By The SABI and Dr. Gregory Ward
When we think about hormone balance and nutrition during pregnancy, common nutrients like folic acid, iron, and calcium often steal the spotlight. These are undeniably crucial for both the mother and the growing baby. However, two equally important nutrients often fly under the radar: Choline and DHA (docosahexaenoic acid). These essential compounds are not only foundational for foetal brain development but also play a significant role in long-term cognitive health, both for the child and the mother.
Pregnancy is the most nutritionally demanding phase of a woman’s life. During this time, the body requires more than just basic energy and nutrients to fuel growth. It must also supply the building blocks necessary for the intricate development of the baby’s organs, particularly the brain. The foetal brain undergoes rapid growth, with billions of neurons forming and connecting to establish the foundation for future cognitive and behavioural functions. This process requires the right balance of nutrients, and Choline and DHA are at the heart of this development.
Despite their critical roles, both choline and DHA are often underrepresented in discussions of prenatal health. Yet, the evidence supporting their importance is substantial. Choline is essential for neurotransmitter synthesis and helps regulate genes that are involved in brain development. At the same time, DHA, a long-chain omega-3 fatty acid, is a key structural component of the brain and retina. Both nutrients are indispensable for ensuring that the child’s brain develops optimally, and that cognitive functions, such as memory and problem-solving, are supported well beyond birth.
Choline: The Brain’s Building Block
What is Choline, and Why is it Essential?
Choline is an essential nutrient that plays a critical role in many bodily functions, but it is especially important during pregnancy. It is involved in synthesising DNA, forming cell membranes, and producing neurotransmitters - chemical messengers that are essential for brain function. During pregnancy, the developing foetus relies on the mother’s choline stores to support the formation of its brain and nervous system.
Choline also plays a significant role in neurodevelopment, particularly in the regions of the brain responsible for memory and learning. Adequate choline intake has been linked to better cognitive function and memory retention in infants and children, as it supports the normal function of the mechanisms that regulate these cognitive behaviours. This nutrient helps ensure that the brain is wired properly, with neural connections forming effectively during critical periods of development.
Recommended Daily Intake and Food Sources
Pregnant women should aim to consume 450 mg of choline per day, increasing to 550 mg when breastfeeding, as this nutrient is also passed to the baby through breast milk. Many people do not consume enough choline in their daily diets, making it essential for pregnant women to be mindful of their intake.
Some of the best food sources of choline include:
- Egg yolks: One large egg yolk contains about 147 mg of choline.
- Beef liver: A 3-ounce serving of cooked beef liver provides around 356 mg of choline.
- Poultry: A 3-ounce serving of cooked chicken breast contains about 72 mg of choline.
- Fish: A 3-ounce serving of fish like salmon contains about 187 mg of choline.
- Soybeans: A half-cup of cooked soybeans offers around 107 mg of choline.
- Cruciferous vegetables (like broccoli, Brussels sprouts, and cauliflower): One cup of cooked broccoli or Brussels sprouts contains approximately 60 mg of choline. Consuming several servings of these vegetables throughout the day can help boost your intake.
While choline is found in many foods, it can be difficult to meet the recommended intake through diet alone, and supplementation may be necessary for some individuals.
Choline and Folate: A Vital Relationship
Choline and folate work synergistically in the body. Both nutrients are involved in the process of methylation, which is critical for DNA synthesis and gene expression. When folate levels are low, choline can act as a substitute methyl donor, ensuring that key biological processes continue. This makes adequate choline intake even more essential for pregnant women, particularly if folate consumption is insufficient.
Risks of Choline Deficiency
Underconsumption of choline during pregnancy can have serious consequences for both the mother and the developing baby. Deficiency may increase the risk of neural tube defects, similar to folate deficiency, and may also negatively affect foetal brain development, leading to memory and cognitive impairments later in life. In mothers, low choline levels can contribute to fatty liver disease and other liver-related issues, as choline plays a critical role in maintaining liver health by transporting fats out of the liver.
DHA: The Omega-3 for Brain and Eye Development
Why is DHA Crucial for Pregnancy?
DHA (docosahexaenoic acid) is a long-chain omega-3 fatty acid that is a primary structural component of the brain and retina. During pregnancy, DHA supports the formation of neurons and synapses—the building blocks of cognitive development. The foetal brain grows rapidly in the third trimester, and DHA is critical during this time to ensure that the brain's structure and function develop properly.
Adequate DHA intake is also linked to enhanced problem-solving abilities and improved visual acuity in infants. Babies whose mothers consumed sufficient DHA during pregnancy are more likely to show advanced cognitive skills as they grow. Additionally, DHA may play a role in reducing the risk of preterm birth, a leading cause of infant morbidity and mortality. Its anti-inflammatory properties help reduce inflammation that can lead to premature labour.
Recommended Daily Intake and Food Sources
Pregnant women are advised to consume 200-300 mg of DHA per day. DHA can be obtained through dietary sources such as:
- Oily fish (like salmon, mackerel, sardines, tilapia and anchovies)
- Fortified foods (such as DHA-enriched milk, eggs, or cereals)
- DHA supplements (for those who don’t consume enough DHA through food)
- Algae-based DHA omega-3 supplements (vegan-friendly alternative without the risk of mercury contamination)
It is recommended that women consume fish that are low in mercury to avoid potential harm to the foetus while benefiting from the high DHA content.
DHA’s Role in Maternal Health
DHA isn’t only important for the baby. It also supports the mother’s well-being by reducing the risk of perinatal depression. Many studies suggest that women who consume adequate DHA during pregnancy are less likely to experience mood disorders in the postpartum period. DHA’s anti-inflammatory effects may also contribute to a healthier pregnancy overall, helping to regulate the mother’s immune responses and reduce the risk of complications related to inflammation.
Consequences of Deficiency
Choline and DHA deficiencies can have far-reaching effects, not only for foetal development but also for long-term health and hormone balance. Children born to mothers with low intake of these nutrients may face challenges related to learning, memory, and behavioural regulation later in life. Cognitive and neurological functions rely heavily on these nutrients during critical windows of development, and deficiencies may lead to structural and functional impairments that are difficult to reverse.
For the mother, low intake of choline can lead to liver damage and an increased risk of pregnancy complications. DHA deficiency, on the other hand, can increase the likelihood of preterm birth and make the mother more susceptible to postpartum depression.
The Critical Importance of Choline and DHA
Choline and DHA, though often overshadowed by more widely discussed prenatal nutrients, are critical pillars in supporting both maternal health and foetal development. Their impact goes far beyond immediate nutritional needs, playing a crucial role in building the baby’s brain architecture and nervous system. Together, these nutrients shape cognitive function, memory retention, and behavioural regulation throughout life. Inadequate levels, conversely, can result in developmental delays, impaired memory function, and increased susceptibility to neuropsychiatric conditions.
Prioritising a good intake is not just about ensuring a healthy pregnancy but about laying the groundwork for the child's future neurological health and even emotional resilience well into adulthood. In a world where prenatal nutrition is key to lifelong health, ensuring sufficient levels of choline and DHA during pregnancy becomes one of the most impactful decisions a mother can make for her baby’s cognitive future. These nutrients are more than just important—they are foundational to unlocking the full potential of a child’s developing mind.
