Implications for wide range of disorders -- hypertension to mental health problems
Just as women are advised to get plenty of folic acid around the time of conception and throughout early pregnancy, new research suggests another very similar nutrient may one day deserve a spot on the obstetrician's list of recommendations.
Consuming greater amounts of choline - a nutrient found in eggs and meat - during pregnancy may lower an infant's vulnerability to stress-related illnesses, such as mental health disturbances, and chronic conditions, like hypertension, later in life.
In an early study in The FASEB Journal, nutrition scientists and obstetricians at Cornell University and the University of Rochester Medical Center found that higher-than-normal amounts of choline in the diet during pregnancy changed epigenetic markers - modifications on our DNA that tell our genes to switch on or off, to go gangbusters or keep a low profile - in the fetus. While epigenetic markers don't change our genes, they make a permanent imprint by dictating their fate: If a gene is not expressed - turned on - it's as if it didn't exist.
The finding became particularly exciting when researchers discovered that the affected markers were those that regulated the hypothalamic-pituitary-adrenal or HPA axis, which controls virtually all hormone activity in the body, including the production of the hormone cortisol that reflects our response to stress and regulates our metabolism, among other things.
More choline in the mother's diet led to a more stable HPA axis and consequently less cortisol in the fetus. As with many aspects of our health, stability is a very good thing: Past research has shown that early exposure to high levels of cortisol, often a result of a mother's anxiety or depression, can increase a baby's lifelong risk of stress-related and metabolic disorders.
"The study is important because it shows that a relatively simple nutrient can have significant effects in prenatal life, and that these effects likely continue to have a long-lasting influence on adult life," said Eva K. Pressman, M.D., study author and director of the high-risk pregnancy program at the University of Rochester Medical Center. "While our results won't change practice at this point, the idea that maternal choline intake could essentially change fetal genetic expression into adulthood is quite novel."
Pressman, who advises pregnant women every day, says choline isn't something people think a lot about because it is already present in many things we eat and there is usually no concern of choline deficiency. Though much more research has focused on folate - functionally very similar to choline and used to decrease the risk of neural tube defects like spina bifida - a few very compelling studies sparked her interest, including animal studies on the role of choline in mitigating fetal alcohol syndrome and changing outcomes in Down syndrome.
A long-time collaborator with researchers at Cornell, Pressman joined a team led by Marie Caudill, Ph.D., R.D., professor in the Division of Nutritional Sciences at Cornell, in studying 26 pregnant women in their third trimester who were assigned to take 480 mg per day, an amount slightly above the standard recommendation of 450 mg per day, or about double that amount, 930 mg per day. The choline was derived from the diet and from supplements and was consumed up until delivery.