The essential nutrient choline participates in several vital biological functions including neurogenesis, synapse formation, placental development and lipid transport. However, in this article, I wish to focus on the role of choline during foetal development.
The epigenome refers to epigenetic marks, DNA methylation, that modify the activity of the genome without altering its DNA sequence. Epigentic modifications can exert lasting effects on gene expression and physiological systems, and may be inherited by future generations. Because epigentic mechanisms regulate many important biological processes, these mechanisms are involved in many developmental outcomes in offspring. The prenatal period is associated with the establishment and maintenance of the epigenome. The foetal epigenome exhibits substantial plasticity, altered by a range of maternal environmental factors including nutrition. The environmental conditions of the foetus can profoundly influence its biology and long term health, a process known as developmental programming of adult disease. One of the pathways most sensitive to programming by in-utero exposures e.g. nutrition, is neural function. Interestingly, developmental programming of adult disease differs between male and female offspring with males often exhibiting greater sensitivity to the maternal in-utero environment.
Maternal nutrition can affect offspring cognitive function throughout the life-cycle of the child. Phenomenal! Research teams at the Department of Health and Nutrition Sciences, Brooklyn College, have found that maternal plasma concentrations of choline and betaine (the oxidised form of choline; found in beetroot) at 12 weeks gestation are positively associated with measures of early cognitive development at age 18 months, indicating a possible benefit of choline supply on cognitive function in humans. Reinforcing the foregoing research is Boeke et al (2013) who reported that children born to mothers in the highest quartile of choline intake performed significantly better on measures of visual memory at age 7.
Nonetheless, it is important to identify that three studies, including a randomised control trial supplementing mothers with choline from the second trimester through 3 months post-partum did not detect a benefit in cognition, despite higher maternal choline intake. It is suggested that the mixed findings may be attributed to various factors including the age of the child at the time of assessment, the type of cognitive testing utilised, and the index of maternal choline status.
Cognitive Defects and Developmental Disorders
The effect of maternal choline intake and supplementation on the occurrence and severity of offspring congenital defects and developmental disorders has also been investigated. For example, there is evidence to suggest that maternal choline intake and choline concentrations in maternal circulation are inversely associated with offspring neural tube defect risk in humans, independent of folate.
In a recent randomised control trial (2014), the effect of supplementing pregnant women with 900 mg of choline per day (vs. placebo) from the second trimester through to parturition, and infants with 100 mg of phosphatidylcholine per day (vs placebo) through three months post-partum, on infant cerebral inhibition- a measure of sensory gating that is diminished in the pathophysiology of schizophrenia, found that perinatal choline supplementation (vs placebo) yielded more infants within the normal cerebral inhibition range vs placebo, indicating that choline supplementation during pregnancy and early post-natal life facilitates appropriate sensory gating development. Moreover, additional studies have reported a link between maternal choline supplementation and risk of down syndrome and future risk of Alzheimer's disease.
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Mark Hinchey Naturopathy, Newcastle Naturopath, 601 Glebe Road Adamstown, New South Wales, Australia
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