offer, or just mix in the lecithin granules as other parents have done (and I do with my kids).  This is due to two things - I've talked to one other parent (obviously - a very small sample size - but all of this is based on fundamental research in mammals with larger numbers - but small numbers in humans) - and it seems that with higher lecithin (or specifically phosphotidylcholine) - you get possibly more of an effect.  Also - much of the research data I've read uses either choline chloride or phosphatidylcholine - and since you can't in all practicality use choline chloride (it tastes terrible) - I think that phosphatidylcholine is the best way to go.  There really has been no research to my knowledge on the effectiveness of choline bitartrate or other forms of choline - in this type of application - so its uncharted territory (not that its likely to be unsafe - just not as effective).

        I say this because another parent I've been talking to did simply Lecithin supplementation - and has gotten the same positive results with their daughter as our first child - ie. very significant results.  Our second child did not have as significant results it seems right now (its hard to tell - the second child started walking at 9 months - so just as good as the first child, but the second child's verbal development is lagging significantly the first child's - still above average - but not as good as the first child's.  There are a number of confounding variables that make the link directly with type of choline a difficult one;  namely my wife caught the flu during her pregnancy during the end of her first trimester with the second child - and flu during pregnancy is well known to have a negative impact on IQ and brain development - so that could be the issue.  And the other 25% in choline bitartrate.  In our first pregnancy we started with 100% Lecithin choline  - about 1 gram a day before pregnancy and 1 gram during the first trimester.  Then we ramped it up - and then at some point fairly early on I found some research that suggested some negative potential issues with  higher levels of Soy Lecithin .. I think in some studies done in the mid-1980s it was at the level of 15 grams a day of Lecithin/day - and so that scared me to lowering the Lecithin - and going to 50% each on Lecithin Choline, and 50% Choline Bitartrate.  And that's what we did on the second child. 

2.       I can't "recommend" anything related to choline  to you - I'm just sharing with people our experiences and as much science behind our decision and ongoing developments in this area because I think it has the potential to help a lot of people, and make the world a better place.  I can tell you what I'd do if I was to have another child - but beyond that, it's a very personal decision.  There are risks associated with this type of thing -  there isn't much human data / studies on this supplementation program, but I think the data that I do see, and the information I've gotten from the researchers in private discussions suggests that they think the risk of negative results is very low.  So - make your own choice given your personal risk profile. Or do more research if you aren't comfortable with the lack of solid research.  This is your child - its a big deal.  Don't take these decisions lightly.  One of the key reasons that we ended up supplementing at the higher levels of choline is because my wife was quite stressed at work during the first pregnancy (it was during the whole financial meltdown) and I know that a lot of research indicates that higher stress levels has very negative impacts on the brain of the baby during pregnancy - so we were using the choline as a risk reduction strategy against a very well known negative factor - Stress during pregnancy (Stress during pregnancy  is very well known to lower intelligence, and increase risk of mental illness -- because it seems to change the developmental process of the HPA axis in the brain, which is strongly linked to mental illness) - so Look at the big picture.  My personal belief is that perhaps the biggest benefit of high levels of choline during pregnancy is that it greatly reduces the risk of mental illness in children of mothers who are anxious or who experience higher stress levels during pregnancy.

         On the transgenerational effects of antibiotics and the link you sent to me - I think that we'll be learning a lot about epigenetics over the coming decade and longer.  This is one example  - but there are many others.  I think the research on epigenetics would suggest that the impact of higher levels of choline would be similarly transgenerational - but I haven't seen any data on this.  Its an interesting question.

3.       On the issue of Choline potentially making the kids lower anxiety, and more fearless  (see the recent posting in my blog about the Cornell research).  That's an interesting question - certainly it can be positive or a negative situation depending upon the environment.  If our kids are in a less safe environment and they are not predisposed to anxiety they may miss certain clues or take risks that cause problems.  So that is a concern.  At the same time - what I've seen so far in our kids is that - at least with the older child - the increased intelligence/memory seems to more than outweight that potential issue - as she learns quickly and avoids issues so that seems to mitigate the risk significantly.  Our younger child its too early to tell .  Generally my opinion is that people in today's world are far more anxious than the environment would suggest.  Due to a lot of negative TV news in the US - I think the general perception is that we live in a dangerous society (and certainly in parts of the US, and parts of the world, things are still very dangerous ) - but the research I've seen suggests that we generally vastly over-rate the "danger" that we face in modern society.  Generally - we are much safer than we were 50 years ago, and probably much, much safer than we were 100 years ago.  So my person vote is the intelligence/memory is going to be more important and more valuable than a higher propensity to anxiety and fear.  Its really a person "bet" on what the world will look like when our kids are 20 to 50 years old - so obviously a difficult forecast for anyone.  Anxiety can be valuable in a risky, dangerous world - I'm hoping that we're going to continue to move away from that direction in the next 50 years. We'll see.

4.       On the mood/anxiety/empathy - I think our kids are lower anxiety, generally much less shy, more outgoing than most kids.  Our children have never displayed much stranger anxiety - as many of our peer's children have.  Our 3.5 year old child enthusiastically picks up spiders, snakes, crabs, etc. - and plays with them (with reasonable care), without any issues.  My wife is not so predisposed.  I encourage the lack of fear in these areas - I tend to think that a more fearless perspective on life is probably a good thing generally.  As far as empathy - I think that's something that you teach a child - they'll be as empathetic as you are to their needs and experiences.  I think High-choline kids learn quicker - so if you have a stressful / unempathetic environment - they might learn from these negative experiences faster than the average kid - but I don't think choline has any impact on something like empathy directly.

Hope that helps,

Admin  (AT) cholinebaby.com


April 28, 2012

How much Choline do you or your kids need?

filed under:
I saw this table on "adequate choline" requirements recently (I was reading Steven Zeisel's paper titled "Choline" Critical Role During Fetal Development and Dietary Requirements in Adults" - and thought it would be valuable for people to see what the adequate intake, and tolerable upper limit is (this is a very conservative number - there have been no identified negative effects at the upper limit - its just a boundary that the researchers felt was needed  back in 1998 when the Institute for Medicine reviewed the research.  Its been over 20 years, a lot of research has been done since then - so seems like an update is likely in order.

If you think about the numbers given here - and you think that the average Large egg yolk only has about 125 mg of choline - and you can see that most people are quite deficient in this important nutrient.  When you think about the fact that the researchers like Zeisel are saying that to get the big benefit of choline you need to at least triple - (and there is a dose dependent impact of the choline - so higher - up to some level seems helpful) that "adequate intake" level to see the brain/memory enhancements that they see in their mammal research - then you can see that people rarely get a "good" dose of choline.

Another interesting point that I've read in the research is that  brains that have prenatal exposure to high levels of choline tend to use up choline at a higher rate than brains that don't - which seems to suggest that our kids who had high levels of prenatal exposure to choline may need to continue that higher level of exposure longer term to get the most benefit from the memory enhancement.  There seems like a lot of interesting research that could be done here.

Choline RDA image.pngI think this information (the above table) is also available here:

Dietary Reference Intakes for Choline - National Academies of Science Press


(Note: the "fishy odor" that they talk about in the references with regard to Choline is only seen with the "choline Chloride" form of choline - not with Lecithin or Choline Bitartrate.)


April 25, 2012

Latest Research at Cornell on Pregnancy and Choline and impact on Infants

filed under: Choline Benefits Prenatal Choline News
A recent news story from Cornell University:

The Scientist: Prof. Caudill Researches the Effects of Choline on Fetal Development

April 25, 2012

Caudill researches the effects of the essential nutrient choline on fetal development and child growth.

Anyone who has ever held a relative's baby knows there are usually two types: the ones who can be passed around, smiling and giggling, and the ones who scream and cry once separated from their mothers. According to Prof. Marie Caudill, nutritional sciences, the reason for this difference may lie in the placental environment in which the baby developed.

Caudill researches the effects of the essential nutrient choline on fetal development and child growth. She is internationally recognized for her studies with folate and choline and recently presented her research at an international conference held at the University of Leipzig in Germany.

Choline is sometimes considered the unknown essential nutrient, because although the body does not produce it and not many people have heard of it, it is needed for good health. Choline is typically grouped with the B vitamins, although  it doesn't technically meet the definition of a B vitamin. In the body, choline serves three main functions. First, it is required to make the phospholipid phosphatidylcholine.

"Phosphatidylcholine is a component of all cell membranes that is required for proper cell functioning," Caudill said.

"During pregnancy, large amounts of phosphatidylcholine are needed to support the rapidly dividing cells of the developing fetus, which increases the mother's dietary requirement for choline."she said said.

In addition to making phospholipids, Choline plays an integral part in neurotransmission in its acetylcholine form.  Acetylcholine is involved in memory and learning.

"Many studies involving rodents have shown that giving mom more choline during her pregnancy improves the cognitive ability of her offspring throughout their entire lifespan," Caudill said.

Although choline may be taken by adults, the amount of choline that one is exposed to while still in the placenta has a stronger effect over time according to Caudill.

Choline's third function is to modulate levels of stress. The apprehension and anxiety characteristic of stress is often caused by a steroid hormone called cortisol.

The release of cortisol is the end product of what is known as the hypothalamic-pituitary-adrenal axis. The hypothalamus, in the lower part of the brain, produces the neurotransmitter corticotrpin-releasing hormone, which then travels to the anterior pituitary gland. CRH stimulates the anterior pituitary gland to release another hormone, known as adrenocorticotropic hormone, which in turn travels to the adrenal cortex via the blood circulation.

The adrenal cortex, which is located on top of the kidney, is directly releases cortisol. Once released, cortisol mediates the metabolic increases of the stress response.

"Data from my research group showed that giving pregnant women more choline lowered circulating levels of cortisol in her baby," Caudill said. "The lower circulating cortisol in babies born to the mothers consuming extra choline suggests that HPA activity and reaction to stress may be lower in these babies. While the long-term consequences of our finding are unknown, others have reported a reduction in anxiety, improved learning and memory and a lower risk of stress-related diseases like hypertension among offspring with lower HPA axis activity."

According to Caudill, the key to choline's effect on the HPA axis lies in how choline affects the methylation state of placental DNA, which are the points at which DNA sequences have attached methyl groups. 

"The mechanism by which extra choline influences cortisol production relates to its role as a methyl donor," Caudill said. "We found that giving mom more choline increased the number of methyl groups and lowered the expression of genes involved in regulating the amount of cortisol produced by the HPA axis. We also found that giving mom more choline during pregnancy increased the number of methyl groups across the entire DNA sequence in the placenta which may improve genome stability and placental function"

Despite its integral part in fetal development, choline is not widely sought after as an essential nutrient during pregnancy, even though sources of choline are widely available. Some sources include egg yolks, beef, pork, legumes, and chicken, as well as broccoli and brussel sprouts.

"In the future, we'd like to see if choline may be used in a therapeutic way to lower the heightened activity of the HPA axis among babies born to mothers who experience stress, anxiety and depression during pregnancy," Caudill said.

"We'd also like to see if consuming extra choline during pregnancy may be helpful in improving placental function and enhancing cognitive abilities in the human offspring."

Caudill's research may provide additional tools for fetal programming, or the changing of the placental environment to selectively affect the fetus. Further research with choline may help make smarter, happier and healthier babies. More results of Dr. Caudill's finding will soon be published in The Journal of the Federation of American Societies for Experimental Biology.