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:
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.
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,
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