A group of Canadian nutrition researchers are seeking to raise people's awareness of their needs for the essential nutrient Choline - especially in women who are planning a pregnancy, who are pregnant, or breastfeeding (though research also suggests that high choline levels during the first 3 years of life may have significant benefits on the brain health of a child - see earlier posts on this topic). 

"Despite its apparent health benefits, few Albertans seem to be getting enough choline in their diets, the researchers have found.

"Our preliminary dietary studies clearly show an insufficient choline intake compared to the recommended levels," said Curtis, an analytical chemist and project leader for ongoing choline research at the university.

According to the Institute of Medicine, women should consume 425 milligrams of choline per day--the equivalent of almost four whole eggs. This value is higher for men and pregnant women.

In an ongoing study looking at the nutrition of pregnant women in Edmonton and Calgary, few study participants are meeting the adequate intake for choline and only one of the first 600 women surveyed reported taking a supplement that contained the nutrient.

This statistic is surprising, says Field, given that 97 per cent of women reported consuming at least one supplement.

"Nobody's taking it," Field said. "If there was information out there on choline, we'd see a lot more of it in this group we had."

In a continuing animal study, Field and her team are looking at the effects of choline during lactation--a nutiritionally critical period, but one not well studied.

"It's the most nutritionally stressful period for a woman," Field said. "Her nutritional needs are far greater than during pregnancy because she has to produce milk, an important source of choline, for this growing infant."

New mother rats were fed diets with varying amounts of choline. The amount they consumed appeared to influence the health of their pups.

"The pups that were fed from the moms who didn't have the choline in the diet survived didn't grow as well," Field said. "If there's a decrease in growth, or not a normal rate of growth, that has large implications for later health."

You can read the full press release from the University of Alberta research group here:

U of A researchers strive to increase awareness about Choline during Pregnancy (August 8, 2011)

Here are the results of a new study that relates to prenatal choline (choline taken during pregnancy) and increased health of the baby long term.

Research links diet during pregnancy to breast cancer risk reduction in female offspring

Era of Hope conference to feature compelling research examining benefits to daughters based on mother's diet

ORLANDO, Fla. -- August 3, 2011 -- During pregnancy, women are counseled to refrain from consuming certain types of foods, beverages and medications in order to avoid jeopardizing the health and development of the fetus. In fact, the American Pregnancy Association has a list of a dozen items they recommend expectant mothers omit from their diets. However, there are some additions, such as folic acid, that, when taken before and/or during pregnancy, can actually reduce the risk of birth defects and other disorders.¹ Research presented today at the Era of Hope conference, a scientific meeting hosted by the Department of Defense Breast Cancer Research Program (BCRP), reveals findings suggesting that if an expectant mother increases her consumption of foods high in certain fatty acids or nutrients during her pregnancy, she can potentially reduce the risk of breast cancer in her female offspring.

The research delves into breast cancer risk reductions attributed to the fetus when the mother, while pregnant, increases omega 3 fatty acids within her diet or consumes dietary methyl nutrients (methionine, choline, folate and vitamin B12). Some findings hypothesize that these diet augmentations may even prevent breast cancer from ever developing in the offspring.

"This is exciting and intriguing research," said Captain Melissa Kaime, M.D., Director of the Congressionally Directed Medical Research Programs (CDMRP), under which the BCRP is managed. "To be able to reduce the risk and possibly prevent this devastating disease before birth is an incredible notion; the BCRP is proud to support research with such potential."

Maternal Consumption of Omega 3 Fatty Acids to Reduce Breast Cancer Risk in Offspring
Principal Investigator: Philippe T. Georgel, PhD, Marshall University

Maternal dietary alterations, including increasing the consumption of omega 3 fatty acids, may reduce the risk of breast cancer to the fetus by causing epigenetic changes in utero and later through nursing. These changes may alter gene expression permanently, a change referred to as imprinting. Researchers at Marshall University conducted a study to investigate whether having a diet rich in omega 3s while pregnant would result in changes to fetal mammary gland gene expression, thereby reducing the chance that female offspring would later develop breast cancer.

In this study, there was a reduced incidence of mammary gland cancer observed for the offspring of mice that, while pregnant and nursing, consumed a diet containing canola oil, rich in omega 3, compared with the offspring of mice that, while pregnant and nursing, consumed a diet containing corn oil rich in omega 6 fatty acids. Reviewing the gene expression profiles of both groups showed that many genes related to cancer development differed between the two groups. Significant differences in the patterns of two important epigenetic markers were also observed.

"Pregnant women should be mindful of what they consume since their diet may incite epigenetic changes that could impact the development of their offspring, not just in utero but also for time to come," said Dr. Philippe Georgel, Marshall University. "Additional research continues, as we seek to elucidate the effect of diet on breast cancer-specific gene expression."

In Utero Exposure to Dietary Methyl Nutrients and Breast Cancer Risk in Offspring
Principal Investigator: Chung S. Park PhD, North Dakota State University

Links are being drawn to complete mammary gland development of the mother during pregnancy and reduction in breast cancer risk in her daughters. Supplementing the mother's diet with lipotropic nutrients (methionine, choline, folate and vitamin B12) is thought to increase methyl metabolism which stimulates the full development of the mammary gland, thereby inducing an epigenetic imprint in the mammary gland of the fetus and decreasing its breast cancer risk. Investigators at North Dakota State University are researching this link with the overall objective of determining the extent to which supplementing diets with methyl nutrients during pregnancy reduces the offspring's overall breast cancer susceptibility.

The study looked at 45 pregnant rats and randomized them into two groups: one to receive a control and the other to be fed a methyl-supplemented diet. Once the pups were born, they were separated into three additional groups depending on the feeding regime of their mother. When the female pups reached a specific age, they were exposed to a chemical that induced breast cancer and researchers charted when the first tumor appeared and measured all tumor sizes and volumes. Results demonstrated that the offspring from the methyl-supplemented diet group showed a decrease in tumor incidence and growth when compared to the control group. Also, they had fewer tumors and fewer tumors that multiplied.

"The conclusions of this study suggest that we may be able to prevent the development of breast cancer in daughters of women at risk for breast cancer by supplementing the mother's diet during pregnancy," said Dr. Chung Park, North Dakota State University. "We look forward to exploring this study further to strengthen the implications of these initial findings."

###

About the Era of Hope

The Era of Hope (EOH) conference joins scientists, clinicians and breast cancer advocates committed to advancing research on the prevention, detection, diagnosis and treatment of breast cancer. From August 2-5, 2011 in Orlando, Florida, the EOH will feature prominent scientists and clinicians with presentations of recent remarkable advances in breast cancer research funded by the Department of Defense Breast Cancer Research Program (BCRP). This research challenges paradigms and pushes boundaries to identify innovative, high-impact approaches for future breast cancer research and discoveries.

More good news about taking choline during pregnancy.  A new research study out of Cornell University showed that in a mouse model of down syndrome (a mouse that is genetically designed to develop downs syndrome like disease) the pregnant and lactating mice that received additional choline had babies that fared much better than those whose mother's did no receive choline. 

More choline during pregnancy and nursing could provide lasting cognitive and emotional benefits to individuals with Down syndrome and protect against neurodegenerative conditions such as Alzheimer's disease, suggests a new Cornell study of mice.

The findings, published June 2 in Behavioral Neuroscience, could help lead to increasing the maternal dietary recommendations for choline (currently 450 milligrams a day during pregnancy, 550 milligrams for lactation), a nutrient found in egg yolks, liver, nuts and such vegetables as broccoli and cauliflower.

"We found that supplementing the maternal diet with additional choline resulted in dramatic improvements in attention and some normalization of emotion regulation in a mouse model of Down syndrome," said lead author Barbara Strupp, professor of nutritional sciences and of psychology. The researchers also found evidence for "subtle, but statistically significant, improvement in learning ability in the non-Down syndrome littermates."

In addition to mental retardation, Down syndrome individuals often experience dementia in middle age as a result of brain neuron atrophy similar to that suffered by people with Alzheimer's disease. Strupp noted that the improved mental abilities found in the Down syndrome mice following maternal choline supplements could indicate protection from such neurodegeneration "in the population at large."

Strupp and her co-authors tested Down syndrome model mice born from mothers fed a normal diet and those given choline supplements during their three-week pregnancy and three-week lactation period, as well as normal mice born from mothers with and without additional choline. The choline-supplemented mothers received approximately 4.5 times more choline (roughly comparable to levels at the higher range of human intake) than unsupplemented mothers.

At six months of age, the mice performed a series of behavioral tasks for about six months to assess their impulsivity, attention span, emotion control and other mental abilities.  

In addition to dramatic improvements in attention, the researchers found that the unsupplemented Down syndrome model mice became more agitated after a mistake than normal mice, jumping repeatedly and taking longer to initiate the next trial, whereas the choline-supplemented Down syndrome model mice showed partial improvement in these areas.

"I'm impressed by the magnitude of the cognitive benefits seen in the Down syndrome model mice," Strupp said. "Moreover, these are clearly lasting cognitive improvements, seen many months after the period of choline supplementation."

Strupp noted that the results are consistent with studies by other researchers that found increased maternal choline intake improves offspring cognitive abilities in rats. However, this is the first study to evaluate the effects of maternal choline supplementation in a rodent model of downs syndrome.  This is also one of the few studies that has evaluated offspring attentional function and effects in mice, rather than rats, Strupp noted.

Previous studies of humans and laboratory animals have shown that supplementing the diets of adults with choline has proven to be largely ineffective in improving cognition. "Although the precise mechanism is unknown, these lasting beneficial effects of choline observed in the present study are likely to be limited to increased intake during very early development," Strupp said.

Source: Cornell University

Choline is being increasingly identified as a key nutrient for a child's healthy brain development during pregnancy. 

A newborn's risk for brain and spinal-cord defects rises if the mother has low blood levels of the nutrient choline during pregnancy, researchers at the Stanford University School of Medicine have discovered.

The scientists used a collection of 180,000 blood samples from pregnant California women to look for risk factors for two neural tube birth defects: anencephaly, a lethal condition in which the brain and skull do not develop, and spina bifida, a spinal-cord malformation that causes paralysis and lifelong disability. Neural tube defects have become less common since the 1996 decision to fortify the U.S. food supply with folic acid, a B-vitamin shown to prevent the defects, but they have not disappeared.

"Families whose infants die or suffer permanent disability from NTDs still feel the burden of these defects," said Gary Shaw, DrPH, professor of neonatology and primary author of the new research, which will appear Aug. 14 in Epidemiology.

About 500 pregnancies per year are affected by neural tube defects in California alone, noted Shaw. "We're keen on understanding what risk factors explain the continued disease."

Shaw's study targeted a group of nutrients suspected to promote brain and spinal-cord development. In early pregnancy, a sealed tube forms along the embryo's back that later grows into the brain and spinal cord. Neural tube defects occur if the tube does not seal correctly. Based on prior research on folic acid, scientists believe that development of the neural tube may depend on a specific biochemical pathway that requires several vitamins and essential nutrients to operate properly. Shaw's team measured blood levels of 13 of these nutrients in two groups of women who participated in California's prenatal birth-defect screening program.

From 180,000 pregnant women screened between 2003 and 2005, the researchers identified 80 whose pregnancies were affected by neural tube defects. Their blood samples were compared to 409 samples randomly selected from among the women whose infants had no structural birth defects.

Choline, an essential nutrient found in egg yolks, soy, wheat germ and meats, was the only nutrient measured whose blood levels were linked to risk of neural tube defects.

"As choline levels went up, risk went down," Shaw said. Risk for neural tube defects was 2.4 times higher in women with the lowest blood choline levels compared to women with average blood choline levels. The highest blood choline levels were associated with the lowest risk. A previous study by Shaw's group showed that consumption of choline-rich foods was associated with lower risk for neural tube defects, but this is the first study to evaluate blood levels of choline and NTD risk.

Shaw's work provides a promising target for future clinical trials on neural tube defect prevention, said Louanne Hudgins, MD, division chief of medical genetics at Lucile Packard Children's Hospital, who did not participate in the study. Hudgins, who is also a professor of pediatric genetics at the medical school, regularly counsels families facing prenatal diagnoses of neural tube defects. "You can't change an individual's genetic predisposition to these defects. But nutrition components to NTD risk are ripe for therapy," she said.

Shaw cautioned that the blood samples tested were obtained between the 15th and 18th week of pregnancy, well after formation of the neural tube, which seals around the sixth week of pregnancy. Future research will be needed to examine blood choline levels in early pregnancy, he said. Researchers also need to test whether choline supplements given in early pregnancy reduce the rates of neural tube defects. Right now, prenatal multivitamins contain little or no choline.

For women who want to become pregnant, "the best source for choline is still eating a variety of foods," Shaw concluded. Women of reproductive age should also follow U.S. Public Health Service recommendations to take a multivitamin containing other nutrients previously shown to promote healthy pregnancies, he said.

The study was funded by grants from the U.S. Centers for Disease Control and Prevention, theNational Institute of Neurological Disorders and Stroke, and the Foundation to Promote Research into Functional Vitamin B12 Deficiency.

Doctors at the University Of Colorado Are Testing Choline (taken during pregnancy by the mother) to Prevent Mental Illness in the children.

A popular word at the University of Colorado Denver's Department of Psychiatry is "choline," a nutrient found in many of our foods, but not prenatal supplements.

Researchers believe choline may be a missing link when it comes to preventing mental illness in the womb, helping developing brain cells become stable and properly communicate with one another.

"We've looked at it specifically for its ability to help a brain develop resistance to mental illness," said Dr. Randy Ross, the study's lead investigator.

In this new study Moms-to-be take three capsules of choline two times a day during pregnancy. After birth, children are observed for 18 months to document motor skill, problem solving and language development.

This same group of researchers has already published research on animals that demonstrated that Choline during pregnancy seemed to prevent many of the brain changes that are common in young rodents that are predisposed to "mental illness" (see links below for this research). 

Source: University of Denver Choline during Pregnancy Study, ClinicalTrials.gov

Animal Studies that have shown how choline during pregnancy may prevent mental illness:

Permanent improvement in deficient sensory inhibition in DBA/2 mice with increased perinatal choline.

Perinatal choline deficiency produces abnormal sensory inhibition in Sprague-Dawley rats.